Total Sperm Count Research Articles

Evaluation of the Combination of Recombinant FSH and Antioxidant Therapy on DNA Fragmentation Index (DFI) in Infertile Men

Introduction. Medications such as antioxidants and recombinant FSH are prescribed to improve sperm DFI (DNA fragmentation index) and treat infertility. Due to the high cost and duration of medications, in this study, we decided to investigate the effectiveness of combining these two medications with lower doses and in less time, compared to previous studies prescribing them individually, to reduce sperm DFI in infertile men. Methods. This study, a retrospective observational before and after trial, included a group ( <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1"> <mi>n</mi> <mo>=</mo> <mn>94</mn> </math> ) of men aged 18-50 years with <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2"> <mtext>DFI</mtext> <mo>&gt;</mo> <mn>20</mn> <mi>%</mi> </math> suffering from male factor infertility in an andrology clinic in Tehran, Iran, from 2019 to 2020. Patients received the combination of two medications, recombinant FSH every 5 days (75 IU subcutaneously) and an antioxidant every day (selenium, vitamin E, CoQ10, and folic acid) for 2 months. The patient’s sperm DFI and sperm parameters have been measured before and after the medication and were reported in patient’s files. In all patients, we compare the sperm DFI and sperm parameters before and after the treatment to evaluate the effect of the combination therapy. Results. The sperm DFI was significantly reduced ( <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3"> <mi>p</mi> </math> value ≤0.001) in the patients treated by the combined medication. The sperm DFI improvement was 50.16% in the total population. However, there were no significant changes in other sperm parameters such as sperm concentration, total motility, progressive motility, immotile sperms, and abnormal morphology. Total sperm count and nonprogressive motility had significant changes statistically. Conclusion. Sperm DFI is an important indicator for evaluating the quality of semen. In this study, we demonstrate that the combination of recombinant FSH and antioxidants in a shorter time and with lower doses is effective in reducing DFI significantly. But in terms of other sperm parameters, it does not make a significant difference.

Mixed exposure effect of seminal metals on semen quality, mediation of total antioxidant capacity, and moderation of GSTM1/GSTT1 gene deletion in Chinese reproductive-aged men

BackgroundThe effects of metal exposure on semen quality and the role of oxidative damage in this process remain unclear. MethodsWe recruited 825 Chinese male volunteers, and 12 seminal metals (Mn, Cu, Zn, Se, Ni, Cd, Pb, Co, Ag, Ba, Tl, and Fe), the total antioxidant capacity (TAC), and reduced glutathione were measured. Semen parameters and GSTM1/GSTT1-null genotypes were also detected. Bayesian kernel machine regression (BKMR) was applied to evaluate the effect of the mixed exposure to metals on semen parameters. The mediation of TAC and moderation of GSTM1/GSTT1 deletion were analyzed. ResultsMost seminal metal concentrations were correlated with each other. The BKMR models revealed a negative association between the semen volume and metal mixture, with Cd (cPIP = 0.60) and Mn (cPIP = 0.10) as the major contributors. Compared to fixing all scaled metals at their median value (50th percentiles), fixing the scaled metals at their 75th percentiles decreased the TAC by 2.17 units (95%CI: −2.60, −1.75). Mediation analysis indicated that Mn decreased the semen volume, with 27.82% of this association mediated by TAC. Both the BKMR and multi-linear models showed that seminal Ni was negatively correlated with sperm concentration, total sperm count, and progressive motility, which was modified by GSTM1/GSTT1. Furthermore, Ni and the total sperm count showed a negative association in GSTT1 and GSTM1 null males (β[95%CI]: 0.328 [-0.521, −0.136]) but not in males with GSTT1 and/or GSTM1. Although Fe and the sperm concentration and total sperm count were positively correlated, they showed inverse “U” shapes in univariate analysis. ConclusionExposure to the 12 metals was negatively associated with semen volume, with Cd and Mn as the major contributors. TAC may mediate this process. GSTT1 and GSTM1 can modify the reduction in the total sperm count caused by seminal Ni exposure.

MP30-08 EVALUATING THE CHANGES IN SEMEN PARAMETERS OVER TIME FOR MEN WITH AZOOSPERMIA FACTOR C (AZFc) MICRODELETIONS

You have accessJournal of UrologyCME1 Apr 2023MP30-08 EVALUATING THE CHANGES IN SEMEN PARAMETERS OVER TIME FOR MEN WITH AZOOSPERMIA FACTOR C (AZFc) MICRODELETIONS Jessica Marinaro, Jonathan Gal, Anna Mielnik, and Peter Schlegel Jessica MarinaroJessica Marinaro More articles by this author , Jonathan GalJonathan Gal More articles by this author , Anna MielnikAnna Mielnik More articles by this author , and Peter SchlegelPeter Schlegel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with complete azoospermia factor C (AZFc) microdeletions may have variable degrees of spermatogenic failure. While some are persistently azoospermic, most intermittently or consistently have sperm in the ejaculate. It has been proposed that these men may experience a temporal decline in semen quality with age. The objective of this study was to assess changes in semen parameters over time among men with complete AZFc deletions. METHODS: We retrospectively reviewed 163 men with complete AZFc deletions who were tested at our center from 4/1996 to 7/2022. Of these, 41 had ≥2 semen analyses performed (SA). ANOVA tests were used to compare mean demographic values between azoospermic, intermittently azoospermic, and non-azoospermic men. Wilcoxon matched-pairs signed rank tests were used to compare initial and final semen analyses. RESULTS: In total, 179 SAs were reviewed. The mean number of SAs per patient was 4.4 ± 2.2. The mean time between each SA was 189.6 ± 420.0 days, and the mean time between the first and last SA was 638.9 ± 850.9 days. Of 41 men, 13 (32%) were azoospermic, 9 (22%) intermittently azoospermic, and 19 (46%) were non-azoospermic. Of the non-azoospermic men, most (n=14, 73.7%) had severe oligospermia (<1 million/mL).Of 9 men with intermittent azoospermia, most had an increase in sperm concentration (n=8, 89%), total sperm count (TSC) (n=8, 89%), and total motile sperm count (TMSC) (n=6, 67%) between the first and last SA. Similarly, most non-azoospermic men also had an increase in sperm concentration (n=12, 63%), TSC (n=11, 58%), and TMSC (n=11, 58%). In comparing semen parameters, men with intermittent azoospermia had an increase in sperm concentration (p=0.0078) and TSC (p=0.0078) between the first and last SA, but no change in TMSC. There was no difference in concentration, TSC, or TMSC over time for non-azoospermic men.While non-azoospermic men were older (mean: 37.0 +/- 5.6 years; p=0.004) versus intermittently azoospermic (mean: 33.4 +/- 3.3 years) or azoospermic men (mean: 30.3 +/- 5.6 years), there were no differences in baseline testosterone (p=0.24), baseline FSH (p=0.31), or testis size (p=0.17 right, p=0.50 left). CONCLUSIONS: In this study, there was no significant decline in sperm concentration, TSC, or TMSC over time for men with complete AZFc deletions; rather, sperm number tended to increase over time. These data suggest that men with AZFc deletions are not at substantive risk of decline in sperm production and do not need to take aggressive early measures for fertility preservation. Source of Funding: Authors JM and JG are supported in part by the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e393 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Marinaro More articles by this author Jonathan Gal More articles by this author Anna Mielnik More articles by this author Peter Schlegel More articles by this author Expand All Advertisement PDF downloadLoading ...

MP43-18 ADOLESCENT VARICOCELE: EFFECTS OF VEIN SIZE AND ARTERIAL FLOW RATE ON SEMINAL PARAMETERS

You have accessJournal of UrologyCME1 Apr 2023MP43-18 ADOLESCENT VARICOCELE: EFFECTS OF VEIN SIZE AND ARTERIAL FLOW RATE ON SEMINAL PARAMETERS Selin Ocal, Alina Sheikh, Joseph Pizzuti, Alexander Fang, Joseph Boroda, Steven Friedman, Ronnie Fine, Mark Horowitz, Ronnie Fine, Richard Sclussel, Lori Dyer, Paul Zelkovic, Jaime Freyle, Israel Franco, and Jordan Gitlin Selin OcalSelin Ocal More articles by this author , Alina SheikhAlina Sheikh More articles by this author , Joseph PizzutiJoseph Pizzuti More articles by this author , Alexander FangAlexander Fang More articles by this author , Joseph BorodaJoseph Boroda More articles by this author , Steven FriedmanSteven Friedman More articles by this author , Ronnie FineRonnie Fine More articles by this author , Mark HorowitzMark Horowitz More articles by this author , Ronnie FineRonnie Fine More articles by this author , Richard SclusselRichard Sclussel More articles by this author , Lori DyerLori Dyer More articles by this author , Paul ZelkovicPaul Zelkovic More articles by this author , Jaime FreyleJaime Freyle More articles by this author , Israel FrancoIsrael Franco More articles by this author , and Jordan GitlinJordan Gitlin More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Varicocele severity has been associated with larger testicular vein size but the relationship to decreased fertility remains debatable. In clinical practice, largest vein diameter is used to screen for surgical intervention, yet more recent studies have found venous reflux patterns and total testicular volume (TTV) to be associated with total motile sperm count (TMSC). This study compares largest testicular vein size and arterial flow rates to identify patients at risk for reduced seminal parameters. METHODS: We conducted a retrospective single institution chart review over 14 years of 487 Tanner V adolescents. 148 met inclusion criteria of palpable, non-operated left sided varicoceles who underwent at least one SA and color doppler ultrasonography. Abnormal TMSC was defined by WHO 2010 criteria. Descriptive statistics, ROC analysis, univariate and multivariate logistic regression were performed using SPSS. RESULTS: Data on 148 Tanner V adolescent males with mean age 18.24±1.38 years were evaluated. Median diameter of largest left testicular vein was 3.5 mm (IQR 3.1-4.6), median peak systolic velocity (PSV) of left testicular artery was 10.4 cm/s (IQR 9.1-12.5), median end diastolic velocity (EDV) of left testicular artery was 5.1 cm/s (IQR 4.3-5.9), median value of PSV/EDV was 2.1 (IQR 1.8-2.3) and median TMSC was 37.4 million sperm/ejaculate (IQR 15.8-84.2). On ROC analysis regarding prediction of abnormal TMSC (<9 million sperm/ejaculate), left testicular PSV was found to have the greatest AUC at 0.73 (95% CI 0.62-0.85) with Youden index analysis determining cutoff of 10.22 cm/s while largest vein diameter was found to have an AUC of 0.48. On univariate logistic regression, PSV<10.22 cm/s resulted in a significantly greater likelihood of abnormal TMSC (OR: 5.51 [1.84-16.46], p=0.002), which persisted on multivariate logistic regression with adjustment for age (OR: 5.49 [1.83-16.43], p=0.002). CONCLUSIONS: Left testicular PSV was most significantly correlated to TMSC. PSV <10.22 cm/s was predictive of an abnormal TMSC. No significant association was found between larger veins and greater risk for abnormal TMSC. When assessing varicocele, left testicular artery PSV may help stratify future fertility risk, allowing for improved surveillance regarding surgical intervention. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e608 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Selin Ocal More articles by this author Alina Sheikh More articles by this author Joseph Pizzuti More articles by this author Alexander Fang More articles by this author Joseph Boroda More articles by this author Steven Friedman More articles by this author Ronnie Fine More articles by this author Mark Horowitz More articles by this author Ronnie Fine More articles by this author Richard Sclussel More articles by this author Lori Dyer More articles by this author Paul Zelkovic More articles by this author Jaime Freyle More articles by this author Israel Franco More articles by this author Jordan Gitlin More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-09 ARE COMPLETE AZFc DUPLICATIONS ASSOCIATED WITH SPERMATOGENIC POTENTIAL? THE FIRST REPORTED SERIES

You have accessJournal of UrologyCME1 Apr 2023MP30-09 ARE COMPLETE AZFc DUPLICATIONS ASSOCIATED WITH SPERMATOGENIC POTENTIAL? THE FIRST REPORTED SERIES Kian Asanad, Mary Samplaski, Elena Kolomeitz, Stephen Scherer, Ryan Yuen, Christian Marshall, Kirk Lo, Ethan Grober, Brendan Mullen, Susan Lau, and Keith Jarvi Kian AsanadKian Asanad More articles by this author , Mary SamplaskiMary Samplaski More articles by this author , Elena KolomeitzElena Kolomeitz More articles by this author , Stephen SchererStephen Scherer More articles by this author , Ryan YuenRyan Yuen More articles by this author , Christian MarshallChristian Marshall More articles by this author , Kirk LoKirk Lo More articles by this author , Ethan GroberEthan Grober More articles by this author , Brendan MullenBrendan Mullen More articles by this author , Susan LauSusan Lau More articles by this author , and Keith JarviKeith Jarvi More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: It is well established that complete AZFc microdeletions are a common cause of male factor infertility. With advances in detection methodology, increasing cases of partial AZFc deletion and Yq duplication, especially those involving the AZFc region, have started to emerge. Here, we report the first series of infertile men with complete AZFc duplications. METHODS: Men presenting for a fertility evaluation at a single male infertility specialty clinic from 2012-2014 who had AZFc complete duplications using a targeted microarray in peripheral blood were identified. Demographics, medical, surgical, family and reproductive history, semen and hormonal parameters, as well as response to therapies were characterized. Fischer’s exact test was used to compare the rate of complete AZFc duplications in the infertile population versus fertile controls. RESULTS: We identified five men having complete AZFc duplications, which represented 4.8% (5/104) of men undergoing Y-chromosome microarray testing and 21% of men with men with AZFc abnormalities. The mean age was 33.7 years. There was a significantly higher proportion of AZFc duplications in the infertile population (5/104) vs. the fertile controls (0/148) (p= 0.013). The mean testicular volume was 18 mL. One man had a left grade 2 varicocele. The mean FSH was 5.5 IU/L (range 1-11 IU/L), LH 3.6 IU/L (range 3-4.2 IU/L), and testosterone 14.5 nmol/L (range 12.5-18.3 nmol/L). With respect to semen parameters, one man was persistently azoospermic. The second man alternated between severe oligospermia and rare non-motile sperm. The third man had one semen analysis demonstrating azoospermia and a second demonstrating a total sperm count (TSC) of 4 ×106. The fourth man was persistently oligospermic with TSCs ranging from 3.96-12.6 ×106. The fifth man had severe oligospermia, with a mean TSC of 1.5 ×106; after intervention (varicocele embolization, clomiphene citrate), his TSC rose to 21.7 ×106. He then fathered a spontaneous pregnancy. CONCLUSIONS: This is the first study to report that complete AZFc duplications are common in those infertile men with AZFc abnormalities, representing 21% of the AZFc alterations in this group. Studies only targeting AZFc deletions are underestimating the frequency of AZFc abnormalities in men with spermatogenic failure. They represent a heterogeneous group, having a variable reproductive potential. Cases should be managed on an individual basis. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e394 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kian Asanad More articles by this author Mary Samplaski More articles by this author Elena Kolomeitz More articles by this author Stephen Scherer More articles by this author Ryan Yuen More articles by this author Christian Marshall More articles by this author Kirk Lo More articles by this author Ethan Grober More articles by this author Brendan Mullen More articles by this author Susan Lau More articles by this author Keith Jarvi More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-11 DISTRIBUTION OF FOLLICLE STIMULATING HORMONE (FSH) LEVELS AMONG FERTILE AND SUBFERTILE NON-AZOOSPERMIC MEN

You have accessJournal of UrologyCME1 Apr 2023MP30-11 DISTRIBUTION OF FOLLICLE STIMULATING HORMONE (FSH) LEVELS AMONG FERTILE AND SUBFERTILE NON-AZOOSPERMIC MEN Solomon Hayon, Sai Kaushik S.R. Kumar, Xinlei Mi, Anthony Kang, Jasmine Lin, Daniel Greenberg, Robert Brannigan, and Joshua Halpern Solomon HayonSolomon Hayon More articles by this author , Sai Kaushik S.R. KumarSai Kaushik S.R. Kumar More articles by this author , Xinlei MiXinlei Mi More articles by this author , Anthony KangAnthony Kang More articles by this author , Jasmine LinJasmine Lin More articles by this author , Daniel GreenbergDaniel Greenberg More articles by this author , Robert BranniganRobert Brannigan More articles by this author , and Joshua HalpernJoshua Halpern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While the clinical utility of FSH is well-established in the diagnosis and management of azoospermic men, the utility of FSH in non-azoospermic men is unclear. First, we characterized the distribution of FSH in fertile and subfertile non-azoospermic men. Second, we sought to determine an optimal FSH threshold that would distinguish between these groups. METHODS: We performed a retrospective analysis of men presenting for fertility evaluation between 2002 and 2020. Men with at least two semen analyses (SA) over a one-month period and one FSH level within 6 months of their index SA were included. Men with semen volume < 1.0cc, azoospermia, or men on hormonal medications were excluded. Men with at least one SA with total motile sperm count (TMSC) ≥ 20 million were classified as fertile, while men who had <20 million TMSC on both SAs were classified as subfertile. FSH was evaluated as an independent variable to determine a threshold that would predict fertility status. A multivariable logistic regression using dichotomized FSH with a broad range of FSH thresholds and other clinical variables was used to predict fertility status. We determined the area under the curve (AUC) for each FSH threshold via 5-fold cross-validation, repeated 1000 times. The optimal FSH threshold was selected according to the mean AUC. RESULTS: Among 1876 men, 1115 (59.4%) were fertile and 275 (14.7%) were subfertile. Age, varicocele, and testosterone were similar between groups. Median FSH was 4.00 vs 5.96 (p<0.001) among fertile vs subfertile men. AUC analysis was performed for FSH thresholds corresponding to the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentile FSH level for each cohort. While the FSH threshold of 5.6 had the highest AUC for prediction of fertility status (0.663), multiple additional thresholds ranging from 4.0 to 9.4 had very similar AUCs. Positive predictive value of FSH increased with higher FSH thresholds. CONCLUSIONS: This is the first large-scale study to characterize FSH values in non-azoospermic men. While there are significant differences in FSH among fertile and subfertile non-azoospermic men, no single FSH cutoff had high accuracy for prediction of fertility status. These findings suggest that the utility of FSH in non-azoospermic men may be greatest in identifying men with extreme FSH values, which may guide further clinical management. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e394 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Solomon Hayon More articles by this author Sai Kaushik S.R. Kumar More articles by this author Xinlei Mi More articles by this author Anthony Kang More articles by this author Jasmine Lin More articles by this author Daniel Greenberg More articles by this author Robert Brannigan More articles by this author Joshua Halpern More articles by this author Expand All Advertisement PDF downloadLoading ...

MP12-06 SOCIOECONOMIC DETERMINANTS AS A PREDICTOR OF HORMONE AND SEMEN PARAMETERS

You have accessJournal of UrologyCME1 Apr 2023MP12-06 SOCIOECONOMIC DETERMINANTS AS A PREDICTOR OF HORMONE AND SEMEN PARAMETERS Jordan Kassab and Larry Lipshultz Jordan KassabJordan Kassab More articles by this author and Larry LipshultzLarry Lipshultz More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003227.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Social determinants of health, including economic resources, lifestyle choices, and access to adequate healthcare, have been shown to predict certain health outcomes. While past studies have indicated varying fertility outcomes as a result of social determinants of health, little research has been done to look into how biological markers are affected. Thus, the aim of this study is to investigate whether hormone and semen quality parameters are influenced by socioeconomic determinants. METHODS: Using the Distressed Community Index (DCI), disparate communities were identified by ZIP code within a ten-mile radius of our university hospital. The DCI compiles seven metrics regarding income and vulnerability to generate a percentile score with lower scores indicating better economic well-being. We identified zip codes that fall within the highest quintile of scores and zip codes that fall within the lowest quintile of scores in order to provide a stratified patient cohort. Using these zip codes, 179 urology patients were included in our retrospective chart analysis noting DNA fragmentation rates, testosterone, PSA, and total sperm count. T-tests for each parameter were calculated using SPSS. RESULTS: The statistical analysis revealed that semen parameters greatly differed between the low and high DCI score patient cohorts. The low DCI cohort had less than half of the DNA fragmentation rate of the high DCI cohort (12.64% vs. 30.50%, p=.0245). The low DCI group had significantly higher testosterone levels (632.5 ng/dL vs. 353.7 ng/dL, p=.00001). Additionally, PSA levels varied significantly between the low and high DCI groups (0.685 ng/mL vs. 3.28 ng/mL, respectively, p=.0125). Lastly, the total sperm count varied greatly between the two groups: the low DCI group had an average of 125 million and the high DCI group had an average of 68.3 million (p=.0316). CONCLUSIONS: Our study has demonstrated that men residing within wealthier and less vulnerable areas had documented more normal DNA fragmentation rates, testosterone and PSA levels, and total sperm counts. This relationship emphasizes the need to prioritize efforts towards supporting urologic care in disadvantaged communities. Our findings establish the basis for further population based studies to address the impact of socioeconomic status as a factor of urologic health outcomes. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e135 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Kassab More articles by this author Larry Lipshultz More articles by this author Expand All Advertisement PDF downloadLoading ...

V11-09 PENILE VIBRATORY STIMULATION (PVS): THE METHOD OF CHOICE FOR ANEJACULATION AFTER SPINAL CORD INJURY

You have accessJournal of UrologyCME1 Apr 2023V11-09 PENILE VIBRATORY STIMULATION (PVS): THE METHOD OF CHOICE FOR ANEJACULATION AFTER SPINAL CORD INJURY Emad Ibrahim Emad IbrahimEmad Ibrahim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Spinal cord injury (SCI) is the leading cause of anejaculation in young men. After SCI 90% of men with SCI will need a method of assisted ejaculation to achieve biological fatherhood. Penile vibratory stimulation (PVS) was popularized in 1994 after the production of the first vibrator specifically designed for semen retrieval in men with SCI. The success of this device was based on a calculated amplitude of 2.5 mm which was proven to be optimal for successfully producing an ejaculate. PVS is safe, reliable, can be performed by the male partner at home after an initial evaluation by a health care provider and yields the best sperm quality.A newly designed vibrator was produced in 2019 and was tested by a group of international experts for safety and efficacy. The study concluded the device was safe and effective in inducing ejaculation in men suffering from anejaculation after SCI. METHODS: Initial encounter: standard history, physical exam and level of injury determination using the International Standards for Neurological Classification of Spinal Cord Injury were performed. In addition, assessment of Hip Flexor Reflex and Bulbocavernosus Reflex was performed. Procedure: Patients with a level of injury at or rostral to T6 were pretreated with 10-40 mg of sublingual nifedipine to mange autonomic dysreflexia. The patient lied supine on the exam table and the vibrator was applied to the dorsum or frenulum of the glans penis. Stimulation was delivered in 2-minute increments to a maximum of 10 minutes per visit. Stimulation using 2 vibrators (Sandwich technique) or with abdominal electrical stimulation can be performed in select patients. Semen: Ejaculated semen was collected in a sterile cup and a semen analysis was performed after liquefaction. Bladder preparation using sperm wash medium was performed in patients suspected of having retrograde ejaculation. RESULTS: PVS was successful in 86% of men whose level of injury was T10 or rostral. A total of 3,698 PVS procedures were successfully performed by our group. The total motile sperm count in antegrade ejaculates produced by PVS was >5 million (lower limit considered for IUI) in 71% of ejaculates. CONCLUSIONS: PVS is a safe and effective method to manage anejaculation in men with SCI. Sperm can be obtained non surgically from most men with SCI. Sufficient sperm are available for simple insemination procedures. PVS should be considered as the method of choice for semen retrieval in this patient population. Source of Funding: Paralyzed Veterans of America (PVA) Educational Grant #877 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1001 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emad Ibrahim More articles by this author Expand All Advertisement PDF downloadLoading ...

MP01-04 A NEW SEMEN CONTAINER DESIGNED TO MINIMIZE DAMAGE TO SPERM DURING TRANSPORTATION AT LOW TEMPERATURE CONDITIONS

You have accessJournal of UrologyCME1 Apr 2023MP01-04 A NEW SEMEN CONTAINER DESIGNED TO MINIMIZE DAMAGE TO SPERM DURING TRANSPORTATION AT LOW TEMPERATURE CONDITIONS Hiroshi Okada, Toshiyuki Iwahata, Hiroshi Okada, Hiroshi Okada, Kazutaka Saito, and Kouhei Sugimoto Hiroshi OkadaHiroshi Okada More articles by this author , Toshiyuki IwahataToshiyuki Iwahata More articles by this author , Hiroshi OkadaHiroshi Okada More articles by this author , Hiroshi OkadaHiroshi Okada More articles by this author , Kazutaka SaitoKazutaka Saito More articles by this author , and Kouhei SugimotoKouhei Sugimoto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003212.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Rapid cooling is believed to be harmful to mammalian spermatozoa. Thus, special care should be taken when transporting semen in low temperature conditions. A new semen container, TPS-2 was designed to protect sperm against damage caused by cold shock. We investigated the ability of TPS-2 to protect sperm from low temperature conditions, using sperm from both fertile and infertile men. METHODS: We measured the change in temperature of semen stored in TPS-2 at 10°C compared with Sperm Cup, a conventional semen collecting cup. We also investigated change in total sperm motility, sperm DNA fragmentation index, and seminal oxidation-reduction potential when stored in TPS-2 or Sperm Cup at 10°C. We used Sperm Cup and TPS-2 to transport 25 semen samples of infertile patients from home to the clinic below 10°C, and compared the difference of sperm motion parameters. RESULTS: After storage for 3 h, the temperature in TPS-2 and Sperm Cup was 20.1°C and 12.1°C, respectively (Figure 1). The temperature dropped more gradually in TPS-2 than in Sperm Cup. Semen from fertile volunteers stored in Sperm Cup showed significantly lower total sperm motility, whereas in TPS-2, total sperm motility was the same as at 25°C (Figure 2). Semen from infertile patients stored at 10°C showed significantly lower total sperm motility in Sperm Cup. In TPS-2, total sperm motility did not change after storage at 10°C for 3 h. TPS-2 could maintain sperm motility (p=0.000), percentage of rapid moving sperm (p=0.002) and total motile sperm count (p=0.014) during transportation in low temperature conditions (Figure 3). CONCLUSIONS: TPS-2 maintains the temperature of semen stored in it during exposure to low temperatures conditions, preventing sperm damage. TPS-2 is recommended for transportation of semen in cold conditions. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e2 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hiroshi Okada More articles by this author Toshiyuki Iwahata More articles by this author Hiroshi Okada More articles by this author Hiroshi Okada More articles by this author Kazutaka Saito More articles by this author Kouhei Sugimoto More articles by this author Expand All Advertisement PDF downloadLoading ...

MP43-12 TESTOSTERONE THERAPY AT THE TIME OF VASECTOMY REVERSAL: IMPACT ON INTRA-OPERATIVE DECISION MAKING AND INTERPRETATION OF POST-OPERATIVE OUTCOMES.

You have accessJournal of UrologyCME1 Apr 2023MP43-12 TESTOSTERONE THERAPY AT THE TIME OF VASECTOMY REVERSAL: IMPACT ON INTRA-OPERATIVE DECISION MAKING AND INTERPRETATION OF POST-OPERATIVE OUTCOMES. Ethan D. Grober and Udi Blankstein Ethan D. GroberEthan D. Grober More articles by this author and Udi BlanksteinUdi Blankstein More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: During vasectomy reversal (VR), accurate intra-operative microscopic assessment of the vasal fluid for sperm presence and quality is essential in determining the indication for a vasovasostomy (VV) or vasoepididymostomy (VE). The use of testosterone therapy (TT), known to suppress spermatogenesis, can potentially interfere with this determination. The current initiative evaluates the impact of testosterone therapy on vasal and epididymal fluid sperm characteristics and intra-operative decision-making among men on testosterone therapy at the time of VR. METHODS: Of 2622 consecutive VRs performed between 2007-2022, patients actively using TT at the time of VR were identified. Details as to the type, dose and duration of TT were documented. All patients were counselled regarding the impact of TT on spermatogenesis and encouraged to discontinue TT if possible. During VR, vasal and epididymal fluid (as indicated) was sampled and each aspirate underwent microscopic evaluation for sperm presence and quality and was categorized as: motile sperm/intact-non-motile sperm/sperm parts/no sperm. Rates of sperm presence/absence in the vasal/epididymal fluid, frequency of VV/VE, post-operative patency (presence of motile sperm) and semen parameters were compared among patients on TT vs. clinically-matched patients not using TT at the time of VR. RESULTS: Among the 2622 VRs reviewed, 54 men (2%) reported using TT at the time of their VR. Despite its impact on spermatogenesis, intra-operative microscopic analysis of the reproductive fluid (vasal or epididymal) identified the presence of sperm in 95% (51/54) of patients. Testis biopsy confirmed sperm production among 3 patients with absence of sperm within the vasal or epididymal fluid. Rates of VV or VE, did not significantly differ among men using TT at the time of VR compared to nonusers. Post-operative patency rates (TT:78 % vs. No TT:94%) and mean total motile sperm counts (TMC) were lower among patients using TT at the time of VR (7.9 vs. 28.3, p=0.02). CONCLUSIONS: Use of TT at the time of VR does not appear to impact rates of intra-operative microscopic identification of sperm within the reproductive fluid or the indication for VV/VE. Post-operative patency rates and total motile sperm counts may be lowered by use of TT. Moreover, the determination to the etiology azoospermia post-operatively (production vs. obstruction) may be clouded by the use of TT during VR. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e605 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ethan D. Grober More articles by this author Udi Blankstein More articles by this author Expand All Advertisement PDF downloadLoading ...

MP43-15 MICROSURGICAL VARICOCELE REPAIR IMPROVES SPERM CAPACITATION AND PROBABILITY OF GENERATING A PREGNANCY, AS MEASURED BY PRE- AND POST-OPERATIVE TESTING WITH CAP-SCORE

You have accessJournal of UrologyCME1 Apr 2023MP43-15 MICROSURGICAL VARICOCELE REPAIR IMPROVES SPERM CAPACITATION AND PROBABILITY OF GENERATING A PREGNANCY, AS MEASURED BY PRE- AND POST-OPERATIVE TESTING WITH CAP-SCORE Muhamed Qalawena, Eric Seaman, Jared Johnson, Ahmed El-Sakka, and Joshua Bodie Muhamed QalawenaMuhamed Qalawena More articles by this author , Eric SeamanEric Seaman More articles by this author , Jared JohnsonJared Johnson More articles by this author , Ahmed El-SakkaAhmed El-Sakka More articles by this author , and Joshua BodieJoshua Bodie More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Infertility is a worldwide problem, with up to 40-50% of cases involving male infertility. Varicocele represents the most common correctable cause of male infertility. While semen analysis (SA) remains the primary diagnostic tool of infertility, it does not provide information about sperm function. The Cap-Score is designed to assess sperm capacitation via localization patterns of ganglioside GM-1, which has been shown to be a viable surrogate of capacitation-competent human sperm. The predicted probability of generating a pregnancy (PGP) is a validated metric based on semen volume, concentration, and Cap-Score. PGP is defined as the percent chance of obtaining a pregnancy within three consecutive rounds of intrauterine insemination (IUI). The objective of this study was to determine the effect of microscopic varicocelectomy on sperm capacitation and the probability of generating a pregnancy. METHODS: Data were collected prospectively of 40 consecutive adult men who presented with infertility confirmed by SA and found to have a varicocele on exam or ultrasound who underwent unilateral or bilateral subinguinal microscopic varicocelectomy. We recorded pre and post-operative SA, Cap-Score, and PGP with a 3-month follow up. Values were compared using paired t-test and Wilcox rank-sum test. RESULTS: Of the 40 men enrolled, 29 (72.5%) demonstrated improved Cap-Score with an average increase of 4% (p=0.001). The absolute change in probability of generating a pregnancy was 6% higher (p=0.001) after varicocelectomy, which represents a 25% relative increase in PGP. The change in Cap-Score was not associated with the grade of varicocele (p=0.0703) or whether the patient had a unilateral or bilateral repair (p=0.9682). There were no differences in semen volume (p=0.061) or morphology (p=0.091), however, there was improvement in sperm motility (p=0.021), total sperm count (p=0.030) and concentration (p=0.004). CONCLUSIONS: It is known that varicocelectomy improves semen parameters and chances of conception in the majority of cases, including pregnancies via intercourse or via assisted reproduction. This study confirms that varicocelectomy augments male fertility by improving sperm capacitation, and that varicocele repair improves the probability of generating an IUI pregnancy to a statistically-significant degree. The improvement in sperm capacitation ability may explain how varicocele repair may improve the chance of pregnancy, regardless of standard semen parameter improvements. Source of Funding: This study did not receive industry support. The only external funding for the study came from doctor M. Qalawena, a scholar visiting the University of Minnesota from the faculty of Medicine Suez Canal University, Egypt, whose personal educational grant by the Egyptian ministry of higher education funded the sixteen tests for the eight patients contributed from the University of Minnesota. Patients from the New Jersey site had received Cap-Score testing by Androvia LifeSciences Lab at patient expense. Physicians received no funding from Androvia for running the study, and the Androvia Labs did not have editorial control of the study results © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e607 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Muhamed Qalawena More articles by this author Eric Seaman More articles by this author Jared Johnson More articles by this author Ahmed El-Sakka More articles by this author Joshua Bodie More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-01 TEMPORAL TRENDS IN SPERM COUNT OF FERTILE PATIENTS: A SYSTEMATIC REVIEW AND META-REGRESSION ANALYSIS

You have accessJournal of UrologyCME1 Apr 2023MP30-01 TEMPORAL TRENDS IN SPERM COUNT OF FERTILE PATIENTS: A SYSTEMATIC REVIEW AND META-REGRESSION ANALYSIS Rossella Cannarella, Raneen Sawaid Kaiyal, Shinnosuke Kuroda, Kieran Lewis, Sarah Vij, and Scott Lundy Rossella CannarellaRossella Cannarella More articles by this author , Raneen Sawaid KaiyalRaneen Sawaid Kaiyal More articles by this author , Shinnosuke KurodaShinnosuke Kuroda More articles by this author , Kieran LewisKieran Lewis More articles by this author , Sarah VijSarah Vij More articles by this author , and Scott LundyScott Lundy More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: While current evidence suggests the existence of a downward trend of sperm concentration and count in unselected men from both industrialized and underdeveloped countries, these data have been controversial due to the heterogeneity of the study populations and the differences in World Organization Health (WHO) manual edition used. In response, we performed a focused meta-analysis specifically in men with proven paternity and restricted our analysis to studies using the 5th edition of the WHO manual (2011-2020). METHODS: A literature search was performed using Scopus, PubMed, Ovid, Embase and Cochrane databases according to PRISMA guidelines. Men were defined as fertile if demonstrating proven paternity with variable interval between conception and semen analysis. The primary outcomes of this study was sperm concentration, and the secondary outcomes included semen volume, progressive motility, total sperm count, and morphology. A meta-regression analysis was performed to determine the change in the selected outcomes over time. RESULTS: 4286 abstracts were initially reviewed, 139 full text articles were fully assessed for eligibility, and a total of 8 articles were included in the final cohort. Sperm concentration (mean 86.2M/ml, 95% CI 49.0, 123.4, I2= 99.1%; p<0.001) did not change from 2011 to 2020 (p= 0.4105). Only three studies reported total sperm count (322.7M/ejaculate, 95% CI 52.2, 593.2, I2= 99.9%; p<0.001), and the data were insufficient to run a meta-regression analysis. Semen volume (3.6 ml, 95% CI 2.5, 4.7, I2= 99.3%; p<0.001) did increase from 2011 to 2020 (+0.303 mL/year; p<0.01). Interestingly, both sperm motility (59.7%, 95% CI 53.5, 66.0, I2= 97.8%; p<0.001) and progressive motility (48.5 %, 95% CI 47.6, 49.3, I2= 95.4%; p<0.001) significantly reduced over the study time period (-2.2%/year, p<0.0001 and -3.1%/year, p<0.01). Sperm morphology (71.8 %, 95% CI 71.0, 71.6, I2= 99.7%; p<0.001) and vitality (30.4 %, 95% CI 19.6, 41.2, I2= 97.1%; p<0.001) did not change from 2011 to 2020. CONCLUSIONS: The results of this study suggest that sperm motility, but not total count, may be falling for unknown reasons. Further work is needed to better understand the mechanisms and clinical implications for this finding. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e391 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rossella Cannarella More articles by this author Raneen Sawaid Kaiyal More articles by this author Shinnosuke Kuroda More articles by this author Kieran Lewis More articles by this author Sarah Vij More articles by this author Scott Lundy More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-20 HUMAN PAPILLOMAVIRUS SEMINAL CARRIAGE, SPERMOGRAM ABNORMALITIES AND MALE INFERTILY: A FRENCH COHORT STUDY

You have accessJournal of UrologyCME1 Apr 2023MP30-20 HUMAN PAPILLOMAVIRUS SEMINAL CARRIAGE, SPERMOGRAM ABNORMALITIES AND MALE INFERTILY: A FRENCH COHORT STUDY Armin Priam, Amiens, France, Antoine Le Bozec, Kremlin Bicetre, France, Vasco Dias Meireles, Fabien Saint, Rosalie Cabry, Moncef Benkhalifa, Baptiste Demey, and Dorian Bosquet Armin PriamArmin Priam More articles by this author , Amiens Amiens More articles by this author , France France More articles by this author , Antoine Le BozecAntoine Le Bozec More articles by this author , Kremlin BicetreKremlin Bicetre More articles by this author , France France More articles by this author , Vasco Dias MeirelesVasco Dias Meireles More articles by this author , Fabien SaintFabien Saint More articles by this author , Rosalie CabryRosalie Cabry More articles by this author , Moncef BenkhalifaMoncef Benkhalifa More articles by this author , Baptiste DemeyBaptiste Demey More articles by this author , and Dorian BosquetDorian Bosquet More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.20AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The impact of HPV on the male genital tract remains largely underestimated and underexplored, compared to the female side. Epidemiological data in men are scarce, and few studies have investigated the prevalence of HPV in the male population and spermogram abnormalities. The objective was to study the prevalence of Human papillomavirus seminal carriage in male genital tract and its association with the spermogram and spermocytogram abnormalities. METHODS: From May to October 2021, patients were recruited in the SPERM-VIR study and provided semen samples. A total of 461 patients evaluated for fertility disorders was included. Individual informed consent was obtained to use biological, demographic, health, and lifestyle data. The spermogram, spermocytogram and sperm migration assays were carried out by the local Department of Medicine and Reproductive Biology. Then, overages of semen were sent to the local Virology Department for Human Papillomavirus (HPV) screening. Semen characteristics (semen volume, sperm concentration, total sperm count, sperm motility, sperm morphology, spermatic denaturation, spermatic DNA fragmentation, sperm migration test results), demographic, health, and lifestyle data of patients carrying or not HPV in the sperm were compared using univariate and multivariate analyses with a logistic regression model. RESULTS: HPV was detected in 22.34% of sperm samples. Multivariate analysis showed that positive HPV status was significantly associated with at least one spermogram abnormality, according to WHO 2021 standards (oligozoospermia and/or asthenozoospermia and/or teratozoospermia) with an adjusted odds ratio of 4.10 [95% CI 2.32-7.25]. This statistical association was also found for the type of infertility (OR: 1.61 [95% CI 1.00-2.57]), the notion of varicocele (OR: 3.99 [95% CI 1.48-10.71]), Cryptorchidism/Testicular Ectopy/Monorchidism antecedent (OR: 3.54 [95% CI 1.07-11.66]). Either mono or pluri-HPV infection were significantly associated with at least 1 spermogram abnormality (OR: 3.93 [95% CI 2.08-7.41] and 4.11 [95% CI 1.58-10.68], respectively), independently of HPV oncogenic risk. The association between HPV spermatic infection and the risk of infertility was significant in multivariate analysis (OR: 5.63 [95% CI 3.16-10.01]) and by adjusting to propensity score (OR: 6.10 [95% CI 3.33-11.21]). CONCLUSIONS: Our study is an additional argument supporting the impact of seminal HPV carrying on male infertility, especially in cases labelled as idiopathic. The determination of spermatic HPV could therefore be a part of the exploration of an infertile man Source of Funding: No external funding was received for this project. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e399 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Armin Priam More articles by this author Amiens More articles by this author France More articles by this author Antoine Le Bozec More articles by this author Kremlin Bicetre More articles by this author France More articles by this author Vasco Dias Meireles More articles by this author Fabien Saint More articles by this author Rosalie Cabry More articles by this author Moncef Benkhalifa More articles by this author Baptiste Demey More articles by this author Dorian Bosquet More articles by this author Expand All Advertisement PDF downloadLoading ...

MP43-10 FERTILITY PRESERVATION AND SPERM QUALITY IN ADOLESCENT TRANSGENDER PATIENTS PRIOR TO HORMONAL TREATMENT

You have accessJournal of UrologyCME1 Apr 2023MP43-10 FERTILITY PRESERVATION AND SPERM QUALITY IN ADOLESCENT TRANSGENDER PATIENTS PRIOR TO HORMONAL TREATMENT Philippa Ralph, Daniel Schalger, Wai Gin Lee, Elizabeth Williamson, Raheala Wafa, Gary Butler, David Ralph, and Philippa Sangster Philippa RalphPhilippa Ralph More articles by this author , Daniel SchalgerDaniel Schalger More articles by this author , Wai Gin LeeWai Gin Lee More articles by this author , Elizabeth WilliamsonElizabeth Williamson More articles by this author , Raheala WafaRaheala Wafa More articles by this author , Gary ButlerGary Butler More articles by this author , David RalphDavid Ralph More articles by this author , and Philippa SangsterPhilippa Sangster More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003289.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: As increasing numbers of adolescents with gender dysphoria(GD) start gonadotrophin-releasing hormone agonists (GnRHa), their unknown affects make fertility preservation (FP) increasingly important and strongly recommended, prior to starting hormone treatment (HT). We investigated the take up, hormonal profile and sperm quality in adolescents undergoing FP via cryopreservation or surgical sperm retrieval (SSR), prior to starting HT. METHODS: Data for adolescents wanting to FP was prospectively maintained. Young people were counselled for FP and serum testosterone (T), FSH, and LH were recorded prior to providing semen samples. Semen samples were classified by concentration; normal >15 mil/ml, oligospermia <15 mil/ml, poor <1 sperm/slide, azoospermia. If the sample was insufficient or the patient was unwilling to masturbate, SSR was offered using electroejaculation (EE)±TESE. RESULTS: Overall, 122 patients were referred for FP (median age 16.1 years [12.4-18.7]). 23 patients (19%) declined FP. 64% (n=78, median age 16.7) successfully masturbated and cryopreserved an average of 6.6 straws. In this subcohort, mean total sperm count was 34.24 million. Sperm concentration was normal in 44%, 36% had oligospermia, 9% had poor sperm concentration, and 12% were azoospermic. Mean blood results showed a T of 12.32 nmol/l [1.2-28.4], FSH 3.83 IU/L [0.8-21.1], LH 4.39 IU/L [0.8-16.7]. SSR was required in 24 patients. These patients were younger, with a median age 14.8 [12-18]. EE was successful in 4 (16%), while the rest proceeded with testicular sperm extraction; 4 mTESE patients were azoospermic. Of the remaining 16 patients, an average of 5 vials were stored. Semen parameters in this cohort were poor - but possibly adequate for ICSI. Hormone levels were similar to the masturbation cohort. Mean T 11.7nmol/l [5.9-12-8], FSH 3.4 IU/L [1.2-4.9], LH 3.5 IU/L [2.3-4.7]. SSR resulted in no serious complications.3 patients had previously used GnRHa pre SSR. Following a washout period, 1 remained azoospermic despite a T of 21 nmol/l. The other 2 had sperm found with abnormal morphology and motility. CONCLUSIONS: This the largest cohort of transgender girls referred for FP in the UK. Semen concentrations were below 15 mil/ml in 67% of those who masturbated, but an average of 6.6 straws were frozen. SSR wasn’t successful in all despite T levels >8nmol/l. Testicular sperm parameters were poor in all cases. Previous GnRHa use may have an adverse effect though numbers are small. Masturbation is often possible but SSR provides patients with a safe alternative to potentially have their own biological children. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e605 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Philippa Ralph More articles by this author Daniel Schalger More articles by this author Wai Gin Lee More articles by this author Elizabeth Williamson More articles by this author Raheala Wafa More articles by this author Gary Butler More articles by this author David Ralph More articles by this author Philippa Sangster More articles by this author Expand All Advertisement PDF downloadLoading ...

MP51-08 IS THE UROLIFT A FERTILITY SPARING TECHNIQUE IN PATIENTS SUFFERED FROM BPH?

You have accessJournal of UrologyCME1 Apr 2023MP51-08 IS THE UROLIFT A FERTILITY SPARING TECHNIQUE IN PATIENTS SUFFERED FROM BPH? Pasquale Annese, Nicola d'Altilia, Ugo G. Falagario, Vito Mancini, Antonella Ninivaggi, Edoardo Tocci, Mariano Bruno, Anna Ricapito, Gian M. Busetto, Carlo Bettocchi, and Giuseppe Carrieri Pasquale AnnesePasquale Annese More articles by this author , Nicola d'AltiliaNicola d'Altilia More articles by this author , Ugo G. FalagarioUgo G. Falagario More articles by this author , Vito ManciniVito Mancini More articles by this author , Antonella NinivaggiAntonella Ninivaggi More articles by this author , Edoardo TocciEdoardo Tocci More articles by this author , Mariano BrunoMariano Bruno More articles by this author , Anna RicapitoAnna Ricapito More articles by this author , Gian M. BusettoGian M. Busetto More articles by this author , Carlo BettocchiCarlo Bettocchi More articles by this author , and Giuseppe CarrieriGiuseppe Carrieri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003299.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign prostatic hypertrophy (BPH) is a common disease in aging males. Although less common, some patients under 50 years of age reported lower urinary tract disorders (LUTS) due to BPH. If desirous of paternity, pharmacological treatment remains the only one due to the risk of anejaculation after surgery. The first aim of the study was to report functional outcomes related to fertility preservation evaluatet by sperm test in a population under 50 years of age who underwent UroLift in a single Center. METHODS: We included 20 young men with symptomatic BPH assessed by the International Prostate Symptom Score (IPSS), with normal erectile function (EF) and ejaculatory function (EjF) assessed by the International Index of Erectile Dysfunction (IIEF-5) and Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD-SF).Semen analysis was performed before surgery and repeated at 3 months with evaluation of pH, volume, sperm concentration, total motility, vitality and morphology of sperms. All patients, preoperatively underwent, uroflowmetry (UFM), digital rectal examination, transrectal prostate ultrasound to measure prostate volume, PSA, cystoscopy and urodynamics test if necessary. Urinary function was scheduled at 1, 3, 6, 12 months with UFM, IPSS, IIEF-5, and MSHQ-EjD-SF. First PSA and cistoscopy were repeated at 6 month. RESULTS: The mean age of the patients was 44.5 (36.5, 48) years. Mean operative time was 15 (10, 20) min and 2.5 (2, 4) implats per patients were used. At 3 months there were no difference in terms of total sperm count, volume, pH, motility, vitality, morphology, liquefaction, leucocytes (p=0.9; p=0.8; p=0.7; p=1; p=1; p=1; p=0,2; p=0.5). No patient presented retrograde ejaculation. Q-max increased by 64.4% (p=0.001), PVR decreased by 66.6% (p=0.016), and IPSS decreased by 60% (p<0.001). IIEF and MSHQ-EjD-SF were similarly preserved (p=0.14, p=0.4). CONCLUSIONS: From the results obtained, we can conclude new findings regarding sparing of sperm test parameters following UroLift, furthermore, no one reported retroejaculation or volume alteration. UroLift was confirmed to be effective as a technique in improving urinary functional disorders secondary to BPH. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e695 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Pasquale Annese More articles by this author Nicola d'Altilia More articles by this author Ugo G. Falagario More articles by this author Vito Mancini More articles by this author Antonella Ninivaggi More articles by this author Edoardo Tocci More articles by this author Mariano Bruno More articles by this author Anna Ricapito More articles by this author Gian M. Busetto More articles by this author Carlo Bettocchi More articles by this author Giuseppe Carrieri More articles by this author Expand All Advertisement PDF downloadLoading ...

Correlation Between Testis Weight, Testis Volume, and Total Sperm Count in the Indonesian Domestic Cats (Felis catus)

Information regarding the domestic cat as a model animal in the biomedical research has not been widely carried out. This study was aimed to see the correlation between testicular weight, testicular volume and total sperm count between the left testicle, right testicle and both testes. In addition, this study was aimed to examine the effect of testicular weight and volume on quantitative histomorphometry of the testes in domestic cats in Indonesia. The results showed that there was no difference between the left and right testes. Testes weight has a positive and highly significant correlation with testes volume and total sperm count, both in the left, right, and both testes. The heavier the weight of the testes, the wider the diameter of the seminiferous tubules, the wider the lumen, and the taller the tubular epithelium. It can be concluded that the increase in testicular weight is in line with the increase in cells in the seminiferous tubules

A Cross-Sectional Analysis of the Effect of Obesity on Sperm Quality in Infertile Couples

Background: The obesity pandemic is emerging which is clearly because of changes in caloric habits and lifestyles of people worldwide. A number of serious medical problems are associated with obesity. One of them is infertility. Objective: The main purpose of this research was to evaluate the relationship of body mass index (BMI) with standard semen parameters by measuring hip circumference and waist circumference. Study design: A cross-sectional study Place and Duration: This study was conducted at Abassi Shaheed Hospital Karachi hospital from November 2021 to November 2022. Methodology: All infertile couple who visited gynaecology outpatient department for infertility treatment interviewed and after taking relevant history of both partners total of 180 men were enrolled in this research . By using the standard methods, the weight and height of the patients was measured. Moreover, their WC (waist circumference) and hip circumference were also measured. After two to five days of abstinence from coitus, the patients were advised to give the semen in laboratory for semen analysis. First, the liquefaction was done. Later, the Makler counting chamber was used to analyze the semen. A number of semen parameters were noted by using the Worth Health Organization criteria Results: Most of the individuals were from the age group of 31 to 40 years. Most of the men (n=144) were having primary infertility, representing 80% of the total sample size. The waist-hip ratio was seen in the majority of the men. There was a negative link seen between semen parameters and WHR. The majority of the men were having a body mass index of 23 to 27 kg/m2, representing 51.5% of the total sample size. A total of 27 males were having mildly decrease sperm concentration, representing 15% of the sample size. On the other hand, a total of 35 men with mildly decrease sperm counts, represented 19.4 percent of the sample size. Conclusion: There is a negative relationship between semen parameters (total sperm count, total motility, sperm concentration, and total progressive motility) and WHR. Keywords: Semen analysis, obesity, waist-hip ratio, infertility

Spontaneous alterations in semen parameters are associated with age, accessory gland function and the FSHB c.-211G>T variant.

There is a strong within-subject alteration of semen parameters in men with infertility. However, it remains unknown in which subgroup variations are likely to occur and which semen parameters are affected. To evaluate parameters associated with spontaneous alterations in semen analysis. We retrospectively selected 3456 men with infertility without known causes affecting spermatogenesis or sperm output for analysis of repeated ejaculate samples. Exclusion criteria comprised sperm concentration <1 million/mL, abnormal follicle-stimulating hormone or low testosterone, and low bitesticular volume (<10mL). Grouped linear two-level nested mixed-effect models were applied. The analyzed parameters included abstinence time, bitesticular volume, age, accessory gland markers, follicle-stimulating hormone, and FSHB c.-211 variants. Groups include A (n=397): ≥1.0 to <5.0 million/mL, B (n=708): ≥5.0 to <15.0 million/mL, and C (n=2351): ≥15.0 million/mL. Groups A, B, and C: changes in ejaculate volume were associated with alterations in total sperm count and motility (p<0.003). Changes were, controlled for abstinence time (p<0.001), related to α-glucosidase, fructose, or zinc (p=0.005-0.02). Group A+B: fluctuations in follicle-stimulating hormone level influenced sperm concentration/count (p=0.004-0.02), albeit only in men with FSHB c.-211 GG (p=0.007-0.02). T-allele carriers did not show changes in follicle-stimulating hormone levels (p>0.1). Group B: age <50 years (p=0.007-0.01) and normal bitesticular volume (p=0.008-0.02) were associated with spontaneous increases in sperm concentration, count, and motility. Semen parameters exhibit intra-individual alterations associated with organic, hormonal, and genetic variables. Changes are pronounced in younger men with normal bitesticular volume and oligozoospermia to almost normozoospermia. The effect is modulated by abstinence time, accessory gland function, and fluctuations in follicle-stimulating hormone level, which is bound to FSHB c.-211G>T variant. Judgment of semen analysis should be based on two semen samples, with abstinence times between 4 and 5 days. As a future perspective, it might be investigated whether younger men with normal bitesticular volume who are unable to elicit increases in serum follicle-stimulating hormone (FSHB c.-211 genotype of GT/TT) benefit from improving accessory gland function and increasing follicle-stimulating hormone.

Truncating PICK1 Variant Identified in Azoospermia Affected Mitochondrial Dysfunction in Knockout Mice.

The protein interacting with C kinase 1 (PICK1) plays a critical role in vesicle trafficking, and its deficiency in sperm cells results in abnormal vesicle trafficking from Golgi to acrosome, which eventually disrupts acrosome formation and leads to male infertility. An azoospermia sample was filtered, and the laboratory detection and clinical phenotype indicated typical azoospermia in the patient. We sequenced all of the exons in the PICK1 gene and found that there was a novel homozygous variant in the PICK1 gene, c.364delA (p.Lys122SerfsX8), and this protein structure truncating variant seriously affected the biological function. Then we constructed a PICK1 knockout mouse model using clustered regularly interspaced short palindromic repeat cutting technology (CRISPRc). The sperm from PICK1 knockout mice showed acrosome and nucleus abnormalities, as well as dysfunctional mitochondrial sheath formation. Both the total sperm and motility sperm counts were decreased in the PICK1 knockout mice compared to wild-type mice. Moreover, the mitochondrial dysfunction was verified in the mice. These defects in the male PICK1 knockout mice may have eventually led to complete infertility. The c.364delA novel variant in the PICK1 gene associated with clinical infertility, and pathogenic variants in the PICK1 may cause azoospermia or asthenospermia by impairing mitochondrial function in both mice and humans.

Maternal vitamin D levels and male reproductive health: a population-based follow-up study.

Maternal vitamin D levels during pregnancy may be important for reproductive health in male offspring by regulating cell proliferation and differentiation during development. We conducted a follow-up study of 827 young men from the Fetal Programming of Semen Quality (FEPOS) cohort, nested in the Danish National Birth Cohort to investigate if maternal vitamin D levels were associated with measures of reproductive health in adult sons. These included semen characteristics, testes volume, and reproductive hormone levels and were analysed according to maternal vitamin D (25(OH)D3) levels during pregnancy. In addition, an instrumental variable analysis using seasonality in sun exposure as an instrument for maternal vitamin D levels was conducted. We found that sons of mothers with vitamin D levels < 25nmol/L had 11% (95% CI - 19 to - 2) lower testes volume and a 1.4 (95% CI 1.0 to 1.9) times higher risk of having low testes volume (< 15mL), in addition to 20% (95% CI - 40 to 9) lower total sperm count and a 1.6 (95% CI 0.9 to 2.9) times higher risk of having a low total sperm count (< 39 million) compared with sons of mothers with vitamin D levels > 75nmol/L. Continuous models, spline plots and an instrumental variable analysis supported these findings. Low maternal vitamin D levels were associated with lower testes volume and lower total sperm count with indications of dose-dependency. Maternal vitamin D level above 75nmol/L during pregnancy may be beneficial for testes function in adult sons.