Male Factor Research Articles

Evaluation of spermatic DNA fragmentation in smoking normospermic infertile individuals

Aim: In approximately 20% of infertile couples, the male factor is the only main cause. In recent years, it has been hypothesized that sperm DNA integrity may be a better indicator than routine semen analysis. Although the effects of smoking on male infertility have not yet been proven, smoking is considered a reasonable risk factor for infertility. In our study, we aimed to evaluate DNA damage in normospermic infertile men who smoke and do not smoke using the acridine orange method. Material and Methods: This study was conducted on semen samples from 50 male cases, 25 of whom were smokers and non-smokers, who met the infertility criteria and applied to the urology clinic of Dicle University Medical Faculty Hospital. Microscopic examinations and morphological evaluations were performed in accordance with the WHO 2010 criteria. The acridine orange method was applied to evaluate DNA fragmentation and DNA fragmentations were calculated. Statistical analysis of the obtained data was performed using the Mann-Whitney U Test. Results: In our study, in the smoking group, age was significantly associated with the duration of infertility, concentration with total motile sperm count, total sperm count with total motile sperm count, and amorphous head anomaly (p<0.01). In the non-smoking group, age and infertility were significantly associated with the duration, volume and total count, concentration and total count, total motile sperm count, and DNA fragmentation (p<0.01). However, there was no statistical difference between the smoking and non-smoking groups in terms of semen parameters and DNA fragmentation (p>0.05). Conclusion: In order to obtain more reliable results, it is thought that large-scale studies are needed in the same groups and in the general population. Keywords: sperm, infertility, DNA fragmentation, smoking

An Evidence-Based Case Series of Male Infertility (OAT Syndrome Associated with Hypospermia) Treated with Constitutional Medicine

AbstractA major clinical problem that still affects 8 to 12% of couples globally, infertility and issues with diminished fecundity have long been a cause for worry. Approximately 35% of the cases of infertility result from deficiencies associated with male factor and as many as 2% of all men will exhibit suboptimal sperm parameters. Medical therapy includes the treatment of reversible endocrine or infectious causes of subfertility that may cause a variety of adverse effects. This study aimed to highlight the importance of employing homoeopathic constitutional medicine in the cases, caused by suboptimal seminal parameters (oligospermia, asthenospermia, teratospermia associated with hypospermia) due to non-specific causes. In this study, three males who had a poor seminal parameter visited the outpatient clinic. Their cases were recorded, appraised and analysed according to homoeopathic principles and repertorised using a complete repertory. Finally, each case received a constitutional medicine for prescription. Causal attribution of changes in their condition to the homoeopathic treatment was assessed by Modified Naranjo Criteria for Homoeopathy (MONARCH) inventory score. After a couple of months of medical care, a second semen analysis of the patients was performed. The reports revealed the improvement in the seminal variables. At the end, the values obtained were according to the 2010 World Health Organization standards. The outcome of the case series supports the clinical potency of constitutional treatment in homoeopathy in idiopathic infertile men. In future, randomised control trials with large sample sizes may be undertaken for validation of results.

Microfluidic in compared with Zeta potential, MACS and swim up methods, resulted in improved chromatin integrity and high quality sperms.

Sperm parameters and DNA integrity are crucial factors in ART outcomes. This study compared four sperm preparation methods (microfluidics, MACS, zeta potential, and swim-Up) for sorting spermatozoa with normal parameters and chromatin integrity. This study evaluated semen samples from 25 couples with male factor infertility. The semen samples were divided into four portions: one prepared by MACS, one by zeta potential, the other by microfluidics, and the last by swim-up. After preparation, sperm viability, motility, and morphology were assessed based on the WHO guidelines. DNA intergrity was assessed by SDF assay, and the CMA3 staining test was used to evaluate sperm chromatin packaging. Compared to other preparation techniques, microfluidic preparation significantly improved sperm parameters, including motility, viability, morphology, and DNA integrity as well as chromatin packaging (p-value <0.05). The results also demonstrated that sperm motility, viability, and sperm DNA integrity as well as chromatin packaging, were not significantly different after preparation with MACS and Zeta potential methods. However, the MACS and Zeta methods produced improved sperm parameters and better DNA integrity than the swim-up method. Our results indicate that microfluidics can improve sperm quality compared to other methods of sperm preparation. When the microfluidic chip is not available, considering the similar results of sperm preparation by MACS and Zeta potential methods, it is preferred to use the Zeta method for the ART cycle due to its simplicity and cost-effectiveness.

A multivariate model for the prediction of pregnancy following laparoscopic artificial insemination of sheep.

The causes of variation in the success of laparoscopic artificial insemination (AI) in sheep are not well understood. As such, this study incorporated the contributions of multiple male and female factors relevant to the success of AI into a comprehensive prediction model for pregnancy success. Data from Merino ewes (N = 30 254) including age, uterine tone (1; pale/flaccid-5; turgid/pink), intra-abdominal fat (1; little to no fat present-5; high fat), time of insemination and sire used, were recorded during AI. A subset of semen per sire (N = 388) was thawed and assessed for volume, subjective motility, sperm concentration, and morphology. Sperm motility (CASA), viability and acrosome integrity (FITC-PNA/PI), membrane fluidity (M540/Yo-Pro), mitochondrial superoxide production (Mitosox Red/Sytox Green), lipid peroxidation (Bodipy C11), level of intracellular reactive oxygen species (H2DCFDA) and DNA fragmentation (Acridine Orange) were also assessed 0, 3 and 6h post-thaw. Logistic binomial regression revealed sperm concentration (P < 0.001), CASA parameters at 0h (PCA3; P = 0.03), viable acrosome intact sperm at 6h (P = 0.02), abnormal morphology (P < 0.001), uterine tone (P < 0.001) and intra-abdominal fat (P = 0.03) of ewes influenced likelihood of pregnancy. Results generated will help standardise the pre-screening and selection of semen and ewes prior to artificial breeding programs, reducing variation in the success of sheep AI.

Exploring lncRNA expression in follicular fluid exosomes of patients with obesity and polycystic ovary syndrome based on high-throughput sequencing technology.

Infertility is a reproductive health problem that attracts worldwide attention. Polycystic ovary syndrome (PCOS) is a major cause of female infertility and patients with obesity and PCOS are particularly common in clinical practice. Long non-coding RNA (lncRNAs) are a functional core in cells that regulate gene expression, transcription, and chromatin modification processes, and participate in epigenetics, cell cycle, and cell differentiation. LncRNAs are assumed to play a role in the occurrence and development of PCOS; however, their specific mechanism of action remains to be elucidated. High-throughput sequencing technology has been used to sequence and analyze lncRNAs in exosomes from the follicular fluid of patients with obesity and PCOS and those who underwent assisted reproductive therapy owing to male factors. Specific expression profiles of patients with obesity and PCOS were obtained and functional information analysis combined with a literature review were performed to screen for differentially expressed lncRNAs, which were validated using real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR). High-throughput sequencing analysis revealed that compared to normal patients with male infertility, patients with obesity and PCOS had a total of 20 lncRNAs with significant expression differences in follicular fluid exosomes. Among them, 17 lncRNAs were upregulated and three were downregulated. Functional analysis showed that differentially expressed genes were mainly enriched in "cell metabolism," "cell adhesion," and other aspects: related gene pathways mainly involved Huntington's disease, Parkinson's disease, spliceosomes, non-alcoholic fatty liver disease, and ribosomes. Verification of differentially expressed lncRNAs revealed that the expression of lncRNAs TPT1-AS1, PTOV1-AS1, PTPRG-AS1, and SNHG14 in follicular fluid exosomes was consistent with the sequencing results. A preliminary differential expression profile of lncRNAs in exosomes of patients with obesity and PCOS was established by transcriptomic analysis of these individuals. Our bioinformatics analysis results may be applicable to further study of the impact mechanism involving obesity and PCOS. These differentially expressed lncRNAs maybe served as potential biomarkers for in-depth studies of the occurrence, development on Follicle quality and function for patients with PCOS in the future.

Analysis of influencing factors of clinical pregnancy rate in second cycle intrauterine insemination.

To explore the factors influencing the clinical pregnancy rate in the Reproductive Center of the Affiliated Hospital of North Sichuan Medical College in the second cycle, a retrospective analysis of the clinical data of 175 patients who underwent the second cycle of intrauterine insemination (175 cycles) from July 2019 to July 2022 was performed. According to whether the patients reached clinical pregnancy, they were divided into the pregnant group (32 cycles) and non-pregnant group (143 cycles). The age, infertility years, infertility factors, infertility type, number of sinus follicles, intimal thickness, intimal type, basal follicle-stimulating hormone, basal luteinizing hormone, basal estradiol, stimulation regimen, season, body mass index, and male semen quality were statistically analyzed between the 2 groups. The number of intrauterine insemination (IUI) in the second cycle was 175, and the clinical pregnancy rate was 18.3% (32/175). The age of the pregnant group was lower than that of the non-pregnant group [(26.7 ± 1.07) vs (30.56 ± 0.51), P = .05]. The clinical pregnancy rate in patients aged ≤30 years was significantly higher than that in patients aged > 30 years [28.6% vs 7.1%, P < .05]. Among infertility factors, the pregnancy rate of patients who underwent IUI due to female factors was significantly higher than that of male factors, combined factors (both male and female), and unexplained infertility, and the differences were statistically significant [37.1% vs 22.4%, 18.2%, 3.2%, P < .05]. In multivariate logistic regression analysis, age and infertility factors were independent influencing factors of clinical pregnancy rate in the second cycle of IUI. In, while in artificial insemination, female age and infertility factors were important factors affecting the clinical pregnancy rate of the second cycle of IUI. If the outcome of the first cycle is not pregnant, the female age is <30 years, infertility is the female factor, and the second cycle of IUI can be considered.

Association between mental health and male fertility: depression, rather than anxiety, is linked to decreased semen quality

BackgroundInfertility is increasingly recognized as a global health issue affecting couples of reproductive age, with male factors contributing to approximately 50% of infertility cases. However, the association between depression and anxiety-two of the most prevalent mental health conditions-and impaired male fertility remains a subject of ongoing debate.MethodsIn this cross-sectional study, male participants seeking fertility counseling at an IVF clinic were recruited. Symptoms of depression and anxiety were assessed using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7), respectively. Generalized linear regression models (GLMs) were employed to investigate the relationships between mental health status and semen parameters.ResultsStatus of depression was negatively associated with semen quality parameters, whereas no statistically significant association was recognized between anxiety and semen quality except that sperm concentration was decreased by 25.60 (95% CI, 1.226 to 49.965, P=0.040) ×106/ml in moderate to severe anxiety group referring to normal group. Furthermore, when stratified by sleep duration, moderate to severe depression group showed a great decrease in progressive motility (PR), total motility, concentration and total sperm count (TSC) as referred to normal group in participants with sleep duration less than 7 hours.ConclusionThe present study revealed that depression rather than anxiety was a negative factor that affected semen quality, especially in individuals with shorter sleep duration.

Enhanced sperm isolation via bulk acoustic waves for high-throughput motility screening

The increasing infertility rate has become a worrying global challenge in recent years. According to the report of the World Health Organization, the male factor is responsible for over half of infertility cases, which includes the lack of desirable characteristics in sperm motility, morphology, and DNA integrity. In recent years, it has been shown that clinical methods including density gradient centrifugation cause damage to sperm DNA and besides being invasive, they are costly and time-consuming. In contrast, microfluidics has been used as a promising and non-invasive approach to manipulate biological cells. Here, by using the microvortices created by the oscillation of the bubbles caused by the bulk acoustic waves, we were able to trap sperms with less motility. In contrast, the highly motile sperms overcame the force of the microvortices and were guided to the outlet pool by following the channel boundaries. As a result, over 50% and 44% improvement in sperm progressive motility and viability, respectively, as well as 40% improvement in DNA integrity, were observed in the analysis of sperms retrieved from the output pool. In addition to being fast and non-invasive, the proposed device benefits from an easy method for sperms retrieval and does not require any preprocessing of the raw sperm sample.

Predictions of live birth in IVF programs of patients with recurrent implantation failure

BackgroundWhen a high-quality embryo is implanted into the uterus, but the pregnancy is not established as shown by the ultrasound visualization of an intrauterine gestational sac, this is known as “implantation failure.” Cases when more than two times implantation failure occurred was defined as recurrent implantation failure (RIF). Additional testing is done at this stage of infertility treatment to avoid a repeat of the same result with a future in vitro fertilization (IVF) effort. Aim of the studyThe study aimed to evaluate predictive value of using embryo transfer personalization because of the implantation window study in combination with preimplantation genetic testing in patients with recurrent implantation attempts. MethodsBriefly describe the main methods or treatments applied: Ninety-three infertile women make up the sample for this prospective cohort study. In regard to treatment results, the study intends to assess the predictive importance of patient characteristics, screening indicators, and several features of IVF cycles, such as the quantity, quality, and developmental stage of the transferred embryos. Statistical methods employed include the calculation of the median (Me) and interquartile range (IQR) for continuous variables. The Mann-Whitney U test was used to discern differences between unrelated samples, while categorical variables were presented as absolute and percentage values. The Pearson’s Chi-squared test assessed differences between groups. Logistic regression, utilizing both enter and backward Wald methods, was applied to establish associations with binary outcomes. ResultsThe integration of individualized embryo transfer and preimplantation genetic testing (PGT) significantly enhanced the likelihood of live births by 3.4 times in patients experiencing recurrent implantation failure (RIF), with a statistical significance of p = 0.026. In contrast, employing PGT alone increased the probability of live births by 1.5 times; however, this result was not statistically significant (p = 0.439). The predictive model for live birth in patients with RIF, based on our study findings, is defined as follows: the probability of live birth = 1.936 + [1.014 if PGT-A embryos are utilized for transfer] + [1.742 if endometrial preparation is tailored according to the Wellbeing Index (WI)] − [1.860 in cases of secondary infertility] − [1.891 when a male factor is involved]. ConclusionsThe determination of the implantation window (IW) and PGT of the embryo are efficient methods of live birth achievement for patients with RIF.

Male Factor Infertility and the Rural—Urban Continuum

OBJECTIVETo examine the association between male factor infertility and the Rural—Urban continuum. MATERIALS AND METHODSSingle institution retrospective cohort study using the Utah Population Database (UPDB), which combines demographic, medical, and residential data for patients residing in Utah and links to the Subfertility Health Assisted Reproduction and Environment (SHARE) database, which houses fertility data from 1998-2017. The data was divided by metropolitan (metro-) [large, medium, small], and non-metropolitan (non-metro-) [urban, rural] status, based on United States Department of Agriculture (USDA) rural-urban continuum codes (RUCC). RESULTSNon-metro urban/rural males were less likely to be a racial/ethnic minority (91.3% non-Hispanic white vs 85.7%), or use assisted reproductive technology (ART) (13.4% vs 18.5%). Multivariate regression controlling for race/ethnicity, age, semen analysis category (oligozoospermic vs normozoospermic), previous successful fertility outcome, and use of ART, demonstrated complete rurality was associated with decreased likelihood of successful fertility outcome (Hazard Ratio [HR] 0.63, 95% CI 0.44–0.91, n=65). Non-metro urban individuals trended towards lower likelihood of successful fertility outcome ([HR] 0.93, 95% CI 0.85–1.01). Complete rurality was associated with longer time for 50% cohort successful fertility outcome (>60 months vs approximately 34 months both metro). All comparisons p<0.001. CONCLUSIONSAcross the rural—urban continuum, residing in a metro area was associated with higher rates of racial/ethnically diversity, fertility treatment utilization, and successful fertility outcomes (live births). Given approximately 18% of the United States resides with a rural community (12% in Utah), these findings can provide more informed infertility care.

Outcome of Endometriosis Treatment In Infertile Patients In A Tertiary Level Hospital

Introduction: Prevalence of endometriosis is 6-10% in reproductive-age females. Around 25-35% of infertile women may be affected by endometriosis. Modalities of treatment for infertile patients depends on the stage of the disease. It starts from ovulation inducing drug to advanced ART. The objective of this study was to assess the outcome of surgical treatment in infertile, endometriosis patients. Materials and Methods: It was an observational study, which was conducted at Reproductive Endocrinology and infertility Unit, Dhaka Medical College. Total 144 patients were included during July 2018 to July 2021, aged 20-40 yrs. All the demographic variables, clinical and sonographic findings, and hormonal assessment were done. Then, staging was done by clinical pelvic assessment, and ultrasonographic findings. Patients who had ovarian endometrioma, more than 4 cm, were selected for laparoscopic surgery. In patients whose endometrioma was less than 4 cm, or had no ovarian endometrioma, were selected for ovulation induction with or without prior GnRH agonist therapy. Further infertility management were planned according to ovarian reserve, tubal patency, and male factor. Result: Mean age of the patients were 28.30±4.95 yrs. 75.0% patients had primary infertility. Dysmenorrhea was the most common symptom (86.96%), followed by chronic pelvic pain (81.16%). Bilaterality of endometrioma was associated with decreased serum AMH. Laparoscopic surgery was the mainstay of treatment, Cystectomy was done in 58% patients. Conservative treatment was done in remaining patients. Fertility enhancing treatment was done by ovulation inducing drug -letrozole, GnRH agonist, followed by controlled ovarian stimulation and followed by IUI. IVF was advised for fertility management in 26patients (18.06%). Conclusion: Endometriosis is not only associated with decreased ovarian reserve but also responsible for diminished response to ovarian stimulation. So, it is a great challenge to obtain successful fertility treatment for this group of patients. J Dhaka Med Coll. 2023; 32(1) : 9-15

Transplantation of human umbilical cord-derived mesenchymal stem cells improves age-related ovarian functional decline via regulating the local renin–angiotensin system on inflammation and oxidative stress

BackgroundAge-related reproductive aging is a natural and irreversible physiological process, and delaying childbearing is increasingly common all over the world. Transplantation of mesenchymal stem cells (MSCs) is considered a new and effective therapy to restore ovarian function, but the relevant mechanisms remain unclear. Recently, it has been found that there is a local Renin–angiotensin system (RAS) in human ovary and it plays a key role.MethodsAfter collecting follicular fluid from women who received oocyte retrieval for pure male factor infertility, the level of RAS components in it were detected, and the correlation analysis by linear regression. Then, the in vivo experiments on female C57BL/6 mice were designed to measure ovarian function, and the transcription and translation levels of RAS pathway were detected by molecular biology methods. Moreover, the role of RAS in regulating inflammation and oxidative stress in the co-culture system were explored in in vitro experiments on KGN cells.ResultsFirst, a total of 139 samples of analyzable follicular fluid were obtained. The local RAS of ovary, which is independent of systemic RAS (P > 0.05), is affected by age (Pearson r < 0, P < 0.05) and related to ovarian function, inflammation, oxidative stress indexes and assisted reproduction laboratory outcomes (P < 0.05). Next, the ovary/body weight of aging mice decreased significantly and serum sex hormones levels changed significantly (P < 0.01). The number of functional follicles decreased, while the atresia follicles increased (P < 0.05). After MSCs transplantation, all the above measures have been partially recovered (P < 0.05). Although several RAS components in aging ovary changed, MSCs only improved the expression level of AT1R (P < 0.05). Furthermore, the secretion ability and mitochondrial membrane potential of aging KGN cells decreased, while the intracellular ROS level and the aging cells ratio increased (P < 0.01). All the above measures have been partially recovered when co-cultured with MSCs (P < 0.05). After Ang(1–7) were added into the co-culture system, the above have been more significantly restored compared with Ang II (P < 0.05). Nevertheless, there was no statistical difference in estradiol level no matter which one was added (P > 0.05).ConclusionsTogether, our findings indicate that a novel possible mechanism to explain how stem cells restore age-related ovarian functional decline.

Investigation of FF-MAS oxysterole’s role in follicular development and its relation to hedgehog signal pathway

The Hedgehog signaling pathway plays a crucial role in folliculogenesis; however, the association between FF-MAS oxysterol activity in folliculogenesis and the Hedgehog signaling pathway has not been revealed. The evaluation of FF-MAS activity in polycystic ovary syndrome (PCOS) with folliculogenesis disorder might provide a new approach to tackle follicular and oocyte maturation failure. The question is: does FF-MAS oxysterol affect granulosa cell (GC) proliferation? If so, is this effect facilitated through the Hedgehog pathway? To answer these questions, GCs were isolated from follicle fluids obtained from patients undergoing oocyte retrieval during in vitro fertilization (IVF) treatment. After the isolated GCs were incubated in different cell culture media, the levels of Hedgehog pathway components (SMO, Gli1) were measured by using immunohistochemical methods, cytoELISA, and qRT-PCR. Meanwhile, cell proliferation rates were determined. Significant increases (p < 0.001) in SMO and Gli1 expressions and cell proliferation were observed in the FF-MAS-treated subgroups of both PCOS and male factor participants compared to the FF-MAS deficient subgroup. Remarkably, FF-MAS positively affected the pathway components despite the pathway inhibitor cyclopamine. Although the increase in Hedgehog pathway components was slightly higher in the male factor group (MF), it was not statistically significant. In our study, we demonstrated for the first time the molecular effect of FF-MAS on human GCs in folliculogenesis. Since FF-MAS is already used in assisted reproductive techniques in animals and is known to be synthesized in the human body, it could be considered a new approach in human IVF treatments.

Evaluation of serum inhibin B and inhibin B/FSH ratio in the diagnosis of non-obstructive azoospermia and oligozoospermia.

Infertility affects approximately 15 % of couples globally, with 50 % cases of male factor infertility. Precise assessment of spermatogenesis is essential for evaluating male infertility. Recent studies suggest serum inhibin B as a promising biomarker for testicular function. This study aims to evaluate the diagnostic utility of serum inhibin B in predicting male infertility, particularly focusing on its relationship with sperm count. A cross-sectional study was conducted on 80 adult men (mean age 31.4±6.89 years) presenting with infertility at gynecology and urology outpatient departments. Semen analysis was performed following WHO (2010) guidelines, and serum inhibin B levels were quantified. The correlation between serum inhibin B levels and sperm parameters was assessed using Pearson's correlation test. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the diagnostic accuracy of serum inhibin B and the inhibin B/FSH ratio for non-obstructive azoospermia (NOA) and oligozoospermia. A significant positive correlation was observed between serum inhibin B and sperm count (r=0.94, p<0.001). ROC analysis demonstrated that the inhibin B/FSH ratio had the highest diagnostic accuracy for NOA and oligozoospermia (AUC=0.986), with sensitivity of 100 % and specificity of 91.67 %. Serum inhibin B alone also showed high diagnostic value (AUC=0.965 for NOA and 0.969 for oligozoospermia). Serum inhibin B is a reliable biomarker for assessing male infertility, particularly in evaluating spermatogenic function. The inhibin B/FSH ratio provides superior diagnostic accuracy for NOA and oligozoospermia, offering valuable clinical utility in male infertility diagnosis.

Pharmacological therapies for male infertility.

Male factor infertility is a multifaceted problem that affects approximately 50% of couples suffering from infertility. Causes of male infertility include endocrine disturbances, gonadotoxins, genetic abnormalities, varicocele, malignancies, infections, congenital or acquired urogenital abnormalities, iatrogenic factors, immunological factors, and idiopathic reasons. There are a variety of treatment options for male infertility, depending on the underlying cause(s). These can include surgical treatments, medical/hormonal therapies, and assisted reproductive techniques (ART), which can be combined with surgical sperm retrieval (SSR) if necessary. In this review article, the pharmacological therapies for male infertility are grouped by their underlying causes. Some of these therapies are targeted and specific, while others are used empirically to treat idiopathic male infertility. This will include treatments to optimize infertility in patients who have hypogonadism, ejaculatory dysfunction, infections, or idiopathic male infertility. Finally, we will provide an overview of the future directions of pharmacological therapies for male infertility. Significance Statement Male infertility is a significant worldwide problem. Detailed knowledge of the pharmacological therapies available will ensure the prescription of appropriate therapy and avoid the use of unnecessary or harmful treatments.

Identification and Manipulation of Spermatogonial Stem Cells with the Aim of Inducing Spermatogenesis in Vitro.

Assisted reproduction techniques for infertile men with non-obstructive azoospermia require a sufficient number of functional germ cells produced in vitro. Understanding the mechanisms that allow the resumption of spermatogenesis outside the testicular environment is crucial for fertility preservation in these patients. A review of the literature was conducted using databases such as PubMed, Scopus and Web of Science, with keywords including "spermatogonial stem cell," "germ cells," "male factor infertility," and "enrichment and propagation of SSCs in vitro." Currently, two models-"in vivo" and "in vitro"-have been developed for producing haploid germ cells. The "in vivo" models include spermatogonial stem cell transplantation and testicular xenograft techniques. In contrast, the "in vitro" models consist of conventional culture systems, organ culture, and three-dimensional culture systems, all designed to induce spermatogenesis in vitro. These culture systems enable the simulation of the seminiferous epithelium in vitro, which facilitates better regulation of cell-signaling pathways that control the self-renewal and differentiation of SSCs. This review provides up-to-date information on the organization of SSCs, focusing on the identification, proliferation, and differentiation of spermatogonia in vitro.

Demographic Risk Factors Vary in the Invasion Front of Chronic Wasting Disease in West Virginia, USA.

After detecting chronic wasting disease (CWD) in white-tailed deer (Odocoileus virginianus) in Hampshire County, West Virginia, USA, in 2005, we investigated the change of CWD apparent prevalence and potential factors influencing infection risk during the invasion front. Over eight sampling years (2006-2012 and 2017) during a 12-yr period within a 101-km2-area monitoring zone, we sampled and tested a total of 853 deer for CWD by ELISA and immunohistochemistry. Bayesian logistic regression of risk factors included collection year, age class, sex, and adjusted body weight (weight after accounting for sex, age, kidney fat index, and number of fetuses). In the whole-herd model (n=634), collection year, age, and adjusted body weight were associated with increased odds of CWD, whereas an age-weight interaction had a negative relationship. We found that males drove the positive associations with age and adjusted body weight, whereas females were responsible for the negative interaction effect. These findings suggest potential behavioral and physiological mechanisms related to sex that may influence CWD exposure. Older males exhibited higher CWD prevalence, aligning with previous studies. Notably, the novel finding of adjusted body weight as a risk factor in males warrants further investigation, and this study highlights the need for future research on social behavior and its role in CWD transmission within white-tailed deer populations.

Ensemble machine learning models for sperm quality evaluation concerning success rate of clinical pregnancy in assisted reproductive techniques

This study aimed to investigate the influence of various sperm quality characteristics, including morphology, motility, and count, on the success rates of clinical pregnancy achieved through assisted reproductive technologies (ART) such as in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and intrauterine insemination (IUI). The secondary objective was to assess the impact of these sperm parameters on the clinical pregnancy rate that resulted in the detection of a fetal heartbeat during the 11th week of gestation, a crucial milestone in successful ART-derived pregnancies. The researchers employed a retrospective analysis, evaluating data from 734 couples undergoing IVF/ICSI and 1197 couples undergoing IUI across two infertility centers. Exclusion criteria included cases involving donated eggs or sperm, surrogate uteri, and infertile couples with combined male and female factors. Five ensemble machine-learning models were utilized to predict the clinical pregnancy success rates. The Random Forest (RF) model achieved the highest mean accuracy (0.72) and area under the curve (AUC) (0.80), outperforming the other models for both IVF/ICSI and IUI procedures. The Shapley Additive Explanations (SHAP) value analysis revealed that for IUI cycles, all three sperm parameters (morphology, motility, and count) had significant negative impacts on the prediction of clinical pregnancy success. In contrast, for IVF/ICSI cycles, sperm motility had a positive effect, while sperm morphology and count were negative factors. In cycles with 1 to 5 retrieved eggs, sperm motility, and count, they positively affected the clinical pregnancy rate. The study also identified cut-off values for sperm count, with 54 and 35 being the respective thresholds for IVF/ICSI and IUI. Additionally, a significant cut-off point 30 was found for the sperm morphology parameter across all procedures. This study underscores the immense potential of leveraging ensemble machine learning models with traditional sperm quality assessments. This integrated approach can elevate the precision and personalization of clinical decision-making in the field of assisted reproductive technologies, ultimately offering more hope and better outcomes for couples struggling with infertility.

Depression and Functioning during the COVID-19 Pandemic among Adults across Tunisia.

We aimed to understand how risk (trauma history, health problems, financial problems, family problems) and protective (friend support, family support) factors influenced daily functioning (e.g., self-care, mobility, social participation) among Tunisian adults during the COVID-19 pandemic, directly and through their impact on depression, with a focus on gender differences. We recruited a representative sample of 2014 participants (1024 males, 990 females) using random digit dialing of mobile phone numbers across all 24 governorates in Tunisia. Females reported higher depression, greater impaired functioning, and a higher likelihood of having had COVID-19. Path analysis showed a good fit to the model when paths for males and females were allowed to vary, providing evidence for gender differences. Associations between trauma exposure and depression and depression and age with functioning were stronger among females. Social support from friends was a protective factor for males only. For males, all study variables were associated with functioning indirectly through their association with depression, except for support from friends. For females, family responsibilities and health problems had both direct and indirect effects, whereas other study variables were only linked with functioning through depression. Findings provide insights into factors that can be targeted in interventions aimed at reducing depression and improving daily functioning for males and females.

A Multi-site Examination of Relationship Violence Intervention Program Attrition for Male and Female Clients

The current study addresses the paucity of research on relationship violence intervention program (RVIP) attrition examining both male and female clients and risk factors for attrition across gender. Bivariate comparison tests and logistic regression were used to examine gender differences among participants from four RVIPs in Maryland that serve both male and female clients ( n = 1,307). Findings showed significant bivariate differences by gender for 14 of the factors examined. Less than half of clients (48%) completed RVIP, and women were significantly more likely to complete than men. A greater number of factors predicted attrition for male clients, but unemployment was the strongest predictor of attrition for both men and women. Implications for integrating gender-responsive practices into RVIP are discussed.