Semen Tests Research Articles

The Correlation Study Between Seminal Fluid Enzymes and Effects on Men's Fertility

Objective: By analyzing the relationship between ALP, GOT, and LDH action within the seminal plasma of fruitless men and comparing it with ripe men, this study aimed to investigate the physiological conditions that remain unexplained in most cases. Methods: This study collected forty-four semen tests from normospermic men and 20 tests from fertile men, after a period of forbearance (3-5 days). The tests were analyzed within the Babylon Maternity and Children research facility and private research facilities, from January 2024 to April 2024. Results: The results indicated that ALP and AST activity had a negative correlation in both fertile (r = - 0.123) and normospermic men (r = - 0.038). Similarly, ALP and LDH activity had a negative correlation in fertile men (r = -0.334), but a positive correlation that was not significant (P˃0.05) in normospermic men (r= 0.128). Moreover, the results showed that AST and LDH activity positively correlated in both normospermic (r=0.058) and fertile men (r=0.242). Conclusion: The study hypothesized that normal semen components and gland secretory ability may be indicated by ALP, AST, and LDH activity. The levels of ALP, AST, and LDH activity in males who were fertile and those who were not showed any discernible differences.

Patient Portal Engagement Affects Postvasectomy Semen Analysis Completion

To identify factors that affect completion of post-vasectomy semen analysis (PVSA) in men receiving telehealth pre-vasectomy counseling. Telehealth visits have become increasingly common for pre-vasectomy consultations. Prior studies have shown that men prefer telehealth vasectomy consultations over in-person options. Post-vasectomy semen testing should be completed to confirm sterilization. Three-hundred and seventy-one men aged 19 and older who saw a single physician for a telehealth pre-vasectomy consultation and completed an in-office vasectomy were included in the study. Demographic information such as age, patient relationship status, and distance from the clinic were accessed via EMR. Patients were assessed based on their engagement with electronic pre-procedure instructions, and the primary outcome measured was completion of PVSA. 45.6% of men completed a PVSA. There was no significant difference in completion of the PVSA between those who opened their electronic instructions before their vasectomy and those who did not (46.1% vs 44.4%, p=0.77). Of those who messaged the clinic for any reason at least once after their consultation, 62% completed their PVSA; 41% who did not contact the clinic completed the PVSA (p=0.0009). While there was no difference in completion of PVSA in patients who opened their instructions vs. those who did not, patients with a higher level of engagement with the patient portals were more likely to complete their semen test. By understanding factors influencing patient compliance with post-vasectomy semen testing, healthcare professionals can develop targeted interventions to ensure safe and successful outcomes.

Global Practice Patterns in the Evaluation of Non-Obstructive Azoospermia: Results of a World-Wide Survey and Expert Recommendations.

Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations. Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Re-assessment of the close relationship between serum FSH levels and semen quality: a retrospective cohort study of 11,929 Chinese men.

To establish a medically valuable normal reference interval of follicle-stimulating hormone (FSH) levels in males with normal semen and to assess the predictive value of FSH in males exhibiting semen abnormalities. The study involved male patients who underwent their initial serum sex hormone test and semen test between October 2013 and June 2023. The reference interval was identified as the 95% confidence interval (CI) of FSH values in the patients with normal semen parameters. Then, in the total study population, receiver operating characteristic (ROC) curves were performed to evaluate the discriminatory ability of FSH for oligozoospermia and non-obstructive azoospermia (NOA). Besides, multivariable logistic regression was performed to investigate the association of FSH with oligozoospermia and NOA adjusted by age. A total of 11,929 patients were finally enrolled in the study. The normal reference interval of FSH ranged from 1.70 IU/L to 7.60 IU/L (median: 3.98 IU/L) based on 4595 patients with normal semen routine parameters. In the total patients, ROC curves showed FSH to have a "fair" discriminatory ability for oligozoospermia (area under receiver operating characteristic curve (AUC) 0.747, threshold 7.32 IU/L, accuracy 0.734, positive predictive value (PPV) 0.754, negative predictive value (NPV) 0.726), while ROC curves showed FSH to have a "excellent" discriminatory ability for NOA (AUC: 0.921, threshold 10.18 IU/L, accuracy 0.903, PPV 0.593, NPV 0.972). Besides, multivariable logistic regression showed that FSH ≥ 7.32 IU/L was associated with a 8.51-fold increase in the risk of oligozoospermia adjusted by age, while FSH ≥ 10.18 IU/L was associated with a 38.93-fold increase in the risk of NOA. Our findings indicated that the reference interval for FSH in males with normal semen was 1.70-7.60 IU/L and found that FSH was capable of effectively discerning oligospermia and NOA.

Performing a sperm DNA fragmentation test in addition to semen examination based on the WHO criteria can be a more accurate diagnosis of IVF outcomes

BackgroundWe analyzed the sperm DNA fragmentation index (DFI) and general semen test based on the World Health Organization (WHO) criteria and compared the two tests using semen factors. In addition, we examined whether DFI is a reliable parameter associated with in vitro fertilization (IVF) outcomes.MethodsSperm chromatin dispersion (SCD) and general semen tests were conducted in accordance with the WHO 2010 guidelines, and correlations between the two tests were investigated. The WHO criteria were set as the cutoff values for each of the following factors: semen volume, concentration, total sperm count, motility, and normal morphology, and compared with the DFI results.ResultsThe subjects had a mean sperm DFI of 15.3% ± 12.6%, and the DFI increased with age. In contrast, motility and normal morphology decreased as the DFI increased. Patients who satisfied the WHO criteria in terms of concentration, total sperm count, and motility had a significantly lower DFI than those who did not satisfy the criteria. Therefore, evaluation with a general semen test based on the WHO criteria should be regarded as a qualitative evaluation of all factors other than semen volume and normal morphology.ConclusionsHigh DFI (≥ 30%) caused a low blastocyst development rate following intracytoplasmic sperm injection. Male infertility due to DFI should be suspected when IVF results are poor despite normal semen findings based on the WHO criteria. The results of this study suggest that the SCD test may more accurately evaluate the correlation between IVF clinical outcomes and male infertility. Therefore, it is important to focus on DFI measurements.

MECP2 germline mosaicism plays an important part in the inheritance of Rett syndrome: a study of MECP2 germline mosaicism in males

BackgroundGermline mosaicisms could be inherited to offspring, which considered as “de novo” in most cases. Paternal germline MECP2 mosaicism has been reported in fathers of girls with Rett syndrome (RTT) previously. For further study, we focused on MECP2 germline mosaicism in males, not only RTT fathers.MethodsThirty-two fathers of RTT girls with MECP2 pathogenic mutations and twenty-five healthy adult males without history and family history of RTT or other genetic disorders were recruited. Sperm samples were collected and ten MECP2 hotspot mutations were detected by micro-droplet digital PCR (mDDPCR). And routine semen test was performed at the same time if the sample was sufficient. Additionally, blood samples were also detected for those with sperm MECP2 mosaicisms.ResultsNine fathers with RTT daughters (28.1%, 9/32) were found to have MECP2 mosaicism in their sperm samples, with the mutant allele fractions (MAFs) ranging from 0.05% to 7.55%. Only one father with MECP2 c.806delG germline mosaicism (MAF 7.55%) was found to have mosaicism in the blood sample, with the MAF was 0.28%. In the group of healthy adult males, MECP2 mosaicism was found in 7 sperm samples (28.0%, 7/25), with the MAFs ranging from 0.05% to 0.18%. None of the healthy adult males with MECP2 germline mosaicisms were found with MECP2 mosaicism in blood samples. There were no statistical differences in age, or the incidence of asthenospermia between fathers with RTT daughters and healthy adult males with MECP2 germline mosaicisms. Additionally, there was no linear correlation between MAFs of MECP2 mosaicisms and the age of males with germline MECP2 mosaicisms.ConclusionsGermline MECP2 mosaicism could be found not only in fathers with RTT daughters but also in healthy adult males without family history of RTT. As germline mosaic mutations may be passed on to offspring which commonly known as “de novo”, more attention should be paid to germline mosaicism, especially in families with a proband diagnosed with genetic disorders.

Infertile men with semen parameters above WHO reference limits at first assessment may deserve a second semen analysis: Challenging the guidelines in the real-life scenario.

To investigate which infertile men with semen parameters above WHO reference limits at first semen analysis deserve a second semen test. Data from 1358 consecutive infertile men were analysed. Patients underwent two consecutive semen analyses at the same laboratory. Descriptive statistics and logistic regression models tested the association between clinical variables and semen parameters. A new predicting model was identified through logistic regression analysis exploring potential predictors of semen parameters below WHO reference limits after a previously normal one. Diagnostic accuracy of the new model was compared with AUA/ASRM and EAU guidelines. Decision curve analyses (DCA) tested their clinical benefit. Of 1358, 212 (15.6%) infertile men had semen parameters above WHO reference limits at first analysis. Of 212, 87 (41.0%) had a second semen analysis with results above WHO reference limits. Men with sperm parameters below reference limits at second analysis had higher FSH values, but lower testicular volume (TV) (all p<0.01) compared to men with a second semen analysis above WHO limits. At multivariable logistic regression analysis, lower TV (OR 0.9, p = 0.03), higher FSH (OR 1.2, p<0.01), and lower total sperm count (OR 0.9, p<0.01) were associated with second semen analyses below WHO limits. DCA showed the superior net benefit of using the new model, compared to both AUA/ASRM and EAU guidelines to identify those men with a second semen sample below WHO limits after a previously normal one. Approximately 60% of infertile men with a first semen analysis above WHO limits have a second analysis with results below limits. The newly identified risk model might be useful to select infertile men with initial semen results above WHO limits who deserve a second semen analysis.

The Effect of Palm Pollen and Black Seed Pollen on Male Sex Hormones and Sperm Quality: A Single-Blind, Placebo-Controlled Clinical Trial Study.

Nowadays, using medicinal properties is a good alternative for infertility treatment to use them is increasing in the world. The aim of this study was to determine the effects of Herbal oral capsules included palm pollen extract (DPP) and Nigella Sativa extract (NS) on sex hormones in adult infertile men. In this a single-blind, placebo-controlled clinical trial study, a total of 62 infertile men between 22 and 42 years of age were randomly selected and tested for sex hormones and prolactin. Thirty people in the case group received two 500 mg/kg capsules on a daily basis containing an herbal composition of palm pollen extract (350 mg) and black seed powder extract (250 mg) and the 20 in the control group received a placebo in the morning and at night for 3 months. The herbal composition capsules were manufactured by the Golbadistan Company. At the end of the three -month period, blood and semen tests were performed before and after the intervention in the case group that was compared with the control group. Hormonal assays were performed by Immunoradiometric Assay (IRMA) method. The data entered SPSS statistical software and the level of significance was set at P≤0.05. The spermiogram test results showed significant changes in the sperm count, progressive motility and rapid progressivity of the case group at the end of a quarterly period after consuming plant composition except for morphology (P=0.001, P=0.001, P=0.02, P=0.23). In addition, in the case group, the concentration of testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH) was significantly increased compared to the control group (P=0.000, P=0.004, P=0.012). It seems that taking one 500 mg/kg capsule of DPP and NS extract can significantly increase sperm parameters and testosterone (registration number: IRCT2015020120895N1).

ラテックス凝集免疫比濁法を用いた吐物証明法に関する法科学的研究

For forensic science, vomit identification is essential for crime scene reconstruction in various crimes, such as murder, abuse and drug poisoning. In order to develop a rapid and simple method for vomit identification, we modified the protocol for pepsinogen I (PGI) and pepsinogen II (PGII) detection kits based on latex agglutination turbidimetric immunoassay for clinical examination. Although these kits are assumed for using expensive automated biochemical analyzers, we examined the analysis on a general absorption spectrometer. As a result, PGI and PGII could be detected in up to 1000-fold diluted human gastric juices and mock casework samples by our modified method. However, cross-reactions with urine for PGI and semen for PGII were observed. If urine and/or semen is considered to be mixed in the casework samples, urine and/or semen tests should be performed in addition to PGI and PGII tests. Aged gastric juices stored up to 12 months were also detected, suggesting that the present method could be applicable to aged samples. Because PGI and PGII can be detected within approximately 1 hour by simple operations using an absorption spectrometer, the present method has the potential to be applicable to forensic caseworks as a new tool for vomit identification.

Longitudinal clinical course in patients with 5α-reductase type 2 deficiency treated with testosterone and dihydrotestosterone during infancy and puberty.

5α-reductase type 2 (5αRD2) deficiency is a 46,XY disorder of sex development caused by impaired conversion of testosterone (T) to dihydrotestosterone (DHT). Penile enlargement therapy is important for male patients with 46,XY 5αRD2 deficiency who have undermasculinized external genitalia, such as severe micropenis. High-dose T and percutaneous DHT replacement are reportedly efficacious for penile enlargement in patients with this disorder. We presented herein the longitudinal course of four patients with 46,XY 5αRD2 deficiency who received T and DHT. T replacement therapy during infancy increased the stretched penile length (SPL) in three of the patients but was ineffective in one patient. DHT was administered to the three patients after T replacement therapy and further increased the SPL. During and after puberty, two patients asked for and received T replacement therapy, which contributed to increasing their SPL. A semen test in one patient with T replacement therapy at age 27 years revealed cryptozoospermia despite normal testicular volume. The clinical course of our patients during infancy indicated that DHT therapy may be preferrable to T replacement therapy for penile enlargement in patients with 5αRD2 deficiency. During and after puberty, T replacement therapy promoted penile enlargement possibly because of increased conversion of T to DHT via increased 5α-reductase type 1 activity even in patients in whom it was ineffective during infancy. In conclusion, DHT is effective for penile enlargement during infancy in patients with 5αRD2 deficiency while T replacement therapy is a viable option during puberty.

Linear and non-linear relationships between sulfur dioxide and semen quality: A longitudinal study in Anhui, China

Existing evidence indicates that ambient air pollutants pose a threat to human semen quality; however, these findings are sparse and controversial. Besides, their non-linear dose-response relationship has not yet been well investigated. This study aimed to explore the linear and non-linear associations of gaseous air pollutants exposure with semen quality based on a large longitudinal cohort. A total of 15,112 males (with 28,267 semen tests) from the Anhui prospective assisted reproduction cohort were analyzed. Individual air pollutants exposure before semen tests in four exposure windows (i.e., 0–9, 10–14, 70–90, and 0–90 days) were estimated by inverse distance weighting interpolation. Linear mixed-effects models, cubic spline analysis and piecewise regression were used to test the potential linear and non-linear dose-response relationships. Ambient SO2 exposure was negatively associated with all semen quality parameters (all p values < 0.05), except for the progressive motility in the 0–90 and 70–90 days exposure windows. There were ‘J’ or ‘U’ shaped dose-response relationships of ambient SO2 exposure with total sperm count, progressive motility, total motility, progressively motile sperm count, and total motile sperm count (p values for non-linearity < 0.05), but not sperm concentration. Piecewise regression analysis also indicated a negative association of SO2 exposure with semen quality only when SO2 exposure was below the cut-off points identified by cubic spline analyses, which were all smaller than 40 μg/m3, the 2021 updated WHO air quality guideline level for SO2 exposure. Overall, we found that SO2 exposure was negatively associated with semen quality. Ambient SO2 exposure could reach the maximum hazardous dose even below the WHO air quality guideline level for SO2 exposure, suggesting a refinement to the current guideline.

Evaluating the sensitivity of presumptive and confirmatory tests for body fluids

Most exhibits received in the forensic genetics laboratory of Ras Al Khaimah (United Arab Emirates) are swabs or clothing with stains suspected of being either blood, semen or saliva; swabs from touch DNA are also reasonably common. Routine practice has been to use presumptive tests to characterize the materials before DNA extraction. In this study we evaluated the presumptive methods currently used for blood (Hemastix® and Kastle-Meyer), semen (Phosphatesmo KM) and saliva (Phadebas®) in comparison to the confirmatory tests OBTI Hexagon and RSID™ Blood, RSID™ Semen and RSID Saliva™. Results from this study showed that, as expected, presumptive tests were generally more sensitive in detecting body-fluids than confirmatory tests. The presumptive tests were at least two-fold more sensitive than the RSID™ Blood, Semen and Saliva confirmatory tests. However, the OBTI Hexagon test showed comparable sensitivity to Kastle-Meyer and Hemastix® for the detection of blood; this test utilizes an anti-hemoglobin antibody, which enables the high level of sensitivity. DNA was extracted from different dilutions and quantified using real-time PCR with the Quantifiler™ Human kit. Except for the RSID™-Blood and Saliva, the limit of detection for the tests was at dilutions where recovery of sufficient DNA for STR analysis was not likely.

Statistical methodologies for evaluation of the rate of persistence of Ebola virus in semen of male survivors in Sierra Leone.

The 2013-2016 Ebola virus (EBOV) outbreak in West Africa was the largest and most complex outbreak ever, with a total number of cases and deaths higher than in all previous EBOV outbreaks combined. The outbreak was characterized by rapid spread of the infection in nations that were weakly prepared to handle it. EBOV ribonucleic acid (RNA) is known to persist in body fluids following disease recovery, and studying this persistence is crucial for controlling such epidemics. Observational cohort studies investigating EBOV persistence in semen require following up recently recovered survivors of Ebola virus disease (EVD), from recruitment to the time when their semen tests negative for EBOV, the endpoint being time-to-event. Because recruitment of EVD survivors takes place weeks or months following disease recovery, the event of interest may have already occurred. Survival analysis methods are the best suited for the estimation of the virus persistence in body fluids but must account for left- and interval-censoring present in the data, which is a more complex problem than that of presence of right censoring alone. Using the Sierra Leone Ebola Virus Persistence Study, we discuss study design issues, endpoint of interest and statistical methodologies for interval- and right-censored non-parametric and parametric survival modelling. Using the data from 203 EVD recruited survivors, we illustrate the performance of five different survival models for estimation of persistence of EBOV in semen. The interval censored survival analytic methods produced more precise estimates of EBOV persistence in semen and were more representative of the source population than the right censored ones. The potential to apply these methods is enhanced by increased availability of statistical software to handle interval censored survival data. These methods may be applicable to diseases of a similar nature where persistence estimation of pathogens is of interest.

O-019 Covid 19 and male infertility-how long should fertility treatment be deferred to overcome the postcovid changes in semen parameters and to restore male fertility?

Study questionMale recovered from covid19 showed negative impact on sperm quality- are these changes reversible and are antioxidant therapy beneficial to overcome sperm quality changes?Summary answerOxidative stress created by the proinflammatory cytokine storm by covid19 virion might interect with spermatozoa to cause changes in spermiogram and antioxidant is the treatmentWhat is known alreadyCovid19 virion might interect with human spermatozoa and disrupt male fertility. Suppression of semen volume, progressive motility, morphology, sperm number and DNA integrity as a result of covid19 infection were correlated with markers of oxidative stress and inflammation. Sperm DNA damage is the key feature of the disease but the effect on semen quality seem to subside with the passage of time although further studies are needed to substantiate this point. My study is to determine whether the proposed antioxidant treatment to restore the negative impact of covid19 on sperm vitality is beneficial or not.Study design, size, durationThe study included 20 male aged 20-45yrs among those couples who were undergoing infertility treatment at Shristi Healthcare between April/2020 to October/2020 with a positive covid19 test and has recovered from the disease atleast 3-5months earlier and who had undergone spermiogram test before the onset of the disease. Semen samples were taken3-5months after recovery from covid19 and after 3 months treatment with antioxidant(CoenzQ10/300mg).Participants/materials, setting, methodsInclusion criteria: precovid normal spermiogram, with mild to moderate covid symptoms without hospitalisation. Exclusion criteria: those with precovid oligospermia or azooospermia, h/o steroid therapy for covid, h/o hormonal drug use that could affect spermiogenesis, with severe covid symptoms requiring ICU treatment. Time between last negative nasal swab test to semen analysis was 120-150days. Antioxidant(CoenzQ10/300mg)given as once daily dose for 3months after recovery from covid and semen test reviewed after treatment and compared with precovid data.Main results and the role of chanceThe mean age of participants were 30.4±4.8yrs and smoking status, BMI, medical history, presence of varicocele were recorded. Semen samples were processed according to WHO guidelines(2010, 5th edition). Statistical analysis was done by paired t test for paired samples and p value <0.05 was considered statistically significant. When semen samples before and after covid19 were evaluated, it showed marked decline in sperm volume/ml(precovid 3(2.5-3.5) to postcovid 1.5(1-2), p < 0.005); total sperm count x10^6per ejaculate(precovid 42(25-65) to postcovid 5(1-10), p < 0.005); progressive motility% (precovid 55.1±21.7 to postcovid 15.1±5.7, p < 0.001); sperm morphology%(precovid 45(30-60)to postcovid10(5-25), p < 0.001).After 3months CoenzQ10/300mg treatment semen showed significant improvement in all 3 parameters eg sperm count (3.15±3.38-20.9±2.11, p < 0.001), sperm motility(5.25±3.25- 42.85±3.30, p < 0.001) sperm morphology(7.81±2.26- 25.89±7.05, p < 0.001). All previous studies about postcovid semen changes used normal male as reference but strength of my study was precovid semen profile of same participant was available as a reference point. It was seen that fertility of male restores between3-6months postcovid with antioxidant treatment and can resume planning pregnancy.Limitations, reasons for cautionSmall sample size, interpatient variation in the severity of covid19, inadequate study design and retrospective nature. All patient examined had mild to moderate symptoms and none suffered from severe covid19 symptoms or needed ICU treatment so no data available to comment on severe postcovid19 case semen changes.Wider implications of the findingsMany couples initially deferred fertility care due to concern about covid19 disease. Globally many fertility centre has resumed delivering care. Men and their partners must be appropriately counselled regarding what is known and remains unknown about covid19 and male reproductive health.Trial registration numbernot applicable

Ability and accuracy of the smartphone-based O`VIEW-M® sperm test: Useful tool in the era of Covid-19

Male infertility affects up to 12% of men. Although manual testing using microscope examination and computer-assisted semen analysis are standard methods of measuring sperm count and motility, these methods are limited by being laboratory based. To investigate the usefulness of a novel semen analysis device using a smartphone camera. This prospective multicenter randomized parallel design trial enrolled 200 men aged ≥19 years of age between August and December 2018. Each subject was advised to use the Smart Sperm Test for OVIEW-M at home after 5 days of abstinence. The accuracy of the OVIEW-M test relative to the in-hospital test was determined. A questionnaire was administered to assess subject likelihood of using the OVIEW-M. Measurements using standard methods and the OVIEW-M showed similar sperm counts and similar motile sperm counts. Correlation analysis showed significant correlations between sperm count and sperm motility when measured by OVIEW-M tests (r = 0.893, p < 0.01) and standard microscope examination (r = 0.883, p < 0.01). Of the subjects who responded to questionnaires, 43% regarded the results of the OVIEW-M tests as reliable and 18% as unreliable. Semen analysis with the smartphone-based application and accessories yielded results not inferior to those of laboratory tests. Men who visit the hospital for evaluation of infertility can easily perform OVIEW-M semen tests at home.

Risk Factors for Ebola Virus Persistence in Semen of Survivors in Liberia.

Long-term persistence of Ebola virus (EBOV) in immunologically privileged sites has been implicated in recent outbreaks of Ebola virus disease (EVD) in Guinea and the Democratic Republic of Congo. This study was designed to understand how the acute course of EVD, convalescence, and host immune and genetic factors may play a role in prolonged viral persistence in semen. A cohort of 131 male EVD survivors in Liberia were enrolled in a case-case study. "Early clearers" were defined as those with 2 consecutive negative EBOV semen test results by real-time reverse-transcription polymerase chain reaction (rRT-PCR) ≥2 weeks apart within 1 year after discharge from the Ebola treatment unit or acute EVD. "Late clearers" had detectable EBOV RNA by rRT-PCR >1 year after discharge from the Ebola treatment unit or acute EVD. Retrospective histories of their EVD clinical course were collected by questionnaire, followed by complete physical examinations and blood work. Compared with early clearers, late clearers were older (median, 42.5 years; P < .001) and experienced fewer severe clinical symptoms (median 2, P = .006). Late clearers had more lens opacifications (odds ratio, 3.9 [95% confidence interval, 1.1-13.3]; P = .03), after accounting for age, higher total serum immunoglobulin G3 (IgG3) titers (P = .005), and increased expression of the HLA-C*03:04 allele (0.14 [.02-.70]; P = .007). Older age, decreased illness severity, elevated total serum IgG3 and HLA-C*03:04 allele expression may be risk factors for the persistence of EBOV in the semen of EVD survivors. EBOV persistence in semen may also be associated with its persistence in other immunologically protected sites, such as the eye.

A rare case of spinal and bulbar muscular atrophy (SMBA) diagnosed by hypertestosteronemia during infertility treatment

ABSTRACT Introduction Hypertestosteroneemia can be caused by a variety of diseases and drugs, some of which can cause male infertility. We report a case of spinal and bulbar muscular atrophy (SMBA) diagnosed by hypertestosteronemia during infertility treatment. Material &amp; Methods The patient was a 28-year-old man. His wife had no cause of infertility, did not become pregnant after 10 cycles of timed-intercourse. His semen test pointed out insufficient semen volume and asthenozoospermia. Although varicocele surgery was performed at the neighboring general hospital, semen findings did not improve. Even though two cycles of intrauterine insemination (IUI) were performed, she did not become pregnant. The couple were introduced to our clinic in November 2019. Semen findings at the first visit were same as first time. Serum hormone levels were LH 12.0 mIU / mL, FSH 3.9 mIU / mL and total testosterone 19.47 ng / mL. The testicular volume was 13 ml on both sides. SHIM: 22 points, EHS: Grade 3; the erectile function was a slight decreased. Drug-induced hypertestosteroneemia was negative. Microscopic pituitary adenoma revealed at the general hospital, but no pituitary dysfunction. The examination was conducted at the local national hospital, and a high value of CK 621 IU / L was pointed out. SMBA was suspected and the patient visited the neurology department. Finally, he had an allele of 49 CAG repeats and SMBA was diagnosed with mild bulbar palsy, weakness of the extremities Results Even with 3 courses of IUI, she did not become pregnant and was scheduled for in vitro fertilization (IVF). At the same time as the start of IVF, the patient had a definitive diagnosis of SMBA and was scheduled for LHRH agonist treatment. Because LHRH agonists were predicted to exacerbate semen findings, we performed sperm freezing for the purpose of fertility preservation. In the initial treatment cycle of ovum pick-up, 11 oocytes were collected, and 7 mature oocytes were obtained. Five oocytes were fertilized by ICSI using frozen sperm, and four blastocysts were vitrified. After that, the second vitrified-warmed blastocyst transplantation led to pregnancy, and the pregnancy is currently ongoing. Discussion SMBA, also known as Kennedy's Disease, affects adult men aged 30-60 years. It is a slowly progressive neuromuscular disease that causes muscle weakness, muscle atrophy, and fasciculation due to degeneration of lower motor neurons. This is a genetic disorder of X-linked recessive inheritance. It is caused by a trinucleotide repeat expansion; &amp;gt;40 CAG repeats, in the androgen receptor gene located on the X chromosome. Patients are mildly desensitized to androgens, causing gynecomastia, testicular atrophy, and diminished fertility. It is also accompanied by mild hypertestosteroneemia. These findings must have been the same for this patient. Conclusion This report is the world's first report of fertility-preserving sperm freezing in SMBA patients using ejaculated sperm, and is also the first report of ICSI-induced pregnancy in frozen sperm in SMBA patients. The effectiveness of ART was suggested for SMBA patients. Disclosure Work supported by industry: no.

Inverse association between ambient particulate matter and semen quality in Central China: Evidence from a prospective cohort study of 15,112 participants

Emerging evidence indicates that ambient particulate matter (PM) is harmful to male fertility, but the associations between ambient PM exposure and semen quality were inconsistent. This study aimed to quantitatively evaluate the association between ambient PM exposure and semen quality based on a large prospective cohort. Using data from the prospective assisted reproduction cohort in Anhui province, China, we included 15,112 males with 28,267 semen tests, whose partner has undergone assisted reproductive technology from September 1, 2015 to September, 22 2020. Individual ambient PM, gaseous air pollutants, and temperature exposures of the participants during 0–90, 0–9, 10–14, and 70–90 days before semen quality tests were evaluated using inverse distance weighting interpolation. Linear mixed-effects models were conducted to evaluate the relationship between PM2.5 and PM10 exposures and standardized semen quality parameters. Models were adjusted for age, body mass index, smoking, drinking, education attainment, occupation type, sampling month, temperature and the principal component of gaseous air pollutants. PM2.5 and PM10 were inversely associated with sperm concentration, total sperm count, total motility, progressive motility, total motile sperm count, and progressively motile sperm count during 0–90, 0–9, and 70–90 days period (all p < 0.05), but not 10–14 days period. The regression coefficients of PM2.5 exposure on semen quality parameters during 0–90 days period were larger than 0–9 and 70–90 days periods, and the effects of PM2.5 on semen quality parameters were stronger than PM10. Our results showed that ambient PM2.5 and PM10 exposures were associated with semen quality, during 70–90 days and 0–9 days before sampling, and the entire spermatogenesis process. The effects of PM2.5 on semen quality parameters were stronger than PM10, and the long-term effects of PM2.5 and PM10, throughout spermatogenesis, were stronger than the short-term effects.

Recovery of DNA from SERATECⓇ immunochromatographic PSA and saliva test strips.

There is an increased use of immunochromatographic test strips to presumptively identify bodily fluids of forensic interest, such as blood, semen, and saliva. Commonly, forensic samples are of low quantities. In the practice of conserving limited samples, it would be ideal to be able to recover the genetic material deposited on these testing membranes. This research aimed to determine whether DNA could be extracted from semen and saliva test strips, which part of the test strip is best to use, and to assess the quality of the DNA recovered. Semen and saliva samples were deposited on SERATEC® PSA Semiquant and Amylase Tests and analyzed. The testing membrane was then removed from the cassette and DNA extraction methods (forensicGEM Universal, forensicGEM Sperm, QIAamp® DNA Mini kit, Monarch® Nucleic Acid Purification kit, and organic extraction) were performed. Quality was evaluated by qPCR and STR analysis. DNA from semen was best extracted using the Monarch® Nucleic Acid Purification kit, while saliva was best extracted using the forensicGEM or QIAamp kits. No significant differences were observed between collection of the sample well pad and testing strip, thus use of the entire strip is encouraged. DNA from semen and saliva was quantifiable with a 1:1000 dilution. DNA quality analysis by qPCR showed that there is no difference in the DNA quality following elution from the test strip. However, degradation was noted in saliva samples and some semen samples by STR analysis. Scientists are encouraged to consider processed test strips for DNA profiling to preserve evidence.

Selective Serotonin Reuptake Inhibitor (SSRI) Use is Not Associated With Impaired Semen Parameters

ObjectiveTo examine the association between selective serotonin reuptake inhibitor (SSRI) use and semen quality. MethodsWe performed a retrospective review of all men undergoing semen analysis (SA) for fertility evaluation from 2002-2020 at a single academic medical center. Men were excluded if they had prior exposure to spermatotoxic medications, clomiphene citrate, gonadotropins, selective estrogen receptor modulators, or medical conditions known to impact male fertility. SSRI exposure was defined by an outpatient prescription within 90 days prior to any semen test. Differences between men with and without SSRI exposure were assessed with Wilcoxon rank sum for continuous variables and chi-squared testing for proportions. Univariable and multivariable linear regression models were fit to evaluate the relationship between SSRI use and individual semen parameters, controlling for age at the time of the semen analysis and non-SSRI drug use. ResultsA total of 8861 men were identified, of whom 153 men (1.7%) were exposed to SSRIs prior to SA. Median age was 35 years (interquartile range: 32-39) and was similar between groups (P = .999). Non-SSRI medication use was significantly higher in men taking SSRIs (78.4% vs 23.3%, < .001). On univariable and multivariable analyses, SSRI exposure was not associated with differences in semen volume, sperm concentration, motility, total motile sperm count, or normal morphology. ConclusionIn adult men undergoing fertility evaluation, SSRI exposure was not associated with impaired semen parameters. These data may help inform reproductive counseling and medical decision-making regarding SSRI use in men seeking paternity.