Men Seeking Fertility Treatment Research Articles

A retrospective study investigating semen parameter profiles among male patients attending a fertility center in the UAE: Insights from a nationality perspective

ObjectivesThe current study assessed the epidemiological trends of semen phenotypes and their association with ethnicity among men seeking fertility treatment in the United Arab Emirates (UAE). MethodsThis retrospective study assessed the anthropometric information including age, body mass index (BMI), and nationality, along with semen parameters of men who visited a Fertility Center in Abu Dhabi, UAE between January 2011 and July 2022. To understand the epidemiological trend of semen parameters amongst UAE nationals, propensity score analysis and logistic regression were performed. Thus, the exposure variable of interest is ethnicity, categorized into UAE nationals (Emirati) and Others (minus UAE; Global). Statistical analysis was performed using SPSS, R packages and STATA. ResultsIn this study, 32,664 samples were collected from 19,482 patients from 113 countries worldwide over a period of 11 years. Most participants made multiple visits, with around 40% attending at least once. Following covariates adjustment, logistic regression indicated a non-significant increase (4%) in the prevalence of asthenozoospermia among the UAE population compared to Global. Further modeling adjusted for propensity score and Emirati status suggested that Emiratis were 13% less likely to have lower total sperm count (TSC) compared to Global (p<0.001). Whereas approximately 58% of UAE nationals' samples exhibited teratozoospermia compared to 56% in other nationalities. After adjusting for confounders, analysis revealed a significantly higher prevalence (12%) of teratozoospermia among Emiratis compared to other nationals. ConclusionSamples from UAE nationals displayed reduced sperm motility and normal morphology but increased TSC. While the underlying cause of these observed phenotypes was not investigated, it is worth noting that all the men including those from other nationalities resided in the UAE and were subjected to the same climate. Thus, other factors, such as ethnicity, may have primarily influenced the differences observed in these parameters, with genetic makeup also potentially contributing to these outcomes.

Role of Platelet-Rich Plasma in the Management of Non-obstructive Azoospermia.

Non-obstructive azoospermia (NOA) is a common cause of infertility in males, which is characterized by the absence of sperm in the ejaculate, resulting from impaired spermatogenesis. The primary therapeutic approaches for the management of NOA include testicular sperm extraction, varicocelectomy in case of clinical varicoceles, and hormonal manipulation. While traditional treatments are found to have a limited role in the management of NOA, recent studies have explored the potential of platelet-rich plasma (PRP) as a safer and promising therapeutic option. Autologous PRP preparations are derived from the patient's blood and comprise growth factors and cytokines, promoting tissue repair and regeneration. PRP has a wide range of applications in the medical field, including managing infertility in males and females. This literature review aimed to evaluate the existing evidence on the efficacy and safety of PRP in the management of NOA. After a thorough review of relevant data from observational and experimental studies, the findings of this study suggested that PRP may positively influence spermatogenesis, sperm quality, DNA integrity, and sperm retrieval during assisted reproductive procedures. Further research is needed to establish the optimal PRP preparation, administration method, and long-term benefits. The newer studies shall include a diverse patient population and employ long-term follow-up to assess the durability of any positive effects of PRP treatment. The growing body of evidence regarding the therapeutic potential for NOA in humans offers greater opportunities for men seeking fertility treatment, informing clinical practice, and optimizing the use of PRP.

P-721 Exploring the impact of geographical variation: A retrospective study examining semen phenotypes within a cohort of 19,612 men attending a fertility center in the UAE

Abstract Study question What are the epidemiological trends of semen phenotypes and their association with geographic regions among men seeking fertility treatment in the UAE? Summary answer Following covariate adjustment, UAE Nationals attending a fertility center displayed lower incidence of oligozoospermia and higher prevalence of asthenozoospermia and teratozoospermia compared to other nationalities. What is known already Conventional semen analysis remains the gold standard for diagnosing and managing male infertility. It is well documented that semen is heterogenous and can be influenced by diverse factors, including but not limited to race, ethnicity, sociocultural background, seasonality, and geographical region. Although higher infertility prevalence has been reported in regions like North Africa and the Middle East, existing estimates rely largely on data from female partners of infertile couples and studies dating back to 1988. This underscores a significant data paucity in the Middle East. Study design, size, duration In this retrospective study, the anthropometric data (age, weight, height, body mass index, nationality) and semen parameters (semen volume, semen pH, sperm concentration, total sperm count (TSC), total motility (TM), progressive motility (PM), normal morphology, viability) of 19,612 men (32,664 samples) who attended a fertility center in the UAE between 2011 and 2022 were assessed. Ethical approvals for this study were obtained from appropriate bodies (REC/2022/P27 and MBRU IRB-2021-12). Participants/materials, setting, methods Data from patients were categorized into different geographical regions (Sub-Saharan Africa, North Africa, North America, Central America, South America, Asia, Europe, Middle East, and Oceania) based on nationality. Patients were further grouped as MENA (Middle East and North Africa) and non-MENA, while data from UAE Nationals (UAE) were also compared to Other Nationalities (Global). Unadjusted analysis was performed using SPSS. While covariate adjustment and propensity score analyses were performed using R package and STATA. Main results and the role of chance All semen parameters, remained within normal WHO reference values when stratifying according to geographical regions, MENA and Non-MENA as well as UAE and Global. Interestingly, MENA displayed a significant reduction in semen volume (p &amp;lt; 0.0001) and sperm concentration (p = 0.017), and an increase in PM (p &amp;lt; 0.00001). Similarly, PM was higher in UAE versus Global. To address skewed data distribution between UAE and Global, we employed propensity score analysis and logistic regression models, with semen parameters categorized according to WHO lower reference limits. Following covariate adjustment, all models demonstrated no significant difference in PM and TM between the two subgroups. However, logistic regression indicated a non-significant increase (4%) in the prevalence of asthenozoospermia in UAE compared to Global. Categorical analysis indicated that the Global samples had significantly lower TSC compared to the UAE group (24.6% vs. 26.3%, p&amp;lt;.001). Modelling adjusted for propensity score and UAE Nationality further suggested that UAE were 13% less likely to have lower TSC compared to Global (p&amp;lt;.001). About 58% of UAE samples exhibited teratozoospermia, while it was 56% for Global. After adjusting for confounders, analysis revealed a significantly higher prevalence (12%) of teratozoospermia among UAE compared to Global, with a potential range of 9%-16% in the long term. Limitations, reasons for caution A limitation of the current study is data distribution skewness. Of the 32,664 samples from 19,612 patients (113 countries), 21,649 samples are from UAE Nationals. However, logistic regression, propensity score adjustment accounting for Nationality, propensity score matching (1:2 ratio), and inverse probability weighting were applied to mitigate this bias. Wider implications of the findings Paucity of data on male fertility in the UAE and MENA region does not allow for accurate estimation of male infertility. Owed to its sample size and statistical robustness, this study provides evidence addressing this gap, offering insights into interpretation of global data on reproductive health. Trial registration number not applicable

P-031 Viral crossroads: revisiting sperm processing in the context of Human Immunodeficiency Virus (HIV) infection

Abstract Study question Is extensive sperm washing, followed by viral load testing, necessary to ensure safety of assisted reproductive techniques in HIV-positive men? Summary answer In context of viral suppression, there is no added value of extensive sperm washing followed by viral load testing for HIV-positive men seeking fertility treatment. What is known already Sperm washing was initially introduced as a safe reproductive strategy for serodiscordant couples in which the male partner is seropositive. This technique uses a combination of density gradient centrifugation (DGC) and swim-up (SU) to separate the HIV-free spermatozoa from the seminal plasma containing most of the viral particles. Nowadays, due to the increased availability and efficacy of antiretroviral drugs, more patients are adequately suppressed and have no risk of transmitting HIV, which is reinforced by the ‘Undetectable Equals Untransmittable’ principle. This questions the need for extensive sperm washing followed by quantitative polymerase chain reaction (qPCR) testing in the IVF laboratory. Study design, size, duration This single center retrospective study investigates the effectiveness of our existing sperm washing procedures by evaluating the HIV viral load (VL) both in the raw and processed semen fractions, while considering the patient’s viral suppression status. All sperm wash procedures performed on fresh ejaculates between 2012 and 2023 were included. Additionally, clinical outcomes of the subsequent intracytoplasmic sperm injection (ICSI)-cycles were collected. Participants/materials, setting, methods Type 1 (wash-DGC-SU), type 2 (wash-DGC) or type 3 (double wash) sperm processing was executed based on the concentration and motility of the raw sample. The processed fraction was cryopreserved, and the VL was determined in both the raw and processed semen fraction using qPCR. A semen VL below 20 copies/mL was considered negative. Only processed fractions with a negative VL were suitable for further therapeutic use. Threshold for viral suppression was 50 copies/mL. Main results and the role of chance A number of 82 sperm processing procedures were performed for 68 seropositive men, with a mean age at donation of 41.9 ± 7.0 years. All patients were confirmed to be HIV-1 positive, with the exception of one individual presenting a co-infection with both HIV-1 and HIV-2. Incidences for type 1, type 2 and type 3 processing were 23.2%, 62.2% and 14.6%, with mean initial concentration of 91.3(±63.6), 42.1(±47.9) and 0.12(±0.15) million/mL, and mean progressive motility of 54(±12.7)%, 33(±16.8)% and 4(±3.6)% in the respective groups. In 91.5% (n = 75/82) of cases, the patient was suppressed at the time of sperm processing. In case of viral suppression, only one raw sample (n = 1/75, 1.3%) tested positive for HIV (94 copies/mL), likely due to the phenomenon of “viral shedding”. After processing, none of the fractions contained a residual VL. Post-thaw progressive motile sperm survival rate was on average 0.40 ± 0.26. Overall, 61 couples underwent a total of 120 ICSI-cycles, resulting in cumulative clinical pregnancy and cumulative live birth rates per couple of 57.4% (n = 35/61) and 42.6% (n = 26/61), respectively. Limitations, reasons for caution Given that HIV-positive individuals represent a minority within our patient population, the limited prevalence of sperm wash procedures performed over the past decade has led to a relatively small sample size for this study. Wider implications of the findings These findings have the potential to shape future guidelines concerning the use of sperm samples from HIV-positive men. This may optimize the efficiency of sperm processing protocols, while maintaining both the safety and efficacy of assisted reproductive techniques for this specific patient population. Trial registration number Not applicable

Associations between Sperm Epigenetic Age and Semen Parameters: An Evaluation of Clinical and Non-Clinical Cohorts.

The well-documented relationship between chronological age and the sperm methylome has allowed for the construction of epigenetic clocks that estimate the biological age of sperm based on DNA methylation, which we previously termed sperm epigenetic age (SEA). Our lab demonstrated that SEA is positively associated with the time taken to achieve pregnancy; however, its relationship with semen parameters is unknown. A total of 379 men from the Longitudinal Investigation of Fertility and Environment (LIFE) study, a non-clinical cohort, and 192 men seeking fertility treatment from the Sperm Environmental Epigenetics and Development Study (SEEDS) were included in the study. Semen analyses were conducted for both cohorts, and SEA was previously generated using a machine learning algorithm and DNA methylation array data. Association analyses were conducted via multivariable linear regression models adjusting for BMI and smoking status. We found that SEA was not associated with standard semen characteristics in SEEDS and LIFE cohorts. However, SEA was significantly associated with higher sperm head length and perimeter, the presence of pyriform and tapered sperm, and lower sperm elongation factor in the LIFE study (p < 0.05). Based on our results, SEA is mostly associated with defects in sperm head morphological factors that are less commonly evaluated during male infertility assessments. SEA shows promise to be an independent biomarker of sperm quality to assess male fecundity.

One size does not fit all: variations by ethnicity in demographic characteristics of men seeking fertility treatment across North America

To compare racial differences in male fertility history and treatment. Retrospective review of prospectively collected data. North American reproductive urology centers. Males undergoing urologist fertility evaluation. None. Demographic and reproductive Andrology Research Consortium data. The racial breakdown of 6,462 men was: 51% White, 20% Asian/Indo-Canadian/Indo-American, 6% Black, 1% Indian/Native, <1% Native Hawaiian/Other Pacific Islander, and 21% "Other". White males sought evaluation sooner (3.5 ± 4.7 vs. 3.8±4.2 years), had older partners (33.3 ± 4.9 vs. 32.9 ± 5.2 years), and more had undergone vasectomy (8.4% vs. 2.9%) vs. all other races. Black males were older (38.0 ± 8.1 vs. 36.5 ± 7.4 years), sought fertility evaluation later (4.8 ± 5.1 vs. 3.6 ± 4.4 years), fewer had undergone vasectomy (3.3% vs. 5.9%), and fewer had partners who underwent intrauterine insemination (8.2% vs. 12.6%) compared with all other races. Asian/Indo-Canadian/Indo-American patients were younger (36.1 ± 7.2 vs. 36.7 ± 7.6 years), fewer had undergone vasectomy (1.2% vs. 6.9%), and more had partners who underwent intrauterine insemination (14.2% vs. 11.9%). Indian/Native males sought evaluation later (5.1 ± 6.8 vs. 3.6 ± 4.4 years) and more had undergone vasectomy (13.4% vs. 5.7%). Racial differences exist for males undergoing fertility evaluation by a reproductive urologist. Better understanding of these differences in history in conjunction with societal and biologic factors can guide personalized care, as well as help to better understand and address disparities in access to fertility evaluation and treatment.

Sperm mitochondrial DNA biomarkers and couple fecundity.

Do sperm mitochondrial DNA measures predict probability of pregnancy among couples in the general population? Those with high sperm mitochondrial DNA copy number (mtDNAcn) had as much as 50% lower odds of cycle-specific pregnancy, and 18% lower probability of pregnancy within 12 months. Semen parameters have been found to poorly predict reproductive success yet are the most prevalent diagnostic tool for male infertility. Increased sperm mtDNAcn and mitochondrial DNA deletions (mtDNAdel) have been associated with decreased semen quality and lower odds of fertilization in men seeking fertility treatment. A population-based prospective cohort study of couples discontinuing contraception to become pregnant recruited from 16 US counties from 2005 to 2009 followed for up to 16 months. Sperm mtDNAcn and mtDNAdel from 384 semen samples were assessed via triplex probe-based quantitative PCR. Probability of pregnancy within 1 year was compared by mitochondrial DNA, and discrete-time proportional hazards models were used to evaluate the relations with time-to-pregnancy (TTP) with adjustment for covariates. Higher sperm mtDNAcn was associated with lower pregnancy probability within 12 months and longer TTP. In unadjusted comparisons by quartile (Q), those in Q4 had a pregnancy probability of 63.5% (95% CI: 53.1% to 73.1%) compared to 82.3% (95% CI: 73.2% to 89.9%) for Q1 (P = 0.002). Similar results were observed in survival analyses adjusting for covariates to estimate fecundability odds ratios (FORs) comparing mtDNAcn in quartiles. Relative to those in Q1 of mtDNAcn, FORs (95% CI) were for Q2 of 0.78 (0.52 to 1.16), Q3 of 0.65 (0.44 to 0.96) and Q4 of 0.55 (0.37 to 0.81), and this trend of decreasing fecundability with increasing mtDNAcn quartile was statistically significant (FOR per log mtDNAcn = 0.37; P < 0.001). Sperm mtDNAdel was not associated with TTP. This prospective cohort study consisted primarily of Caucasian men and women and thus large diverse cohorts are necessary to confirm the associations between sperm mtDNAcn and couple pregnancy success in other races/ethnicities. Our results demonstrate that sperm mtDNAcn has utility as a biomarker of male reproductive health and probability of pregnancy success in the general population. This work was funded in part by the National Institute of Environmental Health Sciences, National Institutes of Health (R01-ES028298; PI: J.R.P.) and the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland (Contracts N01-HD-3-3355, N01-HD-3-3356 and N01-HD-3-3358). The authors declare no competing interests. N/A.

Regret over the delay in childbearing decision negatively associates with life satisfaction among Japanese women and men seeking fertility treatment: a cross-sectional study

BackgroundCurrently, in developed countries, increasing numbers of women and men are delaying childbearing but begin seeking fertility treatment later in life. Some women undergoing infertility treatment develop negative feelings such as depression associated with low life satisfaction and regret over the delay in childbearing. We therefore examine the association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors among Japanese women and men seeking fertility treatment.MethodsThis cross-sectional study included 253 women and 196 men referred to fertility facilities in Japan from July to December 2018. Participants completed a questionnaire on life satisfaction, regret over the delay in childbearing decision, infertility-related factors and sociodemographic characteristics. Life satisfaction was measured using the Satisfaction with Life Scale (SWLS), and the degree of regret over delay in childbearing decision was measured on a 7-point Likert scale. Multiple linear regressions, conducted separately by sex, were used to analyze the association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors.ResultsOf the 253 women and 196 men, 102 (40.3%) women and 43 (21.9%) men answered “strongly agree” regarding their regret over the delay in childbearing decision. Among women, life satisfaction was negatively associated with regret (β = − 0.155, 95% CI [− 0.938, − 0.093], p = 0.017), use of assisted reproduction technology (ART) (β = − 0.135, 95% CI [− 2.977, − 0.020], p = 0.047). In contrast, previous live birth was positively associated with life satisfaction (β = 0.134, 95% CI [0.122, 3.739], p = 0.037). In men, we found no significant association of life satisfaction with regret over the delay in childbearing decision and infertility-related factors.ConclusionsRegret over the delay in childbearing decision is negatively associated with life satisfaction among Japanese women seeking fertility treatment. It may be important for women to make better informed decision regarding the timing of childbearing to not regret later in life. Health professionals should address regret over the delay in childbearing decision during fertility treatment and explore ways to spread information on fertility awareness.

Efficacy of Antioxidant Supplementation on Conventional and Advanced Sperm Function Tests in Patients with Idiopathic Male Infertility.

Antioxidants are used in the empirical treatment of infertile men. The aim of this study was to evaluate the effects of antioxidant therapy on conventional semen parameters and advanced sperm function tests in men seeking fertility treatment. A total of 148 infertile men of unknown etiology were divided into idiopathic (n = 119) and unexplained male infertility (UMI; n = 29). All participants were treated with the antioxidant supplement ‘FH PRO for Men’ for a period of three months. Compared with pretreatment results, there was a significant improvement in conventional semen parameters including sperm concentration, total and progressive motility and normal morphology, and seminal oxidation reduction potential (ORP), and sperm DNA fragmentation (SDF) in idiopathic infertile men. The changes were more prominent in idiopathic infertile men positive for ORP and SDF. UMI patients showed an improvement in progressive motility, ORP, and SDF after antioxidant treatment. Statistical analysis revealed that the efficacy of FH PRO for Men was significant in idiopathic male infertility compared with UMI. Treatment of idiopathic male infertility patients with the FH PRO for Men antioxidant regimen for three months resulted in a significant improvement in conventional semen parameters and sperm function. Therefore, FH PRO for Men offers promise for the medical treatment of idiopathic male infertility.

Testosterone replacement therapy in men who conceived with intracytoplasmic sperm injection: nationwide register study.

ObjectivesMale hypogonadism is associated with higher risk of co-morbidity and premature mortality. It is, therefore, of utmost importance to identify young men who are at the highest risk of testosterone deficiency and who may benefit from preventive measures. In this context, infertile men constitute a high-risk group. The extent of testosterone replacement therapy (TRT) among infertile men, defined as men who have to undergo assisted reproduction for fatherhood, is currently unknown. Therefore, we evaluated the pattern of prescription of TRT in the years following child conception among men who have fathered children with the help of intracytoplasmic sperm injection (ICSI) or in vitro fertilization (IVF).DesignBy sourcing data from national population registries, hazard ratio (HR) for subsequent TRT was assessed for IVF and ICSI-treated men and compared to those who conceived spontaneously with age Cox regression analysis adjusted for age, educational level and previous intake of medicines for metabolic diseases.ResultsICSI and IVF fathers had increased incidence of newly prescribed TRT compared to fathers conceiving spontaneously (ICSI: HR = 3.81, 95% CI = 3.09–4.69, P < 0.001; IVF: HR = 1.54, 95% CI = 1.15–2.05, P = 0.003). After adjustment for prescription of medication for one or more components of the MetS prior to TRT, the risk estimates attenuated but remained robust both for ICSI-treated (HR = 3.17 (95% CI: 2.56–3.9) and IVF-treated men (HR = 1.06 (95% CI: 1.05–1.07).ConclusionMen who have to utilise powerful techniques, such as ICSI for fathering children, may be at risk for testosterone deficiency. Routine endocrine evaluation of men seeking fertility treatment is hence warranted.

Air pollution and semen parameters in men seeking fertility treatment for the first time.

The purpose of this paper was to analyze the relationship between the selected chemical air pollutants found in the Lublin Province and the semen parameters of men seeking fertility treatment for the first time. The study involved an analysis of semen sample test results obtained from male patients first reporting for fertility treatment in reproductive health centers in the Lublin Province, Poland. The data set comprises semen parameters of 13 148 men, and the number of samples in the reference period was 255-769 annually. Data on air pollution were obtained from the website of the Polish General Environmental Inspectorate and included selected chemical air pollutant levels, i.e., NO2, SO2, O3, and PM10. The mean PM10 levels in the air increased, on average, by 0.65 μg/m3 annually in 2000-2015 (p = 0.029); the mean levels of O3, NO2, SO2 did not change significantly in the analyzed period. There were increasing trends in the mean sperm density and total sperm count of the subjects in 1992-2015 (p < 0.001). The mean percentage of sperm with normal morphology significantly decreased in the subsequent analysis periods: 1992-1998 (p = 0.001); 1999-2009 (p < 0.001); 2010-2015 (p = 0.001). A significant negative correlation was found between the ozone levels in the air in the Lublin Province and the percentage of sperm with normal morphology (r = -0.8311, p = 0.040). Exposure to ozone in the air contributes to decreased percentages of sperm with normal sperm morphology. Over the years, there was an increasing trend in sperm density in the men first reporting for fertility treatment, and a decreasing trend in the percentage of sperm with normal morphology. Int J Occup Med Environ Health. 2019;32(3):387-99.

The fertility quality of life and sexual dysfunction in men seeking fertility treatment

The fertility quality of life and sexual dysfunction in men seeking fertility treatment

045 The Fertility quality of life and Sexual dysfunction in men seeking fertility treatment

To investigate the fertility quality of life (FertiQoL) and the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men. In a cross-sectional study, a total of 351 men seeking fertility treatment completed a questionnaire about sexual experiences and quality of life. ED was evaluated through the simplified International Index of Erectile Function (IIEF-5), ejaculation status was determined by the PE diagnostic tool (PEDT), and the quality of life was measured using the FertiQoL tool. Reliability analyses for the FertiQoL tool demonstrate a sufficiently strong fit (Cronbach’s alpha=0.891). Social and relational domains of FertiQoL were lower in infertile men compared with that reported in other countries. ED and PE were found in 125 (35.6%) and 90 (25.6%) subjects respectively. The emotional, mind/body, relational and social domain scores of FertiQoL were positively associated with the IIEF-5 score whereas the scores were negatively associated with the PEDT score. In a logistic multivariate model, emotional, relational and social domains were significantly associated with ED, while only the emotional domain was related to PE. Furthermore, our data suggested that overweight, extended family, smoking, male factor infertility and primary infertility are risk factors for ED and PE, while the duration of infertility only affect erectile function. However, the education level, family income and the treatment of infertility had no significant effect on sexual experience.

Attachment and sexual functioning in women and men seeking fertility treatment

Objective: The purpose of the study was to examine the frequency of sexual difficulties and the associations among attachment insecurities (anxiety, avoidance) and sexual functioning (problems with sexual function, sexual dissatisfaction) in women and couples seeking fertility treatment.Methods: In a cross-sectional study, 88 Canadian women and 45 couples receiving fertility treatments completed self-reported measures of adult attachment and sexual functioning.Results: The frequency of problems in sexual function varied from 14.8% (pain) to 58.0% (desire) in women and from 6.7% (satisfaction with orgasm) to 28.9% (desire) in men. Among women, attachment-related avoidance predicted their low levels of sexual satisfaction (β = −0.30, p = .007) and sexual pain (β = 0.22, p = .044). Dyadic analyses revealed associations between men’s attachment-related anxiety and their difficulties in reaching erection (β = 0.30, p = .042) and orgasm (β = 0.33, p = .009). Anxiety in women was related to their lubrication difficulties (β = 0.44, p = .006). One partner effect was found: men’s avoidance was related to their partners’ difficulty in achieving orgasms (β = 0.39, p = .045).Conclusions: Results support the pertinence of attachment theory and the relevance of using dyadic designs to understand sexuality in couples seeking fertility treatment.

S&T-09 THE FERTILITY QUALITY OF LIFE AND SEXUAL DYSFUNCTION IN MEN SEEKING FERTILITY TREATMENT

You have accessJournal of UrologyScience & Technology Posters1 Apr 2016S&T-09 THE FERTILITY QUALITY OF LIFE AND SEXUAL DYSFUNCTION IN MEN SEEKING FERTILITY TREATMENT Zhe Zhang, Hui Jiang, Yuzhuo Yang, Hongliang Zhang, Haocheng Lin, Lianming Zhao, Wenhao Tang, Defeng Liu, Jiaming Mao, and Kai Hong Zhe ZhangZhe Zhang More articles by this author , Hui JiangHui Jiang More articles by this author , Yuzhuo YangYuzhuo Yang More articles by this author , Hongliang ZhangHongliang Zhang More articles by this author , Haocheng LinHaocheng Lin More articles by this author , Lianming ZhaoLianming Zhao More articles by this author , Wenhao TangWenhao Tang More articles by this author , Defeng LiuDefeng Liu More articles by this author , Jiaming MaoJiaming Mao More articles by this author , and Kai HongKai Hong More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2838AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Infertility has been reported to have a negative effects on sexual function, especially in men. With the rapid increase in the number of men seeking fertility treatment, there is urgent to better understand the interrelationship between the fertility quality of life and sexual function. The aim of this study was to investigate the fertility quality of life (FertiQoL) and the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men. METHODS In a cross-sectional study, a total of 351 men seeking fertility treatment completed a questionnaire about sexual experiences and quality of life. ED was evaluated through the International Index of Erectile Function-15 (IIEF-5), ejaculation status was determined by the PE diagnostic tool (PEDT), and the quality of life was measured using the FertiQoL tool. RESULTS Reliability analyses for the FertiQoL tool demonstrate sufficiently strong fit (Cronbach’s alpha=0.891). Social and relational domains of FertiQoL were lower in infertile men compared that reported in other countries. ED was found in 125 (35.6%) and PE in 90 (25.6%) subjects. The emotional, mind/body, relational and social domain scores of FertiQoL were positively associated with IIEF-5 score whereas scores were negatively associated with PEDT score. In a logistic multivariate model, emotion, relational and social domains were significantly associated with ED, while only emotion domain was related to PE. Furthermore, our data suggested that overweight, family type (extended family), smoking, infertility reason (male factor infertility) and infertility type (primary infertility) are risk factors for ED and PE, and duration of infertility also affect erectile function. The education level, family income and the treatment of infertility had no significant effect on sexual experience. CONCLUSIONS ED and PE are prevalent among infertile men, who also have poor FertiQoL related to social and relationships, and the emotional, mind/body, relational and social domains of FertiQoL may be associated with sexual dysfunction in infertile men. The quality of life markedly affects sexual function during fertility treatment and should be taken into adequate account and addressed as an important element of infertility health care. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e311 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Zhe Zhang More articles by this author Hui Jiang More articles by this author Yuzhuo Yang More articles by this author Hongliang Zhang More articles by this author Haocheng Lin More articles by this author Lianming Zhao More articles by this author Wenhao Tang More articles by this author Defeng Liu More articles by this author Jiaming Mao More articles by this author Kai Hong More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Testicular lactate content is compromised in men with Klinefelter Syndrome

Klinefelter syndrome (KS) is the most common genetic cause of human infertility, but the mechanism(s) responsible for its phenotype remain largely unknown. KS is associated with alterations in body composition and with a higher risk of developing metabolic diseases. We therefore hypothesized that KS men seeking fertility treatment possess an altered testicular metabolism profile that may hamper the nutritional support of spermatogenesis. Testicular biopsies from control (46, XY) (n = 6) and KS (47, XXY) (n = 6) individuals were collected and analyzed by proton high-resolution magic-angle spinning nuclear magnetic resonance spectroscopy. The mRNA and protein expression of crucial glycolysis-associated enzymes and transporters were evaluated in parallel by quantitative PCR and Western blot, respectively. Our data revealed altered regulation of glucose transporters (GLUT1 and GLUT3); phosphofructokinase 1, liver isoform (PFKL); and lactate dehydrogenase A (LDHA) expression in the testis of KS patients. Moreover, we detected a severe reduction in lactate and creatine accumulation within testicular tissue from KS men. The aberrant levels of the biomarkers detected in testicular biopsies of KS men may therefore be associated with the infertility phenotypes presented by these men. Mol. Reprod. Dev. 83: 208-216, 2016. © 2015 Wiley Periodicals, Inc.

Changes in the semen quality among 5739 men seeking infertility treatment in Northern Norway over past 20 years (1993–2012)

Semen quality plays a pivotal role in sustaining the fertility rate and healthy population growth. Therefore, assessment of temporal trends in the semen quality provides valuable public health information. We analyzed the semen quality parameters of 5739 North Norwegian men among consecutive couples attending the fertility clinic of University Hospital of North Norway for investigation and/or treatment from 1993 to 2012. The seminal fluid volume, sperm concentration, and total sperm count were found to have gradually decreased during the past 20 years. The proportion of hypospermic, azoospermic, and oligozoospermic men had increased by 24.6% ( p &lt; 0.001), 109.5% ( p &lt; 0.001), and 9.5% ( p = 0.05), respectively, in the last decade (2003–2012) compared to the first decade (1993–2002). The parameters of semen quality are rapidly deteriorating in North Norwegian men seeking fertility treatment.

Metabolic fingerprints in testicular biopsies from type 1 diabetic patients.

Diabetes mellitus (DM) is a metabolic disease that has grown to pandemic proportions. Recent reports have highlighted the effect of DM on male reproductive function. Here, we hypothesize that testicular metabolism is altered in type 1 diabetic (T1D) men seeking fertility treatment. We propose to determine some metabolic fingerprints in testicular biopsies of diabetic patients. For that, testicular tissue from five normal and five type 1 diabetic men was analyzed by high-resolution magic-angle spinning (HR-MAS) nuclear magnetic resonance (NMR) spectroscopy. mRNA and protein expression of glucose transporters and glycolysis-related enzymes were also evaluated. Our results show that testes from diabetic men presented decreased levels of lactate, alanine, citrate and creatine. The mRNA levels of glucose transporter1 (GLUT1) and phosphofructokinase1 (PFK1) were decreased in testes from diabetic men but only GLUT3 presented decreased mRNA and protein levels. Lactate dehydrogenase (LDH) and glutamate pyruvate transaminase (GPT) protein levels were also found to be decreased in testes from diabetic men. Overall, our results show that T1D alters glycolysis-related transporters and enzymes, compromising lactate content in the testes. Moreover, testicular creatine content was severely depressed in T1D men. Since lactate and creatine are essential for germ cells development and support, the data discussed here open new insights into the molecular mechanism by which DM promotes subfertility/infertility in human males.

Penile vibratory stimulation in spinal cord injured men: Optimized vibration parameters and prognostic factors

Objective: To study the efficacy of penile vibratory stimulation (PVS) with optimized vibration parameters in spinal cord injured (SCI) men and to examine prognostic factors for success. Design: Case series. Setting: University hospital outpatient clinic. Patients: Thirty-four consecutive SCI men seeking fertility treatment. Intervention: PVS with optimized vibration parameters to induce reflex ejaculation. Main Outcome Measures: Ejaculatory response; semen analysis. Results: Antegrade ejaculation was seen in 65% of patients. High rates were seen in lesions above T10 (81%) and in presence of hip flexion and bulbocavernosus reflexes (77%). Of men with lesions above T10, those with a penile prosthesis had lower ejaculation rates (40% vs 90%). Average total sperm counts were 968 million, with 26% motility. Conclusions: High rates of ejaculation are seen with optimized vibration parameters, especially in men with lesions above T10 and intact lower spinal reflexes. A penile prosthesis may impair success with PVS.