Reasons For Male Infertility Research Articles

Proteomic approach towards identification of seminal fluid biomarkers from individuals with severe oligozoospermia, cryptozoospermia and non-obstructive azoospermia: a pilot study.

Infertility becomes a global problem that affects to the same extent females and males. As reasons of male infertility can differ among individuals, the accurate diagnostics is essential for effective treatment. The most problematic both in diagnostics and in treatment are disturbances of spermatogenesis. Seminal fluid is rich in proteins that potentially can serve as markers for male infertility and among them, markers of spermatogenesis which are highly desired. To find biomarkers of spermatogenesis, we applied comparative proteomics using nano ultra performance liquid chromatography and tandem mass spectrometry (nanoUPLC-MS/MS) followed by single-sample Western blotting (WB) using seminal fluid samples from males with different types of infertility including non-obstructive azoospermia (NOA), cryptozoospermia (C) and severe oligozoospermia (SO). Then, the extensive survey on the identified proteins and their function in male reproductive system has been done. The proteomic approach has enabled to identified five seminal fluid proteins being potential markers of spermatogenesis disorders: ADGRG2, RAB3B, LTF, SLC2A3 and spermine synthase (SMS). Among them ADGRG2 seems to be strongly involved in male infertility. In addition, WB indicated that the distribution of LTF, SLC2A3 and SMS was not coherent among the individuals, especially in a group with NOA. Functional annotation analysis and search in proteomics databases revealed that vast majority of the proteins originated from extracellular environment. The presented data point out several proteins that potentially can become biomarkers of male infertility. The data suggest, however, different mechanisms behind the male infertility indicating that the etiology is more complex. We assume that recognition of these mechanisms may lead to the creation of specific protein panel helpful in the management of male infertility and therefore, further studies are required.

A Case Report of Male infertility and Gynecomastia in High Altitude Area: Clinical Evaluation and Management

Gynecomastia is a common abnormality of breast tissue among men. It is the benign enlargement of male breast glandular tissue. In this report a narrative approach was followed for the qualitative inquiry of three men from the high altitude areas of Pakistan. They presented with gynecomastia and infertility. These men were approached for clinical examination, lab investigations, and further management. The semen findings of these patients showed oligospermia, azoospermia or necrospermia. Serum Prolactin was found to be high and they were overweight with increased breast development. The Serum Prolactin, FSH, LH levels, and Testosterone levels were measured in these patients with infertility. The laboratory investigations of our patients showed high prolactin and estrogen levels. All these men were reported stress due to erectile dysfunction and infertility. The reasons of male infertility in the high-altitude areas of Pakistan need to be explored further. Keywords: Male infertility, gynecomastia, high altitude

Electroacupuncture Effectiveness for Treating Idiopathic Male Infertility.

Male infertility accounts for ∼50% of all infertility cases. The reasons for male infertility may vary, and one of them is related to an idiopathic factor that may impair spermatogenesis. Acupuncture is one of the most well-known and widely accepted alternative treatments and is becoming known as an effective complementary therapy for infertility. The case in this article demonstrated the effectiveness of electroacupuncture (EA) for improving male fertility by referring to the total motile sperm count (TMSC), sperm morphology and motility, DNA Fragmentation Index (DFI) of the sperm before and after EA, and pregnancy success in a couple with male infertility. Couples are given therapy with EA twice per week for up to 12 sessions and planned intercourse during the fertile period (ovulation). After planned intercourse, the wife became pregnant; an intrauterine gestational sac (GS) was seen on transvaginal ultrasound and her human chorionic gonadotropin urine test was positive. The TMSC parameter, sperm morphology and sperm motility, post-EA DFI was improved, compared to pre-EA. The couple was became pregnant after undergoing EA 12 times to treat male infertility. This case illustrated that EA therapy for idiopathic male infertility has an effect toward improvement of the spermiogram test result, DFI, and success in achieving a pregnancy. However, further research is needed because there are many patients with different causes for their infertility.

A Case Report of Male infertility and Gynecomastia in High Altitude Area: Clinical Evaluation and Management

Gynecomastia is a common abnormality of breast tissue among men. It is the benign enlargement of male breast glandular tissue. In this report a narrative approach was followed for the qualitative inquiry of three men from the high altitude areas of Pakistan. They presented with gynecomastia and infertility. These men were approached for clinical examination, lab investigations, and further management. The semen findings of these patients showed oligospermia, azoospermia or necrospermia. Serum Prolactin was found to be high and they were overweight with increased breast development. The Serum Prolactin, FSH, LH levels, and Testosterone levels were measured in these patients with infertility. The laboratory investigations of our patients showed high prolactin and estrogen levels. All these men were reported stress due to erectile dysfunction and infertility. The reasons of male infertility in the high-altitude areas of Pakistan need to be explored further. Keywords: Male infertility, gynecomastia, high altitude

Overview Of Current NGS Testing For Male Factor Infertility

Aim — Infertility is a global health problem. The next-generation sequencing and panel testing are offering new opportunities to further diagnose the reason for male infertility. The aim of this paper is to provide a better insight into the currently available panels for male infertility due to impaired spermatogenesis. Methods — We conducted research in the Genetic testing registry by using the keywords „infertility“, „male infertility“. We also gathered information about the number of tested genes, coverage of the panels, turnaround time, and any additional tests, which could be ordered. Results — As a result there were eleven laboratories, offering panel testing for male infertility, which tested for 230 different genes, but 65 genes (28.26%) from the different panels had an uncertain role for the tested condition. Cystic fibrosis transmembrane conductance regulator was the only gene, suggested by all laboratories. Conclusions — Next-generation sequencing could be extremely helpful in the diagnostic process of male infertility. However, clinicians should be aware that some of the included genes have an uncertain role for male infertility.

OPTIMIZATION OF FACS SORTING FOR THE IMPROVEMENT OF LIVESTOCK SEMEN QUALITY

Fluorescence-activated cell sorting (FACS) of spermatozoa was mainly used for sex sorting. Recently, FACS has been used to eliminate DNA-damaged human spermatozoa using YO-PRO-1 staining. Fragmentation of sperm DNA is considered as one of the reasons of male infertility. Moreover, YO-PRO-1 can effectively mark apoptotic as well as dead spermatozoa. Till now, only two FACS instruments were used for the spermatozoa sorting. However, both of them are not more commercially available from different reasons. In this study, we used novel FACSMelody Cell Sorter for the elimination of apoptotic and dead cells from the rabbit and ram semen samples in order to improve their overall quality. Briefly, semen samples were stained using YO-PRO-1 dye (apoptotic and dead cells) and/or propidium iodide (PI; only dead cells). Three different sorting experiments were performed: E1 – YO-PRO-1 and PI stained rabbit sperm cells were sorted into the tubes containing 1 ml of PBS; E2 – PI stained rabbit sperm cells were sorted into tubes that were washed with FBS prior adding PBS; and E3 – YO-PRO-1 and PI stained ram sperm cells were sorted into tubes washed with FBS prior adding PBS. As a sheath fluid sterile PBS was used. All samples, control (before sorting), negatively and positively sorted fractions, were analysed using CASA for motility assessment. Moreover, all sorted samples were re-stained with PI for viability assessment. In conclusion, elimination of dead (PI+) sperm from rabbit samples might improve their quality, since their progressive motility increased significantly (P<0.001) after sorting from 40 to 65%. However, ram spermatozoa seem to be sensitive to sorting procedure thus further optimisation of this procedure is required.

The IVS8(n)-T variant in the CFTR gene as a factor for male infertility

The CFTR gene is one of the new candidate genes, which are thought to be required for normal spermatogenesis. Different variants in this gene, for example IVS8-(n)T polymorphism, could be associated with its impaired functioning and could lead to male infertility. The aim of this study is to investigate whether this variant is found among Bulgarian patients with male infertility. We conducted molecular genetic testing of 25 men with sperm count below 5×10 6 /mL in order to search for the presence of the IVS8(n)-T variant in their CFTR genes. The derived sequences were analyzed and compared to the human reference genome. The median age of the participants with impaired spermatogenesis was 34.00 years. The median concentration of the sperm cells in the ejaculate was 0.30×10 6 / mL. After we conducted the molecular genetic analysis for variants in the CFTR gene, it was found that one participant (4.00%) was a homozygote for the 5Т/5Т variant, and another one (4.00%) was a heterozygote for the 5Т/7Т variant. As for the remaining participants, 20 men (80.00%) were homozygotes for the wild 7Т variant, two (8.00%) – heterozygotes for the 7Т/9Т variant, and one (4.00%) – a homozygote for the 9Т/9Т variant. This study established the presence of the 5Т variant in the CFTR gene among the participants with impaired fertility due to azoospermia or severe oligozoospermia. This finding supports the role of polymorphisms in the CFTR gene and in particular the 5Т variant as a reason for male infertility.

Correlation between urinary phthalate concentration and semen quality parameters

Objective To explore the correlation between urinary phthalate concentration and semen quality parameters. Methods A total of 112 males with infertility in our hospital were set as infertility group. Another 65 healthy males who had given birth during the same period in our hospital were selected as control group. The semen samples obtained by urine and masturbation were collected in all the subjects. The semen quality parameters were detected by automatic color sperm quality detection system, and the concentrations of dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP) and Di 2-Ethyl Hexyl Phthalate (DEHP) in urine were measured by high performance liquid chromatography, and the correlation between concentrations of four phthalates and semen quality parameters was analyzed by spearman correlation coefficient. Results The concentrations of DMP, DEP, DBP, DEHP and total phthalate in infertility group were significantly higher than those in control group (P<0.05). The sperm density, sperm survival rate and ratios of a+ b level sperm and forward movement in infertility group were significantly lower than those in control group (P<0.05), and the ratio of abnormal sperm was significantly higher than that in control group (P<0.05). The concentrations of DMP, DEP, DBP and DEHP in urine were negatively correlated with sperm density, sperm survival rate and ratios of a+ b level sperm and forward movement (P<0.05), and were positively correlated with abnormal sperm ratio (P<0.05). Conclusions The concentration of phthalate is high in urine of infertile males, and its concentration is negatively correlated with semen quality. Phthalate accumulation may be one of the important reasons for male infertility. Key words: Urinalysis; Phthalate; Semen analysis; Infertility, male

Y chromosome microdeletions as a cause for male infertility

Male infertility represents around half of all cases of infertility. The microdeletions of the azoospermia factor (AZF) region, located in the long arm of Y chromosome, are the second most common reason for reproductive problems among men. This genetic mutation results in low sperm count and fertility rate. The presence of Y microdeletions can lower the success rate of in vitro procedures and would be transmitted to the next generation. We have analyzed 30 articles about the connection between the deletions of the Y chromosome and the decreased sperm count. 25 of them confirm the role of this genetic mutation, while the rest do not, but they investigate only some AZF loci. The negative results could also be due to the different ethnic origin of the participants, difference between the research method and etc. Testing infertile men for Y chromosome deletions could lead to a major improvement in the options for treating infertility. Also, if such mutation is diagnosed, this is an indication for genetic counseling in order to avoid future fertility issues in the next generation. The review of the included articles proves the role of the Y chromosome microdeletions as a reason for male infertility and outlines the main principles when performing the genetic test for this mutation.

Bacterial vaginosis and the risk of early miscarriage in women undergoing intracytoplasmic sperm injection cycles: a prospective cohort study

This study aimed to assess the possible association of bacterial vaginosis (BV) and early miscarriage in 408 women undergoing intracytoplasmic sperm injection (ICSI) for reasons of male infertility. A vaginal sample was obtained before oocyte retrieval and evaluated for BV-associated bacteria using the Nugent scoring system. The primary outcome was early miscarriage and the secondary outcomes included implantation, pregnancy, late miscarriage, preterm delivery and live birth rates. Chi-square, ANOVA, relative risk and odds ratio were used for data analysis where appropriate. The prevalence of BV was estimated as 7.3%. From 336 patients who had embryo transfer, 138 patients (41.1%) conceived. A total of 17% (n = 23) of pregnant women miscarried during the first trimester: 15 patients (15%) were normal, 4 (17.4%) were intermediate and 4 (26.7%) patients had BV (p = 0.52). The relative risk of early miscarriage in BV patients compared to the non-BV and intermediate group was 1.77 (0.68–4.64, 95% CI). Implantation, pregnancy, preterm delivery and live birth rates were comparable between groups. We conclude that BV does not appear to have an adverse impact on outcomes in women being treated with ICSI for male factor infertility and is not associated with miscarriage and preterm birth.

Partial Deletions of Y-Chromosome in Infertile Men with Non-obstructive Azoospermia and Oligoasthenoteratozoospermia in a Turkish Population.

Many genetic alterations have been identified to aid in understanding the genetic basis of male infertility, however, the cause of 30% of male infertility remains unknown. Some studies indicated that subdeletions of Y chromosome may be a reason for male infertility caused by testicular failure. In this regard, we aimed to investigate frequency of AZFc region subdeletions and their clinical effects in patients with idiopathic infertility. A total of 333 male infertile patients with non-obstructive azoospermia (NOA) or oligoasthenoteratozoospermia (OAT), and 87 normozoospermic controls were screened to detect gr/gr, b1/b3 and b2/b3 subdeletions. We recorded higher gr/gr deletion frequency in normozoospermic controls compared NAO and OAT groups (p=0.026). There were no significant differences in b2/b3 subdeletion rates among groups (p=0.437). In the OAT group, follicle-stimulating hormone levels of cases with b2/b3 deletion were statistically lower than cases without b2/b3 deletion (p=0.047). No statistical correlations were indicated among subdeletions, sperm count and assisted reproductive technology (ART) outcomes. These data demonstrate that gr/gr and b2/b3 subdeletions may not play a significant role in the etiopathogenesis of male infertility and ART outcomes in the studied population.

The effects of gardnerella vaginalis on semen quality and quantity parameters for male

Objectives To explore the effects of Gardnerella vaginalis(Gv) infection on male semen quality and determine the possible reasons of male infertility. Methods 217 semen samples were collected and detected by nested PCR to confirm the G. vaginalis.The sperm analysis and the mixed agglutination reaction(MAR) were also tested. The relationships between the Gv infection and all kinds of the sperm parameters were analyzed. Results 17 cases were positive in PCR analysis(7.8%). No significant differences in sperm volume and sperm viscocity were observed between the Gv positive group and the Gv negative group (P>0.05). However, there was significant differences between the Gv positive group and the Gv negative group in the sperm concentration, pH value, motility, PR rate, morphology, the count of leukocytes and MAR (P<0.01). Conclusions G. vaginalis has an effect on sperm quality, which may be the possible reason of male infertility. The further study is needed to elucidate the problem. Key words: Semen; Bacterial Infections

Unusual Drainage of the Right Testicular Vein: A Case Report

Routine dissection was carried out on a 75-year-old male cadaver and the drainage pattern of the testicular veins was identified and photographed. Dissection showed that the right testicular vein demonstrated an abnormal drainage pattern by terminating into the right renal vein. The left testicular vein demonstrated a normal drainage pattern by terminating into the left renal vein. The unusual drainage of the right testicular vein into the right renal vein may complicate hemodynamics thus causing a varicocele. Complications of a varicocele could lead to testis atrophy and/or infertility. Knowing the anatomical variants of the testicular veins drainage pattern may help the surgeon avoid potential complications during routine laparoscopic procedures and may also uncover a reason for male infertility.

Focus Issue on Male Infertility

Male infertility problems can occur when sperms are limited in number or function. In this paper, we describe the clinical evaluation of male infertility. A detailed history, physical examination, and basic semen analysis are required. In addition, ultrasound, karyotyping, and hormonal studies are needed to determine specific causes of infertility. In addition, the World Health Organization (WHO, 2009) has developed a manual to provide guidance in performing a comprehensive semen analysis. Among the possible reasons for male infertility, nonobstructive azoospermia is the least treatable, because few or no mature sperm may be produced. In many cases, men with nonobstructive azoospermia typically have small-volume testes and elevated FSH. Although treatment may not completely restore the quality of semen from men with subnormal fertility, in some cases a successful pregnancy can still be achieved through assisted reproductive technology.

The long-term excessive alcohol consumption on sperm quality and the impact of germ cell apoptosis

Objective To investigate the long-term excessive drinking semen nitric oxide (NO) content in their sperm quality and spermatogenic cell apoptosis and infertility. Methods Nitrate reductase method was used to specific reduce the NO metabolites nitrate (NO3-) to nitrite (NO2-), which was used on behalf of the total NO level. Terminal deoxynucleotidyl transferase (TdT) and mediated nick end labeling (TUNEL) method and binocular optical microscope were used to detect and observe the rate of apoptosis of spermatogenic cells and the morphological structure. The SQA-V sperm quality automatic analyzer was used to measure sperm quality. Results In not drinking semen fertility group, NO content was (54.81±11.45)μmol / L, the rate of spermatogenic cell apoptosis was (4.52±1.23)%, sperm motility was (80.24±0.17)%, energy a+b (78.32±0.12)%, deformity rate (5.30±0.13)%, and long-term excessive alcohol infertility C group was [(128.83±22.73)μmol/L,(17.34±2.53)%,(51.18±0.58)%,(21.45±0.26)%,(21.12±3.24)%] respectively. Compared to a very significant difference (t＝10.04,17.38,6.69,15.59,17.02,P＜0.01) . In long-term excessive drinking group, the levels of NO and spermatogenesis cell apoptosis rate was significantly positive correlated (r＝0.93,P＜0.01).Apoptosis of spermatogenic cell nucleus chromatin was condensed in the formation of crescent-shaped perinuclear, nuclear was cleavaged to form apoptotic bodies. Conclusions In the long-term excessive drinking semen, NO content and spermatogenic cell apoptosis rate was increased, the sperm had poor quality. The results showed that the long-term excessive drinking can cause germ cell apoptosis in male infertility and promote the body to overproduce NO, whichmay be one of the reasons for male infertility. Key words: Alcohol drinking/AE; Alcoholism; Apoptosis; Spermatozoa/DE; Spermatids/DE; Semen/ME; Nitric oxide/ME

Unexpected application of counselling skills by a fertility research nurse

Men attending the Andrology Laboratory for the first time were asked to complete questionnaires regarding their employment, lifestyle, diet and infancy for the Chemicals and Pregnancy Study UK (CHAPS-UK) research study. CHAPS-UK is a multi-centre study investigating reasons for male infertility. During one interview, a patient expressed concerns about his sexual relationship with his wife. Initially, he described his concerns about infertility but as the nurse used her counselling skills, the patient was able to voice his psychosexual difficulties. This was the first time in 5 years of marriage the patient talked about his situation to another person. The research nurse was able to combine good communication and counselling skills to facilitate the patient's need to face his problem, which enabled him to make a constructive decision about his need for further help. This case highlights the difficult situation in which fertility nurses can find themselves and reinforces the need for nurses involved in the care of infertile couples to have training in counselling skills and the ability to make appropriate referral to an infertility counsellor when required.

Genetics of functional and structural defects in spermatogenesis

The genetic reasons for male infertility are still poorly understood. In approximately 30 % of infertile men no reason for their defect in spermatogenesis can be found (idiopathic infertility). In a high percentage of these patients single gene defects are assumed to be responsible for the infertility. Well-known reasons for infertility are microdeletions on the long arm of the Y chromosome. In approximately 3–18 % of patients with azoospermia or severe oligospermia these deletions can be detected by using molecular techniques. In 4–6 % of infertile men chromosomal abnormalities are responsible for their andrological disorder. While numeric aberrations are widely observed in patients with azoospermia, alterations in chromosomal structure are prominent in patients with oligozoospermia. Chromosomal anomalies can be found only in rare cases of patients with structural or functional sperm defects. Up to now the genetic basis has only be described for a few functional or structural sperm defects (immotile cilia syndrome, globozoospermia). More recently, it became possible to identify genes involved in spermatogenesis and to investigate their functions in male germ cell differentiation by using new tools of molecular biology, e. g. gene replacement techniques in the mouse. For the majority of these genes homologous human genes are known. However, the role of these genes in human spermatogenesis and their relevance for male fertility have still to be elucidated.

Cytogenetic Study in 102 Infertile Men

Chromosomal anomalies may be a reason for male infertility. To find out whether this is true mitotic chromosome studies were performed on 41 males with azoospermia and 61 males with oligozoospermia. A constitutional chromosomal abnormality was diagnosed in 14 (34.1%) azoospermic patients and in 2 (3.3%) oligozoospermic patients. The 47,XXY karyotype was the commonest in the azoospermic group. An overall incidence of 15.7% abnormality indicates that routine chromosome analysis of infertile men should be considered.