Incidence Of Male Infertility Research Articles

A metabolomic perspective on the mechanisms by which environmental pollutants and lifestyle lead to male infertility.

The incidence of male infertility (MI) is rising annually. According to epidemiological studies, environmental pollution (e.g., organic, inorganic, and air pollutants), occupational exposure (e.g., high temperature, organic solvents, and pesticides), and poor lifestyle (e.g., diet, sleep, smoking, alcohol consumption, and exercise) are important non-genetic causative factors of MI. Due to multiple and complex causative factors, the dose-effect relationship, and the uncertainty of pathogenicity, the pathogenesis of MI is far from fully clarified. Recent data show that the pathogenesis of MI can be monitored by the metabolites in serum, seminal plasma, urine, testicular tissue, sperm, and other biological samples. It is considered that these metabolites are closely related to MI phenotypes and can directly reflect the individual pathological and physiological conditions. Therefore, qualitative and quantitative analysis of the metabolome, the related metabolic pathways, and the identification of biomarkers will help to explore the MI-related metabolic problems and provide valuable insights into its pathogenic mechanisms. Here, we summarized new findings in MI metabolomics biomarkers research and their abnormal metabolic pathways triggered by the presented non-genetic risk factors, providing a metabolic landscape of semen and seminal plasma in general MI patients. Then, we compared the similarities and differences in semen and seminal plasma biomarkers between MI patients exposed to environmental and poor lifestyle factors and MI patients in general, and summarized some common biomarkers. We provide a better understanding of the biological underpinnings of MI pathogenesis, which might offer novel diagnostic, prognostic, and precise treatment approaches to MI.

The efficacy and mechanism of acupuncture in the treatment of male infertility: A literature review.

Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male infertility has increased significantly, and various risk factors, such as congenital factors, acquired factors, and idiopathic factors, have led to this situation. Male infertility causes substantial psychological and social distress in patients. With the implementation of the two-child policy, male infertility has brought enormous psychological and social pressure and huge economic burden to patients and the healthcare system. This has attracted the attention of not only men of childbearing age but also many male experts. The conventional therapeutic approaches for treating male infertility, including drugs, varicocele surgery, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection, can restore fertility to a certain extent, but their efficacy is far from satisfactory, not to mention some adverse events. Therefore, acupuncture has been chosen by many men to treat their infertility and produced significant effects. In the present paper, the efficacy and mechanism of acupuncture in the treatment of male infertility were analyzed from different perspectives such as regulating hormone secretion, reducing inflammation, and improving semen parameters. The existing literature shows that acupuncture can effectively treat male infertility.

Testicular Glycogen Metabolism: An Overlooked Source of Energy for Spermatogenesis?

The incidence of male infertility has been increasing over the years and is now becoming a serious health problem. This trend has been followed by an increase in metabolic diseases, which are known to induce clear alterations in testicular metabolism, although the underlying mechanismremain unclear. Testicular metabolism displays several unique features, with testicular somatic cells being central in providing the conditions needed for spermatogenesis, including its nutritional and hormonal support. In addition to glucose and lactate, the two main energy sources used by the testis, glycogen is also present in testicular cells. Glycogen metabolism is a potential source of glucose to both testicular somatic (namely Sertoli and Leydig cells) and germ cells. Many of the enzymes involved in the pathways of the synthesis and degradation of glycogen were identified in these cells, emphasising the relevance of this complex carbohydrate. Glycogen, however, has other non-canonical functions in testicular cells; besides its role as a source of energy, it is also associated with events such as cellular differentiation and apoptosis. In this review, we address the relevance of testicular glycogen metabolism, focusing on its role in Sertoli and Leydig cells and spermatogenesis. In addition, all the available information on the role of glycogen and related pathways in male infertility cases is discussed. Our discussion highlights that glycogen metabolism has been somewhat overlooked in testis and its contribution to spermatogenesis may be underestimated.

O-058 Obstetric outcomes of twin gestation after In-Vitro Fertilization and Embryo Transfer (IVT-ET) treatment in patients who underwent hysteroscopic septoplasty for subseptate uterus

Abstract Study question Is there an associated increased risk of preterm birth (PTB) in patients who underwent hysteroscopic septoplasty for subseptate uterus (SSU) with twin gestation through IVF-ET? Summary answer This study suggests an increased risk of PTB in patients, who underwent hysteroscopic septoplasty for SSU, and subsequently conceived twins after IVF-ET treatment. What is known already In general, the incidence of PTB is higher after IVF-ET treatment. In addition, Müllerian uterine anomalies, such as unicornuate uterus, are considered risk factors for PTB, even with singleton pregnancy. Furthermore, historical data suggest that some patients with uterine anomaly may have cervical incompetence. Twin gestation is associated with PTB in approximately 50% of cases. It is assumed that the obstetric outcome of twin gestation after successful septoplasty should be no different from those with normal uterine cavity. The impact of previous septoplasty for SSU on the obstetric outcomes of twin gestation after IVF-ET treatment has not been adequately studied. Study design, size, duration This retrospective cohort study included 377 fertility patients who received treatment between 2006-2019. The study group included 162 patients who underwent hysteroscopic septoplasty for SSU and subsequently conceived dichorionic-diamniotic (DI-DI) twins after IVF-ET treatment (Group 1). The control group included 215 patients who had normal endometrial cavity on hysteroscopy (#109) or Transvaginal 3D ultrasound scan with saline sonohysterogram (#106) and subsequently conceived DI-DI twins after IVF-ET treatment (Group 2). Participants/materials, setting, methods This study was conducted at an infertility clinic affiliated with an academic hospital. Demographic, clinical, and obstetric outcome data were collected for both groups and compared using appropriate statistical methods. PTB, severe PTB, extreme PTB, and peri-viable birth were defined as < 37 weeks, <32 weeks, <28 weeks and between 20 weeks-25 weeks 6 days gestation respectively. Main results and the role of chance There was no significant difference in mean age, BMI and infertility duration or in the incidence of smoking, primary infertility, tubal factors and unexplained infertility between the two groups. There was significantly lower mean baseline FSH levels (p < 0.01), lower incidence of male infertility (p < 0.001) and higher incidence of ovulatory disorders (p < 0.001) and endometriosis (p < 0.05) in Group 1 compared to Group 2. As expected, there was past history of lower parity rate (p < 0.01) and higher miscarriage rate (p < 0.001) in Group 1 compared to Group 2 prior to septum division. There was significantly higher incidence of PTB (72.8% vs 56.3%, p < 0.01), severe PTB (20.3% vs 8.2%, p < 0.01), extreme PTB (8.3% vs 3.9%, p < 0.05), and peri-viable birth (6.3% vs 1.9%, p < 0.05) in Group 1 compared to Group 2. There was no significant difference in cesarean section rate (82.8% vs 87.5%, p = 0.349) between Group1 and Group 2 respectively. There was significantly lower gestational age at birth in weeks (34.0 + 4.0 vs 35.6 + 3.0, p < 0.001), birth weight of the first newborn (2180.5 + 717.9 vs 2436.4 + 606.6, p < 0.001), and the second newborn (2235.2 + 674.2 vs 2398.0 + 537.9, p < 0.05) in grams in Group 1 compared to Group 2. Limitations, reasons for caution Our study has limitations being retrospective in nature. Data on cervical length measurements via ultrasound, if performed, was not available. However, recall bias was prevented by retrieving data from that submitted to the Society of Assisted Reproductive Technology. Additionally, procedural variation was reduced as this was a single-center study. Wider implications of the findings Our study suggests that twin gestation after IVF-ET in patients who underwent successful hysteroscopic septoplasty for SSU may increase the likelihood of PTB. Such patients may require increased surveillance with ultrasound cervical length and signs for preterm labor. Future research should focus on measures to reduce PTB in such patients. Trial registration number Not Applicable

Research Progress on the Microregulatory Mechanisms of Fertilization: A Review.

The process of fertilization includes sperm capacitation, hyperactivation, an acrosome reaction and the release of acrosome enzymes, membrane fusion and channel formation, the release of the sperm nucleus, and gamete fusion. This process is closely related to the shape and vitality of the sperm, acrosome enzyme release, and the zona pellucida structure of the egg, as well as the opening and closing of various ion (e.g., calcium) channels, the regulation of signaling pathways such as cyclic adenosine monophosphate-protein kinase A, the release of progesterone, and the coupling of G-proteins. The interaction among multiple factors and their precise regulation give rise to multiple cascading regulatory processes. Problems with any factor will affect the success rate of fertilization. Recent studies have shown that with rapid societal development, the incidence of male infertility is increasing and occurs at younger ages. According to World Health Organization statistics, 15% of couples of childbearing ages have infertility problems, of which 50% are caused by male factors. Additionally, the cause of infertility cannot be identified in as many as 60% to 75% of male infertility patients. In this article, we review the research progress on the microregulation of fertilization and mechanisms underlying this process to identify causes and develop novel prevention and treatment strategies for male infertility.

The factors affecting male infertility: A systematic review.

Background In recent years, the incidence of male infertility has increased worldwide. It is necessary to study the factors that influence male infertility in each area/region for better management.ObjectiveTo determine the factors affecting male infertility in the Iranian male population.Materials and MethodsAn online search was conducted in electronic databases including PubMed, Google Scholar, SID, and Scopus to identify articles on the factors associated with male infertility, published in English and Persian. The keywords used to perform the search included “factor", “epidemiology", “causes of infertility", and “male infertility". The search was conducted without a time restriction, up to April 2020.ResultsThe search resulted in a total number of 691 studies. After an assessment of the articles, finally 14 studies were included in this study with a total number of 26,324 infertile males. The factors associated with male infertility included semen abnormalities, varicocele and testis disorder, smoking, exposure to heat, obesity, anabolic steroids, vascular abnormalities, anti-spermatogenesis factors, antidepressants, taking ranitidine and cimetidine, penile discharge and genital ulcers, painful micturition, occupational factors, alcohol, chronic disease, sexual disorder, Surgical and urological diseases, genetic factors and herpes infection. Among these, the semen and varicocele disorders were common in most studies.ConclusionThe present review suggests that the factors affecting male infertility in Iran are similar to those reported from other countries. The results of this study can be used in adopting appropriate strategies for infertility management in Iran.

P–746 Obstetric outcomes of singleton birth after hysteroscopic division of septate uterus

Abstract Study question The aim of this study is to determine the obstetric outcomes in patients with a singleton birth after hysteroscopic division of septate uterus. Summary answer The data suggest excellent obstetric outcomes for singleton gestation after hysteroscopic division of a septate uterus reaching either the internal or the external cervical os. What is known already Septate uterus is a rare Müllerian anomaly with major impact on reproductive outcomes, particularly with a septum over 10mm. Controversy still exists over the need for surgical correction of the septum due to conflicting data on outcomes, particularly in women with histories of good obstetric outcomes and incidental septum findings. Placental location in relation to the septum may account for such conflicting reports. Most data on reproductive outcomes after hysteroscopic surgical correction combine both septate and subseptate uteri. There is limited published data on obstetric outcomes after hysteroscopic surgical correction of septate uteri, especially septate uteri reaching the external os. Study design, size, duration This retrospective cohort study included 107 patients with infertility and/or recurrent pregnancy loss (RPL) who received treatment between 2002 –2019. The study group included 24 patients with a singleton birth after hysteroscopic correction of septate uterus (Class Va; ASRM classification) that was diagnosed on trans-vaginal 3D ultrasound. The control group included 83 patients with a singleton birth who had normal endometrial cavity on hysteroscopy during the same period of time, before starting treatment. Participants/materials, setting, methods This study was conducted at an infertility clinic affiliated with a teaching hospital. In the study group the septum reached the internal or the external cervical os in 14 and 10 patients respectively. After hysteroscopic correction, all patients were offered various infertility treatments depending on the underlying etiology. The inclusion criterion in this study was to have a singleton birth after hysteroscopy. Demographic and clinical data and obstetric outcomes were compared between the two groups. Main results and the role of chance There was no significant difference in mean age, infertility duration, infertility type and incidence of male infertility or ovulatory disorders between the two groups. There was a significantly higher BMI (0.048), and a higher incidence of history of miscarriage (P = 0.002) and history of RPL (P = 0.017) in the study group. There was significant lower incidence of tubal factors infertility (P = 0.005) and endometriosis (P = 0.03) in the study group, therefore there was higher incidence of spontaneous conception (70.8% vs 19.3%; P = 0.000) and lower incidence of conception with IVF-ET (20.8% vs 66.3%; P = 0.000) in the study group compared to the control group respectively. There was significantly higher incidence of prophylactic cervical cerclage (17.4% vs 0%; P = 0.000), and delivery by CS (69.6% vs 41.2%; P = 0.019) and lower incidence of vaginal delivery (30.4% vs 58.8%; P = 0.019), in the study group compared to the control group. There was no significant difference in gestational age in weeks (38.3 + 1.8 vs 38.6 + 2.0), newborn birth weight in grams (3173.9 + 630.0 vs 3202.1 + 555.6), incidence of premature birth (12.5% vs 12.2%), or other obstetric complications (25% vs 17.6%) between the study and the control groups respectively. For premature births, mean gestational age was 34.3 + 0.47 and 34.6 + 1.2 weeks in the study and control groups respectively. Limitations, reasons for caution A retrospective study has its own inherent bias. Furthermore, the small sample size is explained by the fact that a septate uterus is a rare anomaly leading to difficulties finding cases and organizing a prospective study to achieve a larger sample size. A multicenter prospective study is needed. Wider implications of the findings: Regardless of whether the septum reached the internal or external os, there were excellent obstetric outcomes in singleton gestations after hysteroscopic correction of septate uteri. There was no increased risk with septate uteri involving the cervix. Hysteroscopic surgical correction should be the treatment of choice for patients with septate uteri. Trial registration number Not applicable

P-746 Obstetric outcomes of singleton birth after hysteroscopic division of septate uterus

Abstract Study question The aim of this study is to determine the obstetric outcomes in patients with a singleton birth after hysteroscopic division of septate uterus. Summary answer The data suggest excellent obstetric outcomes for singleton gestation after hysteroscopic division of a septate uterus reaching either the internal or the external cervical os. What is known already Septate uterus is a rare Müllerian anomaly with major impact on reproductive outcomes, particularly with a septum over 10mm. Controversy still exists over the need for surgical correction of the septum due to conflicting data on outcomes, particularly in women with histories of good obstetric outcomes and incidental septum findings. Placental location in relation to the septum may account for such conflicting reports. Most data on reproductive outcomes after hysteroscopic surgical correction combine both septate and subseptate uteri. There is limited published data on obstetric outcomes after hysteroscopic surgical correction of septate uteri, especially septate uteri reaching the external os. Study design, size, duration This retrospective cohort study included 107 patients with infertility and/or recurrent pregnancy loss (RPL) who received treatment between 2002 -2019. The study group included 24 patients with a singleton birth after hysteroscopic correction of septate uterus (Class Va; ASRM classification) that was diagnosed on trans-vaginal 3D ultrasound. The control group included 83 patients with a singleton birth who had normal endometrial cavity on hysteroscopy during the same period of time, before starting treatment. Participants/materials, setting, methods This study was conducted at an infertility clinic affiliated with a teaching hospital. In the study group the septum reached the internal or the external cervical os in 14 and 10 patients respectively. After hysteroscopic correction, all patients were offered various infertility treatments depending on the underlying etiology. The inclusion criterion in this study was to have a singleton birth after hysteroscopy. Demographic and clinical data and obstetric outcomes were compared between the two groups. Main results and the role of chance There was no significant difference in mean age, infertility duration, infertility type and incidence of male infertility or ovulatory disorders between the two groups. There was a significantly higher BMI (0.048), and a higher incidence of history of miscarriage (P=0.002) and history of RPL (P=0.017) in the study group. There was significant lower incidence of tubal factors infertility (P=0.005) and endometriosis (P=0.03) in the study group, therefore there was higher incidence of spontaneous conception (70.8% vs 19.3%; P=0.000) and lower incidence of conception with IVF-ET (20.8% vs 66.3%; P=0.000) in the study group compared to the control group respectively. There was significantly higher incidence of prophylactic cervical cerclage (17.4% vs 0%; P=0.000), and delivery by CS (69.6% vs 41.2%; P=0.019) and lower incidence of vaginal delivery (30.4% vs 58.8%; P=0.019), in the study group compared to the control group. There was no significant difference in gestational age in weeks (38.3 + 1.8 vs 38.6 + 2.0), newborn birth weight in grams (3173.9 + 630.0 vs 3202.1 + 555.6), incidence of premature birth (12.5% vs 12.2%), or other obstetric complications (25% vs 17.6%) between the study and the control groups respectively. For premature births, mean gestational age was 34.3 + 0.47 and 34.6 + 1.2 weeks in the study and control groups respectively. Limitations, reasons for caution A retrospective study has its own inherent bias. Furthermore, the small sample size is explained by the fact that a septate uterus is a rare anomaly leading to difficulties finding cases and organizing a prospective study to achieve a larger sample size. A multicenter prospective study is needed. Wider implications of the findings Regardless of whether the septum reached the internal or external os, there were excellent obstetric outcomes in singleton gestations after hysteroscopic correction of septate uteri. There was no increased risk with septate uteri involving the cervix. Hysteroscopic surgical correction should be the treatment of choice for patients with septate uteri. Trial registration number Not Applicable

Modulatory effects of Punica granatum L juice against 2115 MHz (3G) radiation-induced reproductive toxicity in male Wistar rat.

Advancements in telecommunication sector result in increasing exposure to electromagnetic (EM) radiation, which has been correlated with incidence of male infertility. Therefore, the present study focused on analyzing the consequence of EM radiation (2115 MHz) exposure on the reproductive system of male Wistar rats. Besides, the antioxidant protective effect of Punica granatum juice was also evaluated. For experimental analysis, rats were divided into five groups (control, sham exposed, exposed, herbal plus exposed, and herbal only). Individual group consisted of 6 rats which were exposed to radiation for 45 days (2 h/day). The herbal-treated groups were given 1 ml of Punica granatum extract orally. Various parameters such as organ to body ratio, sperm count, motility, viability, and testis histopathology were studied. Furthermore, oxidative stress parameters and free radical generation were analyzed. The exposed group showed changes in sperm parameters along with decrease in seminiferous tubule diameter. On the contrary, herbal-exposed group showed enhanced sperm count, increased motility, and viability in comparison to exposed group. Histopathology studies also revealed the protective role of herbal juice. Significant alteration in oxidative parameters along with an enhanced free radical generation in exposed group and reduction in herbal groups was observed. The results thus indicate that continuous exposure to EM radiation can lead to oxidative stress which induces biochemical changes in rat sperms. However, Punica granatum extract has a protective role against oxidative damage induced by EM radiation.

Male infertility, a component of couple infertility

Introduction. Couple infertility is defined as the lack of obtaining a pregnancy during regular sexual acti­vi­ty with­out using contraceptive methods, and the eva­lua­ted period is sometimes related to the age of the part­ners. Alth­ough the diagnosis of couple infertility con­cerns both part­ners, the woman is usually the one who performs many inter­dis­ci­pli­nary medical checkups to identify the cause, and her part­ner is often forced to con­duct investigations due to the fact that her health does not affect the reproductive capa­city. Materials and me­thod. We analyzed 180 sper­mo­grams performed in the DOBSIMED medical center in Mediaş, between 2018 and 2020. Collecting the analyses and processing them were per­formed in accordance to the WHO standards. The re­sults revealed an increase in the addressability until the age of 31-35 years old, with an incidence of fertility di­s­orders of 47% after the age of 40. The aim was also to correlate leukospermia with fertility disorders, as well as the signs suggesting the inflammation of the genital tract. Discussion and conclusions. Correlating the re­sults of this study with data from literature, we notice an increase in the incidence of male infertility which may be due to both lifestyle changes and the openness that men begin to show to this kind of investigations.

The Evaluation of Evidence Bisphenol A Exposure and Human Reproductive Health: A review

Infertility is widespread problem defined as the inability to conceive after one year of unprotected intercourse. One of the most notable factors causing this status is the exposure to environmental contaminants. It is now recognized that many contaminants present in the environment have the ability to interfere in the action of hormones and therefore are termed endocrine disruptors (EDs). Some of these compounds are present in nature, but the majority are artificial and released into the environment by the human activities without any prior knowledge of their impact on ecosystems, animal welfare, or wildlife and human health. Many epidemiological studies have reported a radical growth in the incidence of male infertility, accompanied by decreasing sperm quality, decline in spermatozoa motility, defect in Leydig cell morphology, insufficient activity of steroidogenesis and spermatogenesis. The similar situation was observed in female, when the increased risk for endometriosis, reproductive and other endocrine-related cancer, impaired oocytes, ovarian dysfunction, or irregular menstrual cycle was confirmed. All mentioned consequences have been associated with increasing concentration of bisphenol A (BPA) in the environment. Humans are exposed to BPA not only through specific occupational circumstance, but nowadays more generally also from the ordinary day-to-day domestic and workplace lifestyles. Almost 3.4 million tons per year of BPA is used in a variety common product such as food packaging, household products, epoxy resins, dental sealants and many others. Under these endpoints, apprehensions about the reproductive dysfunctions associated with BPA action are unquestionable. In this review, we address the topic of BPA effects on reproductive function in males and females and emphasize its effects on overall health. A considerably more detailed and systematic research in EDs toxicology is required for a better understanding of risks associated with exposure to environmental toxicants.

Wuzi Yanzong Pill for the treatment of male infertility: A protocol for systematic review and meta-analysis of randomized controlled trials.

Background:The incidence of male infertility is increasing worldwide, and has become an important problem that plagues many married couples. Half of the infertility cases have induced by male infertility. Wuzi Yanzong Pill is a traditional Chinese herbal formula used in treating spermatorrhea, premature ejaculation, erectile dysfunction, lumbago and male sterility widely. Therefore, in this systematic review, we design to evaluate the effectiveness and safety of Wuzi-Yanzong Pill for the treatment of male infertility.Methods:The English and Chinese literature published before June 30, 2020 will be searched in PubMed, EMBASE, Cochrane library, and Chinese literature in China National Knowledge Infrastructure, Chinese biomedical document service system, VIP Chinese Science and Technology Journal Database, WANFANG data. All related randomized controlled trials that meet the eligibility criteria will be included and other studies will be excluded. We will search literature with text keywords “male infertility” or “sperm” or “semen” and “Wuzi Yanzong Pill” or “Wuziyangzong” or “WZYZ”. Progressive motility, sperm concentration, sperm morphology, sperm viability, sperm DNA fragmentation, sperm number per ejaculate, pregnancy rates will be evaluated. RevMan 5.3 and Stata 14.0 will be used to conduct this systematic review. The preferred reporting items for systematic reviews and meta-analysis protocols statement is followed in this protocol and the PRISMA statement will be followed in the completed systematic review.Conclusion:The efficacy and safety of Wuzi Yanzong Pill in the treatment of male infertility will be e evaluated. The results of this review may provide some help for the clinician's decision.

Association of demographic and lifestyle factors with semen quality of men with fertility problems attending infertility center in North Karnataka

Background: Male factor is responsible for 50% of infertility cases. Universal deterioration in human sperm quality occurring in recent times is receiving a greater attention. The impact of numerous lifestyle factors including age, smoking, alcohol consumption, and exposure to occupational and environmental pollutants is unfavorable to male reproductive health. The present study intended to find out the association of demographic, occupational, and several lifestyle factors on semen quality of men diagnosed with infertility. Materials and Methods: The study enlisted 432 men diagnosed with fertility issue. Couples were administrated with a structured questionnaire to provide their demographic attributes and medical and reproductive health information. The collected data were statistically analyzed using SPSS software version 20.0. Results: The mean age of men was 34.44 ± 0.21 years at the time of consultation. Among seven semen abnormalities, asthenozoospermia was recorded the highest (30.09%). Most of the participants were having secondary education (32.26%), working as laborers (26.62%), and were having multiple addictions (27.77%). Decreased sperm count and motility was noticed among advanced age group and those with addictions. Different occupational statuses had substantial correlation with the sperm quality of participants. Conclusion: The incidence of male infertility and the potent lifestyle aspects studied have displayed an association with each other. However, influence of these aspects on impairment of male fertility can be overcome with modification toward healthier lifestyle.

Men's knowledge of male infertility and the possibilities for supporting therapy: risk factors and individual responses

In recent decades, the incidence of male infertility has been increasing continuously both worldwide and in Hungary and is becoming a more and more central issue. Millions of men at the reproductive age are affected by male infertility. In addition to the known organic reasons, many life-style and environmental factors can be expected to contribute to this. The biopsychosocial theoretical model of infertility allows us to interpret the lack of fertility not only from the medical point of view, but also as a psychosocial phenomenon. Men's coping strategies, health information seeking habits, and knowledge of infertility are similar to women's, but there are several different points in their responses given to the problem. So medical, nursing and other health professionals dealing with infertile male patients should devote special and high attention to patients' conducting and paramedical counselling as supportive therapy. Within the framework of this - besides giving information - the individual support contributes to the elaboration of information, arising effects and experiences, furthermore to the developement of adaptive coping strategies for stress, and to the modification of direct or indirect changes in health behavior affecting reproductive health during the treatment period. Orv Hetil. 2018; 159(31): 1262-1268.

Y chromosome microdeletions frequency in idiopathic azoospermia, oligoasthenozoospermia, and oligospermia

Genetic factors are candidates for about 30% of male infertility with sperm production-related abnormalities. Y chromosome microdeletions are responsible for around 10% of male infertility. These microdeletions generally occur in azoospermia factor on the Yq. That is often associated with the quantitative reduction of sperm. The aim of this cross-sectional study was to determine the frequency of Yq microdeletions among idiopathic azoospermic, oligoasthenozoospermic, and oligospermic men in Shohada infertility center, Chaharmahal va Bakhtiari province. A total of 81 idiopathic azoospermic, oligoasthenozoospermic, and oligospermic infertile men were selected as cases and 81 fertile men assigned to control group. For molecular investigations, 13 sequence-tagged site markers were chosen from azoospermia factor (AZF) region for detection of Y chromosome microdeletions and amplified by two separate multiplex-polymerase chain reaction. The relationship between the AZF microdeletions and incidence of male infertility in the family, consanguineous parents, smoking, and the levels of reproductive hormones among infertile men were investigated. The total frequency of the microdeletions was 6.17% (2 cases in azoospermic, 3 cases in oligoasthenozoospermic subgroups, and none in the oligospermic participants and the control group). Most deletions (3.7%) were seen in the AZFb followed by the AZFc (2.46%) and none in AZFa. No significant association was seen between the microdeletions and clinical characteristics. Although the frequency of Yq chromosome microdeletions in Chaharmahal va Bakhtiari province is lower than the mean frequency of Iran, the frequency is comparable to those reported by some studies in Iran.

Pleurotus tuber-regium mushrooms in the diet of rats ameliorates reproductive and testicular injury caused by carbon tetrachloride

BackgroundThe incidence of male infertility arising from male sexual dysfunction is high especially in the sub saharan Africa. African foods may hold promise to reverse this trend. The aim of this study therefore is to evaluate the improvement of the reproductive and testicular injuries mediated by CCl4 by the use of a wild edible mushroom, P. tuber-regium.MethodsSixty rats were divide into six groups. Group I received 3 mL/kg olive oil by intraperitoneal injections twice weekly. Group II received 3 mL/kg (30% in olive oil) injected twice weekly i.p, Groups III, IV and V received 100 mg, 200 mg and 500 mg wild edible P. tuber-regium (33.3% in feed) daily in addition to 3 mL/kg CCl4 in oil injected twice weekly i.p. Group VI received 500 mg P. tuber-regium (33.3% in feed) daily. After 13 weeks, the animals were sacrificed and testes weighed.Testicular counts and viability were evaluated. Serum levels of FSH, LH, testosterone, estrogen and prolactin were assayed. Malondialdehyde (MDA), ascorbic acid, α-tocopherol, superoxide dismutase (SOD), catalase, total glutathione and peroxidase were determined in testis homogenate. Also, histopathological examinations of the testes were performed.ResultsAdministration of CCl4 to rats significantly (p < 0.01) increased the relative testicular mass in treated group when compared to control group. Also, CCl4 administration decreased significantly (p < 0.01) the levels of sperm motility, epidydymal and testicular sperm count and viability ratio in the CCl4 group when compared to the control group. Exposure to CCl4 decreased significantly the levels of FSH, LH and testosterone when compared to the control while increasing the levels of estrogen, prolactin and MDA when compared to the control. The levels of ascorbic acid, α-tocopherol, SOD, catalase, total glutathione and peroxidase decreased significantly (p < 0.01) in treated groups when compared to control group. These changes were reversed by diets containing Pleurotus tuber-regium mushrooms in a dose-dependent manner. Photomicrographs also showed that P. tuber-regium prevented the edema, spermatogenic distortions and maturation arrest observed in the CCl4 only group.ConclusionP. tuber-regium is effective in protecting the testes from the free radical injuries mediated by CCl4.

Male infertility following inguinal hernia repair: a systematic review and pooled analysis.

The aim of this systematic review is to establish the clinical impact of open (mesh and/or without mesh) and laparoscopic hernia repair (transabdominal pre-peritoneal (TAP) and/or totally extra-peritoneal (TEP)) on male fertility. The incidence of male infertility following various types of inguinal hernia repair is currently unknown. The lack of high-quality evidence has led to various speculations, suggestions and reliance on anecdotal experience in the clinical practice. An electronic search of the literature in Medline, Scopus, Embase and Cochrane library from 1966 to October 2015 according to PRISMA checklist was conducted. Quality assessment of articles was conducted using the Oxford Critical Appraisal Skills Programme (CASP) and their recommendation for practice was examined through National Institute for Health and Care Excellence (NICE). This resulted in ten studies (n=10), comprising 35,740 patients. Sperm motility could be affected following any type and/or technique of inguinal hernia repair but this is limited to the immediate postoperative period (≤48h). Obstructive azoospermia was noted in 0.03% of open and 2.5% of bilateral laparoscopic (TAP) hernia repair with mesh. Male infertility was detected in 0.8% of the open hernia repair (mesh) with no correlation to the type of mesh (lightweight vs. heavyweight). Inguinal hernia repair without mesh has no impact on male fertility and obstructive azoospermia. However, the use of mesh in bilateral open and/or laparoscopic repair may require the inclusion of male infertility as the part of informed consent in individuals that have not completed their family or currently under investigations.

Melatonin controlled apoptosis and protected the testes and sperm quality against bisphenol A-induced oxidative toxicity

Epidemiological reports have indicated a correlation between the increasing bisphenol A (BPA) levels in the environment and the incidence of male infertility. In this study, the protective effects of melatonin on BPA-induced oxidative stress and apoptosis were investigated in the rat testes and epididymal sperm. Melatonin (10 mg/kg body weight (bw)) was injected concurrently with BPA (50 mg/kg bw) for 3 and 6 weeks. The administration of BPA significantly increased oxidative stress in the testes and epididymal sperm. This was associated with a decrease in the serum testosterone level as well as sperm quality, chromatin condensation/de-condensation level, and the percentage of haploid germ cells in the semen. BPA administration caused a significant increase in apoptosis accompanied by a decrease in the expression of the antiapoptotic proteins Bcl-2 in the testes and epididymal sperm. The concurrent administration of melatonin decreased oxidative stress by modulating the levels of glutathione, superoxide dismutase, and catalase as well as the malondialdehyde and hydrogen peroxide concentrations in the testes and sperm. Melatonin sustained Bcl-2 expression and controlled apoptosis. Furthermore, melatonin maintained the testosterone levels, ameliorated histopathological changes, increased the percentages of seminal haploid germ cells, and protected sperm chromatin condensation process, indicating appropriate spermatogenesis with production of functional sperm. In conclusion, melatonin protected against BPA-induced apoptosis by controlling Bcl-2 expression and ameliorating oxidative stress in the testes and sperm. Thus, melatonin is a promising pharmacological agent for preventing the potential reproductive toxicity of BPA following occupational or environmental exposures.

DIAGNÓSTICO Y TRATAMIENTO DE LA INFERTILIDAD MASCULINA

Objetivo: Determinar el estado actual de la infertilidad masculina en un hospital general. Diseño: Trabajo de investigación descriptivo, retrospectivo. Material y Métodos: En el servicio de infertilidad del Hospital Arzobispo Loayza, se revisó 371 historias de pacientes varones atendidos en un periodo de 4 años. El criterio de inclusión fue diagnóstico de infertilidad masculina con resultados patológicos en dos o más espermatogramas y/o disfunción sexual eyaculatoria. Resultados: Se encontró 79 casos de infertilidad masculina, con incidencia 21,3%. La edad promedio de diagnóstico fue 35,9 años, tiempo de infertilidad promedio cuatro años, 64,8% con infertilidad primaria. Los diagnósticos más frecuentes fueron glándulas sexuales accesorias infectadas (38`%), anormalidad de plasma seminal (16,5%), azoospermia no determinada (15,2%), astenozoospermia idiopática (12, 7%), germen más frecuente Estreptococo alfa hemolítico (50%). Gestó 22,8% de las parejas, lo que se logró en la mayoría con antibióticos, inseminación intrauterina con semen homólogo o sin tratamiento. Conclusiones: La incidencia de infertilidad masculina en el Hospital Arzobispo Loayza en cuatro años fue 21,3%. En 87,3% de los casos coexiste la infertilidad en ambos conyuges. El diagnóstico de infertilidad masculina más frecuente es infección de las glándulas sexuales accesorias.

The Effect of Organochlorine Pollution on the Incidence of Male Infertility under Conditions of Osh Province of Kyrgyzstan.

Objective: To study the effect of organochlorine pollution on the incidence of male infertility. Materials and methods: 1036 dispensary records of males from rural areas suffering from infertility were analyzed. The incidence rate of male infertility per 100, 000 population was calculated by conventional techniques. All patients were allocated into 5 groups. Concentration levels of organochlorine pesticides (OCPs) in soil were measured by gas-liquid chromatography. Results: Group I consisted of men living in mountainous uncontaminated areas. The local population is mainly engaged in cattle breeding. The incidence rate of male infertility per 100, 000 male population was 5.5. Group II comprised men who were engaged in cattle breeding and cultivation of grain legumes. Small amounts of OCPs were used for pest control in the area. The incidence rate in Group II was 20.55. Group ??? consisted of men living in mountainous areas where DDT had been used during the period 1980-1982 for pest control. The incidence rate - 29.19. Group ?V group comprised men living in the areas which were used for tobacco growing. The incidence rate - 24.96. Group V consisted of men from the areas used for rice growing. The incidence rate -31.55. Group V? comprised men from the areas which were used for cotton growing and where OCPs had been used for control of cotton pests. The incidence rate of male infertility ranged from 44.63 to 50.89 per 100, 000 population. Our studies showed that males living in the vicinity of the former pesticides warehouses and airstrips and who are engaged in cultivation of fruit and vegetables are 7-10 times more likely to develop infertility than those from the same areas but living far from the pesticide warehouses. Investigation of soil showed the concentration level of OCPs at the sites of former pesticide warehouses to be 1.2 g/kg. Thus, the incidence rate of male infertility under conditions of Osh Province of Kyrgyzstan depends on the pollution rate.