Sperm Parameters In Patients Research Articles

The Relationship Between Serum Growth Hormone, Seminal Plasma Growth Hormone, and Sperm Parameters in Patients with Acromegaly in Remission

The Relationship Between Serum Growth Hormone, Seminal Plasma Growth Hormone, and Sperm Parameters in Patients with Acromegaly in Remission

The Association Between Oxidative Stress and Sperm Parameters in Patients with Acromegaly.

Spermatozoa are susceptible to oxidative radicals when antioxidant defenses are inadequate. The extent to which oxidative radicals contribute to sperm damage in patients with acromegaly remains unclear. This study aimed to investigate and elucidate this relationship. The overall status of oxidants and antioxidants in both seminal plasma and serum of patients with acromegaly compared to a control group of healthy individuals was investigated. In addition, sperm parameters, including important measures such as growth hormone and insulin-like growth factor-1 concentrations. Twenty-two patients with acromegaly with controlled disease and 14 healthy controls were included. The total oxidant status was significantly higher in the semen samples of the patients with acromegaly. A negative correlation was found between sperm total oxidant status and total sperm count and sperm concentration. Similarly, a negative correlation was found between the total sperm count and the sperm oxidative stress index. In individuals diagnosed with acromegaly, there was a statistically significant increase in sperm growth hormone levels. Conversely, the level of insulin-like growth factor 1 was significantly increased in the sperm of the control group, which consisted of healthy individuals. The correlation analysis revealed a significant relationship between venous total oxidant status and growth hormone levels in semen. The elevated levels of reactive oxygen radicals in individuals with acromegaly suggest a possible link between oxidative stress and its effects on semen quality.

Evaluating the Use of Selective Serotonin Reuptake Inhibitors (SSRIs) and Male Infertility: A Critical Retrospective Study.

Background: The use of selective serotonin reuptake inhibitors (SSRIs) has been associated with potential effects on male fertility, although the exact mechanisms are not fully understood. The aim of this study was to understand the relationship between SSRIs and male infertility; Methods: A retrospective chart review of Saudi males who were treated with SSRIs and attended an infertility clinic in KSMC was undertaken. The medical records of men from an infertility clinic were reviewed to screen the quality of the sperm parameters in patients taking SSRIs; Results: In total, 299 men were identified, of whom 29 (9.6%) were exposed to SSRIs, while 270 (90.4%) did not receive SSRIs, defined as the control infertile group. When comparing the mean ages, a notable disparity was observed between the control group of infertile men (34.2 ± 6.9 years) and the infertile group using SSRIs (41.5 ± 3.2 years) (p < 0.001). Regarding the sperm analysis and the use of SSRIs, the impact of SSRIs use showed no significant differences in sperm liquefaction (p = 0.1), motility (p = 0.17), viscosity (p = 0.16), or count (p = 0.069) with escitalopram, fluoxetine, or paroxetine use; Conclusions: Our study showed no significant difference in the sperm analysis between the SSRI and non-SSRI cohorts. However, the relationship between SSRI use and sperm count warrants further investigation and consideration in clinical practice.

Semen parameters in testicular tumor patients before orchiectomy: What is the impact of testicular tumor stage and histology?

To evaluate the influence of testicular cancer histology and stage on sperm parameters in cryopreserved samples collected prior to orchiectomy. We conducted a retrospective analysis of tumor histology, stage and sperm parameters of patients who underwent pre-orchiectomy sperm cryopreservation for testicular cancer between March 2010 and March 2023. The World Health Organization (WHO) 2010 sperm reference values were used to identify patients with subnormal semen parameters and to further categorize patients by sperm alteration. Localized disease was classified as Stage I, while metastatic disease encompassed Stages II and III. Continuous variables were compared using t-test or Mann Whitney U test, and categorical variables using Chi-square and Fisher´s exact test. A total of 64 patients was identified, 48 (75%) classified as stage I and 16 (25%) classified as stage II/III. No difference was found in semen parameters between patients with seminoma and patients with non-seminoma germ cell tumor (NSGCT). Patients with stage II/III disease had significantly lower percentages of progressive motility (36% vs 53%, p = 0.021) and total motility (60% vs 69%, p = 0.015) than stage I patients. When categorizing by sperm alterations according to WHO 2010 reference values, patients with stage II/III disease had significantly higher proportions of asthenozoospermia (38% vs 15%, p = 0.048) and teratozoospermia (63% vs 31%, p = 0.027) than stage I patients. Elevated tumor markers were not associated with sperm abnormalities. Patients with metastatic testicular cancer present with worse sperm quality than patients with localized disease. Sperm cryopreservation should be offered to all patients with testicular cancer, and especially emphasized in patients with metastatic disease.

P-062 The influence of the ejaculatory abstinence period on semen parameters from the first diagnostic sample – results from analysis of 14000 samples

Abstract Study question Is ejaculatory abstinence period (EAP) associated with semen parameters in males undergoing preliminary fertility investigation? Summary answer Short EAP is associated with increased progressive motility (%), vitality but with reduced volume, concentration, total sperm count. No association was indentified with morphology, DNA fragmentation. What is known already It is known that semen parameters may present important intra-individual variations. At present, the last edition of the WHO Manual recommends ejaculatory abstinence from two to seven days for semen analysis. Nonetheless, this period is not supported by some relevant bodies in the reproductive field guidelines that limit abstinence period to three or four days. Recently published reviews on this matter support that the relationship between the abstinence time and sperm quality is not straightforward. Therefore the aim of this study is to analyze correlation between the ejaculatory abstinence time and sperm parameters in patients having initial work-up in our clinic. Study design, size, duration We conducted a retrospective cross-sectional study on the diagnostic semen samples from individuals having their initial fertility investigation in the Fertility Department of a University Affiliated Hospital between the beginning of 1997 and the end of 2022. Basic semen parameters and sperm deoxyribonucleic acid (DNA) fragmentation were registered in 14067 and 784 samples respectively. Sperm morphology was analysed in 4812 samples. Participants/materials, setting, methods We included exclusively results from the first diagnostic semen sample from males of any age undergoing preliminary infertility work-up. All samples were produced on-site and analysed “ad hoc” for basic semen parameters (according to 6th Edition of WHO Manual) or/and sperm DNA fragmentation (Sperm Chromatin Dispersion test). Samples were divided according to EAP: ≤2(A-group); 2-7(B-group); &amp;gt;7 days (C-group) and compared with ANOVA. Additionally, Spearman Correlation was used to confirm correlation between EAP and sperm parameters. Main results and the role of chance Semen analysis was performed either completely manually (23.4%) or with the use of Computer Assisted Semen Analysis (CASA) system (76.6%) with the exception of morphology which was always assessed manually. Overall, 661 samples were produced after ≤2 days of abstinence, 12734 after 2 to maximum 7 days and 690 after &amp;gt;7 days of which ones 330(50%), 6798(53%) and 336(49%) were normozoospermic, respectively. Mean male age was 39 years (SD 6.5) and EAP 4.5 days (SD 1.9). We found the following parameters positively correlated with EAP in both normozoospermic and abnormal samples: volume (A-2.6ml; B-3.6ml; C-4ml, p &amp;lt; 0.05), concentration (A-72M/ml; B-93M/ml; C-127M/ml, p &amp;lt; 0.05), total sperm count (A-161M; B-285M; C-472M, p &amp;lt; 0.05), total motile count (A-111M; B-186M; C-270M, p &amp;lt; 0.05), straightness coefficient (STR) (A-73.1; B-75.7; C-77.8%, p &amp;lt; 0.05) and Zinc concentration (A-14277; B-17375; C-22538µg/dl, p &amp;lt; 0.05). The following parameters were negatively correlated with EAP in both normozoospermic and abnormal samples: progressive motility (A-46; B-43.6; C-36.6%, p &amp;lt; 0.05), vitality (A-60.5; B-60.3; C-53.7%, p &amp;lt; 0.05). We did not find any correlation with leucocytes, fructose, morphology or DNA fragmentation in unselected patients. However, in the group of abnormal samples there was a negative correlation between EAP and morphology (A-3.7; B-3.1; C-2.8%, p &amp;lt; 0.05) and DNA fragmentation, in generalized additive model (Spearman-Correlation, R2 0.01, p &amp;lt; 0.05). Limitations, reasons for caution This is a cross-sectional study which demonstrates only association and does not allow establishment of a cause-effect relationship between EAP and sperm parameters. Additionally, despite significant correlation between EAP and some sperm parameters, its clinical usefulness remains unclear. Wider implications of the findings To our knowledge this is first study correlating EAP with semen parameters only from diagnostic semen samples produced on-site, which confirms that the abstinence time should be seriously considered when analysing ejaculates, especially when borderline results are obtained. Additionally, different clinical strategies may be considered for normo and non-normozoospermic patients. Trial registration number not applicable

The Effect of L-carnitine supplement on seminal fluid parameters in males with infertility

Background: Male infertility is a significant problem affecting 7.5% of the male population. Approximately 60% of these cases are idiopathic and related to sperm dysfunctions such as oligo-astheno-teratozoospermia (OAT).Aim: The aim of this study was to verify the effect of L-carnitine on sperm parameters in patients who presented with infertility.Patients and Methods: The clinical trial study conducted on a total 142 men but 8 patients with varicocele were excluded. So this study was conducted on the remainder 134 patients presenting with infertility due to idiopathic oligo-astheno-zoospermia (mean age± SD: 30.6 ± 6.07), who didn't use L-carnitine previously. Sample divided into 2 groupd (70 patients treated with L carnitine and 64 with placebo). L-carnitine was prescribed orally at a daily dose of 2 gm/day for 3 months. Before onset of drug intake and after the ending of the L-carnitine treatment, semen analysis was performed. Results: Seminal fluid analysis has been done before treatment and then 3 months after treatment. The mean values of sperm count, total motility and normal morphology of astheno-spermic and oligo-astheno-teratospermic were found significantly at (p&lt;0.05). There is a trend toward an improvement in seminal fluid parameters was noted when comparing baseline with 3 months points in both the placebo and the carnitine arm.The results of the present study clearly demonstrated that L-carnitine at a daily dose of 2 gm/day for a treatment period of 3 months can improve sperm concentration, sperm count, percentage of actively motile sperm, and progressive motile sperm count among men with idiopathic oligo- and/or astheno-zoospermia.Conclusion: The present study concluded that L-carnitine at a daily dose of 2 gm/day for a treatment period of 3 months had positive effect and can be treat infertility.

The Effect of the SARS-CoV-19 Virus on Sperm Parameters of Patients with Male Infertility

The Effect of the SARS-CoV-19 Virus on Sperm Parameters of Patients with Male Infertility

Investigation of the relationship between COVID-19 disease and semen parameters in idiopathic male infertility patients.

Recent studies have shown that there may be a deterioration in sperm parameters in patients who had recovered from COVID-19 disease. We aimed to investigate the relationship between COVID-19 disease and semen parameters in idiopathic male infertility patients. The study was conducted among male patients who applied with infertility between June 2021 and February 2022 following the approval of the Ethics Committee. Idiopathic infertility patients who could give semen analysis were included in the study. Detailed medical history of all patients was obtained. The presence of detectable causes of infertility was defined as exclusion criteria. The patients who had COVID-19 disease history (Reverse Transcriptase-PCR or Computed Tomography findings) in the last year were divided into two groups COVID-19 (+) and COVID-19 (-). The semen samples obtained from patients after a 3 day sexual abstinence in accordance with the WHO 2021 criteria were recorded. A total of 42 male idiopathic infertility patients who met the criteria were included in the study. It was analyzed that both groups were similar in terms of sociodemographic characteristics, comorbidities, and habits (p>0.05). It was determined that 40.4% (n=17) had COVID-19 disease. The mean duration time after COVID-19 was 9.6 (4-17) months. Mean sperm concentration was found to be statistically significantly lower than the COVID-19 (-) group (41.59±17.4 vs. 58.8±21.9; p=0.021). Semen volume (3.05±0.7 vs. 3.32±0.6 mL; p>0.05), progressive sperm motility (34.05±20.96 vs. 43.00±16.94; p=0.12) and normal sperm morphology (3.47±1.42 vs. 3.08±1.41; p=0.41) were similar in both groups.The mean sperm concentration of the patients who recovered in the last 6 months (25.37±9.07 vs. 56.03±29.67 million/ml; p=0.013) compared to patients with >6 months after recovery (n=9) was found to be significantly lower. The COVID-19 disease can cause a significant decrease in sperm concentration in idiopathic infertility patients, especially in the first 6 months, and the rates of oligospermia and asthenospermia are higher.

Correlation of reproductive hormone levels and semen quality in diabetic patient

Because of the paucity of studies and inconsistencies regarding the impact of diabetes mellitus (DM) on semen quality, this disease is seldom looked for in infertile patients. This brief review shows the main sperm parameters in patients with DM and presents the mechanisms hypothesized to explain the changes observed in these patients. Various mechanisms may explain the sperm damage observed in patients with DM. The objective of this cross sectional study was to assess the effect of diabetes mellitus (DM) type2 on pituitary gland hormones (FSH and LH) men. This study comprised a total of (35) subjects out of which (25) were normal. Fasting blood sugar, HbA1c, LH, FSH, TT, E2 and prolactin were measured in blood samples. The results obtained indicated a significant reduction of serum LH, FSH and TT in men with DM comparison to non-diabetics, also there were significant increase in prolactin and E2 in diabetic patients comparison to non-diabetics. The results of semen analysis (PH, sperm count, sperm motility and sperm morphology) for study groups w significantly decreased in diabetic patients compared to non-diabetic

Elastographic evaluation of the effect of sickle cell anemia on testicles: a prospective study.

To quantitatively determine testicular tissue stiffness values using shear wave elastography (SWE) in males that have sickle cell anemia (SCA) and to evaluate the relationship between elastography results and semen analysis parameters and hormone levels. Fifty patients diagnosed with SCA and followed up in the hematology outpatient clinic were evaluated in the urology outpatient clinic as the study group. In addition, there were 88 patients without any SCA-related complaints in the control group. We compared these groups with respect to their values, spermiogram parameters, testicular volume, and SWE values. Among patients in the SCA group, 28% had impaired sperm parameters. When testicular elastography was assessed, the testicular volumes were materially lower in the SCA group in comparison to the control group [right testicular volume: 14.76 (12.77-18.12) and 19.68 (15.12-24.18), respectively, p< 0.001; left testicular volume: 14.11 (11.06-17.32) and 16.59 (13.38-20.13), respectively, p= 0.015]. Additionally, the left testis central stiffness and the left testis inferior stiffness were significantly higher in the SCA group (p< 0.001 and p= 0.014, respectively). The age and hydroxyurea use had a worse effect on sperm parameters in patients with SCA (odds ratio: -0.161 and -1.914, standard deviation: 0.071 and 0.921, and p= 0.024 and p= 0.038, respectively). We consider that the technique utilized in this study for SWE values is fast and can be adopted as a reliable diagnostic tool and follow-up practice in routine clinical practice to evaluate the acuteness of damage to the testicles in patients having SCA.

Effect of keishibukuryogan combined with tocopherol nicotinate on sperm parameters in patients with a varicocele.

To evaluate the efficacy of keishibukuryogan, a traditional Kampo formula known to be an anti-Oketsu (impaired microcirculation and non-physiological blood congestion) drug, in combination with an anti-oxidant for the treatment of varicoceles. We retrospectively analyzed 119 patients with palpable and subclinical varicoceles who were treated with 7.5 g/day of keishibukuryogan and 600 mg/day of tocopherol nicotinate. Their motile sperm concentrations at the start of medication and after 3 months were compared. As a subgroup analysis, a comparison test was carried out between patients with a high-grade varicocele and those with a low-grade varicocele. The mean age of the study patients was 35.6 years. Among them, 17, 41, 44 and 17 had subclinical, grade 1, grade 2 and grade 3 varicoceles, respectively. Overall, the differences in motile sperm concentration (millions/mL) before and after treatment were not significant (median 0.58, 95% confidence interval -0.12 to 1.56; P = 0.115). The results of the subgroup analysis showed that the motile sperm concentration in patients with a low-grade varicocele significantly increased (median 1.21, 95% confidence interval 0.45-2.47; P = 0.024); however, no significant improvements were seen in patients with a high-grade varicocele. The results of the present study showed that the combination of keishibukuryogan and an anti-oxidant had a limited effect on varicoceles, but they suggest that it is effective for the treatment of low-grade varicoceles.

The association of seminal oxidation reduction potential with sperm parameters in patients with unexplained and male factor ınfertility.

ABSTRACTPurpose:Understanding the effects of high oxidation reduction potential (ORP) levels on sperm parameters will help to identify patients with unexplained and male factor infertility who may have seminal oxidative stress and determine if ORP testing is needed. This study aimed to evaluate the association between seminal ORP and conventional sperm parameters.Materials and Methods:A total of 58 patients who provided a semen sample for simultaneous evaluation of sperm parameters and ORP between January and September 2019 were enrolled in this retrospective study. To identify normal and high ORP levels, a static ORP (sORP) cut-off value of 1.36mV/106sperm/mL was used. Sperm parameters were compared between infertile men with normal sORP (control group, n=23) and high sORP values (study group, n=35).Results:Men with sORP values >1.36mV/106sperm/mL had significantly lower total sperm count (TSC) (p <0.001), sperm concentration (p <0.001) and total motile sperm count (TMSC) (p <0.001). In addition, progressive motility (p=0.04) and fast forward progressive motility (p <0.001) were significantly lower in the study group. A negative correlation was found between sORP and TSC (r=-0.820, p <0.001), sperm concentration (r=-0.822, p <0.001), TMSC (r=-0.808, p <0.001) and progressive motility (r=-0.378, p=0.004). Non-progressive motility positively correlated with sORP (r=0.344, p=0.010).Conclusions:This study has shown that TSC, sperm concentration, progressive motility and TMSC are associated with seminal oxidative stress, indicated by a sORP cut-off of 1.36mV/106sperm/mL. Presence of oligozoospermia, reduced progressive motilty or low TMSC in sperm analysis should raise the suspicion of oxidative stress and warrants seminal ROS testing.

Does methylphenidate use affect sperm parameters in patients undergoing infertility investigation? A retrospective analysis of 9769 semen samples.

Methylphenidate (MPH) is the most widely prescribed therapy for attention deficit hyperactivity disorder. Animal studies have shown a potential adverse effect of MPH exposure on male fertility. We examined the impact of MPH on human male sperm parameters. Sperm parameters of 9769 samples from patients 18years of age or older, collected as part of the basic evaluation of couples referred to the Infertility Clinic were analyzed retrospectively. We divided the study population into three groups according to MPH purchasing information: MPH purchased ≤ 90days prior to sperm analysis-current users (n = 83), MPH purchased > 90days prior to sperm analysis-past users (n = 293), and MPH-naïve patients (n = 9393). All sperm samples were analyzed by the same laboratory technician team for the following routine parameters: semen volume, sperm concentration, percentage of motile sperm, and percentage of normal morphology according to World Health Organization. The analysis of the samples was completed by evaluation of total sperm count, total sperm motility, and percentage of fast and slow motile cells. Sperm morphology was evaluated by a laboratory technician using methodological examination according to the strict Kruger-Tygerberg criteria. Methylphenidate exposure did not affect sperm morphology but was associated with increased sperm concentration as well as increased total sperm count and total sperm motility among current and past users compared with MPH-naïve patients. In particular, progressive motility and total motile sperm count were significantly increased following MPH use. A multivariate analysis adjusting for age and current smoking was conducted, further supporting a positive correlation between current MPH use and increased values of total sperm count and total sperm motility. Our study has several inherent weaknesses, foremost of which is its retrospective nature. Another notable weakness is that medication purchasing data may not accurately reflect MPH exposure in the study population. Patients may be purchasing MPH and not taking it as prescribed. In the present study, we could not demonstrate a negative impact of methylphenidate treatment on sperm parameters in adults with ADHD. Hence, we may assume that methylphenidate does not negatively affect male fertility.

The Effects of Sperm Parameters on Pregnancy Results in Patients with Intra Uterine Insemination Using Recombinant FSH

Aim of the study: Although there is an assisted reproductive technique commonly used in intrauterine insemination (IUI) assisted reproductive techniques, there is no definite consensus about sperm parameters affecting the possibility of pregnancy. The aim of this study is to evaluate the effects of motile sperm and morphology on pregnancy rates and determine optimal sperm parameters in patients undergoing IUI with rFSH ovulation induction (OI). Material and Methods: Between January 2009 and December 2010, Dr. Zekai Tahir Burak Women's Health Education and Research Hospital is a retrospective study involving 300 IUI cycles applied to 170 infertile patients in the infertility outpatient clinic. IUI cycles were divided into 10 million according to TPMSS (total progressive motile sperm count) after washing, ≤%4 and> 4% according to morphology, the effect of two parameters on pregnancy results. Findings: In our study, a total of 44 pregnancies were applied to 170 infertile patients with 300 cycles of IUI. Pregnancy was 14.6% according to the number of cycles and 25.8% according to the number of patients. While the pregnancy rate was 17.8% in the spouses of men with sperm morphology 4 4%, the pregnancy rate in the spouses of the patients with morphology> 4% was found 13.9% (p = 0.133). While the pregnancy rate of the spouses of men with TPMSS> 10 million was 14.8%, the pregnancy rate of the spouses of men with TPMSS <10 million was 13.3% (p = 0.668). Result: In our study, it was found that female age is important in the treatment of infertility, and pregnancies in infertility treatment usually occur in the first cycle. Morphology was found to be more important in terms of pregnancy, one of the sperm parameters. It was found that TPMSS alone was not related to pregnancy rates. It was determined that smoking does not affect pregnancy rates in women and it decreases pregnancy rates by disrupting morphology especially in men. Keywords: IUI, infertility, sperm parameters DOI: 10.7176/JSTR/6-05-08

Tekrarlayan İmplantasyon Başarısızlığı Tespit Edilen Hastalardan Elde Edilen Embriyolara Uygulanan Preimplantasyon Genetik Tanımlama (PGT) İşleminin Önceki Deneme Sayısı Hasta Yaşı Sperm Parametrelerine Göre Sınıflandırılarak Aneuploidy Oranlarının Katego

Tekrarlayan İmplantasyon Başarısızlığı Tespit Edilen Hastalardan Elde Edilen Embriyolara Uygulanan Preimplantasyon Genetik Tanımlama (PGT) İşleminin Önceki Deneme Sayısı Hasta Yaşı Sperm Parametrelerine Göre Sınıflandırılarak Aneuploidy Oranlarının Katego

Effect of Hydroxyurea Exposure before Puberty on Sperm Parameters in Males with Sickle Cell Disease

Background: Sperm parameters alteration is documented in untreated men with sickle cell disease (SCD). An aggravating effect of hydroxyurea (HU) on sperm parameters is also well established: HU, at current doses, causes significant, rapid, and unpredictable impairment of spermatogenesis. Reversal of its effect when treatment is stopped has also been documented, albeit in patients given very low doses of treatment (10 mg/kg/d). In France, sperm banking is free of charge and recommended whenever possible before initiation of HU treatment. While recent guidelines have broadened the indication of HU for asymptomatic infantssuch banking is impossible in younger boys before puberty. In addition, little is known on the effect of HU on sperm parameters when given at this specific period. Objectives and Methods: The main objective of this study was to compare sperm parameters after treatment resolution in young males treated by HU prior to puberty with sperm parameters of untreated males. Secondary objective was to analyze longitudinally sperm parameters during HU washout in those treated prior to puberty.Data regarding indication of HU, dosage, date of initiation and stop, clinical profile including vaso occlusive events (VOE) transfusion episodes and date of puberty was collected. Alternative treatment before or during semen analysis was also documented. A period of 3 months of HU wash out was required prior to semen analysis in treated patients. Results: A total of 26 patients (43 semen samples) were studied, with 16 patients treated with HU prior to puberty (HU-PP) and 10 untreated (HU-naive). Characteristics of patients are presented in Table 1. Indication of HU was cerebral vasculopathy (n=3), VOE (n=5), severe anemia (n=1) or combined (n= 7). The median stopping of the HU before CECOS is 4.5 years [0.5-11.0]. An alternative treatment based on a transfusion program was initiated in 14 patients (87.5%) at the time of sperm analysis in the HU-PP group versus 5 patients (50%) in the HU-naive group. Duration of transfusion program was 126 months [3-188] in HU-PP versus 13 [7-100] in the HU naive group. We compared the fraction of abnormal values in semen samples in both groups (25 samples in the HU-PP group and 18 in the HU-naive). No significant difference was observed regarding volume of ejaculate, spermatozoid concentration, total sperm count, spermatozoid motility, morphology and vitality, and sexual abstinence before sampling in both groups (Table 1). In the HU-PP group, there was a trend in improvement of sperm parameters with the duration of transfusion program. In addition, a kinetic analysis of sperm parameters during the period of HU wash out was performed in 3 patients exposed to HU prior to puberty, demonstrating reversibility of HU toxicity in all. All 26 patients were offered semen cryopreservation. For 22 of them, semen parameters after thawing indicated a possible use for assisted reproductive technologies, mostly in vitro fertilization with intracytoplasmic sperm injection. In the remaining 4 (3 in HU-PP group and 1 in HU naïve), there was serious concern about the possible use because of a very low initial sperm concentration and the absence of motile spermatozoids after thawing. Discussion/Conclusion: Toxicity of HU upon spermatogenesis has been well documented in animal studies and in adult males. In many settings, such issues may be a drawback for parents and/or caregivers to treat young boys before semen banking can be performed, given the lack of robust information on reversibility after treatment resolution. Abnormalities of sperm count are also common in non-treated males so that demonstrating the specific effect of HU may be complex. Oseggbe et al. and Berthaud et al. showed that 91% of untreated SCD males have at least one abnormal sperm parameter. Here, we show that after treatment resolution, there are no differences in sperm parameters in patients exposed to HU before puberty compared to untreated males. Because a majority of patients benefitted from transfusion therapy at the time of analysis, we were however unable to demonstrate whether reversal of toxicity occurs spontaneously or requires transfusion. Notwithstanding possible limitations due to small sample size, this study shows that in boys with severe disease requiring HU treatment before puberty, toxicity of HU on sperm parameters should not be a major drawback. Disclosures Bernaudin: AddMedica: Honoraria, Other: Help for travel; GBT: Membership on an entity's Board of Directors or advisory committees; BlueBirdBio: Consultancy. De Montalembert:Novartis: Consultancy, Honoraria; Addmedica: Consultancy, Honoraria; Bluebird Bio: Membership on an entity's Board of Directors or advisory committees. Brousse:bluebird bio: Consultancy; Add medica: Consultancy.

Comparison of pre-operative and post-operative (varicocelectomy) sperm parameters in patients suffering varicocle with and without reflux in Doppler ultrasonography.

Background:Varicocele can cause progressive testicular damage and infertility. Severe retrograde blood flow to the internal spermatic vein has been suggested as a risk factor for infertility or progressive/stable varicocele. We have aimed to Compared th pre-operative and post-operative (varicocelectomy) sperm parameters in patients suffering varicocle with and without reflux in Doppler ultrasonography.Methods:This descriptive-analytic study was carried out at the Imaging Center of Ahwaz University of Medical Sciences in Imam and Golestan Hospitals. The parameters assessed included the presence or absence of internal spermatic vein reflux in both sided. Patients were divided into three groups based on the presence of testicular reflux: no reflux, left-sided reflux, and both sides reflux. The reflux longer than 1 second was considered pathologic. All patients were also referred to the laboratory for semen analysis, including semen volume, sperm morphology, sperm counts, and motility. Semen analysis was repeated 2 months after varicocelectomy.Results:In this study, a total of 70 patients were evaluated. Forty-three patients (61.4%) did not have any reflux, 23 patients (32.9%) had left testicular reflux, and 4 (5.7%) had reflux in both testicles. Semen volume, number of sperms, number of motile sperm, and sperm morphology increased significantly after Varicocelectomy. We did not find any significant correlation between testicular reflux and improvement index of semen analysis factor was found.Conclusion:The findings of this study indicate that the presence of testicular reflux has no effect on semen analysis parameters, but also does not predict the consequences of varicocelectomy and therefore is not a suitable prognosis factor in varicocele patients.

Impact of Bariatric Surgery on Male Sex Hormones and Sperm Quality: a Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aims to establish the effects of bariatric surgery on male sex hormones, sperm parameters, and sexual function. We searched MEDLINE, EMBASE, Web of Science, and Scopus from database inception through June 2018. Articles were eligible for inclusion if they examined the effect of bariatric surgery on male sex hormones and sperm parameters in patients with obesity. Primary outcomes of interest were sex hormones and sperm quality. Secondary outcome was sexual function (International Index of Erectile Function (IIEF) score). Pooled estimates were calculated using random effects meta-analysis. A total of 28 cohort studies with 1022 patients were identified from 3896 potentially relevant citations. Both free and calculated testosterone levels were significantly increased after bariatric surgery (mean difference (MD) - 7.47nM, 95% CI - 8.62 to - 6.31, p < 0.001 and MD - 0.05nM, 95% CI - 0.07 to - 0.02, p < 0.001, respectively). Consistent with the increase in testosterone, LH, FSH, and SHBG levels were also significantly increased after surgery. In contrast, free and total estradiol and prolactin levels were significantly decreased after bariatric surgery. From studies that reported the IIEF score, bariatric surgery led to a significant increase in erectile function after surgery (MD - 0.46, 95% CI - 0.89 to - 0.02, p = 0.04). However, bariatric surgery did not affect sperm quality, DHEA, androstenedione, and inhibin B levels. Sustained weight-loss induced by bariatric surgery had a significant effect on increasing male sex hormones and decreasing female sex hormones in male patients with obesity. However, sperm quality and function were not improved after surgery.

A Novel Method for Investigating the Role of Reflux Pattern in Color Doppler Ultrasound for Grading of Varicocele

Varicocele is the most common correctable cause of infertility. Color Doppler Ultrasound (CDUS) has a sensitivity of 97% and specificity of 94% for diagnosing this condition. This study aimed to propose a new pattern of scrotal Doppler for predicting the severity of varicocele. An observational study was conducted from January 2016 to January 2017 on 120 testes units in 60 patients. Scrotal CDUS and semen analysis were done in all participants. Patients were evaluated for reflux pattern, pampiniform venous plexus diameter, and venous reflux time. The ultrasonography parameters and semen analysis data were compared to assess the correlations between the results. The reflux pattern and vein diameters had a significant correlation. Also, a significant correlation was detected between the reflux pattern and reflux time. There was a significant correlation between the reflux pattern and two parameters of semen analysis namely sperm count and its motility. In conclusion, the reflux pattern classification suggested in this study can be used as a useful predictor of varicocele severity and sperm parameters in patients with varicocele.

Can Ultrasound Findings be a Good Predictor of Sperm Parameters in Patients With Varicocele? A Cross-Sectional Study.

BackgroundVaricocele, one of the most common causes of sperm abnormalities in men, is the dilation of the testicular vein (the pampiniform venous plexus) by more than 2 mm. Ultrasonography is the primary imaging procedure for varicocele diagnosis. The venous diameter is evaluated using B-mode sonography, and venous reflux is assessed using color Doppler sonography.ObjectivesIn this study, we investigated the association of ultrasound findings with sperm parameters in patients with varicocele.MethodsNinety-nine patients with clinically diagnosed varicocele were included in this study, which was performed at a university imaging center. Patients were evaluated for pampiniform venous plexus diameter, venous reflux, and testicular size on both sides. Semen analysis was performed for all patients. The ultrasonography parameters and semen analysis data were compared to assess the correlations between the results.ResultsThe semen analysis parameters, including semen volume and sperm morphology, count, and motility, significant correlations with the diameter of the varicocele vein but were not correlated with testes size. In addition, the patients with reflux of longer than 1 s and those with reflux of less than 1 s had significant differences in sperm parameters and varicocele size.ConclusionsOur study showed that ultrasonography findings can be a good predictor of sperm parameters in patients with varicocele.