Men Of Reproductive Age Research Articles

Reducing Exposures to Endocrine Disruptors (REED) study, a personalized at-home intervention program to reduce exposure to endocrine disrupting chemicals among a child-bearing age cohort: study protocol for a randomized controlled trial

BackgroundExposures to endocrine disrupting chemicals (EDCs) have been linked to chronic diseases including breast cancer, metabolic syndrome, diabetes, and infertility. Exposure during pregnancy may have a lifelong impact on the fetus. Services are needed to allow individuals to learn about their personal EDC exposures and how to reduce them. Million Marker (MM) aims to crowdsource and scale the biomonitoring of environmental chemicals and provide actionable results to empower individuals to proactively assess, track, and reduce their EDC exposures. In previous research, we developed and tested the first mobile EDC intervention service (mail-in urine testing and exposure report-back) for its efficacy in increasing EH literacy (EHL), willingness to reduce exposures (i.e., readiness to change, RtC), and system usability. After intervention, we found increased EHL, increased RtC in women (but not men), and decreased EDC exposure. However, some participants did not increase their RtC and had difficulty carrying out the intervention on their own. The reasons for these less optimal results were the difficulty in the EHL subject matter—participants still felt ill-prepared to apply their knowledge to making healthier lifestyle changes. Therefore, in this study, we will address these perceived limitations.MethodsWe will test a self-directed online interactive curriculum with live counseling sessions and individualized support modeled after the highly effective Diabetes Prevention Program (DPP). Recruiting from the Healthy Nevada Project (HNP), one of the largest population health cohorts in the world, we test the effectiveness of our EDC-specific online intervention curriculum via EHL and RtC surveys and determine changes in EDC exposure before and after intervention in a randomized controlled trial. We will also test for common clinical biomarkers via a commercially available at-home test (Siphox). We will recruit and randomize 300 women and 300 men of reproductive age (total n=600) from HNP. Our target population is men and women of reproductive age (18–44 years old).DiscussionAt the conclusion of this project, we will be well-positioned to scale our services to clinics and the general public, with the eventual aims of FDA approval, insurance coverage, and incorporation into routine clinical care.

Association of Di(2-ethylhexyl) Phthalate Exposure with Reproductive Hormones in the General Population and the Susceptible Population: A Systematic Review and Meta-Analysis.

Di(2-ethylhexyl) phthalate (DEHP), an environmental endocrine disruptor, has hormone-like activity and endocrine-disrupting effects. However, the types of reproductive hormones associated with DEHP vary across the studies. Thus, we conducted a systematic review and meta-analysis to pool existing epidemiological evidence. We searched three databases up to January 31, 2024, for eligible original studies to ultimately include 37 studies from eight countries with a total of 28 911 participants. DEHP exposure was evaluated with urinary metabolites. Since the main types, production sites, blood concentrations, and functions of reproductive hormones differ between men and women, we reported the combined effect values by gender. Subgroup analyses were conducted by age, subfertility status, and the national sociodemographic index (SDI) level. Furthermore, the effect of maternal exposure during pregnancy on children's reproductive hormone levels was analyzed separately. Overall, in general, in men, DEHP was positively correlated with sex hormone binding-globulin (SHBG) and adversely correlated with total testosterone (TT), free androgen index (FAI), and follicle-stimulating hormone (FSH). Results indicated that among men of reproductive age, DEHP exposure was associated with more significant hormonal suppression in infertile men compared with fertile men. Notably, age subgroup analysis among women revealed that postmenopausal women were more vulnerable to DEHP, which was related to lower TT and estradiol (E2). However, this study did not observe a significant association between prenatal DEHP metabolites and reproductive hormone levels in children. Our research identifies the most susceptible hormones (androgen suppression) after DEHP exposure and suggests that infertile men and postmenopausal women are in great need of more attention as sensitive populations.

Mediterranean Diet, ultra-processed food consumption and semen quality in healthy young men

Abstract Background Diet quality can have beneficial effects on male reproductive health, although studies are still limited, and little is known on the potential impact of ultra-processed foods (UPFs) on semen quality parameters. Methods A cross-sectional analysis was run on 126 participants (mean age 20.0 ± 1.2 y) from the FAST randomized controlled trial in 2018-2019. Food intake was assessed through a FFQ. UPF was defined following the Nova classification and calculated as the ratio (weight ratio) between UPF (g/d) and total food (g/d). Adherence to the Mediterranean Diet (MD) was ascertained by the Mediterranean Diet Score (MDS). The semen analyses were performed using a microscope for optical evaluation with a Makler counting chamber and two automated semen analysers. The primary outcomes were sperm volume, concentration, motility and morphology. A hierarchical mixed model approach was utilized to accommodate the within-subject correlation arising from the triple temporal repetition of measurements. Results Highest UPF consumption (Q4), compared to lowest (Q1), was associated with lower sperm concentration (β=-54.1×106 spz./ml; 95%CI: -92.9 to -15.4; p-trend=0.002 across quarters), and progressive motility (β=-14.2%; 95%CI: -28.2 to -0.09; p-trend=0.036). The percentage of cells with normal morphology tended to be reduced in young men consuming more UPF compared to lowest intake (β=-2.93%; 95%CI: -6.22 to 0.37; p-trend=0.071). The MDS was not associated with any of the parameters under study. Conclusions A larger dietary share of UPF was inversely associated with sperm concentration and progressive motility in young men of reproductive age. MD adherence was not associated with semen quality parameters, and this is possibly due to the low variability of MD adherence in this sample. Dietary recommendations for improving sperm health should prioritize limiting UPF in the diet. Key messages • Ultra-processed food (UPF) intake was unfavourably associated with semen quality parameters amongst young men. • Dietary recommendations for improving sperm health should recommend limiting UPF.

Microscopic Varicocelectomy under Local Anesthesia as the Treatment of Varicocele.

Varicocele, characterized by the dilation of veins within the spermatic cord, is a prevalent disease in males, accounting for 35%-40% of infertility cases among men of reproductive age. This condition may disrupt normal neuroregulation, blood supply, and temperature regulation in the testicles, thereby impacting sperm count, quality (morphology, fragmentation rate), and functionality (motility). It may even induce symptoms such as pain and testicular atrophy. The international standard treatment method is microscopic varicocelectomy, typically performed under general anesthesia. This requires patients to fast before surgery and necessitates recovery and fasting care postoperatively. The arterial blood pressure drop caused by anesthesia may obscure the fluctuation of the spermatic artery, making the precise intraoperative isolation and protection of the spermatic artery more challenging. Therefore, this study proposes and implements microscopic varicocelectomy under local anesthesia. This method facilitates rapid and precise identification of the fluctuating spermatic artery, reducing the risk of spermatic artery damage. It also provides more humane care for patients, reduces economic burden, and offers a new perspective on the treatment of varicocele.

A view of immunologic male infertility from the perspective of preserving seminal fluid homeostasis

The basis of the pathogenesis of immunologic male infertility is the production of antisperm antibodies against sperm antigens by plasmocytes. Extracellular nucleic acids, among other antigens, are perceived as DAMPs. The clearance system for biological fluids is complex. Endonucleases are responsible for the utilization of extracellular DNA. Among endonucleases, DNase 1 is the most studied. Its concentration in biological fluids is higher than others. For the first time, we determined the concentration of DNase 1 in the seminal fluid of men of reproductive age. DNase 1 concentration values were compared with the level of antisperm antibodies in the ejaculate, after which the relationship between the enzyme level and standard spermogram parameters was determined. The material for the study was the ejaculate of 44 relatively healthy men of reproductive age. During spermiological analysis, macroscopic and microscopic parameters of seminal fluid were determined, the concentration of deoxyribonuclease 1 (DNase 1) in the material was determined by enzyme immunoassay, and the presence of antisperm antibodies was assessed using a direct diagnostic method – the MAR test. Statistical processing of the obtained data was carried out using analytical software PAST v. 4.06. Reference intervals for DNase 1 concentrations were calculated using the MedCalc v. 17.4 program. The relationship between spermogram parameters and DNase 1 concentration was assessed by calculating Spearman’s linear rank correlation coefficients. As a result, a negative correlation was found between the DNase 1 ratio and such ejaculate parameters as liquefaction time (rS = -0.37; p = 0.013) and viscosity (rS = -0.37; p = 0.013), as well as the level of antisperm antibodies A (rS = -0.43; p = 0.003) and G (rS = -0.33; p = 0.027), the mucous component of the ejaculate (rS = -0.37; p = 0.012) and agglutination of male germ cells (rS = -0.33; p = 0.029). According to the data obtained, the optimal level of DNase 1 is directly related to the quality of the ejaculate. Determination of DNase 1 concentration can serve as an additional diagnostic criterion for male immunological infertility. These data will expand our understanding of a man’s fertile potential.

Healthy and unhealthy dietary patterns and sperm quality from the Led-Fertyl study.

Dietary patterns may affect sperm quality, but the scientific evidence is limited. To evaluate the association between adherence to different a-priori dietary patterns and sperm quality parameters in healthy reproductive-age men. A cross-sectional analysis was conducted using data from 200 young men enrolled in the Led-Fertyl study. Tertiles of six a-priori dietary patterns were estimated: four healthy dietary patterns [Mediterranean Diet Adherence Screener (MEDAS), Dietary Approaches to Stop Hypertension (DASH), Healthful Plant-Based Diet Index (hPDI) and EAT-Lancet Score], and two unhealthy dietary patterns [Western Diet and Unhealthful Plant-Based Diet Index (uPDI)]. Sperm quality parameters (count, concentration, vitality, total and progressive motility, and normal morphology) were considered the main outcomes. Compared with the lowest tertile, participants in the highest MEDAS tertile had higher total sperm count (β=3.2;95%CI: 1.0, 5.5) and concentration (β=1.8;95%CI: 0.6, 3.0), and total (β=8.2;95%CI: 1.3, 15.1) and progressive motility (β=7.1;95%CI: 0.2, 14.0). Similarly, participants in the highest hPDI tertile had higher total sperm count (β=3.4;95%CI: 1.4, 5.5) and concentration (β=1.2;95%CI: 0.0, 2.3) compared with those in the lowest tertile. When these dietary patterns were modelled as continuous variables (for each 1-point increment in the specific score), an inverse association was found between the uPDI and Western and total sperm count [(β=-2.7;95%CI: -4.8, -0.7) and (β=-3.8;95%CI: -5.8, -1.7), respectively] and sperm concentration [(β=-1.2;95%CI: -2.4, -0.1) and (β=-1.7;95%CI: -2.8, -0.5), respectively]. Compared with participants in the lowest tertile, those in the highest uPDI tertile presented higher odds of abnormal sperm concentration (OR: 4.6;95%CI: 1.0, 19.9) and one or more seminogram abnormalities (OR: 2.3;95%CI: 1.1, 5.0). Our findings suggest that higher adherence to healthy dietary patterns (Mediterranean and healthful plant-based diet) was positively associated with better sperm quality parameters, in contrast, greater adherence to unhealthy dietary patterns was inversely associated.

Влияние COVID-19 на спермиологические показатели у мужчин репродуктивного возраста

Introduction: The new coronavirus infection is dangerous not only in the acute period of the disease, but also during the period of convalescence, causing various complications. The long-term effects of the SARS-CoV 2 virus on male reproductive function are an important prognostic factor requiring comprehensive study. Purpose of the study: to study the long-term results of the impact of COVID-19 mild to moderate severity on spermological indicators in men of reproductive age. Materials and Methods: the study included 14 healthy men of reproductive age who were not vaccinated against COVID 19, who had negative results of an STI examination, normal spermological parameters, TUNEL test values <15%, who subsequently suffered a viral infection caused by the SARS-CoV 2 virus of mild and moderate severity, with persistent negative results of an STI examination. Results: а comparative analysis of the results of spermograms of patients before and after COVID 19 showed that the total number of spermatozoa before and after the disease (422.5 ± 53.9 and 410.2 ± 176.9 million, respectively), the indicator of the number of spermatozoa with progressive translational (PR) mobility (56.4 ± 8.7 and 54.4 ± 8.0%, respectively), morphologically normal male gametes before and after 3 months after COVID-19 (21.2 ± 4.3 and 20.2 ± 3.6%, respectively) are comparable. Normozoospermia was observed in all cases, TUNEL test values <15%. Conclusion: in the conducted study, mild and moderate COVID-19 did not have a clinically significant effect on the spermological parameters of men 3 months after COVID-19. Keywords: COVID-19, SARS-CoV 2 virus, spermological indicators, TUNEL-test.

Infertility: A Family Nurse Practitioner Approach in Primary Care

Infertility affects ∼19% of women between the ages of 15 and 49 years, and ∼9% of men of reproductive age in the United States. Rising infertility rates have led to couples presenting with infertility concerns in the primary care setting, emphasizing the nurse practitioner's vital role in beginning the infertility workup. Using an infertility algorithm can aid in the diagnosis and seamless transition to a fertility specialist. The nurse practitioner can obtain a detailed medical and reproductive history, perform an appropriate physical examination, order initial diagnostic testing, perform a medication reconciliation, provide patient education, and initiate referrals to specialists.

The state of erectile and reproductive functions in young men who have undergone COVID-19

Introduction. The negative consequences of the pandemic caused by the COVID-19 virus are being actively studied nowadays. It is known that the new coronavirus infection aggressively affects not only the organs of the respiratory system, but also the male reproductive system through binding to the ACE-2 receptor on the surface of cells of reproductive organs.The purpose of the study: to identify the impact of the virus on erectile and reproductive functions in young men of childbearing age 20–45 years who have undergone a new coronavirus infection.Material and methods. The study included 75 men of reproductive age 20–45 years who had undergone COVID-19. During the period of COVID-19 disease and 12 weeks after recovery, the study participants completed a questionnaire to assess erectile function "International Index of Erectile Function" (ICEF-5). The men underwent a blood test for hormones: luteinizing hormone (LH), follicle-stimulating hormone (FSH), the ratio of FSH to LH (FSH/ LH), testosterone total, prolactin, thyroid-stimulating hormone (TSH), T4 free, prostate specific antigen total (PSA total). The analysis of the ejaculate of 29 study participants was also carried out during the illness and 12 weeks after the recovery from COVID-19.Results. When processing the ICEF-5 questionnaire data, erectile dysfunction was detected in 81% of cases, p < 0,01 during the illness, after coronavirus infection, sexual disorders persisted in 44% of cases, p < 0,01. A study of the hormonal status in 80% of men during the COVID-19 disease revealed a significant decrease in the level of total testosterone, p < 0,01, which remained reduced in 64% of men 12 weeks after recovery, p < 0,01. According to the results of 29 spermograms, 42% of the study participants during the COVID-19 disease had oligospermia, p < 0,01, in 44% of cases oligozoospermia was noted, p<0,01. After recovery, there was a decrease in the volume of ejaculate, the concentration of spermatozoa remained in 17% of cases, p < 0,01.Conclusion. A new coronavirus infection negatively affects the erectile and reproductive functions in men who have undergone COVID-19.

P-091 The Dopamine Transporter (DAT) and it’s role in male fertility- an in vitro investigation

Abstract Study question Does Ritalin (DAT antagonist) and dopamine (DAT agonist), influence human sperm parameters, and do these act via the DAT protein? Summary answer DAT is positively expressed on human sperm membranes with dopamine regulating sperm functions through mechanisms involving DAT whereas Ritalin does not affect sperm parameters. What is known already Spermatozoa exhibit a biphasic dose-response to dopamine: low concentrations enhance key sperm functions such as motility and viability, while high concentrations impair them. This biphasic response suggests the presence of a dopamine transporter (DAT), however its role in human sperm function remains under-investigated. Concerns regarding the unprescribed use of Ritalin, a dopamine reuptake inhibitor, are growing among men of reproductive age, given its potential to mimic dopamine’s negative effects on sperm function. Further research is crucial to elucidate the mechanisms and potential consequences of Ritalin exposure on male fertility. Study design, size, duration Twenty samples were collected and utilized to identify and localize DAT via indirect Immunofluorescence (IF) assays. Thirty samples were collected and sperm were treated at 37 °C to 100 nM, 10 μM, and 1 mM dopamine concentrations for 1, 3 and 6 hours; similarly sperm were exposed to 4 ng/mL, 30 ng/mL, and 100 ng/mL Ritalin concentrations for 1, 2 and 3 hours, whereafter the effects on basic and advanced sperm parameters were investigated. Participants/materials, setting, methods Participants were recruited from the Faculty of Medicine and Health Sciences at Stellenbosch University, Cape Town, South Africa. Male students aged 18-29 years donated a semen sample via masturbation. An indirect IF assay, adapted from Ramírez et al. (2009), was utilized to identify DAT. Computer-Aided Sperm Analysis (CASA) was employed to determine motility parameters. Viability was assessed via a dye-exclusion staining technique and the acrosome reaction was assessed via fluorescent microscopy. Main results and the role of chance Immunofluorescence confirmed the presence of the Dopamine Transporter (DAT) on human sperm, primarily localized in the mid-piece and tail regions. Interestingly, dopamine exhibited a biphasic effect on sperm function. Low doses offered protection, while high doses (1 mM) negatively impacted motility (total and progressive motility) and kinematic parameters (Curvilinear Velocity (VCL) and Average Path Velocity (VAP)) as early as 60 minutes, and significantly decreased viability after 3 hours. Additionally, the high dose prematurely triggered the acrosome reaction. Conversely, Ritalin, even at supraphysiological concentrations (100 ng/mL), showed no significant impact on basic or advanced sperm parameters. This suggests that, unlike high-dose dopamine, Ritalin exposure might not negatively affect sperm function within the tested parameters. This study highlights the complex role of dopamine in sperm function and emphasizes the need for further research to clarify potential consequences of high dopamine exposure or dopaminergic drugs such as Ritalin. Limitations, reasons for caution Ejaculated spermatozoa are transcriptionally and translationally silent, therefore the in vitro nature of this study is a limitation. The physiological relevance needs to be assessed in an in vivo system, additionally the treatments (dopamine plus Ritalin) should be investigated in combination to demonstrate their concurrent existence within a system. Wider implications of the findings These findings suggest a possible regulatory role for DAT inhibitory drugs on sperm parameters and cautions users thereof. Dopamine may be utilized as a physiological regulator of in vivo fertilization and should be further investigated with regards to Assisted Reproductive Techniques (ART’s). Trial registration number not applicable

Apigenin improves testosterone synthesis by regulating endoplasmic reticulum stress

Obesity is a growing epidemic among reproductive-age men, which can cause and exacerbate male infertility by means of associated comorbidities, endocrine abnormalities, and direct effects on the fidelity and throughput of spermatogenesis. A prominent consequence of male obesity is a reduction in testosterone levels. Natural products have shown tremendous potential anti-obesity effects in metabolic diseases. This study aimed to investigate the potential of apigenin (AP) to alleviate testicular dysfunction induced by a high-fat diet (HFD) and to investigate the underlying mechanisms, focusing on endoplasmic reticulum stress (ERS) and testosterone synthesis. A murine model of obesity was established using HFD-fed mice. The effects of AP on obesity, lipid metabolism, testicular dysfunction, and ERS were assessed through various physiological, histological, and molecular techniques. Administration of AP (10 mg/kg) ameliorated HFD-induced obesity and testicular dysfunction in a mouse model, as evidenced by decreased body weight, improved lipid profiles and testicular pathology, and restored protein levels related to testosterone. Furthermore, in vitro studies demonstrated that AP relieved ERS and recovered testosterone synthesis in murine Leydig cells (TM3) treated with free fatty acids (FFAs). It was also observed that AP rescued testosterone synthesis enzymes in TM3 cells, similar to that observed with the inhibitor of the PERK pathway (GSK2606414). In addition, ChIP, qPCR, and gene silencing showed that the C/EBP homologous protein (CHOP) bound directly to the promoter region of steroidogenic STAR and negatively modulated its expression. Collectively, AP has remarkable potential to alleviate HFD-induced obesity and testicular dysfunction. Its protective effects are attributable partly to mitigating ERS and restoring testosterone synthesis in Leydig cells.

Preconceptional paternal obesity may increase the risk of congenital urogenital anomalies in offspring: A case-control study.

Congenital urogenital anomalies affect 4-60 per 10,000 births. Maternal obesity, along with other risk factors, is well documented as a contributing factor. However, the impact of paternal obesity on risk is unclear. Obesity is prevalent among men of reproductive age, highlighting the need for further research into the potential association between paternal obesity and offspring congenital urogenital anomalies. This study aims to determine the association between paternal obesity and the risk of congenital urogenital malformations in offspring. Case-control study conducted on 179 newborns (91 cases, 88 controls) selected from the Notre Dame des Secours-university hospital database. Cases were identified as newborns presenting at least one congenital urogenital abnormality, defined as developmental anomalies that can result in a variety of malformations affecting the kidneys, ureters, bladder, and urethra. Controls were identified as newborns without any congenital abnormalities. The exclusion criteria were maternal obesity, infections during pregnancy, chronic diseases, prematurity, growth retardation, assisted reproductive technologies for conception, substance abuse, down syndrome, and other malformations. Data were collected through phone interviews, medical records, and questionnaires. In this study, the exposure was the preconceptional paternal body mass index (BMI), which was calculated based on self-reported height and weight. According to guidelines from the US Centers for Disease Control and Prevention (CDC), individuals are considered to be in the healthy weight range if their BMI (kg/m2) is between 18.5 and<25. They are classified as overweight if their BMI is ≥ 25, obese class I if their BMI is between 30 and<35, obese class II if their BMI is between 35 and<40, and obese class III if their BMI is 40 or higher. Logistic regression analysis was employed to quantify the association between paternal obesity and urogenital conditions in offspring. Significant differences in median (minimum-maximum) paternal BMI values were noted between the cases and controls at the time of conception (cases: 27.7 (43-20.1), controls: 24.8 (40.7-19.6); p<0.0001). Logistic regression analysis confirmed that at the time of conception, compared to normal-weight fathers, overweight fathers displayed a heightened risk of offspring congenital malformations, with an odds ratio (OR) of 4.44 (95% CI=2.1-9.1). Similarly, fathers categorized as obese Class I at conception had approximately eight times higher odds (OR=8.62, 95% CI=2.91-25.52) of having offspring with urogenital conditions compared to normal-weight fathers. Additionally, fathers classified as obese Class II at conception exhibited 5.75 times higher odds (OR=5.75, 95% CI=0.96-34.44) of having offspring with urogenital conditions in comparison to normal-weight fathers. We found that the risk of urogenital malformations increased with paternal BMI during the preconceptional period. The findings suggest the importance of addressing paternal obesity in efforts to reduce the risk of urogenital congenital malformations in offspring.

Urinary haloacetic acid concentrations in relation to sex and thyroid hormones among reproductive-aged men

Sex and thyroid hormones are critical for male reproductive health. However, the associations between haloacetic acid (HAA) exposure – a known endocrine disruptor – and sex and thyroid hormones in humans remains unclear. We thus recruited 502 male participants seeking fertility evaluation from a reproductive center. We measured concentrations of sex and thyroid hormones in a single blood sample and dichloroacetic acid (DCAA) and trichloroacetic acid (TCAA) in repeated urine samples. Multivariable linear regression models were constructed to evaluate the associations between HAA concentrations and hormone measurements. After adjusting for potential confounders and urinary creatinine concentrations, urinary concentrations of TCAA were inversely associated with serum levels of sex hormone-binding globulin (SHBG), testosterone (T), T/luteinizing hormone ratio (T/LH), and thyroid stimulating hormone (TSH) (all P for trend < 0.10). Compared with participants in the lowest quartile of TCAA concentrations, those in the highest quartile had reduced serum levels of SHGB by 14.2 % (95% CI: −26.7, −3.0 %), T by 11.1 % (95% CI: −21.7, −1.3 %), T/LH by 21.0 % (95% CI: −36.7, −7.1 %), and TSH by 19.1 % (95% CI: −39.7, −1.5 %). Additionally, we observed inverse associations between continuous measurements of urinary HAAs and serum levels of free T, bioactive T, and estradiol. Our findings suggest that male HAA exposure may be associated with disrupted sex and thyroid function.

Concentration of fatty acid binding protein as a new indicator of ejaculate fertility

Objective. To determine the marker function of fatty acid binding protein (FABP) concentration in seminal plasma (SP) in order to assess ejaculate fertility used in in vitro fertilization (IVF) treatment of infertility in couples. Materials and methods. The study involved semen samples of 96 men of reproductive age: the study group (n=63) – patients with a decrease in concentration and/or total content of spermatozoa in ejaculate, the comparison group (n=33) – men with normal concentration and number of spermatozoa in ejaculate. The content of FABP in SP was determined by enzyme-linked immunosorbent assay using the test system “FABP – ELISA – BEST” (A-9102, Vector-Best, Russia). In order to determine the informative value of using the concentration of FABP in SP as a criterion of ejaculate fertility of men of the study group, the predictive value of positive and negative IVF results was determined by calculating the diagnostic sensitivity, specificity and efficiency. Results. The content of FABP in SP accounted for 1.29 ± 0.24 ng/mL, the median and interquartile range comprised 1.23 [1.13–1.35] ng/mL, ranging from 1.08 to 2.79 ng/mL. The study revealed statistically significant intergroup differences (Mann-Whitney test U=79.00; p=0.000016), a weak correlation between the level of FABP and the concentration of spermatozoa (R=0.578008) and their number in ejaculate (R=0.583599). The diagnostic sensitivity of the test for FABP in SP of the men of the study group accounted for 81.82%, specificity – 78.95%, efficiency – 80.95%. Conclusion. Seminal plasma FABP can act as a marker of spermatogenesis disorders. The study of this protein in ejaculate provides the accuracy of predicting the outcome of in vitro fertilization.

Influence of substance use on male reproductive health and offspring outcomes.

The prevalence of substance use globally is rising and is highest among men of reproductive age. In Africa, and South and Central America, cannabis use disorder is most prevalent and in Eastern and South-Eastern Europe, Central America, Canada and the USA, opioid use disorder predominates. Substance use might be contributing to the ongoing global decline in male fertility, and emerging evidence has linked paternal substance use with short-term and long-term adverse effects on offspring development and outcomes. This trend is concerning given that substance use is increasing, including during the COVID-19 pandemic. Preclinical studies have shown that male preconception substance use can influence offspring brain development and neurobehaviour through epigenetic mechanisms. Additionally, human studies investigating paternal health behaviours during the prenatal period suggest that paternal tobacco, opioid, cannabis and alcohol use is associated with reduced offspring mental health, in particular hyperactivity and attention-deficit hyperactivity disorder. The potential effects of paternal substance use are areas in which to focus public health efforts and health-care provider counselling of couples or individuals interested in conceiving.

Causal associations of male infertility with stroke: a two-sample Mendelian randomization study.

Stroke is a devastating global health issue, with high mortality and disability rates. The increasing prevalence of male infertility among reproductive-aged men has become a growing concern worldwide. However, the relationship between male infertility and stroke incidence remains uncertain. This study aimed to address this knowledge gap by employing a Mendelian randomization (MR) approach. Utilizing genetic instrumental variables derived from a genome-wide association study (GWAS) on male infertility and stroke, a two-sample MR design was implemented. Five different analysis methods, with inverse-variance weighted as the primary approach, were used to examine the genetic causal associations between male infertility and various stroke subtypes. Heterogeneity analysis, pleiotropy tests, and leave-one-out validation were conducted to assess heterogeneity, evaluate pleiotropy, and ensure the robustness of the findings. The results indicate a potential lower risk of small vessel stroke associated with male infertility (odds ratio, 95% confidence interval: 0.82, 0.68 to 0.99, p=0.044), although no significant impact on other stroke subtypes was observed. The study exhibited low heterogeneity and no apparent pleiotropy; however, the stability of the results was not optimal. Male infertility might potentially confer a protective effect against small vessel stroke risk. Caution is warranted due to potential confounding factors. Additional studies are necessary to confirm these findings and provide further validation.

The demand for male contraception: Estimating the potential market for users of novel male contraceptive methods using United States National Survey of Family Growth data

ObjectiveTo estimate the potential market for novel male contraceptives (NMCs) using United States National Survey of Family Growth (NSFG) data, 2015–2017. Study designWe described the market for NMCs via secondary analysis of the 2015–2017 NSFG’s weighted male respondent data, utilizing surrogate markers for contraceptive switching (NSFG) and contraceptive discontinuation data from the Contraceptive CHOICE project. Potential NMC users included men relying on: (1) no methods or less effective methods but who reported that they would be “very upset” if they got someone pregnant, (2) permanent methods but who reported that they might still want more children, (3) a female partner’s method that she might discontinue in the next year, (4) a male method even when his partner uses her own contraceptive. ResultsOf 3340 respondents—representing 55,890,830 sexually active, reproductive-age men—23.2% used no contraception at last intercourse, 15.8% condoms, 5.1% withdrawal, and 5.1% vasectomy. Among respondents relying solely on condoms, withdrawal, or no method, 19.7%, 3.8%, and 4.4% would be “very upset” if they got someone pregnant. For permanent contraceptive users, 17.3%−20.5% wanted another child. For men reliant on their partner’s long-acting reversible or combined hormonal contraceptive, 12–17% and 45–51% of partners might discontinue their method. These data conservatively suggest that 13% or more than 7 million men would potentially use NMCs, rising to 15.5 million with less restrictive contraceptive switching criteria. ConclusionAdjusting for pregnancy attitudes and likelihood of contraceptive switching, a substantial portion (between 7–15.5 million) of reproductive age men in the US are potential NMC users. ImplicationsThe population of potential novel male contraceptive users extends beyond just users of condoms, withdrawal and vasectomy and should include couples practicing dual-partner contraception and female partners using contraceptive methods that they may become dissatisfied with and discontinue.

Preoperative level of sex hormones as a predictor (prognostic factor) of the morphological characteristics of testicular malignancies

Introduction. Testicular cancer (TC) mostly affect young men of reproductive age. Several studies have shown correlation between the level of sex hormones in testicular cancer and serum tumor markers. However, currently, the relationship between hormone levels before orchidectomy and the clinical and pathomorphological characteristics of the tumor has not been sufficiently studied. Aim of the study: to analyze the relationship between hormone levels and the clinical stage and histological characteristics of the tumor in patients with testicular cancer and to develop prognostic models. Material and Methods. This prospective single-center study included 66 patients with testicular cancer. Localized, locally advanced and metastatic testicular cancer was diagnosed in 55 (83.3 %), 9 (13.6 %) and 2 (3.0 %) patients, respectively. A preoperative assessment of hormones such as total and free testosterone (T), estradiol (E2)), gonadotropic hormones (LH, FLH, Prolactin) and b-HCG was carried out. Patients were divided into 2 groups depending on the histological structure of the tumor: seminoma (n=31) and non-seminoma (n=35). The following parameters were assessed: tumor size, lymphovascular invasion and rete testis invasion. Results. In non-seminoma tumors, the values of sex hormones and beta-hCG were higher, but the values of gonadotropic hormones were lower compared with typical seminomas (p&lt;0.05). High concentrations of b-HCG were observed predominantly in pT3 compared to pT1 stages (p=0.018). Correlation analysis revealed a connection between total (ρ=0.351; p=0.004) and free T (ρ=0.342; p=0.008), E2 (ρ=0.292; p=0.022), b-HCG (ρ=0.244; p= 0.048), LH (ρ=-0.287; p=0.039), FSH (ρ=-0.264; p=0.04) and the size of the primary tumor. The presence of rete testis invasion was accompanied by a low LH value and a high b-HCG value compared to patients without this prognostic parameter (p=0.015, p&lt;0.001, respectively). Prognostic models were developed to determine the probability of histological structure and the presence of rete testis invasion (p&lt;0.001) with high sensitivity (82.1 % and 76.5 %) and specificity (76.9 % and 100 %). Conclusion. The findings suggest that non-seminoma tumors are associated with changes in the pituitary-gonadal (HPG) axis. The high values of sex hormones and low values of gonadotropic hormones before orchidectomy are associated with a large size of the primary tumor. Additionally, a low LH value and a high b-HCG value are predictors of rete testis invasion. High b-HCG levels are associated with more aggressive tumor biology and poor prognosis.

Effect of COVID-19 infection on Semen Parameters

Objective To investigate the possible effects of coronavirus disease 2019 (COVID-19) infection on semen parameters in recovering men. Patients and methods In this prospective study, we investigated the impact of COVID-19 infection on semen parameters in a cohort of 44 reproductive-aged men who had recently recovered from COVID-19. Two sperm samples were collected from these participants at 3 and 6 months after infection and were compared with the patients’ pre-COVID-19 semen parameters. Results The mean age of the participants was 35±5 years. The mean duration of fever was 3 days. Most of our studied patients 32 (73%) were not hospitalized, and none were admitted to an intensive care unit. Thirty-two cases (73%) had a normal baseline semen analysis. There was no statistically significant change in semen volume after 3 or 6 months or between 3 and 6 months. Meanwhile, the sperm concentration, total sperm count, progressive sperm motility, and normal morphology significantly declined after 3 and 6 months compared with baseline. These parameters partially recovered after 6 months, compared with 3 months. In contrast to patients with normal baseline semen analysis, patients with abnormal baseline semen analysis had a significant increase in semen volume, a decrease in sperm concentration, and progressive motility at 3 and 6 months. Patients who had high-grade fever had a statistically significant change in total count at 3 and 6 months and normal morphology at 3 months compared with patients with low-grade fever. Conclusion This study demonstrated that most semen parameters were negatively impacted after COVID-19 infection. The changes were partially reversible 6 months after the infection.

Morphology and Cyto-Architecture of the Testis and Assessment of Selected Biochemical Parameters Associated with Male Fertility Following the Consumption of Tom Brown Weaning Diet in Albino Wistar Rats

Objectives/Background Natural products are preferred over synthetic drug as fertility enhancers as they are cost effective. Infertility among men of reproductive age keeps rising. Synthetic drugs ameliorate the problem but leave adverse side effects as men advance in age, hence the need for alternative medicine. Tom brown weaning diet is a processed cereal-based powdery blend which is cooked into a semi-liquid food for children from 6 months and contains good nutrient levels. This work focused on the effects of Tom brown weaning diet on testes of Wistar rats. Method Fifteen Wistar rats were divided into 3 groups namely: Control group, 50% tom brown group and 100% tom brown group. Control received only rat chow, 50% Tom brown group received tom brown diet and normal rat chows at 12 h cycle per time. This cycle was repeated till the end of the experiment. 50% Tom brown group received only tom brown diet throughout the experimental period. The testes were excised, measured, and processed for morphological and histological analysis. Results Average testicular weight and relative weight in the 50% tom brown, 100% tom brown and control groups were not significant at alpha level of P ˂ .05. This was also supported by the normal histological features seen in sections of the testes of rats in all groups as there were no shrinking and denser spermatogenic cells in the seminiferous tubules. Hormonal analysis showed a non-significant difference in the level of FSH and LH at alpha levels of P˂0.05. However, testosterone level increased significantly in 100% group compared to 50% and the control group at P˂ .05. Also, GC-MS study on the diet revealed 30 compounds in the diet. Conclusion This study revealed that Tom brown diet has no detectable damaging effect(s) on the testes but could improve the cytoarchitecture and enhance fertility.