Semen Quality In Infertile Men Research Articles

Novel approach for oligospermia (NAPO) - Protocol for a randomized controlled trial

BackgroundInfertility affects millions of couples globally, with up to 40–50 % of cases linked to impaired semen quality. Insemination or in vitro fertilization are used frequently, regardless of the cause of infertility due to the lack of specific medical interventions for male infertility. Denosumab, an antibody blocking RANKL signaling, may enhance semen quality in infertile men. This randomized controlled trial evaluates if denosumab improves spermatogenesis in men with severely impaired semen quality identified by serum AMH levels as a predictive marker. MethodsNAPO is a single-center, sponsor-investigator-initiated, placebo-controlled, double-blinded randomized trial. Subjects will be randomized in a 2:1 fashion to receive either denosumab 60 mg subcutaneously or a placebo. The study will be carried out at the Division of Translational Endocrinology, Copenhagen University Hospital, Herlev, Denmark. The primary outcome of the study is defined as the difference in sperm concentration (millions/mL) at one spermatogenesis (80 days) after inclusion. DiscussionAn important step in addressing infertility is establishing a viable treatment option for male infertility. With this study, we describe the protocol for a planned RCT aimed at evaluating whether treatment with denosumab can improve sperm concentration in men with severely impaired semen quality. The results of this study will provide evidence crucial for future treatment in a patient group where treatment options are minimal at best. Trial registrationClinical Trials: NCT06300229. Registered on March 12, 2024. Clinical Trials Information System (CTIS): 2023-508325-27-00. Approved on December 19, 2023.

The effect of astaxanthin after varicocele surgery on antioxidant status and semen quality in infertile men: A triple‐blind randomized clinical trial

AbstractVaricocele (VC) is widely recognized as a prevalent etiological factor contributing to male infertility. It has been established that the generation of reactive oxygen species (ROS) plays a significant role in the progression and development of VC. Antioxidants may regulate ROS levels in these patients. Astaxanthin (ASX) is a carotenoid compound with notable antioxidant and anti‐inflammatory characteristics. The current study postulated that the administration of ASX following varicocelectomy (VCT) could potentially enhance antioxidant status and semen quality in these patients. A total of 40 infertile males with clinical VC and abnormal semen analyses were randomly assigned to take part in the current trial. For 3 months following surgery, the intervention group took ASX (6 mg/day) while the control group received a placebo. After intervention, semen parameters, antioxidant status, and pro‐inflammatory cytokines were compared between the two groups. Regarding semen parameters, antioxidant treatment led to a significant improvement in total and progressive motility in the treatment group (p < 0.05). Additionally, ASX led to a considerable increase in the expression levels of NRF2, Keap1, SOD2, SOD3, and BCL2, though the enhancement in the expression level of SOD3 was not statistically significant (p > .05). However, ASX significantly decreased the BAX expression level (p < .05). Even though the level of total antioxidant capacity (TAC) of seminal fluid (SF) increased significantly in the treatment group (p < .05), the level of total oxidative stress (TOS) in SF did not differ substantially between treatment and control groups (p > .05). Based on inflammatory factors in SF, ASX led to a considerable reduction in levels of TNF‐α, IL‐1β, and IL‐6 (p < .05). Our findings demonstrated that ASX treatment provides an important contribution to VCT outcomes by modulating antioxidant status and pro‐inflammatory cytokines. Our results indicated that ASX may be beneficial as an adjuvant therapy for infertile men following VCT.

Low-serum antimüllerian hormone is linked with poor semen quality in infertile men screened for participation in a randomized controlled trial

ObjectiveStudies investigating associations between serum anti-Müllerian Hormone (AMH) and semen quality in infertile men have shown conflicting results. Here, we investigated possible associations between serum AMH and semen quality in infertile men. DesignInfertile men were included during screening for participation in FITMI, a double-blinded, placebo-controlled 1:1, single-center randomized clinical trial. SubjectsAt the screening visit, 400 participants produced a semen sample and had their serum analyzed for AMH. Main Outcome MeasuresSerum AMH and semen quality ResultsAll men were stratified according to serum AMH in quartiles (Q1-Q4). Men in the lowest quartile had a lower sperm concentration (million/mL) (Q1: 8.0 vs. Q2: 10.4 vs. Q3: 11.0 vs. Q4: 13.0; p=0.006), total sperm count (million) (Q1: 29.1 vs. Q2: 38.2 vs. Q3: 44.4 vs. Q4: 55.7; p=0.022), sperm motility (%) (Q1: 41 vs. Q2: 57 vs. Q3: 50 vs. Q4: 53; p=0.042), and progressive sperm motility (%) (Q1: 31 vs. Q2: 44 vs. Q3: 35 vs. Q4: 40; p=0.031) compared with the other quartiles. Moreover, men with a sperm concentration < 2 million/mL had a lower serum AMH compared with men having 2-16 million/mL and > 16 million/mL (31 pmol/L vs. 38 pmol/L vs. 43 pmol/L, respectively; p=0.015). In accordance, men with sperm motility < 20% had a lower serum AMH compared with men with sperm motility 20-42%, and > 42% (31 pmol/L vs. 43 pmol/L. vs. 39 pmol/L, respectively; p=0.008). ConclusionThis study shows that low serum AMH is associated with poor semen quality in infertile men, which implies that serum AMH may have clinical value during the evaluation of male infertility.

Spatial–Temporal Characteristics of Semen Quality in Infertile Men in Wenzhou, China during 2010–2018

Background. Declining semen quality has become one of the most serious public health problems worldwide; however, the spatial–temporal characteristics of semen quality of infertile men remain unknown. Objective. To explore spatial–temporal characteristics of semen quality of infertile men in Wenzhou from 2010 to 2018 and thereby provide a scientific basis for development of strategies to enhance male reproductive health. Methods. We obtained 22,978 semen sample data from 2010 to 2018 from the Reproductive Medicine Center and Urology of the First Affiliated Hospital of Wenzhou Medical University in Wenzhou, China. Linear regression analyses and spatial autocorrelation analyses were used to study spatial–temporal characteristics of semen quality parameters. Results. Overall, from 2010 to 2018, mean values for total sperm number and semen volume showed linear increasing trends, and mean values for total sperm motility showed linear decreasing trend (all P &lt; 0.05 ). Cold spot analyses of progressive sperm motility, total sperm motility, and normal sperm forms were also in main urban area of Wenzhou (Lucheng District, Ouhai District, Longwan District, and Dongtou District) and hot spot were also in nonmain urban area of Wenzhou (mainly including Taishun County, Pingyang County, and Wencheng County). However, hot spot analyses of total sperm number and semen volume were mainly in Dongtou District. Conclusions. The main urban area is the “harder-hit area” of semen quality, while for the islands area is the “high-withdrawal area.” Government departments need to pay more attention to improve male reproductive health in the main urban areas and actively control the potential influencing factors of male reproductive health, such as occupational exposure and life stress. Good environmental quality and plenty of seafood intake may be beneficial to semen quality.

P-102 Inhibition of RANKL increases the number of motile sperm in a subgroup of infertile men

Abstract Study question Does inhibition of RANKL increase semen quality in infertile men? Summary answer Overall, inhibition of RANKL (Denosumab) did not affect semen quality. However, in a subgroup of men with high serum AMH sperm production was significantly increased. What is known already Currently, there is no treatment available for male infertility, but studies in animal and preclinical human data have suggested a role for RANKL in male reproduction. Study design, size, duration A single-center, double-blinded, randomized clinical trial in 100 infertile men randomly assigned (1:1) to s.c. injection with 60 mg/mL Denosumab or s.c. saline injection 1 mL (0.9%) (placebo). The primary endpoint was changes in semen production, though the study was designed as an explorative study, with the aim of investigating the profile of which infertile men who would have a beneficial treatment outcome of Denosumab. Participants/materials, setting, methods All participants were infertile men referred to our andrological clinic due to impaired semen quality. Blood and semen samples were collected at baseline and after one and two cycles of spermatogenesis on day 80 and day 160, respectively. Main results and the role of chance There were no differences in semen quality or reproductive hormones at day 80 or day 160 between men treated with Denosumab or placebo. However, men with a serum AMH ≥ 40 pmol/L had a significant increase in total motile sperm (143% (SD 116%); p = 0.011), progressive motile sperm (133% (SD 100%); p = 0.039) and a borderline increase in sperm concentration (64% (SD 95%); p = 0.056) at day 80 compared to baseline. Further stratifying men according to both serum AMH (≥ 40 pmol/L) and serum RANKL (highest 50%), showed a significantly higher increase in sperm concentration (107% (SD 111%) vs. -8% (SD 68%); p = 0.009), total motile sperm (256% (SD 270%) vs. 31% (SD 125%); p = 0.039) and progressive motile sperm (191% (SD 194%) vs. 18% (SD 134%) p = 0.013) at day 80 in men treated with Denosumab compared to placebo treated men. Furthermore, serum FSH (-28% (SD 33%) vs. 0%, (SD 22%); p = 0.041) and serum LH (-29% (SD 28%) vs. 20% (SD 51%), p = 0.048) were significantly lower and testosterone/LH ratio (50% (SD 51%) vs. -7% (SD 43%); p = 0.024) significantly higher at day 80 in men treated with Denosumab compared to placebo treatment. Limitations, reasons for caution This is a report from a randomized clinical trial, with an explorative design. Randomized clinical trials in a predefined group of infertile men with high serum AMH, are needed to explore if inhibition of RANKL improves semen quality and pregnancy rate in infertile couples with male factor infertility. Wider implications of the findings The increase in sperm production after Denosumab treatment in infertile men with preserved Sertoli cell function needs to be validated, in a trial selecting men based on serum AMH. Ultimately, Denosumab may be a potential breakthrough in treating male infertility at least in some infertile men with high serum AMH. Trial registration number NCT03030196

Low serum anti-Müllerian hormone is associated with semen quality in infertile men and not influenced by vitamin D supplementation

BackgroundAnti-Müllerian hormone (AMH) is released by testicular Sertoli cells and of great importance during fetal male sexual development, but less is known about the role of circulating AMH during adulthood. In vitro studies have shown that vitamin D may induce AMH transcription, but a controlled trial investigating the possible effect of vitamin D on serum AMH has not been conducted in men.MethodsA single-center, double-blinded, randomized placebo-controlled clinical trial (NCT01304927) conducted in Copenhagen, Denmark. A total of 307 infertile men were included and randomly assigned (1:1) to a single dose of 300,000 IU cholecalciferol followed by 1400 IU cholecalciferol + 500 mg of calcium daily (n = 151) or placebo (n = 156) for 150 days. Difference in serum AMH was a predefined secondary endpoint. Explorative outcomes were associations between serum AMH and gonadal function in infertile men. The primary endpoint was difference in semen quality and has previously been published.ResultsInfertile men in the lowest AMH tertile had significantly lower sperm concentration (∆T3-1 16 mill/mL (228%); P < 0.001), sperm count (∆T3-1 55 million (262%); P < 0.001), motile sperm count (∆T3-1 28 million (255%); P < 0.001), progressive motile sperm count (∆T3-1 18 million (300%); P < 0.001), testis size (∆T3-1 2.7 mL (16%); P < 0.001), serum inhibin B (∆T3-1 72 pg/mL (59%); P < 0.001), inhibin B/FSH ratio (∆T3-1 48 (145%); P < 0.001), and higher FSH (∆T3-1 2.6 (38%); P < 0.001) than the tertile of infertile men with highest serum AMH. Vitamin D supplementation had no effect on serum AMH compared with placebo treatment.ConclusionsIn infertile men, low serum AMH is associated with severely impaired gonadal function illustrated by poor semen quality and lower testosterone/LH ratio. Serum AMH in infertile men was not influenced by vitamin D supplementation.

Bilateral varicocele leads to ferroptosis, pyroptosis and necroptosis of human spermatozoa and affects semen quality in infertile men.

Purpose: This study explored the effects of bilateral varicocele on male semen quality in infertile men and the molecular mechanisms involving ferroptosis, pyroptosis and necroptosis signaling pathways. Methods: Totally, 20 healthy males and 26 patients with bilateral varicocele receiving infertility treatment were enrolled. Semen samples were collected. Basic semen parameters, acrosome integrity and membrane integrity, mitochondrial membrane potential (MMP) and apoptosis rate were compared. Levels of reactive oxygen species (ROS), iron, glutathione (GSH), total superoxide dismutase (T-SOD), and, Catalase (CAT), were detected in human seminal plasma. Relative mRNA expression of Ca 2+-independent phospholipases A2 beta (iPLA 2β), P53, Zinc finger E-box binding homeobox 1 (ZEB1) and GSH-dependent peroxidase 4 (GPX4) were evaluated. Relative protein expression was determined for GPX4, receptor interacting serine/threonine kinase 1 (RIPK1) and receptor interacting serine/threonine kinase 3 (RIPK3), as well as pyroptosis markers of Gasdermin E (GSDME) and heat shock protein 90 (HSP 90). Results: The results revealed that the bilateral varicocele group had significantly higher abnormalities (sperm progressive rate and sperm motility) compared to the control group. Meanwhile, compared to control group, GSH, T-SOD, and CAT levels were reduced in the bilateral varicocele group (p < 0.05). However, the level of ROS and iron were significantly increased (p < 0.05). Relative mRNA expression of P53, iPLA 2β, ZEB1, and GPX4 were reduced. In addition, ROS exposure activated ferroptosis-related signal pathways. RIPK1, RIPK3, GSDME and HSP 90 were increased in bilateral varicocele group. ROS exposure affected signaling pathways related to ferroptosis, necrosis and pyroptosis in human spermatozoa. Conclusion: Bilateral varicocele leads to ferroptosis, pyroptosis and necroptosis of human spermatozoa and affects semen quality in infertile men.

Sulfur dioxide may predominate in the adverse effects of ambient air pollutants on semen quality among the general population in Hefei, China

Previous studies have reported potential adverse effects of exposure to ambient air pollutants on semen quality in infertile men, but studies on the general population have been limited and inconsistent, and the pollutants that play a major role remain unclear. This study aimed to explore the potential association between exposure to six air pollutants (PM2.5, PM10, NO2, SO2, O3 and CO) during different sperm development periods and semen quality among the general population, and to explore the interaction between different air pollutant exposures. We included 1515 semen samples collected from the Human Sperm Bank. We improved individuals' exposure level estimation by combining inverse distance weighting (IDW) interpolation with satellite remote sensing data. Multivariate linear regression models, restricted cubic spline functions and double-pollutant models were used to assess the relationship between exposure to six air pollutants and sperm volume, concentration, total sperm number and sperm motility. A negative association was found between SO2 exposure and progressive motility and total motility during 0–90 lag days and 70–90 lag days, and SO2 exposure during 10–14 lag days adversely affected sperm concentration and total sperm number. Sensitive analyses for qualified sperm donors and the double-pollutant models obtained similar results. Additionally, there were nonlinear relationships between exposure to PM, NO2, O3, CO and a few semen parameters, with NO2 and O3 exposure above the threshold showing negative correlations with total motility and progressive motility, respectively. Our study suggested that SO2 may play a dominant role in the adverse effects of ambient air pollutants on semen quality in the general population by decreasing sperm motility, sperm concentration and total sperm number. Also, even SO2 exposure lower than the recommended standards of the World Health Organization (WHO) could still cause male reproductive toxicity, which deserves attention.

Correlation between the levels of anti-sperm antibodies and some cytokines in the seminal plasma with sperm parameters and leukocytes concentration of infertile men

Background: The aim of this work is study the relationship between sperm parameters, anti-sperm antibody and some cytokines levels for infertile men. Semen samples were studied for 88 infertile men;of these (28) infertile men with normozoospermic, (29) with oligozoospermic and (31) with asthenozoospermic ,samples were collected from Fertility Centre in Al-Sadder teaching hospital in Al-Najaf / Iraq during the period of (2/11/ 2021) and (5/2/2022). All participants underwent seminal analysis and measurement of seminal plasma antisperm antibody and some cytokine. The result of the study showed negative correlation between antisperm antibody and of interleukin (IL-1and IL-6) with sperm parameter and posative correlation with leucocytes. The presence of leucocytes in the semen is associated with an increase in levels of interleukin (IL-1and IL-6) in the seminal plasma of infertile men. The presence of antisperm antibody and interleukin (IL-1and IL-6) in the seminal plasma is associated with a negative relationship in the semen quality of infertile men.

Effect of a single-dose denosumab on semen quality in infertile men (the FITMI study): study protocol for a randomized controlled trial

BackgroundInfertility is a common problem globally and impaired semen quality is responsible for up to 40% of all cases. Almost all infertile couples are treated with either insemination or assisted reproductive techniques (ARTs) independent of the etiology of infertility because no medical treatment exists. Denosumab is an antibody that blocks RANKL signaling and inhibition of testicular RANKL signaling has been suggested to improve semen quality in a pilot study. This RCT aims to assess whether treatment with denosumab can improve spermatogenesis in infertile men selected by serum AMH as a positive predictive biomarker. This paper describes the design of the study.Methods/designFITMI is a sponsor-investigator-initiated, double-blinded, placebo-controlled 1:1, single-center, randomized clinical trial. Subjects will be randomized to receive either a single-dose denosumab 60 mg subcutaneous injection or placebo. The study will be carried out at the Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen. The primary outcome of the study is defined as the difference in sperm concentration (millions pr. mL) one spermatogenesis (80 days) after inclusion.DiscussionWe describe a protocol for a planned RCT aimed at evaluating whether treatment with denosumab can improve the semen quality in infertile men selected by using serum AMH as a positive predictive biomarker. The results will provide evidence crucial for future treatment in a patient group where there is a huge unmet need.Trial registrationClinical Trials.gov NCT05212337. Registered on 14 January 2022.EudraCT 2021–003,451-42. Registered on 23 June 2021.Ethical committee H-21040145. Registered on 23 December 2021.

Association between generalized anxiety symptoms and semen quality in infertile men: A multicentre study in North China.

This study was conducted to investigate the generalized anxiety levels and its association with semen quality in infertile men. We recruited male patients who visited the infertility outpatient departments of three teaching hospitals in North China and evaluated their generalized anxiety symptoms using the self-administered 7-item generalized anxiety disorder (GAD-7) scale. Seminal analysis was performed as per WHO guidelines. A total of 378 infertile men (average age: 31.43 ± 5.85 years) were classified into the normal group (n=174, 46%) and the anxiety group (n=204, 54%) according to their GAD-7 scale score. The proportion of patients with hyperlipidaemia in the normal group was significantly higher than that in the anxiety group (14.9% vs. 5.9%, p=0.004). The other demographic characteristics were not statistically different between both groups. Patients with abnormal GAD-7 scale scores had a significantly lower sperm count (202.48 vs. 166.80 million per ejaculate, p=0.023), sperm concentration (54.75 vs. 46.54 million/ml, p=0.033), and progressive motility (40.25 vs. 37.16, p=0.020) than those with normal GAD-7 scale scores. Multivariate linear regression models revealed that anxiety was significantly negatively associated with sperm concentration (percent change=-9.79, 95%CI: -12.38 to -7.12, p < 0.001), total sperm count (percent change=-13.07, 95%CI: -16.05 to -9.84, p < 0.001), progressive motility (β=-1.41, 95%CI: -1.86 to -0.96, p < 0.001), total sperm motility (β=-1.73, 95%CI: -2.38 to -1.08, p < 0.001), and normal sperm morphology (β=-0.16, 95%CI: -0.28 to -0.04, p=0.009), respectively. Taken together, generalized anxiety disorder could significantly influence the clinical semen quality in infertile men in North China, and psychological stress management might be helpful.

Effects of high serum uric acid levels on oxidative stress levels and semen parameters in male infertile patients.

This study is to investigate the effect of high serum uric acid (UA) level on oxidative stress and semen quality of male infertility patients.A cohort of 654 male individuals aged between 20 and 45 years old were included in this study, and their semen and venous blood samples were collected. The serum UA, blood glucose, blood lipids, and hormone levels were determined by chemiluminescence method. The changes in inflammatory factors, oxidative stress, adipokines, and biochemical indices in seminal plasma were determined by ELISA. Organic acids in seminal plasma were detected with reversed-phase ultra high performance liquid chromatography.Compared with the control group, the amount of semen and the total number of sperm in the hyperuricemia group significantly reduced (P < .05). Semen volume decreased with the increase of serum UA level, and the total number of sperm also decreased. The level of luteinizing hormone increased and the level of testosterone decreased in the hyperuricemia group. The concentration of superoxide dismutase decreased and the concentration of endothelin increased in the hyperuricemia group (P < .05). The concentration of seminal plasma α-glucosidase and alkaline phosphatase in the hyperuricemia group decreased significantly (P < .05). Compared with the control group, the contents of ascorbic acid, tartaric acid, lactic acid, and UA in the seminal plasma were significantly reduced in the hyperuricemia group (P < .05).Blood UA level may become a new risk predictor of semen quality in infertile men.

Semen Quality of Infertile Men and Correlation with Demographic Characterictics

Objective: To analyze semen quality of infertile men and its correlation with demographics characteristics.Methods: This was an analytic observational study with cross-sectional retrospective study design on 92 infertile men. The study began in May 2021 to December 2021 in the Obstetrics and Gynecology Clinics at BMC Hospital Padang.Results:The correlation between age and marital duration was positively correlated (r= 0,558), with a weak correlation and there is statistically significant relationship between age and marital duration. Age and sperm concentration was positively correlated (r=0.048), with a weak correlation. Marital duration and sperm concentration was positively correlated (r=0.052), with a weak correlation. The correlation between age and progressive motility and non-progressive motility percentage were positively correlated (r = 0.009 and 0.035),with a weak correlation. The correlation between age and progressive immotile sperm percentage were negatively correlated (r = - 0,030),with a weak correlation.Conclusion: There was a positive correlation between age and sperm concentration, and progressive and non progressive motility with a weak correlation. There was a positive correlation between age and marital duration with a strong correlation. There was negative correlation between and sperm immotility with a weak correlation.Keywords: Â male infertility, semen, age, marital duration

The impact of gram positive bacteria on semen quality in infertile men and assessment antibiotic Susceptibility profile

The impact of gram positive bacteria on semen quality in infertile men and assessment antibiotic Susceptibility profile

P–585 The influence of omega–3 fatty acids on female fertility in assisted reproductive technology

Abstract Study question Is there evidence that the intake of omega–3 fatty acids has a positive effect on probability of clinical pregnancy in women undergoing IVF/ICSI treatment? Summary answer No significant correlation was found between omega- 3 fatty acid intake (neither supplemental or as fish intake) and clinical pregnancy. What is known already: Omega–3 fatty acids are important substrates in metabolism and the supplement of omega–3 fatty acids have been thought to have a positive effect on semen quality in infertile men. Studies have shown that the intake of omega–3 fatty acids might also have a direct effect on oocytes, the quality of the embryos, and implantation of the embryo in the uterus at conception. However, the role of omega–3 fatty acids in female fertility still remains unclear as the relationship between omega–3 fatty acids and successful IVF treatment in women has shown conflicting results. Study design, size, duration Systematic review. Systematic literature research (PRISMA) on PubMed, Embase, and Cochrane identifying clinical studies focusing on omega–3 fatty acid intake amongst women receiving IVF treatment, using good scientific practice for literature search and management. 5 articles meeting inclusion criteria were found, with a total of 1.100 women undergoing IVF/ICSI treatment. Participants/materials, setting, methods: Population: women in fertility treatment Intervention: omega–3 fatty acid and/or fish intake Comparison: No/low intake of omega–3 fatty acid and/or fish intake Outcome: Primary: clinical pregnancy rate, Secondary: number of follicles, embryo quality, live birth rate Main results and the role of chance Number of follicles was found to be inversely associated to omega–3 intake in a single study. Higher levels of total omega–3 intake were found to be positively associated to embryo morphology scores, and thus quality, independent on energy intake. None of the four studies considering clinical pregnancy found any statistical significance in the association between fish intake and clinical pregnancy. Regarding live birth as an endpoint, fish intake, but not fish oil supplements, was seen to significantly increase the probability in one study with a dose-response relationship. A similar association was not found by the only other study also examining live birth. Limitations, reasons for caution: Only five studies were found to meet inclusion criteria. None of the included studies were randomized controlled trials. No meta-analysis was carried out due to the heterogeneity of the studies. Wider implications of the findings: The need for further studies, including randomized controlled trials of high quality with larger population sizes, is critical in order to thoroughly investigate and conclude any possible association of the beneficial effect of omega–3 fatty acids on female fertility in regard to IVF treatment. Trial registration number Not applicable

The effect of Phoenix dactylifera pollen on the expression of NRF2, SOD2, CAT, and GPX4 genes, and sperm parameters of fertile and infertile men: A controlled clinical trial.

BackgroundOxidative stress is caused by the imbalance occurring between the creation and clearance of the reactive oxygen species (ROS), which is responsible for 30–40% of male infertility. The positive impact of phoenix dactylifera pollen (Date palm pollen, DPP) on the improvement of sperm parameters has been well documented in animal models.ObjectiveFor evaluating the effect(s) of DPP on sperm parameters, ROS levels, expression of antioxidant genes, and activity of antioxidant enzymes of infertile men.Materials and Methods In this controlled clinical trial, a total of 60 male case with infertility and 20 normospermic fertile men were recruited. Before and after the treatment with DPP, the case were administered 400 mg/kg of gelatinous capsules daily for 30 consecutive days and semen samples were taken. Quantitative real-time polymerase chain reaction was applied for the evaluation of the mRNA expression levels of Nuclear factor erythroid 2-related factor 2(NRF2), superoxide dismutase (SOD2), glutathione peroxidase 4(GPX4), and catalase (CAT) genes.Results The mRNA expression levels of NRF2, SOD2, GPX4, and CAT (p 0.05 for all) and significantly increased after treatment with DPP. The increased expressions of all antioxidant genes and enzymes significantly correlated with improvement in semen parameters including count (p = 0.01), motility (p = 0.05), and morphology (p = 0.01) of sperm. A significant correlation between the alteration of SOD2 gene expression and SOD activity, GPX4 and GPX, and CAT were also observed (p = 0.05).ConclusionDPP can increase the expressions of NRF2, GPX4, SOD2, and CAT genes and also improve the semen quality in infertile men.

Effects of Varicocele on Serum Testosterone Levels and Changes of Testosterone Levels after Varicocelectomy among Infertile Men: A Prospective Controlled Study

Background: Varicocele repair has been advocated as an option to prevent and treat low serum testosterone, even in men with normal semen quality. The association between clinical varicocele and impaired testosterone production is less clearly understood. Although, the conceptions of the negative impact of clinical varicocele on Leydig cell functions and the beneficial effect of varicocele repair on testosterone production have been proposed for decades. Objective: To examine the hypotheses that clinical varicoceles affect baseline serum total testosterone levels and to study the effects of varicocelectomy on serum testosterone levels and semen quality in infertile men who suffer from varicocele. Patients and Methods: This study included 100 patients (50 control and 50 cases) presented to the General Surgery and Endocrine Surgery Unit Outpatient Clinic at Mansoura University Hospitals with clinical varicocele for primary infertility. The study was conducted during the period between 1st April 2020 and end of March 2021. Results: Regarding preoperative and postoperative testosterone level among the intervention group, there were highly statistically significant increases in total testosterone as well as significant improvement in gonadal functions (significant increase in number of cases with euogonadism) after the operation among the intervention group (P < 0.001). however the percent of improvement was more than among hypogonadal compared to euogonadal. Conclusion: Varicocelectomy was demonstrated to significantly improve both sperm quality (in terms of volume, count, motility and morphology) as well as serum testosterone in infertile men, especially in cases with hypogonadism.

P0515 - SERPIN may have a potential as biomarker in reflecting the improvement of semen quality in infertile men who underwent varicocele repair

P0515 - SERPIN may have a potential as biomarker in reflecting the improvement of semen quality in infertile men who underwent varicocele repair

SERPIN A5 may have a potential as a biomarker in reflecting the improvement of semen quality in infertile men who underwent varicocele repair.

We aimed to identify proteins that were differentially regulated in spermatozoal samples collected from fertile healthy men (FHM) and infertile patients with varicocele (IFPV) before and after varicocelectomy. Seminal samples were collected from 20 IFPV before and after varicocelectomy and from 14 FHM as controls. Samples underwent seminal examination and proteomic analysis. Extracted spermatozoal proteins were analysed using two-dimensional gel electrophoresis, and differentially regulated spermatozoal proteins (DRSPs) were identified. In particular, attention was placed on those DRSPs in which the concentration changed after varicocelectomy and corrected to approximate levels observed in FHM. Varicocelectomy significantly improved the sperm count and concentration in IFPV (p<0.05). Proteomic analysis showed that 11 DRSPs were identified when comparisons were made among the three groups. Among these 11 proteins, change in the SERPIN A5 concentrations was notable because it was 100-fold downregulated in pre-operative IFPV samples and nearly resembled to control concentrations following varicocelectomy. Western blot analysis using an anti-SERPIN antibody validated the changes observed in SERPIN A5 levels before and after varicocelectomy operation. Increase in SERPIN A5 after varicocelectomy may be due to improvement in semen quality, suggesting that SERPIN A5 is a potential seminal biomarker for assessment of semen quality in varicocele-related infertility.

Effect of antioxidant supplementation containing L-carnitine on semen parameters: a prospective interventional study.

Objective:One of the remarkable causes of infertility in men is oxidative stress having a reducing effect on their reproductive function. In the present study, we investigated the efficacy of supplementation with antioxidants and L-Carnitine (contained in Androferti) on semen parameters.Methods:We included 180 infertile male patients diagnosed with idiopathic oligoastenoteratozoospermia (OAT) in this study, and we analyzed the semen sample from 59 patients before and after oral antioxidant treatment, with the commercial name of Androferti (containing 1500 mg of L-Carnitine, 60 mg of vitamin C, 20 mg of coenzyme Q10, 10 mg of vitamin E, 10 mg of zinc, 200 µg of vitamin B9, 50 µg of selenium, 1 µg of vitamin B12). All of the patients received Androferti twice a day for 3 months. Results:There were significant improvements in the sperm concentration (p=0.004) after the antioxidant supplementation. There was also a meaningfully improvement in sperm morphology (p=0.01) after treatment. However, sperm motility was not significantly altered after antioxidant treatment (p=0.2).Conclusions:Antioxidants supplementation containing 1500 mg L-carnitine can improve the semen quality in infertile men diagnosed with idiopathic OAT. However, further studies are required to determine the antioxidant effects on reproduction function.