Male Health Status Research Articles

Kidney function impairment in men with primary infertility: A case-control analysis.

Infertile men have a worse overall health status than their fertile counterparts. We aimed to (1) compare kidney function in men presenting for primary couple's infertility with that of fertile men and (2) assess kidney function impairment toward sperm quality in infertile men. In this case-control study, 387 consecutive white-European infertile men were matched by age with 134 same-ethnicity fertile men. Complete clinical and laboratory data were available for each patient. The Chronic Kidney Disease Epidemiology Collaboration function was used for estimated glomerular filtration rate calculation. Kidney functional impairment was defined as an estimated glomerular filtration rate <90mL/min per 1.73m2 , according to the Kidney Disease Improving Global Outcomes criteria. Multivariable logistic regression analysis was used to (1) assess the association between kidney function impairment and infertility status and (2) investigate the association between kidney function and semen analysis abnormalities in infertile men. After matching, 34 (8.8%) infertile men depicted at least a mild unknown impairment of kidney function compared to only four (3%) fertile men, with four (3%) of the infertile presenting with an overt kidney function impairment (estimated glomerular filtration rate <60mL/min per 1.73m2 ). There were no differences in terms of age, body mass index and rate of comorbidities between the two groups (all p>0.05). After adjusting for major confounders, infertility status was associated with a higher risk of reduced estimated glomerular filtration rate (odds ratio 3.20; 95% confidence interval 1.21-5.2; p=0.002). Conversely, estimated glomerular filtration rate was not associated with sperm abnormalities in infertile men. Mild kidney function impairment was found in 9% of asymptomatic and unaware men presenting for primary couple's infertility investigation. This novel finding corroborates growing data on a significant association of male infertility with a poorer overall male health status and the need for tailored preventive strategies.

Гинекологические аспекты сексуальной дисфункции в постменопаузальном периоде

Sexuality is defined as a physical, emotional, psychological, and social welfare state associated with sexual desires. The prevalence of sexual dysfunction among postmenopausal women is estimated to be 68% to 87%. The most significant causes of sexual disorders in this period are physiological changes of female body, psychological problems, lack of special knowledge, and male health status. Sexual function is linked to the complex neurotransmitter-hormone interaction both at the central and peripheral levels. The major cause of sexual dysfunction in postmenopausal women is genitourinary menopausal syndrome. Most commonly, gynecologist becomes a first contact physician dealing with female sexual disorders. Sexual dysfunction diagnosis in postmenopause includes the use of validated questionnaires, the assessment of the type and severity of menopausal disorders, the impact of somatic diseases and psychological issues, as well as a thorough physical examination. As sexual dysfunction in postmenopausal women is caused by multiple factors and has a complex pathogenesis, it is necessary to set up a multidisciplinary approach to problem solving. According to the biopsychosocial model, gynecologist has a wide range of therapeutic options for dealing with sexual disorders — pharmacotherapy (hormonal and non-hormonal agents), rational psychotherapy, and multimodal treatment methods. KEYWORDS: sexual dysfunction, postmenopause, sexual hormones, estrogens, androgens, genitourinary menopausal syndrome, biopsychosocial model of healthcare. FOR CITATION: Sandakova E.A., Zhukovskaya I.G. Gynecological aspects of sexual dysfunction in the postmenopausal women. Russian Journal of Woman and Child Health. 2023;6(1):26–30 (in Russ.). DOI: 10.32364/2618-8430-2023-6-1-26-30.

Related factors of periodontal health among Chinese middle school students, findings from a national cross-sectional survey

BackgroundTo investigate the related risk factors of periodontal health status among Chinese middle school students.MethodsThis study is a part of the Fourth National Oral Health Epidemiological Survey, which is by far the largest oral epidemiological survey in China, including all provinces, municipalities and autonomous regions in mainland China. A multi-stage stratified sampling method was used to select middle school students aged 12–15 from the sampled middle school for investigation. The survey consisted of two parts: oral examination and questionnaire survey. The oral examination included gingival bleeding and calculus. The questionnaire included sociodemographic information, oral health knowledge, attitudes and behaviors. Logistic regression and generalized linear mixed model were used to investigate the risk factors of gingival bleeding and calculus.ResultsA total of 118,514 middle-school students has been examined. Less gingival bleeding (OR = 0.746, CI 0.718–0.774) and calculus (OR = 0.550, CI 0.529–0.527) were found in 12-year-old group compared to 15-year-old group. The periodontal health status of males was worse than that of females (gingival bleeding OR = 1.102, CI 1.074–1.132, calculus OR = 1.258, CI 1.223–1.295). Besides age and gender, region, living place, ethnic groups, family structure, parent’s education level, oral health knowledge and behavior were also related to gingival bleeding and calculus.ConclusionsGingival bleeding and calculus occurred most of 12–15 years old adolescents in China. Several related factors, such as gender, age, ethnicity, father’s education level, oral health knowledge and behavior, were found in multi-factorial models. The impact of province should arouse people’s attention.

P–094 Kidney function impairment in primary infertile men

Abstract Study question We investigated the prevalence of kidney function impairment in a homogeneous cohort of white-European primary infertile men. Summary answer Mild kidney function impairment characteristics were found in 9% of asymptomatic and unaware patients presenting for primary infertility investigation. What is known already Infertile men have shown a worse overall health status compared to the fertile counterpart. We investigated the prevalence of kidney function impairment in a homogeneous cohort of white-European primary infertile men. Study design, size, duration In this corss-sectional study, complete clinical and laboratories data from a cohort of 557 consecutive men aged &amp;gt;18 years, presenting for primary infertility investigation were analyzed. Participants/materials, setting, methods Comorbidities (as scored with the Charlson Comorbidity Index (CCI)) were collected in each patient. Primary outcome was the presence of functional impairment of the kidney (defined as an estimated glomerular filtration rates &amp;lt;90 ml/min/1.73m², according to the Kidney Outcomes Quality Initiative). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) function was used for eGFR calculation. Logistic regression analyses tested the association between kidney function impairment and clinical and semen features. Main results and the role of chance Of 557, 51 (9.3%) patients depicted at least a mild loss of kidney function (eGFR&amp;lt;90 ml/min /1.73m²). Median [interquartile (IQR)] age was 38 (35–42) years for normal kidney function group vs. 41 (36–46.5) years for those with impaired renal function (p &amp;lt; 0.001). Those with impaired renal function had also a higher BMI [26.1 (24.4–27.8) vs. 24.9 (23.2–26.8); p = 0.002] and higher numbers of comorbidities [CCI≥ 1 in 11 (21.5%) vs. 40 (7.9%) patients (p &amp;lt; 0.001)]. Of note, they had more frequently history of hypertension [10 (19.6%) vs. 31 (6.1%), p = 0.001]. Groups did not differ in terms of hormonal and semen features. At logistic regression analysis, older age and CCI≥1 were associated with a higher risk of impaired eGFR (OR 1.06; 95%CI 1.01–1.11; p = 0.016 and OR 2.41; 95%CI 1.06–5.15; p = 0.028, respectively)(table). No association was found between sperm parameters and eGFR impairment (all p &amp;gt; 0.05), after accounting for age, CCI, BMI, FSH, testicular volume, and varicocele. Limitations, reasons for caution Mild kidney function impairment characteristics were found in 9% of asymptomatic and unaware patients presenting for primary infertility investigation. Age and the rate of comorbidities are associated with reduced eGFR. Wider implications of the findings: This novel finding confirms growing data on a significant association of male infertility with a poorer overall male health status. Trial registration number Not applicable

Exploring preconception health beliefs amongst adults of childbearing age in the UK: a qualitative analysis

Background‘Preconception health’ or ‘pre-pregnancy health’ are terms used to describe the health status of males and females prior to pregnancy. The goal of preconception health strategies is to optimise the health of future offspring via improved parental health, which may result from planned/unplanned pregnancies. Greater emphasis is being placed upon preconception health amongst research and public health, yet there is limited evidence on this topic from the perspective of UK adults. This research explored beliefs, knowledge and attitudes on preconception health amongst adults of childbearing age, drawn from the UK.MethodsA descriptive qualitative focus group study was undertaken with healthy males and females of childbearing age (18–45 years) between October 2018 and July 2019. Two groups were held in a rural location (one focus group, one mini focus group) and three groups held in an urban location (two focus groups, one mini focus group), with a range of males and females, with and without children. A semi-structured topic guide was devised based on previous literature. All groups were conducted with two researchers trained in qualitative research methods. Focus groups explored understanding/prior knowledge of preconception health, beliefs and attitudes towards preconception healthcare support and personal health. Focus groups were transcribed verbatim and analysed using thematic analysis.ResultsTwenty-one males and females of childbearing age (aged 18 to 45 years) participated in the research. Discussions revealed a lack of comprehensive awareness of the importance of preconception health and a sense of reluctance to visit a doctor regarding the issue, favouring the internet, unless having problems conceiving. Five themes identified included: preconception education, preconception awareness, wider knowledge networks/support, optimal parental health, and attitudes/emotions towards preconception health. The roles of males regarding positive preconception care was not well understood.ConclusionsThis study highlighted a lack of detailed awareness surrounding the importance of preconception health per se, despite general agreement that health status should be optimal at this time. It identified a willingness to learn more about preconception health, creating an opportunity to improve preconception healthcare awareness via evidence-based education, social media campaigns, and within healthcare systems in a life course approach.

Male infertility as a proxy of the overall male health status.

Male infertility (MI) has been widely associated with different comorbid conditions. The aim of this review is to summarize the available evidences investigating the link between MI cancer, chronic non-malignant conditions and overall health. A literature search has been conducted using the MEDLINE/PubMed and Scopus databases for English-language original and review articles and selecting publications from January 2007 to June 2017, although highly regarded older publications were also considered. The following key words and MeSH terms were combined: "male infertility," "semen analysis," "health," "comorbidities," "cancer," "metabolic syndrome," "diabetes," "hypertension," "cardiovascular diseases," and "mortality." Several studies supported a higher risk of testis cancer for patients with MI; conversely, controversial findings have been reported on the association between prostate cancer and MI. Beside urogenital malignancies, melanoma, bladder, thyroid and hematological malignancies have been also more frequently reported among infertile men. Large cohort studies supported a significant association between diabetes mellitus, metabolic disorders and MI. Similarly, the risk of developing cardiovascular diseases appears to be higher among infertile men. Of note, a significant association between semen alterations and the overall burden of comorbidities, as well as the overall mortality, has been reported. A common genetic background appears as the main pathophysiological link between infertility and other comorbidities. Male infertility is a proxy of the overall male health status. Physicians should comprehensively assess men presenting for couple infertility and properly followed-up these patients given their higher risk of developing cancer.

Metabolic syndrome in white European men presenting for primary couple's infertility: investigation of the clinical and reproductive burden.

Despite complex interactions between obesity, dyslipidemia, hyperinsulinaemia, and the reproductive axis, the impact of metabolic syndrome on human male reproductive function has not been analysed comprehensively. Complete demographic, clinical, and laboratory data from 1337 consecutive primary infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (categorised 0 vs. 1 vs. 2 or higher). NCEP-ATPIII criteria were used to define metabolic syndrome. Semen analysis values were assessed based on the 2010 World Health Organisation (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and metabolic syndrome. Metabolic syndrome was found in 128 (9.6%) of 1337 men. Patients with metabolic syndrome were older (p<0.001) and had a greater Charlson Comorbidity Index of 1 or higher (chi-square: 15.6; p<0.001) compared with those without metabolic syndrome. Metabolic syndrome patients had lower levels of total testosterone (p<0.001), sex hormone-binding globulin (p=0.004), inhibin B (p=0.03), and anti-Müllerian hormone (p=0.009), and they were hypogonadal at a higher rate (chi-square: 32.0; p<0.001) than patients without metabolic syndrome. Conversely, the two groups did not differ significantly in further hormonal levels, semen parameters, and rate of either obstructive or non-obstructive azoospermia. At multivariate logistic regression analysis, testicular volume (OR: 0.90; p=0.002) achieved independent predictor status for WHO pathological semen concentration; conversely, age, Charlson Comorbidity Index scores, metabolic syndrome, and inhibin B values did not. No parameters predicted normal sperm morphology and total progressive motility. Metabolic syndrome accounts for roughly 9% of men presenting for primary couple's infertility. Although metabolic syndrome patients have a lower general male health status, semen analysis values seem independent of the presence of metabolic syndrome.

Gender Approach to the Difference in the Health Status of Women and Men, Riskesdas 2013

chronic diseases. Differences in health and illness patterns of men and women are not primarily technical or medical innature, but also attributable to social factors such as powerlessness, access to resources, and constrained roles. Usingthe latest data of Riskesdas 2013, this analysis intends to use gender approach analyzing and interpreting health statusdifference between female and male to get inputs for the appropriate measures to reduce the gap between female and malemorbidity on NCD. Methods: Riskesdas 2013 data was analyzed using gender framework which stressed the importance ofsocio economic factors on health status defi ned as prevalence of chronic diseases. Results: With the exception of youngerage, women have higher prevalence of non communicable/chronic diseases. High education appears to benefi t only middleage women to achieve equal health status with men. Conclusion: Education, access to information is important factors toreduce the gap of female and male health status, however biological factor remains as primary factor. Recommendation:Since improving health status of women needs comprehensive approach, government policy should facilitate access toeducation and economic resources to women. Gender approach should be implemented for analysing health data.

2287 PREVALENCE AND CLINICAL MEANING OF METABOLIC SYNDROME IN EUROPEAN CAUCASIAN MEN PRESENTING FOR PRIMARY COUPLE'S INFERTILITY

You have accessJournal of UrologyInfertility: Evaluation1 Apr 20132287 PREVALENCE AND CLINICAL MEANING OF METABOLIC SYNDROME IN EUROPEAN CAUCASIAN MEN PRESENTING FOR PRIMARY COUPLE'S INFERTILITY Andrea Salonia, Paolo Capogrosso, Marco Bianchi, Eugenio Ventimiglia, Maria Chiara Clementi, Giulia Castagna, Michele Colicchia, Luca Boeri, Cesare Regina, Alessandro Serino, Emanuele Zaffuto, Luca Villa, Ryan Matloob, Rocco Damiano, Luca Carmignani, and Francesco Montorsi Andrea SaloniaAndrea Salonia Milan, Italy More articles by this author , Paolo CapogrossoPaolo Capogrosso Milan, Italy More articles by this author , Marco BianchiMarco Bianchi Milan, Italy More articles by this author , Eugenio VentimigliaEugenio Ventimiglia Milan, Italy More articles by this author , Maria Chiara ClementiMaria Chiara Clementi Milan, Italy More articles by this author , Giulia CastagnaGiulia Castagna Milan, Italy More articles by this author , Michele ColicchiaMichele Colicchia Milan, Italy More articles by this author , Luca BoeriLuca Boeri Milan, Italy More articles by this author , Cesare ReginaCesare Regina Milan, Italy More articles by this author , Alessandro SerinoAlessandro Serino Milan, Italy More articles by this author , Emanuele ZaffutoEmanuele Zaffuto Milan, Italy More articles by this author , Luca VillaLuca Villa Milan, Italy More articles by this author , Ryan MatloobRyan Matloob Milan, Italy More articles by this author , Rocco DamianoRocco Damiano Catanzaro, Italy More articles by this author , Luca CarmignaniLuca Carmignani Milan, Italy More articles by this author , and Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2228AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Assess prevalence of and clinical impact of metabolic syndrome (MetS) in European Caucasian men presenting for primary couple's infertility. METHODS Complete demographic, clinical and laboratory data from 1169 consecutive infertile men were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI; categorized 0 vs 1 vs ≥2); NCEP-ATPIII criteria were used to define MetS. Testicular volume was assessed with a Prader orchidometer. Semen analysis values were assessed based on 2010 World Health Organization (WHO) reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. RESULTS Of all, male factor infertility and mixed infertility were found in 890 (76.1%) and 279 (23.9%) men, respectively. MetS was found in 101 (8.6%) of 1169 men. Patients with MetS were older (p<0.001), had a higher BMI (p<0.001), a greater rate of CCI≥1 (χ2:44.205; p<0.001), and lower testicular volumes (all p<0.03), as compared with those without MetS. Moreover, MetS patients had a lower serum total testosterone (tT) (p=0.002), a higher level of luteinizing hormone (LH) (p=0.001), and were hypogonadal in a higher rate (χ2:6.958; p=0.008) than patients without MetS. Conversely, no differences were found between groups in terms of follicle-stimulating hormone (FSH), inhibin B, 17β estradiol (E2) levels, and tT/E2 ratio values. Likewise, the two groups did not significantly differ in terms of semen parameters and rate of either obstructive or non-obstructive azoospermia. At multivariate logistic regression analysis serum FSH (OR: 1.36; p<0.001) and testicular volume (OR: 0.59; p<0.001) achieved independent predictor status for WHO normal semen concentration; conversely, age, CCI scores, MetS, and inhibin B values did not. No parameters predicted normal sperm progressive motility and morphology. CONCLUSIONS MetS accounts for roughly 9% in men presenting for primary couple's infertility. Overall, while MetS patients have a lower general male health status, semen analysis values seem independent of the presence of MetS. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e938 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Salonia Milan, Italy More articles by this author Paolo Capogrosso Milan, Italy More articles by this author Marco Bianchi Milan, Italy More articles by this author Eugenio Ventimiglia Milan, Italy More articles by this author Maria Chiara Clementi Milan, Italy More articles by this author Giulia Castagna Milan, Italy More articles by this author Michele Colicchia Milan, Italy More articles by this author Luca Boeri Milan, Italy More articles by this author Cesare Regina Milan, Italy More articles by this author Alessandro Serino Milan, Italy More articles by this author Emanuele Zaffuto Milan, Italy More articles by this author Luca Villa Milan, Italy More articles by this author Ryan Matloob Milan, Italy More articles by this author Rocco Damiano Catanzaro, Italy More articles by this author Luca Carmignani Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Osteocalcin is associated with testosterone in the general population and selected patients with bone disorders

Research in the last decade has revealed that bone is not only a target tissue for numerous circulating hormones but functions as an endocrine organ itself. As a recent study demonstrated a stimulatory effect of the osteoblast-derived hormone osteocalcin (OCN) on testosterone production in mice, we investigated whether such an association can be replicated in humans. We used data from 1338 men (25-86years) in the population-based epidemiological Study of Health in Pomerania and from 110 male outpatients with bone disorders (18-85years) for the study. We analysed cross-sectional associations between OCN and total testosterone serum concentrations (TT), as well as associations between further markers of bone turnover [bone-specific alkaline phosphatase (BAP), serum C-terminal telopeptides of Type I collagen (CTX), urinary deoxypyridinoline] and TT using ordinary least square (OLS) regression models. Multivariable OLS models revealed a positive association between OCN and TT in the population-based (β coefficients for a one standard deviation increase, 0.590; standard error (SE), 0.175; p-value, <0.01) and patient-based (β coefficient, 0.575; SE, 0.132; p-value, <0.01) samples even after adjustment for age and body mass index (both samples), and time of blood sampling (population-based sample only). Furthermore, we observed positive associations between BAP and TT (β coefficient, 0.403; SE, 0.170; p-value, 0.02) as well as between CTX and TT (β coefficient, 0.733; SE, 0.172; p-value, <0.01) in men from the general population. The present investigation shows that OCN is associated with TT in the general population and in patients with bone disorders, and may thus indicate general male health status. Additional longitudinal observational studies are warranted to confirm our findings and future experimental research is necessary to elucidate potential mechanisms underlying the observed associations.

Chronic Diseases, Self-Rated Health Status, Health Care Utilization and Health Insurance Status of Males in a Caribbean nation

Previous research which has examined men’s health have not coalesced in a single study chronic illness, self-rated health status, health care seeking behaviour, health insurance coverage and income function. The current study seeks to evaluate the general health status of males and association between chronic illness and particular socioeconomic factors, and model socioeconomic and other determinants of (1) chronic diseases; (2) self-rated health status; (3) health care utilization; (4) health insurance coverage status and (3) income. A total of 3,303 males were extracted from the 2007 Jamaica Survey of Living Conditions (JSLC). The JSLC is an annual cross-sectional probability sample survey which began in 1988. It is a modification of the World Bank’s Living Standard Household Survey. Stepwise logistic and multiple regressions were utilize to establish socioeconomic and other factors which are associated with the particular dependent variable. The prevalence of illness was 12.1% (chronic illness 33%; hypertension, 17.0%; diabetes mellitus, 9.1%). Almost 62% of those with chronic illness visited a health care practitioner in the last 4-weeks; and 72% were 60+ years. The mean age of male who had chronic illness was 66.2 years (SD = 14.2) compared to 31.0 years (27.9) for those with acute conditions. More males in the upper income strata had chronic illness (47.8%) compared to those in the lower socioeconomic strata (34.5%). Two variables emerged as significantly associated with chronic illness (age – OR = 1.03, 95% CI = 1.01 – 1.05; married respondents – OR = 3.32, 95% CI = 1.58 – 6.99). The findings provide valuable information that are critical to the understanding of male’s health and how these can be used to guide policy formulation and future research on men’s health.

Is Erectile Dysfunction a Reliable Proxy of General Male Health Status? The Case for the International Index of Erectile Function—Erectile Function Domain

Erectile dysfunction (ED) has emerged progressively as a sentinel marker of cardiovascular disease (CVD). The correlation between ED and the burden arising from multiple comorbid conditions has been incompletely analyzed. Assess whether erectile function, defined with the International Index of Erectile Function-Erectile Function (IIEF-EF) domain score, is associated with health-significant comorbidities scored with the Charlson comorbidity index (CCI). Clinical and hemodynamic variables of the last 140 consecutive patients who underwent penile color Doppler ultrasonography for new-onset ED were considered. Patients were assessed with a thorough medical and sexual history. Health-significant comorbidities were scored with the CCI. Descriptive statistics and either linear or logistic regression models tested the association among IIEF-EF, hemodynamic parameters, and CCI, which was included in the model both as continuous and categorized variable (0 vs. ≥1). Complete data were available for 138 patients (98.6%) (mean age 46.6 years [standard deviation 13.0]; range 21-75 years). CCI was 0, 1, and ≥2 in 94 (68.1%), 23 (16.7%), and 21 (15.25%) patients, respectively. Of all, 35 patients (79.5%) did not have a CVD comorbidity. Mean IIEF-EF was 13.7 (9.3). ED severity was no ED, mild, mild to moderate, moderate, and severe in 12 (9.1%), 28 (20.2%), 12 (9.1%), 23 (16.2%), and 63 (45.5%) patients, respectively. At multivariable linear regression analysis, CCI significantly worsened with increased age (β=0.33; P=0.001) and decreased IIEF-EF values (β=-0.25; P=0.01). At logistic regression analysis, age (odds ratio [OR]: 1.05; P=0.004) and IIEF-EF (OR: 0.95; P=0.04) emerged as significant predictors of categorized CCI. Severity of ED, as objectively interpreted with IIEF-EF, accounts for a higher CCI, which may be considered a reliable proxy of a lower general male health status regardless of the etiology of ED.

Gender Inequality and Its Effects in Females Torture Survivors

The study explores the effects of gender discrimination GD as type III trauma in 359, (160 females and 199 males) torture survivors. Data includes measures of GD and other traumas, PTSD and cumulative trauma disorders CTD. GD found to decrease PTSD symptoms in males favoring mental health status of males, and increase CTD symptoms in females. GD mediated the effects of personal identity traumas on PTSD and CTD symptoms of psychosis/dissociation; executive function deficits, and suicidality. The re- sults highlight GD as type III trauma that contributes to the mental health differences between males and females.

Male Infertility and Assisted Reproductive Technology: Lessons from the IVF

Development in ART has been remarkable in the last decades. Several medical conditions affecting the male fertility status are now treated by ART, especially by the combination of in vitro fertilization and intracytoplasmic sperm injection. ICSI is now the treatment of choice of most untreatable causes of male infertility, including immunologic infertility, severe oligozoospermia and azoospermia. Sperm retrieval techniques have been optimized and microsurgery offers the possibility of collecting testicular spermatozoa even in the most difficult cases of non-obstructive azoospermia. Nonetheless, the reproductive potential of sperm from men with defective spermatogenesis is decreased in ART and such treatment modalities may carry an increased risk of transmitting genetic and epigenetic defect to the embryo. Efforts should be made to improve the male health status prior to embarking on ART because current evidence suggests that fertility optimization may improve treatment outcomes. Moreover, laboratory management of male infertility cases requires special attention. Spermatozoa collected from men with severely impaired spermatogenesis are often compromised and fragile. Adherence to state of the art laboratory techniques and quality control are recommended to avoid jeopardizing sperm fertilizing potential and the chances of achieving a live birth. In this study, we present and critically review our 10-year experience in the management of severe male factor infertility using ART.

The Dorsal Patch of Males of the Curaçaoan Long-Nosed bat,Leptonycteris curasoae(Phyllostomidae: Glossophaginae) as a Visual Signal

The seasonal dorsal patch of males of the Curaçaoan long-nosed bat, Leptonycteris curasoae, which exhibits variability in size, shape, and chemical complexity, is a trait associated with courtship and mating in this species. This recently discovered structure develops exclusively during the mating season that occurs once a year between November and December in populations of L. curasoae from northern Venezuela. Although the dorsal patch that develops in males has unique chemical characteristics possibly involved in female attraction, we suggest that this trait also sends distinct visual cues regarding the health status of males. We evaluated the postulated association between dorsal patch shape (symmetry) and ectoparasite load (streblid batflies) in males of L. curasoae. To do so, we quantified the shape of dorsal patches on males to test the hypothesis that streblid load was related to this variable. Over 2,000 streblid batflies of two different species (Nycterophilia coxata and Trichobius sphaeronotus) were recovered from 130 individuals ( = 16 streblids/bat). Among these batflies, N. coxata was the most abundant species found on L. curasoae (2,042 individuals, 95.0% prevalence). Males with dorsal patches had significantly lower batfly loads when compared with males without dorsal patches and with females. Males with the most symmetrical dorsal patches also had the lowest batfly loads. Our results suggest that the odoriferous dorsal patches produced in males of L. curasoae also convey visual cues to female mates as signals of good health.

1539 IS IIEF-EF A PROXY OF GENERAL MALE HEALTH STATUS?

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Evaluation1 Apr 20111539 IS IIEF-EF A PROXY OF GENERAL MALE HEALTH STATUS? Andrea Salonia, Antonino Saccà, Matteo Ferrari, Umberto Capitanio, Rayan Matloob, Fabio Castiglione, Lorenzo Rocchini, Giuseppe Zanni, Luigi Barbieri, Renzo Colombo, Patrizio Rigatti, and Francesco Montorsi Andrea SaloniaAndrea Salonia milan, Italy More articles by this author , Antonino SaccàAntonino Saccà milan, Italy More articles by this author , Matteo FerrariMatteo Ferrari milan, Italy More articles by this author , Umberto CapitanioUmberto Capitanio milan, Italy More articles by this author , Rayan MatloobRayan Matloob milan, Italy More articles by this author , Fabio CastiglioneFabio Castiglione milan, Italy More articles by this author , Lorenzo RocchiniLorenzo Rocchini milan, Italy More articles by this author , Giuseppe ZanniGiuseppe Zanni milan, Italy More articles by this author , Luigi BarbieriLuigi Barbieri milan, Italy More articles by this author , Renzo ColomboRenzo Colombo milan, Italy More articles by this author , Patrizio RigattiPatrizio Rigatti milan, Italy More articles by this author , and Francesco MontorsiFrancesco Montorsi milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1534AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess whether erectile function [as defined with the IIEF-erectile function domain score (IIEF-EF)] is associated with health-significant comorbidities scored with the Charlson Comorbidity Index (CCI). METHODS Clinical and ultrasound variables of the last 100 consecutive patients who underwent penile duplex Doppler ultrasounds performed for erectile dysfunction (ED) at a single Institution by 3 expert technicians (ie, each performing >50 evaluations per year) were considered. Patients were comprehensively assessed with a detailed medical and sexual history, including data on duration of ED, ED severity (as defined with the IIEF-EF). As a proxy of general health status, we scored health-significant comorbidities with the CCI. Descriptive statistics and either logistic or linear regression models tested the association between clinical and ultrasounds variables and CCI. CCI was included in the model both as continuous and categorized variable (namely, 0 vs. ≥1). RESULTS Complete data were available for 99 (99%) [mean (SD) age: 45.9 (13.2) yr; range: 23–75; BMI: 26.7 (6.9); CCI: 0.6 (1.08); range: 0–5; CCI≥1: 35/99 (35.4%)] patients. Mean ED duration was 3.7 (4.7) yr. Mean IIEF-EF was 12.9 (9.3); according to IIEF-EF, patients had no ED, mild ED, mild-to-moderate ED, moderate ED, and severe ED in 9 (9.1%), 20 (20.2%), 9 (9.1%), 16 (16.2%), and 45 (45.5%) patients, respectively. The linear regression analysis showed that CCI linearly increased with ageing (Beta 0.33; p=0.001) and linearly decreased with IIEF-EF (Beta −0.25; p=0.01). Acceleration time parameters were also inversely associated with CCI (all Beta −0.31; all p≤0.04). No clear linear association emerged between BMI, PSV and RI and CCI. At logistic regression analysis age (OR=1.05; p=0.004) and IIEF-EF (OR=0.95; p=0.04) were significantly associated with categorized CCI, after accounting for all other variables. CONCLUSIONS Severity of ED, as objectively interpreted with IIEF-EF, emerged as a significant proxy of general male health status. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e618 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Salonia milan, Italy More articles by this author Antonino Saccà milan, Italy More articles by this author Matteo Ferrari milan, Italy More articles by this author Umberto Capitanio milan, Italy More articles by this author Rayan Matloob milan, Italy More articles by this author Fabio Castiglione milan, Italy More articles by this author Lorenzo Rocchini milan, Italy More articles by this author Giuseppe Zanni milan, Italy More articles by this author Luigi Barbieri milan, Italy More articles by this author Renzo Colombo milan, Italy More articles by this author Patrizio Rigatti milan, Italy More articles by this author Francesco Montorsi milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Male health status, signalled by courtship display, reveals ejaculate quality and hatching success in a lekking species

1. The information content of secondary sexual traits and the benefits gathered by choosy females are at the heart of sexual selection theory. Indicator models of sexual selection assume that secondary sexual traits reflect the phenotypic/genetic quality of their bearers and that females gather benefits from choosing these high-quality males. 2. Here, we tested the idea that courtship display reflects the health status in a bird species with a lek-based mating system, the houbara bustard (Chlamydotis undulata undulata). A group of males was treated with the lipopolysaccharide (LPS) of the cell wall of the bacterium Escherichia coli during the seasonal peak of courtship display, while another group of males was injected with a phosphate-buffered saline solution (PBS) as a control. We then monitored the effect of the treatment on both courtship display and ejaculate quality. Finally, females were artificially inseminated with semen from LPS and PBS males, which allowed us to assess the effect of the immunological treatment on reproduction. 3. We found that the inflammatory challenge reduced courtship display and semen quality compared to controls. Interestingly, males that better resisted to the immune challenge in terms of courtship display also better resisted in terms of ejaculate quality. Early reproductive failure was increased when females were artificially inseminated with semen from immune-activated males. Failure of eggs laid by females inseminated with LPS semen was due to a reduced fertilization power of sperm of LPS males or to increased embryo mortality in the very early stage of embryo development. As a consequence, hatching rate was reduced for females inseminated with semen collected from LPS males. 4. These results show that by assessing male courtship display, females may gain insight into the current phenotypic/genetic quality of mates and gather fitness benefits in terms of reproductive success.

Individual quality and carotenoid-based plumage ornaments in male red bishops (Euplectes orix): plumage is not all that counts

Males in many bird species develop elaborate carotenoid-based plumage ornaments that play an important role as signals of individual quality in intra- or intersexual selection. In the present study, we investigated which of several factors related to male condition and health affect the brightness and coloration of the carotenoid-based orange-red breeding plumage in males of the red bishop (Euplectes orix), a polygynous and sexually dimorphic weaverbird species. The study revealed a very complex pattern, with the relationships between plumage traits and both heterophil-to-lymphocyte ratio and blood parasite load varying considerably among seasons, suggesting a strong influence of environmental conditions. Furthermore, overall condition of males strongly affected the association pattern between plumage traits and other factors, with males in bad condition being forced to allocate resources away from plumage elaboration to body maintenance or the enhancement of immune functions, whereas males in good condition can afford to invest in plumage ornamentation without obvious detrimental effects on health. Thus, females cannot rely on plumage characteristics alone to gather information on male quality, but have to assess additional traits that advertise general male health status. Perhaps surprisingly, testosterone levels were not related to male plumage characteristics.

Health and quality of life of older people, a replication after six years

Replicating a survey of 875 people 55 years old or more undertaken in September 1999 throughout the former Northern Interior Health Region (NIHR) of British Columbia, in September 2005 a sample of 656 people completed a 22-page questionnaire. The average age of the respondents was 68, with a range running from 55 to 96 years, and 64% were women. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 76.1. This mean was a bit higher than the 74.4 mean of 1999. For male respondents aged 65 and older the mean was 69.0, which was also higher than the 68.3 mean of 1999. For females aged 55–64, the mean score for 8 dimensions was 73.1, versus 73.0 in 1999. For female respondents aged 65 and older, the mean score was 67.0, versus 65.4 in 1999. Based on these mean scores for the 8 dimensions, then, it is fair to say that the overall health status of males and females aged 55 years and older in the region in 2005 was at least as good as (i.e., the same as or better than) that in 1999. Comparing 28 average figures for the 2005 respondents on satisfaction with specific domains of life (e.g., financial security, health, sense of meaning) and three global indicators (satisfaction with life as a whole and with the overall quality of life, and happiness) with those of the 1999 respondents, we found that the scores for the 2005 sample were at least as high as those of the other sample. Thus, it seems fair to say that the perceived quality of life of older people in the former NIHR so far as it is revealed in domain and global satisfaction and happiness scores, is at least as good as the perceived quality of life of a similar sample in 1999. Although a large majority perceived increases in crime in the 2 year periods prior to both surveys, smaller percentages of the 2005 sample than of the 1999 sample thought that crime had increased over the past two years, avoided going out at night, feared for their safety, had crime-related worries, engaged in crime-related defensive behaviours and were actually the victims of any crimes. Therefore, it seems fair to say that, so far as crime-related issues are concerned for the two samples of seniors responding to our surveys, there is more evidence of improvement than of deterioration. Applying stepwise multiple regression, each of the eight dependent variables was explained on the basis of four clusters of predictors separately and then a final regression was run using only the statistically significant predictors from the four clusters. Broadly speaking, 7 SF-36 health status scales explained from 28% to 45% of the variance in the 8 dependent variables, running from satisfaction with the overall quality of life (28%) to the single item measure of general health (45%). The seven predictors in the Social Relations cluster explained from 7% of the variance in the SF-36 General Health scale scores to 57% of the variance in the Life Satisfaction scores. The four predictors in the Problems cluster explained from 10% of the variance in the SF-36 General Health scale scores to 24% of the variance in the SWLS scores. The 11 predictors in the Domain Satisfaction cluster explained from 14% of the variance in the SF-36 General Health scale scores to 64% of the variance in the SWB scores. Putting all the significant predictors together for each dependent variable, in the weakest case, 4 of 11 potential predictors explained 33% of the variance in the SF-36 General Health scale scores and in the strongest case, 9 of 15 potential predictors explained 70% of the variance in Life Satisfaction scores. Among other things, these results clearly show that respondents’ ideas about a generally healthy life are different from, but not independent of, their ideas about a happy, satisfying or contented life, or about the perceived quality of their lives or their subjective wellbeing. Finally, the 7 core discrepancy predictors of MDT plus incomes were used to explain the eight dependent variables. From 13% of the variance in the SF-36 General Health scale scores to 57% of the variance in SWLS scores was explained using those predictors. Based on an examination of the Total Effects scores for the predictors of the 8 dependent variables, the most influential predictors were Self-Wants, followed by Self-Others and then Self-Best. In other words, the most influential discrepancy predictors of respondents’ overall life assessments were those between what respondents have versus what they want, followed by what they have versus what others of the same age and sex have, and then by what they have versus the best they ever had in the past.

Respiratory function and self-reported functional health: EPIC-Norfolk population study

Respiratory function is known to be associated with mortality. However, its association with health related quality of life (HRQoL) has not yet been examined. A population-based cross sectional study was conducted in 16,738 subjects aged 40-79 yrs and resident in Norfolk, to examine the association between forced expiratory volume in one second (FEV1) and HRQoL measured by the 36-item short form questionnaire. Individuals who were in the highest quintiles of FEV1 were more likely to report good physical functional health (odds ratio (OR) 1.60; 95% confidence interval (CI) 1.28-2.01 and OR 1.71; 95% CI 1.40-2.10 for males and females, respectively) controlling for age, height, weight or body mass index, smoking, physical activity, prevalent illness and social class. Being in the highest quintile for FEV1 was associated with significantly lower likelihood of poor self-reported mental functional health status in males (OR 0.78; 95% CI 0.61-0.99), but not in females (OR 1.00; 95% CI 0.82-1.22). In conclusion, forced expiratory volume in one second independently predicts self perceived physical well being in a general population across the whole normal distribution of respiratory function.