Infertility Therapy Research Articles

The Association between Non- Enzymatic Dietary Total Antioxidant Capacity and Phytochemical Index with Semen Parameters: A Cross-Sectional Study in Isfahan Infertile Men

Background: Infertility affects about 15% of the population and male factors only are responsible for ~25–30% of cases of infertility. Oxidative stress is an imbalance between the production of free radicals and the capacity of the body to counteract their harmful effects through neutralization by antioxidants. This study aims to access the relationship between non-enzymatic dietary antioxidant capacity and male infertility.
 Methods: In this cross-sectional study, 270 infertile men aged 18-55 years were selected from Isfahan province in 2018. Semen assessment was performed according to the fifth edition of the WHO laboratory manual and a 168-item food frequency questionnaire (FFQ) questionnaire was used to determine the amount of dietary intakes of participants. P-value < 0.05 was considered statistically significant.
 Results: There were no significant association between sperm parameters and dietary total antioxidant capacity (DTAC) tertiles in the crude model and after adjustment for potential confounders. The participants in the highest tertile of DTAC had a higher risk of abnormal density and motility in crude model (OR=1.30; 95% CI: 0.65, 2.59; P = 0.46 and OR=1.69; 95% CI: 0.83, 3.44; P = 0.99) and risk of abnormal density decreased in the adjusted model (OR=0.99; 95% CI: 0.39, 2.50; P = 0.99) and (OR: 1.43; 95% CI: 0.51, 4.01; P = 0.5).
 Conclusion: In this cross-sectional study there was no significant relationship between semen parameters and DTAC tertiles in the crude and adjusted model. Therefore, it is required to conduct more research studies to determine the clear benefits and risks of antioxidant therapy for infertility.

Recent Advancements in In Vitro Fertilisation.

The field of assisted reproductive technologies has witnessed many new developments over the past 10 years. This review examines new stimulation techniques that might increase the number of fully developed oocytes derived during the in vitro fertilisation (IVF) cycle in addition to strategies for enhancing oocyte quality in older women. Before moving on to several fresh methods for determining endometrial receptivity, wetalk about how preimplantation genetic screening (PGS) is currently being utilised. The main goal of this review is to highlight technological fields that might be debatable or are still sufficiently novel to require rigorous controlled trials for recognition. The use of IVF has been on the rise recently, mostly as a result of deferred childbearing, and there is no reason to believe that this trend will alter. Infertility therapies have advanced significantly thanks to the methods and techniques that were established via studies on animals and, more recently, people. Some technical discoveries in reproductive medicine have had a significant impact on innovations and treatment choices in other fields of medicine as well. The objective of this succinct review article is to quickly summarise and explain the advancements made in this intriguing area of medicine over the past 40 years.

The history of Fertility Awareness Methods

Fertility Awareness Methods (FAM) are based on the observation of physiologically occurring symptoms, so-called fertility indicators, which include: cervical mucus, basal body temperature (BBT) and changes in cervical morphology/consistency. Observations of clinical symptoms in a female patient, which change depending on periodic hormonal fluctuations, were used to determine the first and second phases of the menstrual cycle and the period around ovulation. For many years, FAMs have been successfully used by women who want to plan their motherhood in accordance with their beliefs and chosen lifestyle, in an ecological manner, without pharmacological intervention or unnecessary medical treatments.FAMs have developed over the centuries and are now a well-documented field of reproductive medicine. Initially, FAMs were used only as a tool for planning or postponing the conception of a child, now they are more and more often perceived as an effective and easy-to-use tool in the diagnosis, treatment and monitoring of the therapy of cycle disorders and infertility. The aim of the study is to present the history of FAM development, to present groundbreaking discoveries and people to whom we owe the current state of knowledge about the symptoms of human fertility. A review of the medical literature was made, also referring to historical works, which included information on breakthrough discoveries in the field of human fertility. The selection of literature was made on the basis of a review of original papers and review publications in the PubMed and Google Scholar databases with the use of the following keywords: „Fertility Awareness Methods”, „Family Planning” and the „Pearl index”.

MicroRNA-targeting in male infertility: Sperm microRNA-19a/b-3p and its spermatogenesis related transcripts content in men with oligoasthenozoospermia.

Objective: To elucidate and validate the potential regulatory function of miR-19a/b-3p and its spermatogenesis-related transcripts content in sperm samples collected from men with oligoasthenozoospermia. Methods: Men presenting at an infertility clinic were enrolled. MicroRNA (miRNA) and target genes evaluation were carried out using in silico prediction analysis, Reverse transcription-quantitative PCR (RT-qPCR) validation, and Western blot confirmation. Results: The expression levels of miRNA-19a/b-3p were significantly up-regulated and 51 target genes were significantly down-regulated in oligoasthenozoospermic men compared with age-matched normozoospermic men as determined by RT-qPCR. Correlation analysis highlighted that sperm count, motility, and morphology were negatively correlated with miRNA-19a/b-3p and positively correlated with the lower expression level of 51 significantly identified target genes. Furthermore, an inverse correlation between higher expression levels of miRNA-19a/b-3p and lower expression levels of 51 target genes was observed. Consistent with the results of the RT-qPCR, reduced expression levels of STK33 and DNAI1 protein levels were identified in an independent cohort of sperm samples collected from men with oligoasthenozoospermia. Conclusion: Findings suggest that the higher expression of miRNA-19a/b-3p or the lower expression of target genes are associated with oligoasthenozoospermia and male infertility, probably through influencing basic semen parameters. This study lay the groundwork for future studies focused on investigating therapies for male infertility.

Morphometric and immunohistochemical analysis as a method to identify undifferentiated spermatogonial cells in adult subjects with Klinefelter syndrome: a cohort study

To study the prevalence of spermatogonia in adult subjects with Klinefelter syndrome (KS) using MAGE-A4 and UCHL1 (PGP9.5) immunohistochemistry as markers for undifferentiated spermatogonial cells. We aimed to compare this method to the gold standard of hematoxylin and eosin (H & E) staining with histologic analysis in the largest reported cohort of adult subjects with KS. A retrospective cohort study. Infertility Clinic and Institute for Regenerative Medicine. This study consisted of 79 adult subjects with KS and 12 adult control subjects. The subjects with KS (n = 79) underwent bilateral testicular biopsy in an initial effort to recover spermatozoa for invitro fertilization and intracytoplasmic sperm injection. The institutional review board approved the use of a portion of the archived diagnostic pathology paraffin blocks for the study. The samples were superimposed onto microscopic slides and labeled with the PGP9.5 and MAGE-A4 antibodies. Subjects (n = 12) who had previously consented to be organ donors via the National Disease Research Interchange were selected as controls. Dedicated genitourinary pathologists examined the H & E-, PGP9.5-, and MAGE-A4-stained tissue for presence of undifferentiated spermatogonia and spermatozoa with the use of a virtual microscopy software. The primary outcome was the presence of MAGE-A4-positive or UCHL1-positive tubules that indicate undifferentiated spermatogonia. Supportive outcomes include assessing the biopsy specimen for the following: total surface area; total seminiferous tubule surface area; total interstitium surface area; the total number of seminiferous tubules; and MAGE-A4- negative or UCHL1-negative tubules. Additionally, clinical information, such as age, karyotype, height, weight, mean testicle size, and hormonal panel (luteinizing hormone, follicle-stimulating hormone, and testosterone), was obtained and used in a single and multivariable analysis with linear regression to determine predictive factors for the number of UCHL1-positive tubules. The mean age of the subjects in the KS group was 32.9 ± 0.7 years (range, 16-48). UCHL1 (PGP9.5) and MAGE-A4 staining showed that 74.7% (n = 59) and 40.5% (n = 32) of the subjects with KS, respectively, were positive for undifferentiated spermatogonia compared with 100% (n = 12) of the control subjects who were positive for both the markers. Hematoxylin and eosin with microscopic analysis showed that only 10.1% (n = 8) of the subjects were positive for spermatogonia. The mean number of positive tubules per subject with KS was 11.8 ± 1.8 for UCHL1 and 3.7 ± 1.0 for MAGE-A4. Secondary analysis showed 7 (8.9%) adult subjects with KS as positive for spermatozoa on biopsy. The population having negative testicular sperm extraction results (n = 72) showed a spermatogonia-positive rate of 1.4%, (n = 1), 72.2% (n = 52), and 34.7% (n = 25) using H & E, UCHL1, and MAGE-A4, respectively. Further analysis showed that 54 (75.0%) subjects were either positive for UCHL1 or MAGE-A4. Twenty (27.8%) subjects were positive for both UCHL1 and MAGE-A4. Multivariate analysis with linear regression showed no significant correlation between clinical variables and the number of UCHL1-positive tubules found on biopsy specimens. We report a cohort of adult subjects with KS undergoing analysis for the presence of undifferentiated spermatogonia. UCHL1 and MAGE-A4 immunostaining appear to be an effective way of identifying undifferentiated spermatogonia in testicular biopsy specimens of subjects with KS. Despite observing deterioration in the testicular architecture, many patients remain positive for undifferentiated spermatogonia, which could be harvested and potentially used for infertility therapy in a patient with KS who is azoospermic and has negative testicular sperm extraction results.

The Association between Clusterin Sialylation Degree and Levels of Oxidative-Antioxidant Balance Markers in Seminal Plasmas and Blood Sera of Male Partners with Abnormal Sperm Parameters.

Nearly 30% of infertility cases are caused by male factor. This study aimed at checking the associations between the sialylation degree of glycoprotein clusterin (CLU) and levels of oxidative–antioxidant balance markers in infertile men. Using lectin-ELISA with biotinylated lectins specific to α2,6-linked (Sambucus nigra agglutinin, SNA) and α2,3-linked (Maackia amurensis agglutinin, MAA) sialic acid (SA), the CLU sialylation in 132 seminal plasmas (SP) and 91 blood sera (BS) were analyzed. Oxidative–antioxidant status was measured by determining Sirtuin-3 (SIRT3), Sirtuin-5 (SIRT5), total antioxidant status (TAS), and ferric reducing antioxidant power (FRAP) levels. We indicate that multiple sperm disorders are associated with decreased expression of MAA-reactive SA in SP. Decreased SP SIRT3 concentrations may be associated with teratozoospermia and oligoasthenoteratozoospermia. ROC curve and cluster analysis revealed that SP relative reactivity of CLU glycans with MAA, the value of MAA/SNA ratio, and SIRT3 and SIRT5 concentrations may constitute an additional set of markers differentiating infertile oligoasthenoteratozoospermic patients (OAT) from normozoospermic (N), asthenoteratozoospermic (AT) and teratozoospermic (T). The multinomial logistic regression analysis confirmed the potential utility of SIRT3 determinations for differentiation between N and OAT groups as well as between N and T groups for SIRT3 and SIRT5. For BS, based on ROC curve and cluster analysis, relative reactivities of CLU glycans with SNA, MAA, SIRT3 and FRAP concentrations may be useful in the differentiation of normozoospermic patients from those with sperm disorders. The multinomial logistic regression analysis showed that the SNA relative reactivity with CLU glycans significantly differentiated the N group from AT, OAT and T groups, and FRAP concentrations significantly differed between N and AT groups, which additionally confirms the potential utility of these biomarkers in the differentiation of infertile patients with abnormal sperm parameters. The knowledge about associations between examined parameters may also influence future research aimed at seeking new male infertility therapies.

The Treatment of Complementary and Alternative Medicine on Female Infertility Caused by Endometrial Factors.

Recently, with the development of the social economy, the incidence of infertility has increased year by year. With its complex etiology and diversified syndromes, infertility has become one of the most important diseases that plague the physical and mental health of women of childbearing age worldwide. Endometrial factors as an important part affecting female reproductive capacity, due to which induced repeated abortion and multiple uterine cavity operations occur, can destruct endometrium, failing to provide a normal implantation environment for zygote, thus resulting in infertility. Many patients failed to achieve expected results after receiving conventional treatments such as hormone therapy, assisted reproductive technology (ART), granulocyte colony-stimulating factor (G-CSF) therapy, and cell therapy, then turn to complementary and alternative medicine (CAM) therapies for help. Aiming at clarifying the effectiveness and mechanisms of CAM therapy in the treatment of infertility caused by endometrial factors, our paper systematically searched and studied present related literature on the PubMed, CNKI, and other databases, focusing on the aspects of clinical application and mechanism explorations and highlighting the therapeutic effects of Chinese herbal medicine (CHM), acupuncture, and moxibustion on such diseases. Moreover, this paper also introduces the CAM treatments of traditional Chinese medicine (TCM) retention enema, neuromuscular electrical stimulation (NMES), photobiomodulation therapy, dietary intervention, and other measures for infertility caused by endometrial factors, in order to provide a reference for subsequent basic research and clinical work.

Evaluation of the Psychological Status of Infertile Women

Background: The birth of progeny is one of the most satisfying events. The infertility is one of the major concerns of the modern world. Although there are variable physical causes of infertility but the psychological stress is considered as one of the main causes of infertility. Objective: The fertility problem inventory was used to evaluate the psychological status of the infertile women. The relationship between psychological problems and characteristics of infertility was also assessed. Study design: It is a prospective and questionnaire-based study conducted for the duration of one year on the women attended the gynecology and obstetrician department of Allama Iqbal Memorial Teaching Hospital Sialkot. The study was conducted from June 2021 to May 2022. Material and Methods: A two-month prospective, quantitative, descriptive, questionnaire-based study was conducted on women undergoing infertility therapy with the approval of the institution's ethical committee. The stress level were analyzed by Fertility Problem Inventory Questionnaire. Excel and Microsoft was used for tabulation of data. The collected data was stratified by statistical analysis. The SPSS was used for the analysis. For the categorical variables the t-test was performed. Results: The average age of the twenty three patients included in the study was 30 years. The severe level of infertility-related stress was observed in the almost 75% of the included patients. The other 25% were suffering from the moderate level of stress. Conclusion: The serious psychological morbidity was observed in approximately two-third of the participants. Psychological evaluation of the patients taking infertility therapy could be a consideration. Keywords: Psychological problems and infertility therapy.

The Role of Cell and Gene Therapies in the Treatment of Infertility in Patients with Thyroid Autoimmunity.

There is a rising incidence of infertility worldwide, and many couples experience difficulties conceiving nowadays. Thyroid autoimmunity (TAI) is recognized as one of the major female infertility causes related to a diminished ovarian reserve and potentially impaired oocyte maturation and embryo development, causing adverse pregnancy outcomes. Growing evidence has highlighted its impact on spontaneously achieved pregnancy and pregnancy achieved by in vitro fertilization. Despite the influence of thyroid hormones on the male reproductive system, there is insufficient data on the association between TAI and male infertility. In past years, significant progress has been achieved in cell and gene therapies as emerging treatment options for infertility. Cell therapies utilize living cells to restore healthy tissue microenvironment and homeostasis and usually involve platelet-rich plasma and various stem cells. Using stem cells as therapeutic agents has many advantages, including simple sampling, abundant sources, poor immunogenicity, and elimination of ethical concerns. Mesenchymal Stem Cells (MSCs) represent a heterogeneous fraction of self-renewal, multipotent non-hematopoietic stem cells that display profound immunomodulatory and immunosuppressive features and promising therapeutic effects. Infertility has a genetic component in about half of all cases, although most of its genetic causes are still unknown. Hence, it is essential to identify genes involved in meiosis, DNA repair, ovarian development, steroidogenesis, and folliculogenesis, as well as those involved in spermatogenesis in order to develop potential gene therapies for infertility. Despite advances in therapy approaches such as biological agents, autoimmune disorders remain impossible to cure. Recent research demonstrates the remarkable therapeutic effectiveness of MSCs in a wide array of autoimmune diseases. TAI is one of many autoimmune disorders that can benefit from the use of MSCs, which can be derived from bone marrow and adipose tissue. Cell and gene therapies hold great potential for treating autoimmune conditions, although further research is still needed.

Characterization of primary canine Sertoli cells as a model to test male reproductive toxicant

Sertoli cells play critical roles in regulating spermatogenesis and testis development by providing structural and nutritional support. This study aimed to develop a standard protocol for canine Sertoli cell isolation and culture; and characterize its biological features, functionality, and application of compound toxicity testing. Canine testicles were received from the neuter clinic, and three-step of enzymatic digestion was applied to isolate Sertoli cells. We characterized the growth and purity of Sertoli cells with the expression of SOX9, GATA4, and Clusterin. In addition, we selected cadmium as a model toxicant to evaluate the toxic responses in the newly established Sertoli cells using High-content Analysis (HCA). With our optimized protocol, the purity of isolated Sertoli cells was above 95%, as determined with Sertoli cell-specific protein markers of SOX9 and GATA4. More importantly, primary Sertoli cell populations could be expanded rapidly in vitro, passaged (up to seven), and cryopreserved. The HCA-based assay revealed that cadmium at 1 μM induced both disruptions of cytoskeletal and DNA damage responses. Furthermore, we established an HCA assay with the newly isolated and optimized culture of canine Sertoli cells to evaluate the epigenetic markers of histone modification. We found cadmium-induced differential changes in histone modifications H3Me3K9, H3Me3K36, H4Me3K20, and H4acK5. In summary, we have established the standardized protocol to produce canine Sertoli cells with Sertoli cell-specific phenotype. The isolation and expansion of large quantities of canine Sertoli cells will provide broad applications in studying male infertility, reproductive toxicology, testicular cancer, and cell therapy.

Editorial introductions

Editorial introductions

Heterogeneous Immunolocalisation of Zinc Transporters ZIP6, ZIP10 and ZIP14 in Human Normo- and Asthenozoospermic Spermatozoa.

Zinc (in the form of Zn2+) is necessary for male fertility. Both Zn2+ quantity and its localisation have been detected in seminal plasma and ejaculated spermatozoa, suggesting its active uptake via zinc import transporters (ZIPs). Immunofluorescence was used to characterise the expression and localisation of three distinct types of ZIP transporters in ejaculated spermatozoa of normo- and asthenozoospermic sperm samples. ZIP6, ZIP10 and ZIP14 showed heterogeneous sperm cell expression and different compartmental distribution. In both types of sperm samples, ZIP6 and ZIP14 were predominantly localised in the sperm head, while ZIP10 was found along the sperm tail. Compartmental localisation of ZIPs in asthenozoospermia was not changed. However, regarding sub-compartmental localisation in sperm head regions, for ZIP6 asthenozoospermia only decreased its acorn/crescent-like pattern. In contrast, ZIP14 immunostaining was altered in favour of crescent-like, as opposed to acorn-like and acorn/crescent-like patterns. The specific ZIPs localisation may reflect their different roles in sperm cell integrity and motility and may change over time. This is the first report of their specific compartmental and sub-compartmental localisation in ejaculated human sperm cells. Further research will lead to a greater understanding of the roles of ZIPs in sperm cell biology, which could positively influence procedures for human infertility therapy.

One Religion, Two Paths: Making Sense of US and Belgian Catholic Hospitals' Approaches to IVF

This article comparatively analyses the development of Catholic hospitals' approaches to In‐Vitro Fertilisation (IVF) in Belgium and the U.S. Our comparison highlights the different cultures of Catholic healthcare in each of these countries, and their different relation to Vatican opinion on medical matters. We first discuss the roots of Catholic healthcare in both countries and the history of IVF as a viable medical therapy for infertility. Next, we turn to the Catholic University of Leuven (Belgium) where an infrastructure for bioethics brought patient needs and progressive thinking into conversation with Church pronouncements, creating room for IVF within the walls of a Catholic hospital. We then contrast this trajectory with the subsequent versions of the Ethical and Religious Directives for Catholic Health Care (ERDs) in the U.S. The ERDs came to serve as a binding policy document for American clinicians and centralized medical authority in the hands of the U.S. bishops, who adhered closely to the Vatican ban. Comparing the two contexts, we demonstrate how within the Catholic Church approaches to IVF unfolded along two different paths: one of restriction through a unified conservative voice, controlled by the bishops (U.S.), and one of bio‐ethical decision‐making in dialogue with progressive Catholicism (Belgium).

Male infertility: what on earth is going on? Pilot international questionnaire study regarding clinical evaluation and fertility treatment for men.

Infertility is a time-consuming and exhaustive process, which disproportionally affects women. Although concerns have been raised about deficiencies in the clinical evaluation of infertile men, there are currently little published data documenting this. A SurveyMonkey questionnaire was therefore created to capture the current clinical practice of fertility specialists working in in vitro fertilisation clinics. Responses were collected from May to July 2021. A total of 112 clinicians completed the pilot survey with respondents from Europe (n = 49; 43.8%), Africa (n = 39, 34.8%), North America (n = 6; 5.4%), Asia (n = 16; 14.3%), South America (n = 1; 0.9%) and Australasia (n = 1; 0.9%). Forty-one percent of fertility specialists (45/110) reported taking only a brief medical history and 24% reported that they never routinely examined infertile male patients. Fifty-four percent of fertility specialists also reported issues getting men to undertake diagnostic semen analysis. Treatment for male infertility spanned assisted reproductive technology (ART), with themes of individualised medicine influencing treatment recommendations. Of the clinicians, 48.2% clinicians reported using empirical medical therapy for unexplained male infertility. Notably, 3.6% respondents recommended testosterone treatment, despite the likely negative impact on spermatogenesis. However, high levels of opportunistic general health advice were reported, including discussion of life exposures thought to be important for male reproductive health. This study adds novel evidence and highlights current deficiencies in clinical practice relating to male infertility. Evaluation of the infertile male using simple medical tools (detailed history taking and clinical examination) has the potential to identify treatable or reversible conditions and should be an immediate focus for education and improvement in reproductive medicine. Investment in research and development is much needed in the field of andrology to develop effective non-ART treatment options for male infertility.Lay summaryPoor sperm quality (male infertility) significantly reduces the chance of natural conception and accounts for half of all cases of infertility, yet affected men are frequently overlooked when couples seek fertility investigations and treatment. Despite a growing awareness of men’s issues and a need to improve patient experience, there is very little documented about how fertility specialists (clinicians) routinely assess and treat male infertility. This study used a SurveyMonkey® questionnaire to capture current clinical practice, with 112 respondents from around the world. Forty-one percent of clinicians did not routinely consider male medical history in detail and 24% never routinely examined infertile men. This should be a focus for improvement in clinical care. As expected, fertility treatment recommended for male infertility was mostly in vitro fertilisation and intracytoplasmic sperm injection, where a single sperm is injected into each mature egg. However, 48.2% of clinicians also reported prescribing unproven medical therapy for unexplained male infertility. Of concern, a few clinicians routinely recommended testosterone treatment, which is likely to harm sperm production. However, advice regarding general health was universally delivered.

Therapeutic Effects of Xianlu Oral Solution on Rats with Oligoasthenozoospermia through Alleviating Apoptosis and Oxidative Stress.

Idiopathic oligoasthenozoospermia (iOAZS) is one of the major causes of male infertility, and the ideal therapies for iOAZS have not been established yet. Traditional Chinese medicine (TCM), including Xianlu oral solution (XL), has been widely used as an adjunct treatment for male infertility in the clinic. However, the underlying mechanisms of XL treatment on iOAZS are still not known. Here, we found that XL treatment has therapeutic effects on ornidazole (ORN)-induced OAZS model rats through the amelioration of testis tissues spermatogenesis and the improvement of sperm concentration and motility. Moreover, XL treatment ameliorated the serum hormone levels, mitochondrial membrane potential, apoptosis status, and oxidative stress status in the testis tissues of iOAZS model rats. These findings identify a potential mechanism underlying the therapeutic effects of Xianlu oral solution on iOAZS, and Xianlu oral solution may be used as a traditional Chinese medicine (TCM) therapy for male infertility caused by iOAZS in clinical practice.

RNF144B stimulates the proliferation and inhibits the apoptosis of human spermatogonial stem cells via the FCER2/NOTCH2/HES1 pathway and its abnormality is associated with azoospermia.

Studies on gene regulation and signaling transduction pathways of human spermatogonial stem cells (SSCs) are of the utmost significance for unveiling molecular mechanisms underlying human spermatogenesis and gene therapy of male infertility. We have demonstrated, for the first time, that RNF144B stimulated cell proliferation and inhibited the apoptosis of human SSCs. The target of RNF144B was identified as FCER2 by RNA sequencing. We revealed that RNF144B interacted with FCER2 by immunoprecipitation. Consistently, overexpression of FCER2 reversed the phenotype of proliferation and apoptosis of human SSCs caused by RNF144B knockdown. Interestingly, FCER2 pulled down N2ICD (NOTCH2 intracellular domain), while N2ICD could bind to FCER2 in human SSCs. The levels of NOTCH2, FCER2, HES1, and HEY1 were reduced by RNF144B siRNA in human SSCs. Significantly, RNF144B was expressed at a lower level in nonobstructive azoospermia (NOA) patients than in the obstructive azoospermia (OA) patients with normal spermatogenesis, and 52 patients with heterozygous mutations of RNF144B were detected in 1,000 NOA patients. These results implicate that RNF144B promotes the proliferation of human SSCs and suppresses their apoptosis via the FCER2/NOTCH2/HES1 pathway and that the abnormality of RNF144B is associated with spermatogenesis failure. This study thus provides novel molecular mechanisms regulating the fate determinations of human SSCs, and it offers new biomarkers for the diagnosis and treatment of male infertility.

The Potential Benefits of Legumes Germ and Cereal Grains on Roosters' Reproductive Performance.

Vit E is known as one of the most important antioxidant. It has been previously approved that cereal grains and leafy plants are considered as the main source for α-tocopherol (Vit E). One of the recommended therapies for male infertility would be the Vit E therapy. Following Vit E consumption the semen parameters such as sperm concentration, ejaculation volume, sperm progressive motility, and in vitro function (zone binding assay) have been significantly improved. Therefore, present study was designed to investigate the effects of oral administration of cereal grain and seeds on reproductive performance of local cocks. During a period of 63 weeks, 100 local (Iraqi breed) rooster chicks were randomly divided into the five groups (n=20). Animals in group 1 served as control group and had not received any supplementations in their diet. The animals in the Groups 2-5 received diets which were fortified with 100, 200, 300, and 400 g of cereal grain and legume seeds pure germs. The results of the current study showed that the total number of spermatozoa and percentages of abnormal sperm were decreased by adding more amount of germ of cereal grain and seeds (P<0.01). Increased germ of cereal grain and seeds was not associated with pH volume, colour, consistency and motility of the sperm compared to corresponding rates in control group. Phospholipids content and thiobarbituric acid reactive substance of semen sample as well as density of ejaculate (sperm/µl) were decreased by adding increasing germ of cereal grain and seeds in diet of rosters. Weight of testis decreased by increasing levels of cereal grains and legume seeds germ in the diets (P<0.05).

Electroacupuncture Effectiveness for Treating Idiopathic Male Infertility.

Male infertility accounts for ∼50% of all infertility cases. The reasons for male infertility may vary, and one of them is related to an idiopathic factor that may impair spermatogenesis. Acupuncture is one of the most well-known and widely accepted alternative treatments and is becoming known as an effective complementary therapy for infertility. The case in this article demonstrated the effectiveness of electroacupuncture (EA) for improving male fertility by referring to the total motile sperm count (TMSC), sperm morphology and motility, DNA Fragmentation Index (DFI) of the sperm before and after EA, and pregnancy success in a couple with male infertility. Couples are given therapy with EA twice per week for up to 12 sessions and planned intercourse during the fertile period (ovulation). After planned intercourse, the wife became pregnant; an intrauterine gestational sac (GS) was seen on transvaginal ultrasound and her human chorionic gonadotropin urine test was positive. The TMSC parameter, sperm morphology and sperm motility, post-EA DFI was improved, compared to pre-EA. The couple was became pregnant after undergoing EA 12 times to treat male infertility. This case illustrated that EA therapy for idiopathic male infertility has an effect toward improvement of the spermiogram test result, DFI, and success in achieving a pregnancy. However, further research is needed because there are many patients with different causes for their infertility.

Gene therapy for female infertility: A farfetched dream or reality?

A major cause of infertility in women is impaired ovulation or oogenesis. In this issue of Cell Reports Medicine, Kanatsu-Shinohara et al.1 demonstrate the potential of gene delivery with adeno-associated virus that can cross the blood-follicle barrier and restore oogenesis in congenitally infertile mice.

Effect of clomiphene citrate therapy for male infertility

ABSTRACT Introduction &amp; Objectives To assess the efficacy and safety of clomiphene citrate (CC) for idiopathic male infertility. Methods We identified low testosterone (T) and male infertility patients treated with CC at our institution in the period September 2017 to May 2020. Data were gathered on patient characteristics and laboratory values at baseline. We retrospectively evaluated patients whose sperm concentration &amp;lt; 15*106/mL and/or sperm motility &amp;lt; 40%. FSH, LH and total T were measured before and 6-8 weeks after CC therapy. Sperm concentration, sperm motility were evaluated 3 month after CC therapy. Side effects were also recorded. In this series, 25 mg of CC was added every morning in all patients. Results A total of 37 men were included, with a mean age of 36.7 years. After 3month of CC therapy, sperm concentration was significantly increased from 14.07±16.21*106/ml to 30.52±38.10*106/ml. Sperm motility was also increased from 22.61±17.32% to 29.01±17.11%, but not significantly. Total T, FSH, and LH levels all significantly increased. 2 couples (5.4%) got pregnant. 2 patients experienced side effects: acne, n = 1; increased hepatic enzymes, n = 1. There were 5 patients who complained low libido and/or ED, but no improvement by T elevation. Conclusions According to our data, CC therapy increased sperm concentration significantly. CC therapy may be an effective and safe alternative for patients with low T and low sperm concentration. We have to evaluate more cases to know the CC therapy effect for low libido and ED. Disclosure Work supported by industry: no.