Semen Parameters Research Articles

The Efficacy of Mediterranean Diet for Erectile Dysfunction in Diabetes Mellitus Patients: A Narrative Review

Background : Male infertility affects millions globally, with 12-15% of Indonesian couples facing conception challenges, 50% of which are attributed to male factors. Despite extensive research, 70% of male infertility cases remain idiopathic. Diabetes, a prominent factor in male infertility, affects 9.3% of the global population, with projections estimating 700 million cases by 2045. Recent studies suggest the Mediterranean diet positively impacts semen parameters, particularly in diabetic individuals. This review aims to explore the Mediterranean diet's effects on fertility in male diabetic patients. Reviews : The literature review employed three databases, focusing on in-vitro, in-vivo, pre-clinical, and clinical studies from 2014-2024. Diabetes, a chronic disease characterized by abnormal blood sugar levels, affects insulin production or effectiveness, leading to complications if left uncontrolled. Erectile dysfunction (ED), prevalent in diabetic men, is attributed to nerve and blood vessel damage from high blood sugar levels. Treatments for ED include PDE5 inhibitors, but alternative plant-based therapies are being explored. Platelet-rich plasma (PRP) has shown promise in animal studies but lacks human trial data. The Mediterranean diet, rich in plant-based foods and healthy fats, may help prevent sexual function deterioration in diabetic individuals. Comprehensive nutrition education and government efforts are crucial in promoting healthy lifestyles and ensuring access to fresh foods. Summary : In conclusion, the Mediterranean diet shows promise as a dietary intervention for improving male fertility in diabetic populations. Further research is warranted to confirm these findings and to explore the mechanisms underlying the effects of the Mediterranean diet on male fertility.

Correlation of Sperm DNA Fragmentation Index With Semen Parameters, Lifestyle and Clinical Pregnancy Outcome After Intracytoplasmic Injection.

This study aimed to measure the correlation of sperm DNA fragmentation with semen parameters, lifestyle, and fertility outcomes after intracytoplasmic injection (ICSI). The partners who were candidates for ICSI with a history of one In vitro fertilization (IVF) failure or male factor were recruited in the study. Semen parameters including sperm count, motility, and morphology as well as DNA fragmentation index (DFI) (that were divided into 2 groups as high (>15%), and low (≤15%) fragmentation scales) were evaluated either. The correlation of DFI with semen parameters, lifestyle, and clinical pregnancy after ICSI were compared between groups. In 120 included couples, 59 men (49.2%) had DFIs ≤ 15% and 61 (50.8%) cases had DFIs >15%. In the group with higher DFI, abnormal morphology (p=0.010) was higher whereas, progressive motility (p=0.001), total motility (p<0.001), and total count (p<0.001) of sperm were significantly lower. In addition, the DFI was significantly higher in the subgroup of male infertility (0.012). Logistic regression showed that a lower risk of DFI>15% was associated with higher values of progressive motility (OR=0.97, p=0.001), total motility (OR=0.96, p=<0.001), count (OR=0.96, p=<0.001) and even clinical pregnancy (OR=0.27, p=0.011). However, a history of testicular surgery was associated with a higher risk of DFI>15% (OR=3.37, p=0.046). Although no correlation was found between male age and lifestyle components with DFI, the number of embryos was lower in DFI≥15% (p<0.001). DFI provide a clinically important measurement of sperm quality and have an impact on IVF outcomes; however, lifestyle components may not correlate with DFI.

Determination of Electrolytes and Trace Elements in Biological Samples from Patients with Altered Semen Parameters: a Correlational Analysis.

The effects of important nutrients such as calcium (Ca), copper (Cu), iron (Fe), magnesium (Mg), selenium (Se), and zinc (Zn) have been investigated in relation to male fertility due to their roles in proper spermatogenesis, sperm maturation, motility, and optimal sperm function. An imbalance between these elements has been associated with several pathologic conditions and male reproductive issues. The purpose of this study was to determine the essential trace and electrolytes elements, such as Ca, Cu, Fe, Mg, Se, and Zn, in human biological samples (blood, serum, and semen) from patients with male infertility. This study used correlational analysis to determine the potential associations between these elements and male fertility. Imbalances in these elements have been linked to various pathological conditions and male reproductive issues. One hundred eighty referent male adults and two hundred twenty-nine patients diagnosed with subtypes of infertility were included in the study, divided into two age groups. Acid digestion was controlled using a microwave oven, and the essential trace elements and electrolytes in the oxidized biological samples were determined using atomic absorption spectrometry. Certified reference materials of blood and serum were used to validate the accuracy of the methodology. The results showed that the concentrations of Ca, Cu, Fe, Mg, Se, and Zn in the blood, serum, and seminal plasma of male adults in all age groups were higher than those in patients with different infertility phenotypes. Essential element deficiency in all biological fluid samples may significantly negatively affect human reproductive health and lead to male infertility. Through a multidimensional approach, our study sought to unravel the intricate biochemical signatures associated with OAT, providing insights that may shape the landscape of diagnostic and therapeutic strategies for male reproductive health.

Type 1 diabetes mellitus and sperm quality: A case-control study.

The potential impact of diabetes mellitus type 1 (DM1) on male fertility is currently poorly defined. Hyperglycaemia and insulin deficiency may affect spermatogenesis. Some evidence suggests that men with DM1 have a significant reduction in progressive sperm motility, sperm morphology and semen volume, without significant changes in sperm concentration and count, but definite data are lacking. To evaluate the impact of DM1 on clinical parameters related to male fertility and semen analysis. We compared a court of 42 male DM1 patients with 43 nondiabetic subjects overlapping in age and remaining clinical data in an observational case-control study. All subjects underwent a comprehensive andrological reproductive evaluation, including medical history, physical examination, and semen analysis. We collected biochemical data in all patients with DM1, while diabetic patients with any alteration in semen parameters underwent sperm culture and scrotal ultrasound. In addition, all men completed the IIEF-5 questionnaire (International Index of Erectile Function-5) and the AMS (Aging Male Symptom score) questionnaire. Patients with DM1 had a higher prevalence of infertility, erectile dysfunction and worse semen parameters compared with controls. In particular, semen volume, total sperm count, and total and progressive sperm motility were significantly lower (p<0.001, p=0.003, p=0.048, and p=0.022 respectively). In addition, the rate of semen anti-sperm antibody positivity, the AMS score and FSH levels were higher. Several mechanisms may contribute to these semen alterations in DM1 patients, such as oxidative damage to spermatogenesis, seminal infections and pelvic neurological changes. These data suggest that patients with DM1 should be counselled from an andrological-reproductive point of view.

Correlation between sperm DNA fragmentation and methylation in male partners of couples with idiopathic recurrent pregnancy loss

With ∼50% recurrent pregnancy loss cases being termed idiopathic (iRPL), understanding of contribution of male factors to iRPL is still lacking. Higher prevalence of sperm DNA fragmentation index (DFI) and lower sperm 5-methylcytosine (5-mC) levels have been previously reported in male partners of iRPL couples and shed light on importance of the male gamete in maintenance of a successful pregnancy. The present study aimed to determine the serum sex steroid hormone levels, sperm DFI and 5-mC and correlation between them in male partners of fertile and iRPL couples. Further, correlation between sperm DFI and 5-mC with semen parameters and paternal age in both groups were determined. 36 male partners of fertile couples and 45 male partners of women experiencing iRPL were enrolled for this study and semen and blood samples were collected. Serum testosterone and estradiol levels were measured by ELISA; sperm DFI and global 5-mC were determined by TUNEL assay and ELISA respectively. Significantly higher serum testosterone levels were noted in the iRPL group (p = 0.028). Incidence of sperm DNA fragmentation was found to be higher in the iRPL study group but with no significance difference. No significant differences in sperm 5-mC values were noted. Upon correlation analysis within both groups, strong significant negative correlation of sperm DFI % and 5-mC % was observed in the control group (p < 0.001) but not the iRPL group (p = 0.249). Hence, we infer that with lower 5-mC levels in sperm genome, there is a higher incidence of sperm DFI in fertile men. However, this trend is not noted in men of iRPL group which could possibly be due to other underlying epigenetic alterations in genomic regions probably unsusceptible to fragmentation. On the other hand, no significant correlations of semen parameters, testosterone, estradiol and paternal age with sperm DFI and 5-mC were noted in both groups.

High seminal BPA in IVF patients correlates with lower sperm count and up-regulated miR-21 and miR-130a

Bisphenol A (BPA) is a widespread industrial chemical, used as the key monomer of polycarbonate plastics and epoxy resins. BPA has been detected in human seminal fluid and has been correlated with changes in sperm parameters, crucial in determining male fertility. In this study, semen samples were collected from 100 patients aged 29–47 years undergoing fertility assessment between 2021 and 2023 and analyzed according to WHO guidelines. BPA levels in the seminal plasma were then measured through an enzyme-linked immunosorbent assay (ELISA) and compared to sperm quality metrics. The relative mRNA/miRNA expression of key genes associated to male reproduction, including androgen receptor, miR-34c, miR-21, miR-130a, was then quantified and compared between groups with high or low BPA content. Our results revealed that BPA levels were increased with age and were negatively correlated with sperm counts (p<0.05). The negative correlation remained significant when patients were age-matched. No other relationships between seminal BPA and motility, morphology or DNA fragmentation levels were observed. qPCR analysis showed that androgen receptor mRNA expression was significantly greater in sperm with high seminal BPA (p<0.05). Moreover, we found that the expression of miR-21 and miR-130a was also upregulated in the higher BPA group (p<0.05). These results display a relationship between BPA content in the semen and male fertility parameters, and provide insights into the molecular mechanisms through which BPA may be affecting male reproductive capability. Ultimately, this research can potentially drive changes to guidelines and exposure limits for BPA exposure.

Association of lifestyle and occupational exposure factors with human semen quality: a cross-sectional study of 1060 participants

The incidence of male infertility (MI) is rising annually. However, the lifestyle and occupational exposure factors contributing to MI remain incompletely understood. This study explored the effects of self-reported lifestyle and occupational exposure factors on semen quality. Among 1060 subjects invited to participate, 826 were eligible. The participants’ general characteristics, lifestyle, and occupational exposure factors were collected immediately before or after semen evaluation through an online questionnaire. Initially, univariate analysis was used to investigate the relationship between the abovementioned factors and semen quality. The results indicated significant associations between low semen quality and various factors, including age, BMI, infertility type and duration, abstinence time, semen and sperm parameters, smoking, alcohol consumption, irregular sleep habits, and frequent exposure to high temperatures and chemicals at work (p < 0.05). Then, multivariate analysis was conducted to identify factors independently associated with low semen quality. Adjustment for relevant confounders was achieved by including factors with a p-value < 0.25 from univariate analyses as covariates in the binomial and ordered logistic regression models. The results suggested that alcohol consumption was a positive factor for sperm concentration (odds ratio [OR] = 0.60; 95% confidence interval [CI] = 0.36–0.99; p = 0.045). The groups with a BMI ≥ 24 and <28 kg/m2 showed a significant decrease in sperm progressive motility when compared to the reference group (BMI < 24 kg/m2) (OR = 0.63; 95% CI = 0.46–0.87, p = 0.005). In addition, the groups that drank green tea <1 time/week (OR = 1.52, 95% CI = 1.05–2.2) and 1–4 times/week (OR = 1.61, 95% CI = 1.02–2.54) exhibited significantly increased sperm DFI values compared with the group that drank green tea 5–7 times/week. In conclusion, these findings underscore the importance of maintaining a normal weight and regularly consuming green tea for men.

Optimized sperm selection: a highly efficient device for the isolation of progressive motile sperm with low DNA fragmentation index.

To identify the sperm preparation procedure that selects the best sperm population for medically assisted reproduction. Prospective observational study comparing the effect of four different sperm selection procedures on various semen parameters. Unused raw semen after routine diagnostic analysis was split in four fractions and processed by four different methods: (1) density gradient centrifugation (DGC), (2) sperm wash (SW), (3) DGC followed by magnetic activated cell sorting (MACS), and (4) using a sperm separation device (SSD). Each fraction was analyzed for progressive motility, morphology, acrosome index (AI), and DNA fragmentation index (DFI). With DGC as standard of care in intraclass correlation coefficient analysis, only SSD was in strong disagreement regarding progressive motility and DFI [0.26, 95%CI (- 0.2, 0.58), and 0.17, 95%CI (- 0.19, 0.45), respectively]. When controlling for abstinence duration, DFI was significantly lower after both MACS and SSD compared to DGC [- 0.27%, 95%CI (- 0.47, - 0.06), p = 0.01, and - 0.6%, 95%CI (- 0.80, - 0.41), p < 0.001, respectively]. Further comparisons between SSD and MACS indicate significantly less apoptotic cells [Median (IQR) 4 (5), 95%CI (4.1, - 6.8) vs Median (IQR) 5 (8), 95%CI (4.9, - 9.2), p < 0.001, respectively] and dead cells [Median (IQR) 9.5 (23.3), 95%CI (13.2, - 22.4) vs Median (IQR) 22 (28), 95%CI (23.1, - 36.8), p < 0.001, respectively] in the SSD group. The selection of a population of highly motile spermatozoa with less damaged DNA from unprocessed semen is ideally performed with SSD. Question remains whether this method improves the embryological outcomes in the IVF laboratory.

Testosterone therapy at the time of vasectomy reversal: Impact on intraoperative decision-making and interpretation of postoperative outcomes.

During vasectomy reversal (VR), accurate intraoperative microscopic assessment of the vasal fluid for sperm presence and quality is essential in determining the indication for a vasovasostomy (VV) or vasoepididymostomy (VE). The use of testosterone therapy (TT), known to supress spermatogenesis, can potentially interfere with this determination. This initiative evaluated the impact of TT on vasal and epididymal fluid sperm characteristics and intraoperative decision-making among men on TT at the time of VR. Of 2622 consecutive VRs performed from 2007-2023, patients actively using TT at the time of VR were identified. Details as to the type, dose, and duration of TT were documented. All patients were counselled regarding the impact of TT on spermatogenesis and encouraged to discontinue TT if possible. During VR, vasal and epididymal fluid (as indicated) was sampled and each aspirate underwent microscopic evaluation for sperm presence and quality, and categorized as: motile sperm/intact-non-motile sperm/sperm parts/no sperm. Rates of sperm presence/absence in the vasal/epididymal fluid, frequency of VV/VE, postoperative patency (presence of motile sperm), and semen parameters were compared among patients on TT vs. clinically matched patients not using TT at the time of VR. Among the 2622 VRs reviewed, 54 men (2%) reported using TT at the time of their VR. Despite its impact on spermatogenesis, intraoperative microscopic analysis of the reproductive fluid (vasal or epididymal) identified the presence of sperm in 95% (51/54) of patients. Testis biopsy confirmed sperm production among three patients with absence of sperm within the vasal or epididymal fluid. Rates of VV or VE did not significantly differ among men using TT at the time of VR compared to nonusers. Postoperative patency rates (TT: 78 % vs. no TT: 93%) and mean total motile sperm counts (TMC) were lower among patients using TT at the time of VR (7.9 vs. 28.3, p=0.02). Use of TT at the time of VR does not appear to impact rates of intraoperative microscopic identification of sperm within the reproductive fluid or the indication for VV/VE. Postoperative patency rates and total motile sperm counts may be lowered by use of TT. Moreover, the determination to the etiology azoospermia postoperatively (production vs. obstruction) may be clouded by the use of TT during VR.

Variation of sperm quality and circular RNA content in men exposed to environmental contamination with heavy metals in 'Land of Fires', Italy.

Can illegal discharge of toxic waste into the environment induce a new condition of morpho-epigenetic pathozoospermia in normozoospermic young men? Toxic environmental contaminants promote the onset of a new pathozoospermic condition in young normozoospermic men, consisting of morpho-functional defects and a sperm increase of low-quality circular RNA (circRNA) cargo, tightly linked to contaminant bioaccumulation in seminal plasma. Epidemiological findings have reported several reproductive anomalies depending on exposure to contaminants discharged into the environment, such as germ cell apoptosis, steroidogenesis defects, oxidative stress induction, blood-testis barrier dysfunctions, and poor sperm quality onset. In this scenario, a vast geographical area located in Campania, Italy, called the 'Land of Fires', has been associated with an excessive illegal discharge of toxic waste into the environment, negatively impacting human health, including male reproductive functions. Semen samples were obtained from healthy normozoospermic men divided into two experimental groups, consisting of men living in the 'Land of Fires' (LF; n = 80) or not (CTRL; n = 80), with age ranging from 25 to 40 years. The study was carried out following World Health Organization guidelines. Quality parameters of semen from CTRL- and LF-normozoospermic men were evaluated by computer-assisted semen analysis; high-quality spermatozoa from CTRL and LF groups (n = 80 for each experimental group) were obtained using a 80-40% discontinuous centrifugation gradient. Seminal plasma was collected following centrifugation and used for the dosage of chemical elements, dioxins and steroid hormones by liquid chromatography with tandem mass spectrometry. Sperm morpho-functional investigations (cellular morphology, acrosome maturation, IZUMO1 fertility marker analysis, plasma membrane lipid state, oxidative stress) were assessed on the purified high-quality spermatozoa fraction by immunochemistry/immunofluorescence and western blot analyses. Sperm circRNA cargo was evaluated by quantitative RT-PCR, and the physical interaction among circRNAs and fused in sarcoma (FUS) protein was detected using an RNA-binding protein immunoprecipitation assay. Protein immunoprecipitation experiments were carried out to demonstrate FUS/p-300 protein interaction in sperm cells. Lastly, in vitro lead (Pb) treatment of high-quality spermatozoa collected from normozoospermic controls was used to investigate a correlation between Pb accumulation and onset of the morpho-epigenetic pathozoospermic phenotype. Several morphological defects were identified in LF-spermatozoa, including: a significant increase (P < 0.05 versus CTRL) in the percentage of spermatozoa characterized by structural defects in sperm head and tail; and a high percentage (P < 0.01) of peanut agglutinin and IZUMO1 null signal cells. In agreement with these data, abnormal steroid hormone levels in LF seminal plasma suggest a premature acrosome reaction onset in LF-spermatozoa. The abnormal immunofluorescence signals of plasma membrane cholesterol complexes/lipid rafts organization (Filipin III and Flotillin-1) and of oxidative stress markers [3-nitrotyrosine and 3-nitrotyrosine and 4-hydroxy-2-nonenal] observed in LF-spermatozoa and associated with a sperm motility reduction (P < 0.01), demonstrated an affected membrane fluidity, potentially impacting sperm motility. Bioaccumulation of heavy metals and dioxins occurring in LF seminal plasma and a direct correlation between Pb and deregulated circRNAs related to high- and low-sperm quality was also revealed. In molecular terms, we demonstrated that Pb bioaccumulation promoted FUS hyperacetylation via physical interaction with p-300 and, in turn, its shuttling from sperm head to tail, significantly enhancing (P < 0.01 versus CTRL) the endogenous backsplicing of sperm low-quality circRNAs in LF-spermatozoa. Participants were interviewed to better understand their area of origin, their eating habits as well as their lifestyles, however any information incorrectly communicated or voluntarily omitted that could potentially compromise experimental group determination cannot be excluded. A possible association between seminal Pb content and other heavy metals in modulating sperm quality should be explored further. Future investigations will be performed in order to identify potential synergistic or anti-synergistic effects of heavy metals on male reproduction. Our study provides new findings regarding the effects of environmental contaminants on male reproduction, highlighting how a sperm phenotype classified as normozoospermic may potentially not match with a healthy morpho-functional and epigenetic one. Overall, our results improve the knowledge to allow a proper assessment of sperm quality through circRNAs as biomarkers to select spermatozoa with high morpho-epigenetic quality to use for ART. This study was supported by 'Convenzione Azienda Sanitaria Locale (ASL) Caserta, Regione Campania' (ASL CE Prot. N. 1217885/DIR. GE). The authors have no conflict of interest to declare. N/A.

Impact of varicocele repair on semen parameters and spontaneous pregnancy: An endless debate put to rest

ABSTRACT There has been much controversy about the true value of varicocele repair for improving fertility and the chances of natural conception. This review summarizes the latest research findings, current professional societies’ recommendations, and the conclusions of recent systematic reviews and meta-analyses. The current evidence suggests a positive role for varicocele repair in improving basic sperm parameters and increasing the likelihood of natural pregnancy.

Effectiveness of Herbal medicines on male reproductive system: Evidence from meta-analysis

BackgroundThe increasing prevalence of male infertility has become a global concern. Traditional Chinese and Asian medicines have long been using herbal remedies to promote spermatogenesis. This study aimed to systematically explore the potential of herbal medicines and formulations to enhance the male reproductive function in humans. MethodsTwo prominent databases, MEDLINE and EMBASE, as well as scientific journals indexed in the Web of Science, were used for the literature search until October 2023. The studies included in the analysis focused on the impact of herbal medicines (Mucuna pruriens, Withania somnifera, Eurycoma longifolia, Panax ginseng, Lycopersicon esculentum, Crocus sativus, Vitis vinifera, Nigella sativa, Sesamum indicum, Curcuma longa, Lepidium peruvianum) and Chinese and Korean Polyherbal formulations (Shao-Fu-Zhu-Yu-Tang; 少腹逐瘀汤) on human serum reproductive hormone levels, semen parameters, and antioxidant enzymes. ResultsA total of 23 articles were deemed eligible for the review and meta-analysis, which included 1,194 men from seven countries (China, Korea, Iran, Peru, Japan, Malaysia, and India). Of these, 19 articles were analyzed for semen parameters. The use of herbal medicine increased seminal parameters, including semen volume during each ejaculation (standardized mean difference (SMD) = 0.89; 95 % CI: 0.52, 1.26), sperm concentration (SMD = 1.97; 95 % CI: 1.30, 2.64), total sperm count (SMD = 2.28; 95 % CI: 1.44, 3.11), sperm motility (SMD = 1.07; 95 % CI: 0.68, 1.46), and normal morphology (SMD = 1.47; 95 % CI: 0.62, 2.32). Additionally, 18 articles that analyzed sex hormone levels showed that treatment with herbal medicines favorably reduced serum prolactin (SMD = -0.70; 95 % CI: -1.13, -0.28) and FSH levels (SMD = -1.07; 95 % CI: -1.56, -0.56). Meanwhile, herbal medicines did not affect testosterone levels (SMD = 0.41; 95 % CI: -0.24, 1.06) and LH levels (SMD = 0.45; 95 % CI: -0.33, 1.23). Finally, six articles were analyzed for seminal biochemical and antioxidant profiles, and the results showed that herbal medicine increased the levels of ascorbic acid (SMD = 1.19; 95 % CI: 0.51, 1.86), corrected seminal fructose (SMD = 1.32; 95 % CI: 0.89, 1.76), superoxide dismutase activity (SOD) (SMD = 1.06; 95 % CI: 0.45, 1.68), and catalase activity (SMD = 0.91; 95 % CI: 0.69, 1.44) in seminal plasma. ConclusionHerbal remedies have been found to promote spermatogenesis by optimizing semen parameters, sex hormone levels, and antioxidant profiles. As a result, these treatments should be regarded as complementary approaches to male infertility.

Comparison of Testicular Sonography and Elastography Findings With Semen Parameters in Cases Investigated for Infertility.

This study aimed to investigate the correlation between testicular shear wave elastography (SWE) values and semen analysis results in men with infertility. This was a retrospective case-control study. Patients were categorized as normal, abnormal, or azoospermic based on sperm analysis results. Testicular volume was measured using B-mode ultrasonography using the Lambert formula. Subsequently, 40-80 regions of interest measuring 1.5 × 1.5 mm were manually positioned in both testicles based on their size, and two-dimensional SWE was applied through virtual touch imaging quantification software. The patients had a mean age of 33.79 ± 6.3 years, with semen analysis revealing normal results in 15 patients (22.4%), pathological findings in 35 patients (52.2%), and azoospermia in 17 patients (25.4%). Right, left, total, and mean testicular volumes were significantly lower in patients with azoospermia compared to those in both normal and impaired semen parameters (P < .05). Conversely, testicular elastography scores were higher in patients with azoospermia than in the other groups (P < .05). The significant negative correlation between volume and elastographic findings remained independent of age (r = 0.4, P < .001). The accuracy rates for detecting impaired semen parameters and azoospermia were 94.3% and 94.1%, respectively, after considering factors such as age, testicular volume (right/left/total), and elastography (right/left/total). Notably, the total mean elastography score ranked first, with 100% in the independent normalized importance distribution of these variables. SWE can be used effectively alone or in combination with other diagnostic tools to evaluate histopathological changes in the testicles of male patients with infertility.

Effect of repeated semen ejaculation on sperm quality and selected biochemical markers of canine semen

The aim of this study was to evaluate the quality parameters and selected biochemical markers of canine semen sampled at 24-h intervals over a period of 5 days, preceded by 6 months of sexual abstinence. Full ejaculates were obtained from 6 dogs. Ejaculate volume and total sperm counts in the ejaculate decreased gradually on successive sampling days. The percentage of total motile spermatozoa (TMOT), percentage of progressively motile spermatozoa (PMOT), sperm plasma membrane integrity (SPMI), and sperm mitochondrial membrane potential (MMP) increased on successive days of sampling. In addition, ATP content increased in spermatozoa. Total protein content (TPC) and the activity of aspartate aminotransferase (AAT), alkaline phosphatase (AP), and acid phosphatase (AcP) decreased in seminal plasma. Repeated ejaculation over a period of 5 days induced changes in the qualitative and quantitative parameters of canine semen. A decrease in the values of some biochemical markers of semen, secreted by the epididymis and the prostate gland, could point to disturbances in the secretory activity of these organs. Canine semen sampled after prolonged sexual abstinence is generally characterized by less desirable quality parameters, and this observation should be taken into consideration when semen is collected for artificial insemination or preservation. Semen quality can be significantly improved by repeating the sampling procedure after 24 hours. One the other hand, repeated sampling on successive days can significantly decrease total sperm counts in the ejaculate. As a result, a sufficient number of semen doses for artificial insemination may not be obtained from a single ejaculate.

Effect of treatment of chronic hepatitis c virus patients with direct-acting anti-retroviral drugs on semen and hormonal parameters

Objective: Hepatitis C virus (HCV) infection is known to influence the seminal and hormonal parameters of infected men. This study was performed to assess the effects of HCV clearance using direct-acting antiviral (DAA) agents on semen and hormonal parameters. Methods: A total of 50 patients with chronic HCV were enrolled, and conventional semen analysis was performed according to World Health Organization guidelines. Basal levels of total testosterone, free testosterone (FT), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin, and sex hormone-binding globulin (SHBG) were assessed before and 3 months after treatment with DAAs.Results: Following DAA treatment, statistically significant increases were observed in sperm motility and the proportion of grade A sperm. Additionally, the percentage of abnormal forms was significantly decreased after treatment (p=0.000). However, no significant differences were observed in semen volume, concentration, or total sperm count. Sex hormone analysis of patients after DAA treatment revealed significant increases in FT, LH, and FSH levels, along with significant decreases in SHBG, prolactin, and E2 levels.Conclusion: Following HCV clearance, we noted an improvement in sperm motility and an increase in the percentage of sperm with normal morphology. Treatment with DAAs was also associated with increased levels of FT and LH, along with decreased levels of SHBG, prolactin, and E2.

A 2-step remote TUNEL approach for sperm DNA fragmentation assessment. Analysis in donors and patients

ObjectivesInfertility is a disease of the male or female reproductive systems. Male reproductive workup is based on routine semen analysis, although of limited value. The 2021 WHO Manual incorporated Sperm DNA Fragmentation (SDF) assessment, and highlighted the need for individual laboratories to define suitable thresholds. This study aimed to present an alternative to address this issue, determine an SDF cut-off value with fertile donors, and characterize SDF in a patient cohort and their relationship with semen parameters. Study designA service unit was established to remotely perform TUNEL assay in a 2 step-process. Semen samples were received at andrology laboratories, subjected to routine semen analysis (WHO, 2010), partially processed and transported to the service unit for SDF evaluation. Using this setting, studies were done in fertile donors (n = 15) to define the cut-off value, and in men undergoing infertility workup (n = 318). ResultsA cut-off value of 9.17 % was determined with the fertile donor cohort. With this cut-off, a 64.46 % abnormal SDF incidence was determined in the patient cohort. SDF negatively correlated with sperm number, vitality and motility, and positively with abnormal morphology and male age (P < 0.05). TUNEL-positive cases depicted lower sperm quality and higher male age (P < 0.05). A similar abnormal SDF incidence was determined among patients with semen abnormalities. Asthenozoospermic and ≥40 years patient samples depicted higher (P < 0.05) SDF than those of the general population. SDF incidence was also high in normozoospermic patients. ConclusionsUsing a 2-step remote approach with a standardized procedure and an SDF cut-off value established with fertile donors, high SDF incidence in semen samples depicting normal and abnormal quality were identified in men consulting for infertility, highlighting the relevance of its evaluation as part of the male fertility workup.

The Effects of Varicocelectomy on Sperm DNA Fragmentation and Conventional Semen Parameters in Men with Severe Oligoasthenoteratozoospermia: A Prospective Study.

The dilation and torsion of testicular veins in the plexus pampiniformis causes Varicocele, which is a surgically repairable cause of male infertility. This study assessed the impact of varicocelectomy on semen characteristics, total motile sperm count (TMSC) and sperm DNA integrity in patients with severe oligoasthenoteratozoospermia (OAT). In this prospective study, semen samples of 360 men with severe OAT who underwent varicocelectomy according to World Health Organization (WHO) criteria 2021 were studied (pre-operatively and at 6, 12, and 18 months post-operatively). The average age of our patients was 38.5 years. The mean spermatozoa concentration was found to be 1.60 ± 0.83 million/ml pre-operatively, while the mean post-operative concentration was 5.17 ± 1.23 million/ml at 6 months, 8.32 ± 0.98 million/ml at 12 months, and 13.51 ± 1.48 million/ml at 18 months (P<0.0001). The mean percentage of A+B motile spermatozoa was 2.92 ± 1.17% pre-operatively, 6.10 ± 1.51% at six months, 9.58 ± 1.49% at 12 months and 13.92 ± 1.88% at 18 months postoperatively (P<0.0001). The mean Modified David's morphology score was 3.80 ± 1.43% pre-operatively, 5.95 ± 1.23% at 6 months, 7.94 ± 1.18% at 12 months, and 10.82 ± 1.91% at 18 months post-operatively (P<0.0001). The mean of total motile sperm count (TMSC) was statistically improved after varicocelectomy (P<0.001). The mean of DNA fragmentation index (DFI) of the spermatozoa was 31.40 ± 0.52% pre-operatively, and post-operatively at 28.20 ± 0.32% at 6 months, 25.90 ± 0.31% at 12 months and 20.50 ± 0.40% at 18 months (P<0.001). Varicocelectomy was associated with significant improvement of sperm parameters and DNA fragmentation resulting in significant improvement of spermatogenesis quality. We believe that universalization in the routinely used sperm dispersion chromatin (SDC) test could be beneficial in the treatment of infertility.

Interplay between male gonadal function and overall male health.

The process-of-male reproduction is intricate, and various medical conditions-have the potential to disrupt spermatogenesis. Moreover, infertility in males can serve as an indicator of-potential future health issue. Numerous conditions with systemic implications have been identified, encompassing genetic factors (such as Klinefelter Syndrome), obesity, psychological stress, environmental factors, and others. Consequently, infertility assessment-presents an opportunity for comprehensive health counseling, extending-beyond discussions about reproductive goals. Furthermore, male infertility has been suggested as a harbinger of future health problems, as poor semen quality and a diagnosis of-male infertility are associated with an increased risk of hypogonadism, cardiometabolic disorders, cancer, and even mortality. This review explores the existing-literature on the relationship between systemic illnesses and male fertility, impacting both clinical-outcomes and semen parameters. The majority of the literature analyzed, which compared gonadal function with genetic, chronic, infectious or tumoral diseases, confirm the association between overall male health and infertility.

Thyroid Hormones and Their Role in Male Infertility: A Comprehensive Review

Thyroid hormones are pivotal regulators of various physiological processes, including reproductive function. While the impact of thyroid dysfunction on female fertility has been extensively studied, its association with male infertility has gained increasing recognition. This comprehensive review explores the role of thyroid hormones in male infertility, focusing on their effects on spermatogenesis, sperm quality, and reproductive outcomes. The review delves into the physiology of thyroid hormones, the presence of thyroid hormone receptors in the male reproductive system, and the influence of thyroid dysfunction on spermatogenesis and semen parameters. Additionally, it examines the molecular mechanisms underlying thyroid hormone action in the male reproductive system and discusses potential therapeutic strategies targeting thyroid hormone pathways to improve male fertility. Understanding the intricate relationship between thyroid hormones and male infertility is crucial for advancing diagnostic and therapeutic approaches in the management of male infertility associated with thyroid dysfunction.

The Correlation of Paternal Age on Semen Parameters in Assisted Reproduction: A Retrospective Study in Qassim, Saudi Arabia.

In the past, fertility concerns have predominantly revolved around the effect of a woman's age on the quality of her eggs and the success of her pregnancy. While men generally retain their ability to father children throughout their lives, there is evidence suggesting a decline in natural conception rates as paternal age increases. A growing body of research indicates a potential link between advanced paternal age (APA) and various adverse outcomes, including changes in sperm genetics, reduced conception rates, higher rates of miscarriage, lower live birth rates, and even long-term health consequences in offspring. However, it remains unclear whether there is an association between APA and the effectiveness of assisted reproductive technology (ART). This study aims to shed light on the relationship between APA and semen parameters. This is a retrospective, descriptive study analyzing data from electronic medical records of men undergoing ART at a fertility clinic in Saudia Arabia(2017-2022). Men aged 21-60 with at least one semen analysis and no missing data/hormonal treatment were included. Data on age and semen parameters (count, motility, and morphology) were extracted and analyzed using Jeffreys's Amazing Statistics Program (JASP; University of Amsterdam, Amsterdam, Netherlands) (descriptive statistics, Spearman's rank correlation). Analysis of 1506 men undergoing ART revealed a mean age of 37 years (SD=6.94) and a mean sperm count of 55.0 million/mL (SD=46.05). The correlation between age and sperm count indicates a minimal association (r=0.075, p<0.01); moderate positive correlations were observed between sperm count and motility (r=0.406); count and morphology (r=0.543); and motility and morphology (r=0.458). Age may not be a major factor in overall sperm parametersfor this population, but a strong positive correlation was observed between sperm count, motility, and normal morphology. These findings suggest that these semen parameters are interconnected, with higher sperm counts potentially indicating better overall sperm quality.