Role In Male Infertility Research Articles

ETIOLOGY OF MALE INFERTILITY IN JAKARTA

Objective: The etiology and risk factors of male infertility in huge Indonesian population has not yet been defined. This study was aim to evaluate the distribution and pattern of male infertility in Jakarta. Material & Methods: Retrospective study of Infertility database of Cipto Mangunkusumo Referral Hospital Jakarta, Bunda Hospital Jakarta, and ASRI Hospital Jakarta from 2005 until 2015 were analyzed using SPSS ver. 20. Patients’ characteristic and demography were stated. Results: There were 1062 patients with most of them suffered from primary infertility of their first time-marriage. Average age of husband, wife, and duration of marriage were 36.63± 7.10, 32.32 ± 4.92, and 5.7 ± 4.18 years old respectively. Smoking habit was recorded in 25% of patients while exposure and occupational hazard were only found in less than 2% of them. Coital problems occured in 17% of patients with 30% of them did not have routine sexual intercourse per week. Physical examination revealed that more than 70% of them had varicocele while USG Doppler of scrotum found varicocele in less than 50%. Only 5.13% of patients had normal sperm analysis, mostly azoospermia. Hormonal abnormality occured in more than 30% patients, varied in testosterone, FSH, and LH level.Conclusion: Male infertility was mostly caused by abnormal sperm characteristics followed by abnormal hormonal analysis. Exposure and occupational hazard did not play a big role in male infertility. Future study in risk factors of abnormal sperm characteristics could be done.

Association of Seminal Plasma Total Antioxidant Capacity and Malondialdehyde Levels With Sperm Parameters in Infertile Men With Varicocele

Background: Varicocele is one of the most common reasons for male infertility and could impair spermatogenesis through mechanisms that are not well known. Recently, oxidative stress has been introduced as a major reason for male infertility caused by varicocele. Objectives: In the current study, we aimed to assess the TAC (total antioxidant capacity) and MDA (malondialdehyde) as stress oxidative markers in infertile men with varicocele and fertile men, and moreover, their correlation with sperm parameters. Patients and Methods: This case control study was performed on 43 infertilemen with varicocele and 46men with proven fertility. The ferric reducing ability of plasma (FRAP) and thiobarbituric acid (TBA) reaction methods were used for seminal plasma TAC and MDA assay, respectively. Results: Lower TAC levels (1.70.2 vs. 1.30.4 mmol/L, P = 0.0004) and higherMDAlevels (2.51.1 vs. 5.81.9 mmol/L, P < 0.0001) were observed in infertile men with varicocele compared to fertile men. There was no correlation between TAC and MDA in fertile men(r = 0.02, P = 0.9), however, a negative correlation was found between TAC andMDAlevels in varicocele infertilemen(r = -0.44, P = 0.003). Moreover, a positive correlation was found between sperm count and sperm motility with TAC levels in varicocele infertile men (r = 0.4, P = 0.02 and r = 0.6, P < 0.0001, respectively). There was a correlation between sperm motility and TAC levels in fertile men (r = 0.5, P = 0.001), but other parameters did not correlate with TAC in this group. A negative correlation was shown between semen volume, sperm count, total sperm, sperm motility, and sperm morphology with MDA levels in varicocele infertile men (r = 0.3, P = 0.045; r = -0.4, P = 0.009; r = -0.5, P = 0.002; r = -0.5, P = 0.001 and r = -0.4, P = 0.008, respectively). There was no correlation between these parameters and MDA in fertile men. Conclusions: Our findings indicated that oxidative stress could play an essential role in male infertility caused by varicocele and may impair spermatogenesis leading to infertility.

Association of follicle stimulating hormone receptor single nucleotide polymorphisms with fertility in greek men

Although several epidemiological studies have been conducted, the impact of follicle-stimulating hormone receptor (FSHR) polymorphisms on male infertility remains unclear. The aim of this study was to investigate the prevalence of specific FSHR single nucleotide polymorphisms (SNPs) in the Greek population and associate the latter with the clinical phenotype. We enrolled 96 subjects: men with idiopathic non-obstructive azoospermia (n = 78) were compared with a control group of fertile men (n = 18) for SNPs in FSHR positions c.-29, c.566, c.919, and c.2039. The SNP in position 566 (c.566C > T) was assessed by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) and the other three SNPs (c.-29G > A, c.919A > G, c.2039A > G) with single-strand conformation polymorphism (SSCP); all of them were validated with DNA sequence. No polymorphisms were detected in positions c.-29 and c.919 (c.-29G > A, c.919A > G). The heterozygous SNP (AG) at position 2039 was associated with different size of the right testis (p = 0.008). There was no association between the c.566C > T SNPs polymorphism and hormonal or semen parameters. The combination SNP 2039 AA with 566 CT revealed significant association with FSH and LH concentrations. FSHR SNPs at positions c.-29, c.566, c.919, and c.2039 (c.-29G > A, c.566C > T, c.919A > G, c.2039A > G) do not appear to play specific roles in male infertility. Larger studies are needed to confirm these results.

Efficacy of Compound Therapy by Ginseng and Ciprofloxacin on Bacterial Prostatitis.

Genitourinary tract infections play a significant role in male infertility. Infections of reproductive sex glands, such as the prostate, impair function and indirectly affect male fertility. The general aim of this study is to investigate the protective effect of Korean red ginseng (KRG) on prostatitis in male rats treated with ciprofloxacin (CIPX). In this experimental study, we randomly divided 72 two male Wistar rats into 9 groups. The groups were treated as follows for 10 days: i. Control (no medication), ii. Sham [(normal saline injection into the vas deferens and oral administration of phosphate-buffered saline (PBS)], iii. Ginseng, iv. CPIX, v. CIPX+ginseng, vi. Uropathogenic Escherichia coli (E. coli) (UPEC), vii. UPEC+ginseng, viii. UPEC+CIPX, and ix. UPEC+ginseng+CIPX. The rats were killed 14 days after the last injection and the prostate glands were removed. After sample preparation, routine histology was performed using hematoxylin and eosin staining. The terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL) method was used to determine the presence of apoptotic cells. The severity score for acinar changes and inflammatory cell infiltration in the UPEC+CIPX group did not significantly different from the UPEC group. However this score significantly decreased in the UPEC+CIPX+ginseng group compared to the UPEC group. Apoptotic index of all ginseng treated groups significantly decreased compared to the UPEC and CPIX groups. These results suggested that ginseng might be an effective adjunct in CIPX treatment of prostatitis. The combined use ginseng and CIPX was more effective than ginseng or CIPX alone.

Clomiphene Citrate and Male Infertility: Investigation of Treatment on Spermatogenesis and Testicular Histomorphology in a Rat Model

Clomiphene citrate (CC) is used off‐label as a treatment for selected cases of male infertility, acting as a competitive selective‐estrogen receptor modulator. Although CC is used clinically, there have only been a small number of randomized controlled human studies that have yielded inconclusive findings. Here we have used a prospective animal model for studying CC treatment to determine if this drug increases spermatogenesis for treatment of male infertility. We treated sexually mature Sprague‐Dawley rats with CC via oral gavage for either 1 or 2 rat spermatogenic cycles (13 days for 1 cycle or 26 days for 2 cycles) at a dose of 0.6 mg/kg. This dose was chosen as it is a similar dose to what is clinically used in humans. Testes were weighed and sperm counts were measured from rats treated with CC and control animals. Testes were fixed in modified Davidson's solution and stained with HE for histopathological and morphometric analysis. No differences in sperm count and no histomorphologic differences were noted in the testes treated with CC as compared to control. Seminiferous tubule minimum diameter and tubular epithelial height were measured and the number of retained spermatozoa was also scored with no significant differences compared to control. Although previous studies have shown that rats treated with much higher doses of CC (&gt;20 mg/kg) have decreased spermatogenesis, we can conclude that CC treatment at a therapeutic dose of 0.6 mg/kg in rats does not appear to have an effect on spermatogenesis. That said; CC may play a more indirect role in male infertility which may include changes in accessory reproductive organs or alterations in hormonal levels.Support or Funding InformationInternal funding; Department of Urology, University of Iowa

MP70-15 PROFILING SIGNALING PROTEINS IN HUMAN SPERMATOZOA: BIOMARKER IDENTIFICATION FOR SPERM QUALITY EVALUATION

You have accessJournal of UrologyInfertility: Basic Research & Pathophysiology1 Apr 2016MP70-15 PROFILING SIGNALING PROTEINS IN HUMAN SPERMATOZOA: BIOMARKER IDENTIFICATION FOR SPERM QUALITY EVALUATION ANTONIO PATRICIO, JOANA SILVA, NUNO MAIA, SAUL ALMEIDA, JOAO LOURENÇO, MARGARIDA FARDILHA, and STEVEN PELECH ANTONIO PATRICIOANTONIO PATRICIO More articles by this author , JOANA SILVAJOANA SILVA More articles by this author , NUNO MAIANUNO MAIA More articles by this author , SAUL ALMEIDASAUL ALMEIDA More articles by this author , JOAO LOURENÇOJOAO LOURENÇO More articles by this author , MARGARIDA FARDILHAMARGARIDA FARDILHA More articles by this author , and STEVEN PELECHSTEVEN PELECH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1440AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sperm cells are incapable of genetic expression and thus highly dependent upon post-translational modifications and signal cascades to execute their function. However, not much information is available on the biological significance of specific signaling pathways in human spermatozoa or their possible roles in male infertility. In this study we attempted to unravel the signaling pathways involved in regulating human sperm function and to correlate the activity of signaling proteins with clinical data. METHODS We included 37 human semen samples, obtained from a randomized group of donors. Basic semen parameters were analyzed according to the WHO’s guidelines. Sperm DNA fragmentation (SDF) was measured using a Sperm Chromatin Dispersion (SCD) test. Antibody-based arrays were carried out to determine the expression patterns of 18 well-characterized signaling molecules when phosphorylated or cleaved. A commercial Kinetworks™ Protein Kinase Screen was used to analyze the levels of 75 protein kinases. RESULTS Phosphorylated levels of several proteins [Bad, GSK-3ß, HSP27, JNK/SAPK, mTOR, p38 MAPK and p53], as well as, cleavage of PARP (at D214), and Caspase-3 (at D175)] were significantly correlated with motility parameters. Morphologically normal spermatozoa demonstrated a significant positive correlation with the phosphorylated levels of p70 S6 kinase and, in turn, head defects and the teratozoospermia index (TZI) showed a significant negative correlation with the phosphorylated levels of Stat3. There was a significant positive correlation between SDF and the TZI, as well as, the presence of head defects. In contrast, SDF negatively correlated with morphologically normal spermatozoa and the phosphorylation of Akt and p70 S6 kinase. Subjects with varicocele showed a negative correlation between head morphological defects and the phosphorylated levels of Akt, GSK3ß, p38 MAPK and Stat1. Additionally, 34 protein kinases were identified as expressed in their total protein levels in normozoospermic samples. From those, 8 protein kinases were identified for the first time human spermatozoa. CONCLUSIONS This study contributed towards establishing a biomarker “fingerprint” to assess sperm quality based on molecular parameters. Proteins with a high degree of differential activity have the potential to integrate a quantitative array to: (1) overcome the subjectivity of the spermogram; (2) explain idiopathic infertility, failure in ART or repeated abortion; (3) choice of the appropriate ART; and (4) assess the efficacy of medical interventions. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e912 Advertisement Copyright & Permissions© 2016MetricsAuthor Information ANTONIO PATRICIO More articles by this author JOANA SILVA More articles by this author NUNO MAIA More articles by this author SAUL ALMEIDA More articles by this author JOAO LOURENÇO More articles by this author MARGARIDA FARDILHA More articles by this author STEVEN PELECH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Evaluation of the Fas/FasL signaling pathway in diabetic rat testis

We investigated the role of the Fas/Fas ligand (FasL) signaling pathway in diabetic male infertility. Male rats were divided into two groups: a control group and a streptozotocin induced diabetic group. Thirty days after induction of diabetes, samples of testes were harvested and fixed in 10% formalin for light microscopy. Germ cell apoptosis was determined using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate in situ nick end-labeling (TUNEL) and immunostaining of caspase 8 and active caspase 3. We also investigated the expressions of Fas and FasL using immunohistochemistry. Streptozotocin-induced diabetes caused severe histopathological damage and increased apoptotic tubule and apoptotic cell indices, caspase 8 and caspase 3 expressions, and Fas and FasL-immunopositive cells in the rat testes. We suggest that the Fas/FasL signaling pathway may play a role in male infertility caused by diabetes.

Correlation of Seminal Plasma Total Antioxidant Capacity and Malondialdehyde Levels With Sperm Parameters in Men With Idiopathic Infertility

Background: Oxidative stress is the result of an imbalance between the production and scavenging of reactive oxygen species (ROS). Recently, oxidative stress has been introduced as a major cause of male infertility. Objectives: The aim of the present study was to determine the correlation between total antioxidant capacity (TAC) and malondialdehyde (MDA) as markers of oxidative stress in relation to idiopathic male infertility and sperm parameters. Patients and Methods: This case control study was conducted using 35 men with idiopathic infertility and 34 men with proven fertility. Seminal plasma TAC and MDA were measured by ferric reducing ability of plasma (FRAP) and thiobarbituric acid (TBA) reaction methods, respectively. Results: Seminal TAC levels were significantly lower and seminal MDA levels were significantly higher in men with idiopathic infertility than in fertile men (P < 0.0001 and P = 0.004, respectively). A positive correlation was shown between sperm motility, sperm morphology, and TAC levels in men with idiopathic infertility (P = 0.002 and P = 0.002, respectively). In addition, there was a correlation between sperm motility and TAC levels in fertile men (P = 0.005). There was no correlation between sperm count and TAC levels in eithermenwith idiopathic infertility or in fertile men. Negative correlations were observed betweenMDAlevels and sperm motility, morphology, and sperm count only in men with idiopathic infertility (P = 0.003, P = 0.001, and P = 0.006, respectively). Conclusions: Our results show that oxidative stress could play an important role in male infertility as well as in sperm motility and sperm morphology.

Dietary Nutrients and Male Infertility: Review of Current Evidence

Lifestyle factors and nutritional status are regarded as critical determinants of normal reproductive function. Hence, the role of dietary nutrients has attracted the attention of researchers to the extent that some studies have addressed the effects of diet on the risk of male infertility. This study aimed to summarize the literature regarding the association between various dietary factors and male infertility. Literature searching for studies on male infertility and nutrition, published between January 1982 and May 2015, was performed using PubMed and Scopus databases. The bibliographies of included studies were also searched for additional references. About 65 articles were identified and after the elimination of irrelevant studies, 35 related studies available for review were examined. Studies have indicated that in men with idiopathic infertility, omega-3 intervention resulted in significant improvement in total sperm count as well as sperm cell density. Moreover, several studies have shown that higher intake of poultry, cereals, fruit and vegetables may play a beneficial role in male infertility; although, some studies have not attained such results. Taken as a whole, studies demonstrated that food consumption may play a major role in preventing or facilitating male infertility. Further studies are needed to clarify this association. [GMJ.2015;4(4):123-29]

Role of genetic mutations in folate-related enzyme genes on Male Infertility.

Several studies showed that the genetic mutations in the folate-related enzyme genes might be associated with male infertility; however, the results were still inconsistent. We performed a meta-analysis with trial sequential analysis to investigate the associations between the MTHFR C677T, MTHFR A1298C, MTR A2756G, MTRR A66G mutations and the MTHFR haplotype with the risk of male infertility. Overall, a total of 37 studies were selected. Our meta-analysis showed that the MTHFR C677T mutation was a risk factor for male infertility in both azoospermia and oligoasthenoteratozoospermia patients, especially in Asian population. Men carrying the MTHFR TC haplotype were most liable to suffer infertility while those with CC haplotype had lowest risk. On the other hand, the MTHFR A1298C mutation was not related to male infertility. MTR A2756G and MTRR A66G were potential candidates in the pathogenesis of male infertility, but more case-control studies were required to avoid false-positive outcomes. All of these results were confirmed by the trial sequential analysis. Finally, our meta-analysis with trial sequential analysis proved that the genetic mutations in the folate-related enzyme genes played a significant role in male infertility.

Evaluation of mRNA Contents of YBX2 and JHDM2A Genes on Testicular Tissues of Azoospermic Men with Different Classes of Spermatogenesis.

Animal model studies have shown that MSY2 and JHDM2A genes have an important role in spermatogenesis process and fertility of male mice. But the potential role of these genes in human spermatogenesis and fertility is not known yet. Therefore, we evaluated expression ratios of these genes in testis tissues of men with normal and impaired spermatogenesis. In this experimental study, after RNA extraction and cDNA syn- thesis from 50 non-obstructive azoospermic and 12 normal testis tissues, the expression ratios of genes were evaluated by real time polymerase chain reaction (PCR) technique. Hematoxcylin and eosin (H&E) staining was used for histological classification of testis tissues. For statistical analysis, one way analysis of variance (ANOVA) test was carried out. Our results showed a significant reduction in mRNA level of YBX2 in samples with impaired spermatogenesis (p<0.001) compared to samples with qualitatively normal spermatogenesis and normal spermatogenesis; however, in JHDM2A gene, despite sensible reduction in gene expression level in men with impaired spermatogenesis, no significant differences were shown (p>0.05). Furthermore in YBX2, a significant negative correlation was demonstrated between the efficiency score of spermatogenesis and the threshold cycle (CT) (r=-0.7, p<0.0001), whereas in JHDM2A, this negative correlation was not significant (r=-0.4, p=0.06). Generally, these data indicated that YBX2 and JHDM2A genes may play an important role in male infertility, and suggested that these molecules can act as useful biomarkers for predicting male infertility.

Association of MDR1 C3435T and C1236T single nucleotide polymorphisms with male factor infertility.

Infertility affects 1 in 6 couples and approximately 1 in 25 men. Male factor infertility is a major cause of spermatogenic anomalies, the causes of which are largely unknown. Impaired repro-ductive functions in men might result from physiological, genetic, and/or environmental factors such as xenobiotics. The multi-drug re-sistance1 (MDR1) gene encodes a P-glycoprotein which has a role in the active transport of various substrates providing protection of somatic cells from potentially toxic substances, including xenobi-otics. MDR1 is highly expressed at the luminal surface of capillary endothelial cells, and is expressed in Leydig cells, testicular mac-rophages, and Sertoli cells. We performed genotype and haplotype analyses of MDR1 in 192 infertile and 102 fertile Turkish men for the genetic markers C1236T and C3435T, using polymerase chain reaction-restriction fragment length polymorphism analysis. In the overall population, correlations were analyzed in all genotype mod-els. We found that the C3435T polymorphism TT vs CT genotypes showed statistically significant differences in their association with infertility (P = 0.045), and that the CT genotype was associated with high sperm DNA damage (P = 0.02), suggesting that the CT genotype might be a susceptibility factor for infertility. Additionally, the T-T haplotype was significantly more frequent in the control group (13.2 vs 6.5%; odds ratio = 0.459, 95%CI = 0.259-0.814, P = 0.006). This study showed that MDR1 might have a role in male infertility. Fur-ther research in large cohorts with different populations is required to clarify the role of MDR in male fertility.

Phosphorylation of Izumo1 and Its Role in Male Infertility.

Izumo1 is a testis-specific gene product, whose function is essential for sperm-egg fusion. Throughout its lifespan, Izumo1 is posttranslationally modified, being both N-linked glycosylated on its extracellular domain and phosphorylated on the intracellular C-terminal tail. Within the caput regions of the rat epididymis, two phosphorylation events have been documented. However, as sperm pass through the epididymis, this cytoplasmic portion of Izumo1 has been shown to contain up to seven phosphorylation sites. Remarkably, in the rat, in correlation with these events, Izumo1 undergoes sub-cellular re-location, moving from the head/tail regions of the spermatozoa, to a predominantly equatorial segment location once they have reached the caudal end of the epididymis.

Toxic metals signature in the human seminal plasma of Pakistani population and their potential role in male infertility.

Aims of this study were to provide firsthand data on the incidence of trace metals in human seminal plasma and find possible correlations between levels of toxic metals and semen quality of Pakistani population. Human semen samples were collected from male partners of couples undergoing infertility assessment at the National Institute of Health Islamabad (Pakistan). We investigated seventy-five seminal plasma samples, which were further categorized into three groups (normozoospermia, oligozoospermia and azoospermia) according to WHO guidelines. The concentration of 17 different toxic metals in human seminal plasma was determined simultaneously by using Inductively coupled plasma mass spectrometry (ICP-MS). Out of 17 trace metals, Cd and Ni showed significant difference (p<0.05) among three monitored groups. Ni and Cd concentrations in the seminal plasma were negatively correlated with sperm concentration (r=-0.26, -0.29) and motility (r=-0.33, -0.37), respectively. This study suggested that exposure of Ni and Cd is mainly related with the consumption of contaminated dietary items, including ghee (cooking oil), flour and other agri-products. In some semen samples, the concentrations of Sn, V, Cu, Pb, Cr and Hg exhibited high levels suggesting a recent human exposure to surrounding sources. In Pakistani human semen samples, the levels of trace metals were lower and/or comparable to that found in populations of other countries. The results show the first evidence of the effect of toxic metals on semen quality and male infertility in Pakistan.

Cholesterol-enriched diet disrupts the blood-testis barrier in rabbits.

About 15% of heterosexual couples in the USA suffer from infertility issues; male infertility accounts for ∼50% of all infertility cases and roughly 50% of male infertility is idiopathic. Increased levels of plasma cholesterol affect spermatogenesis and male fertility negatively, but by unclear mechanisms. Clearly, spermatogenesis occurs in immune-privileged seminiferous tubules that are protected by the blood-testis barrier (BTB), and BTB disruption results in sperm damage and male infertility. Accordingly, using rabbits fed a 2% cholesterol-enriched diet for 2, 4, and 6 wk to raise levels of plasma cholesterol, we tested the hypothesis that elevated levels of plasma cholesterol disrupt the BTB functionally and biochemically. The cholesterol-enriched diet increased lipid deposition dramatically and time-dependently in the seminiferous tubules and disrupted the BTB as evidenced by increased IgG staining within the seminiferous tubules. Total protein levels of the tight-junction proteins ZO-1 and occludin were increased in the seminiferous tubules of rabbits fed the cholesterol-enriched diet, and the distribution patterns of tight-junction proteins were markedly affected, including an increased accumulation of tight-junction proteins in endosomes. Disruption of the integrity of the BTB due to increased plasma levels of cholesterol might play a role in male infertility.

Angiotensin II regulates testicular peritubular cell function via AT1 receptor: A specific situation in male infertility

We observed that peritubular myoid cells in the human testis are immunoreactive for angiotensin II (AngII) receptors (AT1R) and explored AngII actions in cultured human testicular peritubular cells (HTPCs). In response to AngII they contracted within minutes. The AT1R-blocker losartan blocked contraction, implying involvement of AngII and AT1R in intratesticular sperm transport. AngII also significantly increased IL-6 mRNA levels and IL-6 secretion within hours and losartan again prevented this action. This suggests involvement in inflammatory processes, which may play a role in male infertility. AngII can be generated locally by mast cell (MC)-derived chymase (CHY), which cleaves AngI. In testicular biopsies from infertile men we found abundant MCs, which express CHY, within the wall of seminiferous tubules. In contrast, CHY-positive MCs are hardly found in normal human testis. Testicular inflammatory events may fuel processes resulting in impaired spermatogenesis. Therefore therapeutic interference with MCs, CHY or AT1R might be novel options in male infertility.

Chlamydial Infection and Its Role in Male Infertility

Introduction. Chlamydia trachomatis is an established cause of tubal factor infertility; however its role in male fertility is not as clear. We sought to determine the prevalence of Chlamydia in infertile men and evaluate its impact on male reproductive potential. Materials and Methods. We compared the incidence of Chlamydia in our infertile male population with that reported in the literature. We then reviewed the impact of Chlamydia infection on male fertility. Results. The incidence of Chlamydia infection in our population of infertile men was 0.3%. There is considerable variability in the reported incidence, likely due to variation in the population studied, and detection technique. The optimal testing method and sample are presently unclear. The effect of Chlamydia on male reproductive function is also variable in the literature, but appears to be relatively minimal and may be related primarily to sperm DNA fragmentation or female partner transmission. Conclusions. The prevalence of Chlamydia in the infertile male population is low and routine testing is not supported by the literature. For high-risk infertile men, nucleic acid testing of urine +/− semen is the most sensitive method to detect Chlamydia. A validated testing system for semen needs to be developed, so that a standardized methodology can be recommended. In this way the full implications of Chlamydia on male fertility can be elucidated.

Socio-occupational class, region of birth and maternal age: influence on time to detection of cryptorchidism (undescended testes): a Danish nationwide register study

BackgroundCryptorchidism (undescended testes) is associated with poor male fertility, but can be alleviated and fertility preserved to some degree by early detection and treatment. Here we assess the influence of socio-occupational class, geographical region, maternal age and birth cohort on time to detection and correction of cryptorchidism.MethodsAll boys born in Denmark, 1981 to 1987 or 1988 to 1994, with a diagnosis of cryptorchidism were identified in nationwide registers. The boys were followed for a diagnosis until their 16th birthday. The age at first diagnosis was noted and used as proxy for time to detection of cryptorchidism. Parental employment in the calendar year preceding birth was grouped into one of five socio-occupational classes. Geographical region was defined by place of birth in one of 15 Danish counties. Detection rate ratios of cryptorchidism were analyzed as a function of parental socio-occupational group, county, maternal age and birth cohort by use of Poisson regression.ResultsSome 6,059 boys in the early and 5,947 boys in the late cohort received a diagnosis of cryptorchidism. Time to detection was independent of parental socio-occupational group and maternal age but differed slightly between geographical regions. A similar pattern was obtained for surgical correction after a diagnosis. Age at diagnosis decreased by 2.7 years from the early to the late cohort.ConclusionsThese results indicate that childhood socio-occupational inequality in detection and correction of cryptorchidism would play a negligible role in male infertility in a life course perspective. Geographical region may have exerted some influence, especially for the oldest cohort.

Review of Clinical Trials on Effects of Oral Antioxidants on Basic Semen and Other Parameters in Idiopathic Oligoasthenoteratozoospermia

Infertility affects 50 to 80 million people worldwide. Male factor is a cause of infertility in almost half of cases, mainly due to oligoasthenoteratozoospermia (OAT). With common diagnostic methods no cause can be found in approximately 30% of cases of male infertility due to OAT and these are considered idiopathic. Reactive oxygen species (ROS) play an important role in male infertility and are proved to be higher in infertile men; antioxidants could oppose their effect. The aim of this paper was to review the literature on clinical trials in the period from year 2000 to year 2013 studying the effects of various types of antioxidant supplements on basic and other sperm parameters and pregnancy rates in subfertile males with idiopathic OAT. The majority of studies were randomized and placebo controlled and confirmed beneficial effect of antioxidants on at least one of the semen parameters; the biggest effect was determined on sperm motility. In many of these trials combinations of more antioxidants were assessed. The optimal dosages of one or more antioxidants were not defined. We concluded that antioxidants play an important role in protecting semen from ROS and can improve basic sperm parameters in case of idiopathic OAT.

Obesity Appears to Impact Male Fertility by Degrading Overall Semen Quality Rather than Individual Semen Parameters

Obesity has become a well-recognized medical issue. However its exact role in male infertility remains unclear. The objective of the current study was to determine if an increase inBMIis associated with an increase in semen parameter abnormalities and if this relationship was influenced by other patient activities. Charts were reviewed for one hundred and thirty-three male patients who had also undergone a complete initial office face to face interview, as part of an infertility evaluation and a semen analysis. As part of standard patient care, all patients answered a detailed questionnaire regarding demographics, exposures, medical and reproductive history as part of their infertility evaluation. Patients were grouped according toBMIas normal (20 - 24 kg/m2), overweight (25 - 30 kg/m2), or obese (>30 kg/m2). Semen analysis parameters analyzed included: morphology, volume, concentration, percent motility, and agglutination. While some parameters suggested trends, results were similar between the normal, overweight, and obeseBMI, for concentration (P= 0.18), volume (P = 0.845), motility (P = 0.06); % Positive agglutination: 12%, 7%, 7% (P = 0.668) and % normal morphology (P = 0.083). Unlike a number of previous studies, results indicate that there is no statistically significant association betweenBMIand any of the individual semen parameters tested. Raw data suggested a trend for decreasing concentration with increasingBMI. Further, data also suggested equal numbers of oligospermics in each group. However, when the data looked at globally rather than on the effects on individually parameters (total number of normal motile sperm cells—NMS), functional sperm cells decreased with increasing BMI. None of these factors appeared to be affected by other patient factors. Collectively these data suggest that obesity has a multifactorial effect on male fertility; possibly due to relationships with the hormone cascade, body composition and potentially testis temperature regulation. Further study will be needed to confirm such relationships.