Total Sperm Count Research Articles

The association between hepatitis B virus and semen quality: a systematic review and meta-analysis

BackgroundSome studies have suggested that hepatitis B virus (HBV) infection had a negative association with semen quality, but the conclusions have been inconsistent. The purpose of our study was to systematically assess the association between HBV infection and semen parameters.MethodsWe searched electronic databases for studies published from January 1980 to August 2023. Eleven studies were included in the analysis. Primary outcomes were semen volume, sperm concentration, sperm morphology, sperm motility and sperm progressive motility. We also conducted a subgroup analysis between China and other countries.ResultCompared with the semen quality of HBV-negative men, HBV infection had a negative association with semen volume (MD: −0.20 mL, 95%CI: −0.32 to − 0.09, P = 0.0004), sperm concentration (MD: −4.46 × 106/mL, 95%CI: −7.09 to − 1.84, P = 0.0009), sperm morphology (MD: −2.49%, 95%CI: −4.35 to − 0.64, P = 0.008), sperm motility (MD: −6.85%, 95%CI: −11.53 to − 2.18, P = 0.004), and sperm progressive motility (MD: −6.63%, 95%CI: −10.24 to − 3.02, P = 0.0003). However, HBV infection had no significant association with total sperm count (MD: −31.50 × 106, 95%CI: −74.11 to 11.10, P = 0.15). The association between HBV and semen quality were inconsistent between the subgroups.ConclusionHBV infection had a negative association with sperm concentration, motility, morphology, and semen volume. However, The association between HBV and total sperm count remain unclear. This metaanalysis suggests that we should pay attention to the adverse effect of HBV on sperm quality, and several studies have reported the relevant mechanisms. But due to the significant heterogeneity among studies on some semen parameters, further large and well-designed researches are needed before introducing clinical management recommendations.

Microsurgical varicocelectomy efficacy in treatment of men with primary and secondary infertility (retrospective study).

Varicocele is the most common treatable cause of male infertility. The study aimed to compare varicocelectomy efficacy in men with primary (PI) and secondary infertility (SI). Medical records of 100 men suffering from PI and SI and having varicocelectomy at the Republican Specialized Scientific-Practical Medical Center of Urology were retrospectively selected and analyzed. Patients were divided into 2 groups. Group I included 58 men with PI and Group II 42 men with SI. Preoperative clinical characteristics and semen parameters before and after varicocelectomy were analyzed and compared between groups. Analysis revealed that the mean age of patients of group I was significantly lower (p < 0.001) and the duration of infertility was accurately shorter (p < 0.01) than those of group II. Main semen parameters increased significantly in group I (e.g., sperm concentration increased by 50%, from 62.2 ± 8.7 to 93.5 ± 10.0 M/ml, and total motile sperm count increased by 113%, from 76.7 ± 17.1 to 163.4 ± 27.8 M p < 0.05), while in group II only rate of progressive motile sperm increased significantly (by 107%, from 13.5 ± 2.6 to 28.0 ± 5.2% p < 0.05). We identified a significant difference in varicocelectomy efficacy between group I and group II in change of total motile sperm count (by 113% vs. 74% respectively, p < 0.01). We also revealed a discrepancy between groups in correlation ratio (r) between initial and post-surgical percent of progressive motile sperm. Patients with SI were older and had longer infertility period. Varicocelectomy resulted in significant semen parameters improvement in patients with PI. In patients with SI, only percent of progressively motile sperm improved significantly. It indicates that advanced male age and long infertility duration may have a negative impact on varicocelectomy success.

Penile vibratory stimulation in men with spinal cord injury: an educational video demonstration

To demonstrate the different techniques used to perform successful penile vibratory stimulation (PVS) to induce ejaculation in men with spinal cord injuries (SCIs). A video demonstration of the PVS procedure performed in men with SCIs using the FertiCare 2.0 medical vibrator. Major University Medical Center. Men with SCIs. Spinal cord injury is the leading cause of anejaculation in young men. After SCIs, most of these men will need a method of assisted ejaculation to achieve biological fatherhood. In this study, a newly designed and tested vibrator (FertiCare 2.0) was used to induce ejaculation. The initial assessment of each patient included a standard history, physical examination, level of injury determination using the International Standards for Neurological Classification of Spinal Cord Injury as well as assessment of the hip flexor reflex and the bulbocavernosus reflex. Patients with a level of injury at or rostral to T6 were pretreated with 10-40 mg of sublingual nifedipine to manage autonomic dysreflexia. A single vibrator was applied to the dorsum, or frenulum, of the glans penis. Stimulation is delivered in 2-minute increments to a maximum of 10 minutes per visit. Application of two vibrators or abdominal electrical stimulation concurrently with PVS was used in select patients. Ejaculated semen was collected in a sterile cup and examined after liquefaction. Bladder preparation using sperm wash medium was performed in patients suspected of experiencing retrograde ejaculation. Successful ejaculation after performing the PVS procedure in men with SCIs. Penile vibratory stimulation was successful in 86% of men whose level of injury was T10 or rostral. The total motile sperm count in antegrade ejaculates produced using PVS was >5 million (lower limit considered for intrauterine insemination) in 71% of ejaculates. No complications because of PVS were observed in 3,700 trials performed by our group and none in the patients presented in this video. Penile vibratory stimulation is a safe and effective method for the management of ejaculatory dysfunction in men with SCIs. Penile vibratory stimulation can be performed by the male partner after an initial evaluation by a specialized provider, and the ejaculate can be used to perform home insemination.

Presence of SARS-CoV-2 RNA in Semen and Reproductive Function of Asymptomatic and Mildly Symptomatic Male Patients with a High Viral Load

Background: The potential impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on male fertility is a complex and evolving area of research. Although there is some evidence to suggest that the virus might have negative effects on semen from mild to moderate symptoms or recovery of coronavirus disease 2019 (COVID-19) and might induce epididymal-orchitis, further research is needed to definitively determine the risks. Objectives: This study aimed to investigate the presence of SARS-CoV-2 ribonucleic acid (RNA) in semen and to determine any possible implications of SARS-CoV-2 infection on semen parameters and genital tract complications. Methods: Thirty-two subjects with a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) cycle threshold (Ct) value of less than 20 were recruited, and semen samples were collected. Additionally, testicular discomfort and urogenital abnormality were assessed. Results: No SARS-CoV-2 RNA was detected in the seminal sample of men; however, semen quality impairment was detected, especially in patients with Ct values less than 15 in the upper respiratory tract. Total sperm count, the number of motile spermatozoa, progressive motility, and the percentage of normal morphology were significantly reduced. Acute epididymo-orchitis and testicular tenderness were observed in 4 patients in the acute stage of the disease. Conclusions: This study showed no evidence of SARS-CoV-2 RNA in semen, suggesting that sexual transmission of the virus is unlikely. However, semen quality impairment was observed in patients with SARS-CoV-2 infection, particularly those with higher viral loads. Further research is needed to elucidate the mechanisms by which SARS-CoV-2 affects male fertility and develop effective interventions to protect men's reproductive health during the pandemic.

(199) The Impact of Obesity on Sperm Parameters in Young Adult Males: A Retrospective Study of Sperm Donors

Abstract Introduction Studies estimate that sperm concentrations have declined by 52.4% over the past 40 years. Concurrent with this decline in male fertility, obesity remains a growing epidemic in the United States, with the prevalence in men rising from 26.6% in 1999 to 38.4% in 2016. Thus, this decline in sperm concentration may be attributable to many causes, including lifestyle factors such as obesity. The gold standard diagnostic method for assessing male fertility is semen analysis. Due to screening criteria, sperm banks offer a unique sample of individual-level semen analyses of healthy men without comorbidities including cardiovascular disease, hypertension, heart failure, and diabetes. While the association between BMI and sperm parameters has previously been shown, these studies do not exclude individuals with obesity-related comorbidities, as participants presented as couples who were seeking care for infertility. Objective To utilize a large sample of healthy young men who meet strict sperm bank donor eligibility criteria to evaluate the association between BMI and individual sperm parameters, independent of comorbidities. Methods Sperm parameters from donor candidates at sperm banks across the United States were obtained between 2008 to 2021. Donors were healthy men aged 18-46 years old who abstained from ejaculation for 48 hours prior to donation. Semen samples were analyzed in a Clinical Laboratory Improvement Amendments (CLIA) certified lab using guidelines by the World Health Organization (WHO). A univariable model between BMI and individual sperm parameters (total sperm count, volume, sperm concentration, progressive motility) was conducted. Results There was a total of 135,578 sperm donations included in our study. The median age was 26 (IQR: 8), with 1146 (0.8%) men identified as underweight, 89,590 (66%) as normal weight, 41,362 as overweight (31%), 3,438 (3%) as obesity class I and 42 (0.03%) as obesity class II (Table 1). Participants had a median total motile sperm count of 194 (IQR: 134 million), volume of 3.45 (IQR: 1.8mL), sperm concentration of 58 (IQR: 34 million/mL) and a motility of 61.5 (IQR: 18%). We found that total motile sperm count (B = -69, p &amp;lt; 0.01) and volume (B = -1.14, p &amp;lt;0.01) were significantly lower in men with a BMI ≥ 35, compared to normal weight men (sperm count = 213 million; volume = 3.67 mL; Table 2). Conclusions We report significantly lower total sperm count and semen volume in healthy young men who have a BMI ≥ 35 as compared to those who are normal weight. Although these values are within the normal range of sperm parameters established by the WHO, our ability to detect differences even within this specific population of men without obesity-related comorbidities highlights the importance of maintaining a healthy weight for preserving high sperm counts. With the increase in infertility concerns amongst younger men and the rise of obesity prevalence within the United States, our work highlights the importance of maintaining a healthy diet and exercise regimen throughout early adulthood to maintain normal sperm parameters. Disclosure No.

(300) Systematic Review and Meta-analysis of Seasonal Variation on Human Semen Quality in the United States

Abstract Introduction Different environmental exposures such as daylight hours and temperature influence spermatogenesis, which vary across seasons. However, studies on the variation of semen analysis across different seasons reported inconsistent results. Objective To investigate the seasonality of human semen parameters in the United States through a systematic review and meta-analysis. Methods We systematically searched PubMed, Scopus, and Web of Science for studies on seasonal variation of human semen parameters in the United States from conception to December 11, 2022, without language restriction, and also scrutinized the reference list of included studies for any additional related study. We determined the pooled standardized mean difference (SMD) and its 95% confidence interval (95%CI) between seasons using the random effect model in a case of substantial heterogeneity (I2 index≥50%) and the fixed-effect model in a case of low heterogeneity (I2 index&amp;lt;50%) in STATA version 17. The methodological quality was checked using Newcastle–Ottawa Quality Assessment Scale (NOS). Results Our search yielded 548 studies. After screening, 7 studies on 131,306 semen analyses were included for meta-analysis. All included studies had high methodological quality (NOS ≥ 7). Figure 1 shows the pooled SMD of semen parameters between seasons. Semen analysis in winter had a higher volume than those in spring (p-value=0.010; I2=4.63%). Winter had better semen quality than summer in terms of concentration (p-value=0.014; I2=0%) and total sperm count (p-value=0.044; I2=47.80%). Semen quality was also better in winter than in fall, in terms of volume (p-value=0.001; I2=0%), concentration (p-value=0.016; I2=23.68%), and total sperm count (p-value=0.022; I2=13.95%). Spring had better semen quality than summer in terms of concentration (p-value&amp;lt;0.001; I2=33.74%) and percent of normal morphology (p-value&amp;lt;0.001; I2=0%), and also had higher concentration than fall (p-value&amp;lt;0.001; I2=42.82%). Semen analysis in summer had a lower percentage of total motility than those in fall (p-value=0.045; I2=0%). Conclusions Semen parameters follow a seasonal pattern, with winter and spring showing better sperm quality regarding concentration and total sperm count than other seasons. Disclosure No.

(277) Predictors of Cryopreserved Sperm Quality Among Transgender Females Compared to Cisgender Males

Abstract Introduction Approximately 70% of transgender females express future interest in having children (Auer et al, 2018). However, studies have demonstrated poor semen parameters among this population who undergo sperm cryopreservation (Rodriguez-Wallberg et al, 2021). It remains poorly understood the underlying etiologies which place individuals at increased risk of suboptimal semen parameters. Objective We sought to identify clinical predictors of lower sperm quality among a cohort of transgender females and to compare this to a cohort of cisgender males. Methods We retrospectively identified 19 transgender women who underwent sperm cryopreservation at a single andrology lab within an academic institution between November 2021 and April 2023. We identified 16 age-matched cisgender male patients who also underwent sperm cryopreservation prior to oncologic treatment or vasectomy during this period. Data was abstracted from the electronic medical record. Statistical analysis was performed using SPSS version 28. Results Median age and body mass index of the transgender cohort was 25 years (range: 18-35) and 25.1 kg/m2 (range: 18.0-51.5). Median age and BMI of the cisgender cohort was 29 years (range: 17-37) and 25.2 kg/m2 (range: 18.7-38.0). Cisgender patients underwent sperm cryopreservation for oncologic treatment (81%) and pre-vasectomy planning (19%). 32% of transgender patients were initiated on gender affirming hormonal therapy (estradiol, spironolactone, or both) prior to semen analysis, with mean duration of 25 months (range: 1-108). 37% of transgender and 13% of cisgender patients were on a psychiatric medication with mean duration of 7.6 months (range: 1-19) and 7.5 months (range: 3-12) preceding sperm cryopreservation. 11% of transgender and 6% of cisgender patients endorsed tobacco use. 37% of transgender and 38% of cisgender patients endorsed alcohol use. Mean total motile sperm count (TMSC) was 61 million in the cisgender cohort and 105 million in the transgender cohort (p=0.159). 21% and 38% of the transgender and cisgender cohort had low TMSC (&amp;lt;10 million). Mean post-thaw motility recovery was similar among the two groups (56% vs 57%, p=0.894). Transgender women on hormonal therapy had lower TMSC (p=0.867) and post-thaw motility recovery (p=0.535; Table 1) compared to their hormone-naïve counterparts. Alcohol use was a significant predictor of decreased post-thaw motility recovery among cisgender patients (63% vs 46%; p=0.011; Table 2). Conclusions Cisgender men had lower TMSC, but this was likely confounded by underlying malignancy. There was a trend toward worse semen parameters among transgender women with a history of hormone use, but larger studies are needed to validate this finding. Psychiatric medications similarly did not appear to be significant predictors of sperm quality among transgender women. Further studies are needed with a larger sample size and cisgender males without malignancy to validate the effect of these modifiable lifestyle factors. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific, Endo Pharmaceuticals.

(093) The Continued Use of Testosterone Does Not Interfere with Human Chorionic Gonadotropin-Mediated Return of Spermatogenesis

Abstract Introduction Depression of spermatogenesis is a significant problem in the hypogonadal patient on testosterone therapy (TTh). We commonly prescribe human chorionic gonadotropin (hCG) concomitantly in these men to prevent testicular atrophy and to maintain some degree of spermatogenesis. When a pregnancy is desired, we increase the hCG to 3000 units subcutaneously three times weekly. Traditionally, testosterone therapy is discontinued during this high-dose hCG treatment. However, the question remains as to whether these men can continue TTh with the use of hCG, thus bypassing the need to stimulate pituitary hormones. Objective To investigate whether patients with low testosterone, in an effort to avoid hypogonadal symptoms, can continue their testosterone therapy when using hCG in an effort to reestablish normal spermatogenesis. Methods We studied 260 patients who had been prescribed hCG at a university hospital within the observation range of 01/01/2021–12/31/2022. Two cohorts were evaluated: hCG + TTh and hCG without TTh. Dosage information, other medications, comorbidities, demographic information (including age and race), as well as laboratory results of hormones and semen analyses were captured into a patient database. Baseline laboratory values for each patient were documented prior to being prescribed hCG, followed by subsequent values for each of these variables in the months following this prescription. One-way ANOVAs were employed using SPSS to analyze the longitudinal impacts of hCG on testosterone, total sperm count, and total motile count. For the analysis of testosterone values, we separated patients based on whether they were concomitantly prescribed and taking testosterone therapies (TTh). Results When assessing the baseline testosterone in patients on TTh compared to the following four follow-up visits (n=154) since taking hCG, the f-ratio of the one-way ANOVA was 9.13256 (p-value &amp;lt; 0.00001). In the same assessment for patients not on TTh (n=37), the f-ratio value is 4.93955 (p-value = 0.0011). Lastly, when analyzing total sperm count across all patients with documented semen analyses (SA) across four follow-up visits (n=64) since taking hCG, the f-ratio value is 2.66654 (p-value = 0.034). Both cohorts experienced improvements across these two metrics. Our data did not show any statistically significant differences in the two groups in total motile count across the follow-up visits. Conclusions Our findings confirm strong improvements in testosterone and total sperm count, regardless of whether or not adjunctive TTh was used. These results highlight the efficacy of hCG longitudinally in promoting hormonal and reproductive recovery in hypogonadal men, warranting further investigation into its long-term effects and clinical applications. These data provide valuable insights that can assist healthcare professionals in providing informed guidance to patients regarding the anticipated therapeutic outcomes of hCG treatment, including expected timeline and magnitude. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Larry Lipshultz: AbbVie (Consultant) American Medical Systems/Boston Scientific (Speaker) Aytu BioScience (Consultant) Contraline, Inc. (Consultant) Endo Pharmaceuticals (Consultant/Speaker) Inherent Biosciences (Advisor) Lipocine (Consultant).

(092) Racial/ethnic Differences in Semen Parameters and Male Reproductive Hormones in the United States: A Systematic Review and Meta-Analysis

Abstract Introduction Semen quality and reproductive hormones are key indicators of male fertility potential, but studies have reported inconsistent results on racial/ethnic differences in these factors in the United States. Objective To perform a meta-analysis evaluating pooled differences in semen analysis parameters and male reproductive hormones across racial/ethnic groups in the United States through a systematic literature search. Methods PubMed, Scopus, and Web of Science were systematically searched up to December 17, 2022, with no language limitation. All studies on racial/ethnic variations in semen parameters and male reproductive hormones among the general population of the United States were included in this meta-analysis. Standardized mean difference (SMD) and its 95% confidence interval (95%CI) between races/ethnicities were pooled using the random-effects model. Newcastle–Ottawa Quality Assessment Scale (NOS) was used for risk of bias assessment. Heterogeneity was assessed by the I2 index. Results Our search yielded 731 articles. After screening, 9 studies were included. These studies had a low risk of bias (NOS ≥ 7) and involved a total of 7,641 participants. The pooled analysis showed no significant differences between White and Black men in the percent of total motility (p-value=0.513; I2=99.76%), total testosterone (p-value=0.272; I2=99.79%), free testosterone (p-value=0.220; I2=99.78%), and estradiol (p-value=0.876; I2=96.90%). However, higher sperm concentration (SMD=3.64; 95%CI: 0.18, 7.09; p-value=0.039; I2=99.53%) and total sperm count (SMD=6.04; 95%CI: 0.09, 11.99; p-value=0.046, I2=99.68%) were estimated for White men compared to Black men. Additionally, higher sperm concentration (SMD=1.39; 95%CI: 0.56, 2.23; p-value=0.001, I2=92.06%) and total motility (SMD=3.06; 95%CI: 0.09, 6.02; p-value=0.043, I2=99.14%) were estimated for Hispanic men compared to non-Hispanic men, with no differences in total sperm count (p-value=0.579, I2=97.79%) or total testosterone (p-value=0.078, I2=95.95%) (Figure 1). Conclusions This meta-analysis demonstrated reductions in semen analysis parameters, especially sperm concentration, for Black and non-Hispanic men relative to White and Hispanic men in the United States. Disclosure No.

(299) The Modulating Effects of Follicle Stimulating Hormone and Clomid on Men with Azoospermia or Oligozoospermia Taking Human Chorionic Gonadotropin

Abstract Introduction Depression of spermatogenesis is a significant concern for hypogonadal patients on testosterone therapy. Human chorionic gonadotropin (hCG) is commonly prescribed in these men to prevent testicular atrophy and to maintain some degree of spermatogenesis. Furthermore, hCG dosages are significantly increased when a pregnancy is desired. Historically, we have concomitantly used Clomid to stimulate FSH and testosterone production since both are needed for optimal spermatogenesis. However, with the availability of compounded FSH, we have introduced its usage instead of Clomid to evaluate if it yields superior quantitative sperm production. Objective To investigate which medication pairings yields the greatest improvement in hormone and semen parameters over time. Methods Including men with azoospermia or oligozoospermia who were prescribed hCG, we noted whether the men were additionally taking FSH or Clomid. The patient population of men in the hCG + FSH group had 32, and the hCG + Clomid group totaled 14. Baseline laboratory values were documented for testosterone and total sperm count for each patient prior to being prescribed their combined medications, followed by subsequent values for these variables in the months following this prescription. ANOVAs were employed using SPSS to analyze the change in the two assessed metrics across follow up visits. Results By analyzing increase in testosterone over time, the hCG + FSH cohort experienced the greatest improvement after four follow up visits (600.89 ng/dL after four visits, 150.22 (ng/dL)/visit), outperforming the hCG + Clomid group (505.63 ng/dL after four visits, 126.41 (ng/dL)/visit). The ANOVAs across the subsequent visits for each treatment group are as follows: hCG + FSH: f-ratio = 3.226, p-value = 0.0137; hCG + Clomid: f-ratio = 1.456, p-value = 0.219. Regarding total sperm count, the hCG + FSH group surpassed the HCG + Clomid group across the follow-up visits as well: hCG + FSH: 41.47 million after three follow-up visits; hCG + Clomid: 26.20 million after three follow-up visits. The ANOVAs across the subsequent visits for each treatment group are: hCG + FSH: f-ratio = 3.015, p-value = 0.0339; hCG + Clomid: f-ratio = 1.485, p-value = 0.234. Conclusions Those taking hCG with FSH experienced a greater improvement in both testosterone and total sperm counts compared to men on hCG and Clomid. It would seem that the use of FSH gives a more rapidly successful outcome for hypogonadal patients, since its combination with hCG acts directly to stimulate spermatogenesis, within the testes rather than requiring, as with Clomid, secondary stimulation through the pituitary gland's secretion of LH and FSH. With the relatively recent introduction of FSH as compounded biologics and its reduction in cost compared to brand FSH, the use of this trophic hormone can now be more widely used. Moreover, these data suggest that hCG with FSH results in a more rapid improvement in both spermatogenesis and serum testosterone than historically alternative therapies. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Larry Lipshultz: AbbVie (Consultant) American Medical Systems/Boston Scientific (Speaker) Aytu BioScience (Consultant) Contraline, Inc. (Consultant) Endo Pharmaceuticals (Consultant/Speaker) Inherent Biosciences (Advisor) Lipocine (Consultant).

Cross sectional study on exposure to BPA and its analogues and semen parameters in Czech men

Exposure to bisphenols has been found to have adverse effects on male reproductive function in animals. Human exposure to bisphenols is widespread. Bisphenol A (BPA) and its analogues, including bisphenol S (BPS), bisphenol F (BPF), and bisphenol AF (BPAF) are utilized in various consumer products such as food contact materials and dental resins. The effects of these compounds on male fertility and spermatogenesis are unclear and findings from human studies are inconsistent. In this cross-sectional study, we evaluated the influence of BPA, BPS, BPF, BPAF (BPs) measured in semen on number of spermatozoa, total motility, progressive motility, morphology, and DNA fragmentation. We also examined the association of bisphenols (BPs) exposure with patients’ occupation. A total of 358 patients aged 17–62 years with BMI 18–42 were included in the study from 2019 to 2021. BPs were extracted using solvent extraction followed by preconcentration step and determined by high-performance liquid chromatography and tandem mass spectrometry (LC/MSMS). Bisphenols were detected in 343 from 349 analysed samples (98.3% of all the samples). In 6 samples, the concentration of all BPs was under the limit of detection and in 20 samples under the limit of quantification. We did not find a statistically significant relationship between occupation and BPs. However, we observed significant correlations between the concentration of BPA and a lower motility and normal morphology. For BPS, a significant correlation with a lower ejaculate volume and a lower total sperm count was found. BPF and BPAF were detected only in 14.3% and 23.9% of samples, respectively. For BPF and BPAF, no significant correlations with spermiogram parameters were observed. Our results show that BPs are widespread in the male population (more than 90% of analysed samples), independently of an occupation and in case of BPA and BPS having a negative impact on spermiogram parameters.

Antioxidant treatment for oligoasthenoteratozoospermia and varicocele: a DBPC trial to evaluate the impact of age and body mass index.

Oxidative stress is one of the main mechanisms responsible for male infertility. Various conditions such as varicocele, obesity, advanced age, and lifestyle can lead to an increase in reactive oxygen species, causing an oxidative imbalance in the reproductive environment. Spermatozoa are sensitive to reactive oxygen species and require energy to carry out their main function of fertilizing the egg. Excessive reactive oxygen species can affect sperm metabolism, leading to immobility, impaired acrosome reaction, and cell death, thereby impairing reproductive success. This double-blind randomized study evaluated the effect of supplementation with L-carnitine, acetyl-L-carnitine, vitamins, and other nutrients on semen quality in 104 infertile patients with or without varicocele, while also investigating the impact of factors such as obesity and advanced age on treatment. Sperm concentration significantly increased in the supplemented group compared to the placebo group ( P = 0.0186). Total sperm count also significantly increased in the supplemented group ( P = 0.0117), as did sperm motility ( P = 0.0120). The treatment had a positive effect on patients up to 35 years of age in terms of sperm concentration ( P = 0.0352), while a body mass index (BMI) above 25 kg m -2 had a negative effect on sperm concentration ( P = 0.0110). Results were not showing a net benefit in stratifying patients in accordance with their BMI since sperm quality increase was not affected by this parameter. In conclusion, antioxidant supplementation may be beneficial for infertile patients and has a more positive effect on younger patients with a normal weight.

Semen cryopreservation for an oncological reason: a retrospective study

Research questionHow do cancer type and treatment affect semen quality before and after treatment, and what effect does it have in their clinical management of infertility? Also, what is the rate of patients using cryopreserved semen samples after treatment? DesignPatients who cryopreserved spermatozoa for oncological reasons between 2000 and 2022 in IVI clinics in Spain were retrospectively reviewed. Semen parameters were analysed before and after treatment, and utilization and destruction rates were calculated. Total motile sperm count (TMSC) was used for assisted reproductive technology (ART) counselling. ResultsA total of 724 patients cryopreserved their semen during the study period. The semen parameters of the cancer patients' semen before and after treatment were heterogeneous, with significant differences between cancer type and semen parameters. The utilization rate was relatively low (0.4%), whereas the destruction rate was 23.1%. ConclusionCancer and antineoplastic treatment affect everyone differently. Therefore, sperm cryopreservation should be offered to all patients before starting treatment to ensure their reproductive future. Furthermore, in addition to considering the semen parameters defined by the World Health Organization, it is important to use TMSC in the diagnosis of men to choose appropriate ART according to type of cancer.

SARS-CoV-2 Vaccination Improves Semen Quality in Men Recovered From COVID-19: A Retrospective Cohort Study.

Coronavirus disease 2019 (COVID-19) has been reported to decrease semen quality in reproductive-age men. Semen quality in vaccinated men after SARS-CoV-2 infection remains unclear. We recruited reproductive-age Chinese men scheduled for COVID-19 vaccination from December 2022 to March 2023. Among 1,639 vaccinated participants, an upward trend was found in sperm concentration (p < .001), progressive motility (p < .001), total motility (p < .001), total motile sperm count (TMSC) (p < .001), and normal morphology (p = .01) over time following COVID-19 recovery. Among men with an SARS-CoV-2 infection that lasted less than 30 days, men who received an inactivated vaccine booster had higher sperm progressive (p = .006) and total motility (p = .005) as well as TMSC (p = .008) than those without a booster vaccine, whereas no difference was found in semen parameters among men who received a recombinant protein vaccine. Similarly, an upward trend in semen quality was found among 122 men who provided semen samples before and after COVID-19. Higher risks of asthenozoospermia (odds ratio [OR] = 2.23, p < .001) and teratozoospermia (OR = 2.09, p = .03) were found among men who had an SARS-CoV-2 infection that lasted less than 30 days than among those without COVID-19. Collectively, after receiving SARS-CoV-2 vaccination, adverse but reversible semen parameters were observed in men recovering from COVID-19 over time. Recombinant protein vaccines and inactivated vaccine boosters should be recommended to all reproductive-age men.

Association analysis between mixed exposure to phenols and semen quality

Phenols such as bisphenols, parabens, and triclosan are common environmental endocrine disruptors. Previous epidemiological studies have suggested that phenols may affect semen quality, but the results were inconsistent. In addition, most existing studies have been limited to the effects of a single chemical compound, ignoring the health effects of mixed exposure to multiple chemicals. Thus, we aimed to explore the associations between individual and mixed exposure to phenols and various semen quality parameters. In this study, a rapid and sensitive method was used to determine 18 phenolic compounds in urine samples of 799 volunteers who donated sperm samples to the Shanghai Human Sperm Bank. A spot urine sample was collected from each subject on the day of their clinic visit and stored at -20 ℃ until testing. Urine samples (200 μL) were extracted and added with 20 μL of an internal standard and 50 μL of β-glucuronidase solution. The mixtures were then incubated for 12 h at 37 ℃. After hydrolysis, the samples were extracted twice using ethyl acetate (500 μL). The concentrations of the 18 phenolic compounds were measured using high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). Semen quality parameters were analyzed using a computer-aided semen analyzer. Multiple linear regressions were used to detect the associations between individual phenol exposure and semen quality parameters. In addition, weighted quantile sum (WQS) models were used to explore the associations between mixed-phenol exposure and semen quality parameters. After adjusting for potential covariates, the results of multiple linear regressions showed that exposure to ethyl paraben (EtP) was significantly negatively associated with sperm concentration and total sperm count (P<0.05). In addition, exposure to mixed phenols was significantly associated with decreased sperm concentration; methyl paraben (MeP) and EtP were identified as the main contributors to this decrease. Thus, phenol exposure may be associated with decreased semen quality in young males, particularly with respect to sperm concentration and total sperm count.

Does COVID-19 affect sperm quality in males? the answer may be yes, but only temporarily

BackgroundThe Corona Virus Disease 2019 (COVID-19) pandemic has raised concerns regarding its potential impact on male reproductive health. However, the impact of COVID-19 on sperm quality remains uncertain. This retrospective study aimed to investigate the short-term and relatively long-term effects of COVID-19 infection on sperm quality.MethodsA total of 85 males with fertility requirements, who underwent semen evaluation at Guilin People’s Hospital between June 2022 and July 2023, were included in the study. Changes in semen parameters were analyzed across three specific timeframes: within 6 months before COVID-19 infection, within 3 months after COVID-19 infection, and 3–6 months after COVID-19 recovery.ResultsThe results revealed that the sperm concentration and total sperm number were significantly lower after infection compared to before, while in the recovery period, the sperm concentration, total sperm count, progressive motility, and normal morphology significantly increased. Comparing the three periods, the most significant difference was observed in sperm concentration, which exhibited a significant decrease after infection but returned to normal levels after recovery from COVID-19.ConclusionsThese findings suggest that COVID-19 may exert some impact on sperm quality, particularly evidenced by decreased sperm concentration post-infection. Fortunately, these effects on semen parameters appear to be temporary, with gradual restoration of semen parameters within 3–6 months after recovery. However, further research is needed to explore the underlying mechanisms and long-term implications of these observed changes in semen parameters.

Characteristics of gut microbiota in patients with asthenozoospermia: a Chinese pilot study

BackgroundIdentification of intestinal flora composition is significant for exploring the cause and pathogenic mechanisms of the gut-testis axis and clarifying the relationship between microbiota and infertility. Our study aimed to examine the alternation in gut microbiota composition and identify potential microbes associated with development of Asthenozoospermia (AS).MethodA total of 580 males were recruited in the outpatient department of Tianjin Medical University General Hospital between September 2021 and March 2023. Sperm parameters were analyzed according to the WHO laboratory manual. The 16 S rRNA gene high-throughput sequencing was performed to detect the gut microbiota composition in fecal samples. LEfSe analysis was used to screen key microbiota. PICRUSt2 software was utilized to predict relevant pathways.ResultsAfter rigorous screening, 60 isolated AS patients (AS group) and 48 healthy men (NC group) were enrolled. No significant differences were observed in demographic characteristics (p > 0.05), semen volume (p = 0.718), sperm concentration (p = 0.109), or total sperm count (p = 0.200). Sperm total motility and progressive motility were significantly decreased in the AS group (p < 0.001). AS patients had significantly lower alpha diversity indices (Chao1, observed OTUs, and PD Whole-tree; p < 0.05). The beta-diversity of gut microbiota in AS patients significantly differed from NC men (PCoA analysis, p = 0.001). Firmicutes, Bacteroidota, Proteobacteria, and Actinobacteria were the primary phyla, with the dominant genera including Bacteroides, Prevotella, and Blautia. Eleven key genera such as Escherichia_Shigella and Prevotellaceae_UCG_001 were identified by LEfSe analysis. Most of these genera were negatively correlated with sperm mobility. Eighty-eight KEGG pathways, including steroid biosynthesis and meiosis, were significantly enriched between the two groups.ConclusionsIt appears that gut microbiota composition in AS patients significantly differed from that in healthy men, and the development of AS might be associated with intestinal flora dysbiosis.

The Association of ICSI Outcomes with Semen and Blood Bisphenol A Concentrations of the Male Partner.

This study investigated the association of blood and semen Bisphenol A (BPA) levels of the male partner on the reproductive outcome in intracytoplasmic sperm injection (ICSI) treatment cycles. For this prospective study (ClinicalTrials.gov identifier: NCT02703584), blood and semen samples of the male partner of the 75 women who had ICSI were analyzed. The study group consisted of men who had ICSI for male factor infertility other than azoospermia, while men with normal spermiogram whose partners underwent ICSI due to tubal factor infertility were taken as the study group. Habitual consumption of drinking water from plastic carboys/bottles (PBW) at home was also questioned in both groups as it was considered as chronic BPA exposure. The association of ICSI outcome with blood BPA (bBPA) and semen BPA (sBPA) levels was analyzed in both groups. No significant correlation was found between sperm parameters and bBPA levels in both groups. A negative correlation was found between sBPA levels and total sperm count and progressive sperm motility in men who consumed PBW. Embryo development arrest was found to be significantly higher in patients who have high sBPA levels. Although sBPA levels were not different in PBW consumers, bBPA levels were found to be significantly lower in those who consumed tap water (TW) than those who used PBW. Elevated bBPA were associated with a significant decrease in clinical pregnancy rate. Considering the widespread human exposure to BPA, the effect of BPA on the male reproductive system needs to be further examined.

Second ejaculation produces good quality sperm and blastocyst and decreases the rate of unexpected ICSI cycle: a propensity score-matched analysis

BackgroundSecond ejaculation can influence sperm quality which may define the first-line treatment. The purpose of this study was to evaluate the effectiveness of a second ejaculation in decreasing the unexpected intracytoplasmic sperm injection (ICSI) rate by a propensity score-matched (PSM) analysis.MethodsPatients who were projected to undergo IVF were included between January 2016 and November 2021 in this monocentric, retrospective analysis. 2782 patients included in the study, 143 and 2639 patients were non-randomized in the unexpected ICSI and IVF groups, respectively. One hundred fourteen patients with unexpected ICSI produced two semen samples on the day of ovum pick-up. After 1:4 PSM, we matched 61 patients in the second ejaculation IVF group to 238 patients in the conventional IVF group. Outcomes of sperm quality, fertilization rate, embryo quality, and pregnancy were compared.ResultsSecond ejaculation significantly improved sperm concentration, progressive motility before and after sperm swim-up, total progressive motility sperm count after swim-up, and decreased sperm DNA fragmentation (SDF). Sixty-one of 114 (53.5%) unexpected ICSI couples had enough total progressive motility sperm for IVF with the second ejaculation. There were no differences in basic clinical characteristics between couples in second ejaculation IVF and matched-conventional IVF group. For the two groups, no differences were observed in IVF outcomes. However, a significant increase in good-quality blastocyst rate was observed for second-ejaculation IVF couples. Univariate and multivariate linear regression analysis also confirmed that the second ejaculation was an independent risk factor for the good quality blastocyst rate.ConclusionSecond ejaculation could be an economical and secure alternative to get good quality sperm, and blastocyst and decrease the rate of unexpected ICSI. Multicenter studies should be conducted to confirm the potential advantages of using second ejaculation IVF in effectively reducing the rate of ICSI.

Endocrine and dog factors associated with semen quality

Knowledge of factors associated with semen quality may help in investigations of the aetiology and pathophysiology. We investigated the correlation between biomarkers for testicular cell function (anti-müllerian hormone, AMH, Inhibin B, testosterone, free androgen-index (testosterone/sex-hormone binding globulin), insulin like peptide 3, INSL-3), alkaline phosphate (ALP), canine prostate-specific esterase (CPSE), and heterophilic antibodies with dog variables, semen quality, and fertility. Blood and semen were collected from 65 Bernese Mountain Dogs. We evaluated total sperm count, motility and morphological parameters. The semen quality ranged from poor to excellent, with an average total sperm count of 1.1 × 109 and 50% morphologically normal spermatozoa (MNS). Age and abnormal testicular consistency correlated with decreased motility and MNS. Higher ALP correlated with higher total sperm count. AMH could not be detected in seminal plasma. AMH in blood correlated with head defects and high AMH concentration correlated with a severe decline in several semen parameters. Testosterone was negatively and CPSE positively correlated with age. No correlations were found for INSL-3, inhibin B, or heterophilic antibodies. Our findings contribute to the understanding of factors associated with semen quality in dogs, particularly related to Sertoli cell function.