Semen Volume Research Articles

“Laser vaporization of the prostate: A comparative study between ejaculatory preserving and non-ejaculatory preserving technique”

ABSTRACT Introduction and objectives Laser vaporization techniques have emerged as a prominent alternative to transurethral prostate resection in managing benign prostatic obstruction (BPO). This study focuses on assessing the effectiveness of the ejaculatory preserving laser vaporization of the prostate technique compared to the conventional non-ejaculatory approach in managing BPO. Patients and Methods Our study was performed between August 2022 and September 2023. The study included 120 patients with bladder outlet obstruction, due to benign prostatic hyperplasia (BPH). Patients were randomly assigned to two groups: the first underwent conventional non-ejaculatory preserving laser vaporization of the prostate (n = 80), while the second group underwent the innovative ejaculatory preserving laser vaporization technique using diode laser (n = 40). We assessed baseline International Prostate Symptom Score (IPSS), maximal flow rate (Qmax), post voiding residual urine volume (PVRU), semen volume (semen analysis). Parameters were re-evaluated 3 months post-surgery and the change in sexual satisfaction was evaluated using a scale from 1 (much less satisfied) to 5 (much more satisfied) in response to a question. Results The mean age (±SD) of participants was 59.6 (±7.9) and 57.6 (±7.8) for the non-ejaculatory preserving and ejaculatory preserving groups, respectively, with no statistical difference between groups. Both groups showed significant reduction in IPSS (p < 0.001), improvement in Qmax (p < 0.001), and decline in PVRU (p < 0.001), postoperatively. However, the ejaculatory preserving technique led to a significant improvement in antegrade ejaculation, postoperative semen volume and sexual satisfaction compared to the non-ejaculatory preserving technique (p < 0.001). Conclusions The ejaculatory preserving technique effectively preserved antegrade ejaculation, semen volume and sexual satisfaction compared to the non-ejaculatory preserving technique. However, the later yielded better outcomes in terms of IPSS and urine flow. Both techniques demonstrated significant improvements across all parameters compared to baseline. Further research with extended follow-up periods is needed to fully understand the long-term postoperative effects with this technique.

P-721 Exploring the impact of geographical variation: A retrospective study examining semen phenotypes within a cohort of 19,612 men attending a fertility center in the UAE

Abstract Study question What are the epidemiological trends of semen phenotypes and their association with geographic regions among men seeking fertility treatment in the UAE? Summary answer Following covariate adjustment, UAE Nationals attending a fertility center displayed lower incidence of oligozoospermia and higher prevalence of asthenozoospermia and teratozoospermia compared to other nationalities. What is known already Conventional semen analysis remains the gold standard for diagnosing and managing male infertility. It is well documented that semen is heterogenous and can be influenced by diverse factors, including but not limited to race, ethnicity, sociocultural background, seasonality, and geographical region. Although higher infertility prevalence has been reported in regions like North Africa and the Middle East, existing estimates rely largely on data from female partners of infertile couples and studies dating back to 1988. This underscores a significant data paucity in the Middle East. Study design, size, duration In this retrospective study, the anthropometric data (age, weight, height, body mass index, nationality) and semen parameters (semen volume, semen pH, sperm concentration, total sperm count (TSC), total motility (TM), progressive motility (PM), normal morphology, viability) of 19,612 men (32,664 samples) who attended a fertility center in the UAE between 2011 and 2022 were assessed. Ethical approvals for this study were obtained from appropriate bodies (REC/2022/P27 and MBRU IRB-2021-12). Participants/materials, setting, methods Data from patients were categorized into different geographical regions (Sub-Saharan Africa, North Africa, North America, Central America, South America, Asia, Europe, Middle East, and Oceania) based on nationality. Patients were further grouped as MENA (Middle East and North Africa) and non-MENA, while data from UAE Nationals (UAE) were also compared to Other Nationalities (Global). Unadjusted analysis was performed using SPSS. While covariate adjustment and propensity score analyses were performed using R package and STATA. Main results and the role of chance All semen parameters, remained within normal WHO reference values when stratifying according to geographical regions, MENA and Non-MENA as well as UAE and Global. Interestingly, MENA displayed a significant reduction in semen volume (p &amp;lt; 0.0001) and sperm concentration (p = 0.017), and an increase in PM (p &amp;lt; 0.00001). Similarly, PM was higher in UAE versus Global. To address skewed data distribution between UAE and Global, we employed propensity score analysis and logistic regression models, with semen parameters categorized according to WHO lower reference limits. Following covariate adjustment, all models demonstrated no significant difference in PM and TM between the two subgroups. However, logistic regression indicated a non-significant increase (4%) in the prevalence of asthenozoospermia in UAE compared to Global. Categorical analysis indicated that the Global samples had significantly lower TSC compared to the UAE group (24.6% vs. 26.3%, p&amp;lt;.001). Modelling adjusted for propensity score and UAE Nationality further suggested that UAE were 13% less likely to have lower TSC compared to Global (p&amp;lt;.001). About 58% of UAE samples exhibited teratozoospermia, while it was 56% for Global. After adjusting for confounders, analysis revealed a significantly higher prevalence (12%) of teratozoospermia among UAE compared to Global, with a potential range of 9%-16% in the long term. Limitations, reasons for caution A limitation of the current study is data distribution skewness. Of the 32,664 samples from 19,612 patients (113 countries), 21,649 samples are from UAE Nationals. However, logistic regression, propensity score adjustment accounting for Nationality, propensity score matching (1:2 ratio), and inverse probability weighting were applied to mitigate this bias. Wider implications of the findings Paucity of data on male fertility in the UAE and MENA region does not allow for accurate estimation of male infertility. Owed to its sample size and statistical robustness, this study provides evidence addressing this gap, offering insights into interpretation of global data on reproductive health. Trial registration number not applicable

P-381 Fertility preservation in patients with testicular cancer

Abstract Study question Do the clinical stage and histological characteristics of testicular cancer affect sperm quality? Summary answer Sperm concentration, motility and normal morphology significantly decreased in patients with testicular cancer. However, semen parameters were not significantly associated with tumor histology. What is known already Testicular cancer is rare in most countries, with an incidence ranging from ∼1/100,000 to 10/100,000, and represents about 1% of all cancers in men, but about 60% of all cancers in young males aged between 15 and 35 years. Additionally, the incidence of testicular cancer has doubled in the last 20-40 years. While it is clear that chemotherapy treatment can negatively impact infertility, it is increasingly recognized that male-factor infertility may play a significant role in the overall health status of men, and men with infertility may be at higher risk of developing testicular cancer. Study design, size, duration Retrospective data from 284 males, diagnosed with testicular cancer, undergoing to semen cryopreservation before surgery or chemo- or radiotherapy treatments, from January 2016 to June 2022 at Maternal and Child Department, Gynecology and Obstetrics Unit, Couple Sterility Center at Federico II, University of Naples, were included in the study. Participants/materials, setting, methods All patients signed their informed consent to cryopreservation. In order to have an internal control group coming from the same region, results of semen analysis from male partners of couples with certain female factors (bilateral tubal imperviousness or in case of egg donation) were included in the study. After semen collection and liquefaction, the semen specimens were cryopreserved following manufacturer’s protocol with media conteining TEST-yolk buffer. Main results and the role of chance Overall, taking in to consideration the semen cryopreservation, per WHO 2021 criteria, we observed that the majority of semen parameters of patients with testicular cancer resulted between 5°percentile and 25° percentile. The unique parameter over the 50°percentile was the semen volume. Comparing results from male partners of couples with certain female factors and testicular cancer patients several features were significant different. Especially, semen volume resulted significantly increased in cases respect to the control (p = 0,011). Instead, from microscopic evaluation semen concentration, percentage of total sperm motility and % of spermatozoa with normal morphology appeared significantly decreased in patients with testicular cancer (p = 0,000; p = 0,000; p = 0,002). Based on Histopathological Classification of Testicular Tumors the 59% (168/284) were classified as classic seminoma, 14% (41/284) mixed germ cell tumors including seminomatous and nonseminomatous cell tumors, 13% (38/284) nonseminomatous mixed germ cell tumors, 12% (35/284) nonseminomatous germ cell tumors including 4 cases of teratoma and 30 cases of embryonal carcinoma and 2 cases of cariocarcinoma. However, abnormal semen parameters were not significantly associated with tumor histology. Limitations, reasons for caution No information about semen quality after thawing and ICSI outcome could represent the main limitation for a complete information of the preservation program in these patients. Wider implications of the findings We presented our monocentric experience of oncofertility preservation program with especially attention to testicular cancer patients. Presented data emphasizes the importance of semen monitoring in young men and the fertility preservation in management of the patient. Trial registration number not applicable

Dynamics of ejaculate parameters from 2017 to 2023: a retrospective single-center analysis

Introduction: One of the most important tests to evaluate male fertility is a semen analysis. Assessment of ejaculate parameters allows to assume possible causes of male infertility and helps to determine further treatment. According to modern literature there is a slight but constant deterioration of ejaculate parameters with time.Purpose of the study: to evaluate semen analysis parameters in patients examined in one medical center.Materials and Methods: retrospective evaluation of semen analyses performed in the same laboratory from January 1, 2017 to October 31, 2023 was performed with a total of 47902 patients included. The ejaculate volume, concentration and number of spermatozoa, the proportion of spermatozoa of different categories of motility, sand the proportion of morphologically normal spermatozoa were evaluated. Statistical processing of data was performed using MS Office and SPSS v26 software packages.Results: the mean semen volume from 2017 to 2023 was 3.5 ± 1.5 mL, sperm concentration was 51.9 ± 39.3 million/mL, progressively motile spermatozoa was 48.2 ± 16.5%, number of progressively motile spermatozoa in the sample was 93.7 ± 94.3 million, motile spermatozoa 55.6 ± 17.4%, total motile spermatozoa was 107.5 ± 105.6 million, mean number of morphologically normal forms was 2.8 ± 1.4% in 2017, 2.2 ± 0.9% in 2023, and 3.5 ± 1.5% during the observation period. Mean pH of ejaculate was 7.6 ± 0.3 with noted tendency to increase (7.38 ± 0.33 in 2017, 7.6 ± 0.38 in 2023). The proportion of samples with azoospermia increased from 2.8% in 2017 to 4.5% in 2023. Mean number of patients with cryptozoospermia was 1.5%.Conclusion: there is a trend of decreasing proportion of morphologically normal spermatozoa, increasing ejaculate pH and increasing frequency of azoospermia from 2017 to 2023.

O-018 Utilisation of second successive ejaculate as a way to overcome poor semen parameters for couples who wish to undergo conventional-IVF

Abstract Study question Can a second successive-ejaculate (SSE) be an option for patients with poor sperm parameters (PSPs) on ovum pick-up (OPU)-day who prefer to undergo conventional-IVF (c-IVF)? Summary answer SSE can be a valid option for patients with PSPs who do not wish to undergo ICSI as an assisted reproductive technology (ART) treatment. What is known already ART is applied when first-line treatment for infertility (timed intercourse or intrauterine insemination) is unsuccessful. The male partner is requested to follow ejaculatory abstinence, which according to the WHO guidelines is 2-7 days, while ESHRE recommends 3-4 days. Among these couples there are cases that require ICSI due to semen analysis with PSPs on the day of OPU. However, some couples are reluctant to undergo ICSI and prefer c-IVF as a treatment method. For those cases, we request a second semen sample on the same day (time interval: 1-4 h) and c-IVF is performed using the two ejaculates combined. Study design, size, duration This is a single-centre retrospective study employing 212 semen from male partners with PSPs in the first semen collection on the OPU-day and subsequently, an SSE was requested in order to perform c-IVF according to patients’ wishes. The data were collected from May 2006 to October 2023 in our clinic (SSE-group). The Control group included 271 semen samples from men where c-IVF was conducted using one ejaculate from January to December 2021 in our clinic. Participants/materials, setting, methods The sperm parameters were analysed according to the WHO manual for the examination and processing of human semen and compared between the first and second ejaculates in the SSE-group. Fertilisation rate (FR), percentage of clinically utilised embryos and clinical pregnancy rate were compared between the SSE-group and the Control group. The SSE-group had 254 ART-cycles and the mean maternal age was 36.8±4.9y.o. The Control group included 432 ART-cycles and the mean maternal age was 38.1±5.2y.o. Main results and the role of chance In SSE-group the semen volume of the first ejaculate was significantly higher compared to the second ejaculate (P&amp;lt; 0.0001). The sperm concentration and sperm motility were significantly higher in the second ejaculate compared to the first one (P&amp;lt;0.0001). In the same fashion, the total-motile sperm-count was significantly higher in the second ejaculate compared to the first (P=0.01). All the semen parameters in the Control group were significantly higher compared to both first and second ejaculates from the SSE-group (P&amp;lt;0.00001). The normal FR was significantly higher in the Control group compared to the SSE–group (P&amp;lt;0.01). On the other hand, there was no significant difference in the percentage of embryos that could be utilized (cryopreserved + freshly-transferred) between the two groups (P=0.218). Pregnancy rate for fresh embryo transfers (ETs) was significantly higher in the SSE-group compared to the Control (P=0.005), while there was no significant difference between the two groups for pregnancy rate for frozen/thawed ETs (P=0.728). The main strength of our study is that the utilisation of the SSE combined with the first ejaculate did not decrease the pregnancy rate for the couples with PSPs that wished to follow c-IVF as their treatment and it could actually provide an effective option for them. Limitations, reasons for caution SSE may improve the sperm parameters and give the opportunity to infertile couples to undergo c-IVF according to their wish. However, since the FR was lower in the SSE-group, it is of paramount importance to provide sufficient explanation to those couples and obtain their consent when requesting an SSE. Wider implications of the findings Overall, SSE had positive effect to a large number of parameters evaluated in this study. Additionally, the rate of utilised embryos was similar between the two groups. Two successive-ejaculates combined can be employed without any negative impact for couples with PSPs on the OPU-day that are reluctant to undergo ICSI. Trial registration number not applicable

P-176 A novel electrophoretic sperm isolation system achieves equivalent ICSI outcomes to the combined density gradient centrifugation and swim-up method in a significantly shorter processing time

Abstract Study question Does an electrophoretically sperm isolation method, the Felix™ system, have clinical or operational advantages over the combined density gradient centrifugation and swim-up (DGCS) method? Summary answer The Felix™ system produces results that are comparable to the DGCS method, however, Felix™ has the ability to isolate spermatozoa more efficiently. What is known already The isolation of healthy spermatozoa to improve ART outcomes has received enormous attention in the literature recently. Although swim-up and density gradient centrifugation are the most common sperm separation methods, the optimal technique is still unclear. Recently, good sperm selection approaches using various non-centrifugal devices have emerged. Previous reports have shown that a quick and simple sperm separation device, the Felix™ system, can isolate high-quality spermatozoa and improve the results of ART. The Felix™ system combines electrophoresis and separation membranes to collect negatively charged mature normal sperm. Study design, size, duration A prospective oocyte sibling study was conducted between March 2023 and December 2023. The study involved infertile couples (n = 45) with a semen volume of 2.3 mL or more, a motile sperm concentration of 2 million/mL or more, maternal age under 43 years, and at least four mature oocytes at the time of oocyte retrieval. Ejaculated semen was prepared separately using DGCS and Felix™ on the day of oocyte retrieval and subsequent ICSI results were analyzed. Participants/materials, setting, methods In the DGCS group, semen was layered on a 45/90% of sperm grad and centrifuged for 15 minutes, followed by a 30 min swim-up. Subsequently, 0.3 mL of supernatant was collected. In the Felix™ group, 0.3 mL of sperm was collected following six minutes of membrane hydration and electrophoresis. Sperm concentration, total motility, progressive motility and DNA fragmentation (SDFR) were measured. Fertilization, blastocyst development, good-quality blastocyst development, and embryo utilisation rates were also assessed. Main results and the role of chance The average female age at the time of oocyte retrieval was 36.5±4.0 years, and the average male age was 38.1±5.9 years. Of 401 oocytes, 200 and 201 oocytes underwent ICSI using sperm prepared by DGCS and Felix™, respectively. The average processing time of Felix™ was significantly shorter than that of DGCS (54.0±4.3 vs. 7.4±0.2 minutes, p &amp;lt; 0.001, respectively). No significant difference was observed between the DGCS and Felix™ groups for sperm concentration (p = 0.49), motility (p = 0.05), progressive motility (p = 0.34), and SDFR (p = 0.09). Furthermore, there were no significant differences between the two groups with regards to fertilization rate (81.0% vs. 80.6%, p = 0.92), blastocyst development rate (52.9% vs. 58.4%, p = 0.60), good-quality blastocyst development rate (26.1% vs. 35.7%, p = 0.06), and embryo utilisation rate (54.3% vs 58.0%, p = 0.50). Limitations, reasons for caution Although the DGCS method was used as a comparison group, it is necessary to compare the Felix™ system with DGC alone, swim-up alone, or other sperm isolation methods. Larger, more powered studies are required to determine the impact on pregnancy and live birth outcomes. Wider implications of the findings The Felix™ system is a viable option for sperm isolation. While DGCS requires complicated procedures and time-consuming process including centrifugation and incubation; Felix™ requires six minutes only. The Felix™ system reduces processing times significantly and therefore can improve laboratory operations and workflow. Trial registration number Not Applicable

Seminal characteristics and efficacy of egg yolk free semen extender on cryopreservation of Murrah buffalo bull semen

The experiment was undertaken to study the efficacy of egg yolk free semen extender on cryopreservation of buffalo semen. A total of 24 semen ejaculates from Murrah bulls (5 to 6 years) maintained at Central Semen Station, Anjora, Durg, Chhattisgarh were divided into two aliquots and were diluted using Tris-fructose-egg yolk-glycerol (TFYG) and egg yolk free commercial extender (EYFCE, AndroMed). The overall average Murrah bull fresh semen volume (mL), sperm concentration (million/mL), initial progressive motility (%), live sperm (%), abnormal spermatozoa (%), intact acrosome (%) and HOS reactive sperm (%) were 4.90±0.49, 1286.92±100.23, 75.00±0.67, 81.45±0.61, 10.70±0.51, 80.16±0.43 and 68.83±0.40, respectively. There was significant difference between bulls in semen volume (P&lt;0.01), individual motility (P&lt;0.01) and total sperm abnormalities (P&lt;0.05). The semen extended with TFYG and EYFC extenders were cryopreserved in french mini-straw (0.25 mL) using programmable bio-freezer. The mean values of post thaw motility (%), live sperm (%), abnormal sperm (%), intact acrosome (%), HOST (%) of Murrah bull semen extended with TFYG and EYFCE were 45.83±0.77 vs 49.16±1.33, 57.41±0.54 vs 58.62±0.73, 12.54±0.46 vs 12.45±0.63, 69.62±0.82 vs 71.45±0.64 and 56.45±0.52 vs 57.37±0.55, respectively. Post thaw motility, live spermatozoa and intact acrosome were significantly higher (P&lt;0.01) in frozen thawed semen extended with as EYFCE compared to TFYG in Murrah bull semen. It is concluded that EYFCE results in improvement in post thaw semen characteristics viz. post thaw motility, live sperm percent and intact acrosome.

Association between post-COVID-19 conditions and male semen quality in Japan: A descriptive investigation

Some reports suggest that coronavirus disease 2019 (COVID-19) may affect male reproductive function. There is also concern in Japan that COVID-19 may contribute to the pre-existing decline in male fertility; however, no studies have investigated the effects of COVID-19 on male reproductive function. In this study, we aimed to analyze the semen quality of men who had recovered from COVID-19. Male patients who had recovered from COVID-19 between February 2020 and September 2021 were recruited for this study. Participants were sent a semen collection kit; they were asked to collect semen at home and deliver it to a laboratory at Osaka University. We used these samples to analyze sperm concentration, total sperm count, and semen volume. In total, 125 participants were included in this study. The median age of all patients was 46 years (interquartile range (IQR): 38–52 years). The severity of COVID-19 was mild in 80 patients; 19 were moderate I, 22 were moderate II, and four were severe. The median semen volume was 2.5 mL (IQR: 1.8–3.1), the median sperm concentration was 98.9 million/mL (IQR: 43.8–162.2), and the median total sperm count was 212.1 million (IQR: 89.7–368.2). In a previous study in Japan, the median sperm count in adult men was reported to be 201 million. Participants in our study did not have lower sperm counts than this, despite their older age. Our results suggest that the long-term effects of COVID-19 on spermatogenesis are minimal.

Genetic Selection Approach for Semen Characteristics in Thai Native Grandparent Roosters (Pradu Hang Dum) Using Random Regression Test-Day Models and Selection Indices.

The aim of this study was to analyze suitable genetic models and selection indices to estimate the genetic parameters and breeding values of native Thai roosters. A total of 3475 records of seven semen traits (mass movement, semen pH, semen color, volume, sperm viability, sperm abnormalities, and sperm concentration) from 242 Thai native grandparent roosters were analyzed. Multiple-trait random regression test-day models with five covariance functions were used to analyze the variance components, genetic parameters, and breeding values. The selection index (SI) was calculated to determine the optimal genetic value for different selection percentages. The results showed that a multiple-trait random regression test-day model with a second-order Legendre polynomial function was the most appropriate genetic model for this population. The estimated heritability values were low to moderate, ranging from 0.110 to 0.112 (mass movement), 0.040 to 0.051 (semen pH), 0.092 to 0.097 (semen color), 0.220 to 0.225 (semen volume), 0.067 to 0.083 (sperm viability), 0.086 to 0.099 (sperm abnormalities), and 0.134 to 0.138 (sperm concentration). The repeatability values exceeded the heritability values and were within the range of 0.133 to 0.688. The genetic correlations among semen traits ranged from -0.332 to 0.677, and phenotypic correlations ranged from -0.260 to 0.460. When considering heritability and genetic correlation values, semen volume, sperm concentration, and mass movement were the top three priority semen traits calculated as selection indices. Finally, the top 10% of the selection index was recommended for creating the next generation. Our findings provide useful information on genetic parameters and an appropriate selection index of semen traits for selecting the genetics of individual Thai native grandparent roosters. The heritability estimates for semen traits reported here suggest an adequate response to selection through a genetic evaluation approach. Our results indicate that it is possible to select grandparent roosters with better reproductive performance.

Type 1 diabetes mellitus and sperm quality: A case-control study.

The potential impact of diabetes mellitus type 1 (DM1) on male fertility is currently poorly defined. Hyperglycaemia and insulin deficiency may affect spermatogenesis. Some evidence suggests that men with DM1 have a significant reduction in progressive sperm motility, sperm morphology and semen volume, without significant changes in sperm concentration and count, but definite data are lacking. To evaluate the impact of DM1 on clinical parameters related to male fertility and semen analysis. We compared a court of 42 male DM1 patients with 43 nondiabetic subjects overlapping in age and remaining clinical data in an observational case-control study. All subjects underwent a comprehensive andrological reproductive evaluation, including medical history, physical examination, and semen analysis. We collected biochemical data in all patients with DM1, while diabetic patients with any alteration in semen parameters underwent sperm culture and scrotal ultrasound. In addition, all men completed the IIEF-5 questionnaire (International Index of Erectile Function-5) and the AMS (Aging Male Symptom score) questionnaire. Patients with DM1 had a higher prevalence of infertility, erectile dysfunction and worse semen parameters compared with controls. In particular, semen volume, total sperm count, and total and progressive sperm motility were significantly lower (p<0.001, p=0.003, p=0.048, and p=0.022 respectively). In addition, the rate of semen anti-sperm antibody positivity, the AMS score and FSH levels were higher. Several mechanisms may contribute to these semen alterations in DM1 patients, such as oxidative damage to spermatogenesis, seminal infections and pelvic neurological changes. These data suggest that patients with DM1 should be counselled from an andrological-reproductive point of view.

Exploring correlations: Human seminal plasma and blood serum biochemistry in relation to semen quality.

Male infertility is a pressing global issue, prompting the need for biomarkers correlating with seminal parameters for diagnosis. Our study investigated 10 biochemical and energetic parameters in the seminal plasma and blood sera of fertile (25 subjects) and infertile (88 subjects) Polish men, correlations between their levels in seminal plasma and semen quality, and correlations between blood sera and seminal plasma levels of examined parameters. Infertile men displayed elevated seminal plasma glucose and fructose but reduced HDL levels compared to fertile men. We observed also weak negative correlations between seminal plasma triglycerides and sperm concentration in both groups. Moreover, infertile men exhibited positive correlations between seminal plasma HDL/LDL concentrations and sperm concentration. Fertile men showed moderate negative correlations between glucose/triglycerides concentrations and sperm count and between seminal plasma triglycerides levels and sperm vitality. Semen volume correlated with triglycerides (negative) and fructose (positive) concentrations in infertile men. Sperm motility correlated negatively with total cholesterol, LDL, and triglycerides concentrations in fertile men, and weakly with AMP-activated protein kinase in infertile men. Weak negative correlations between seminal plasma fructose/AMP-activated protein kinase concentrations and sperm progressive motility were observed in infertile men, whereas in fertile men seminal plasma AMP-activated protein kinase levels were positively correlated with progressive motility. Correlation analysis between blood serum and seminal plasma parameters revealed intriguing connections, notably regarding LDL, AMP-activated protein kinase, and carnitine, suggesting systemic influences on seminal plasma composition. These findings emphasize the complex interplay between metabolic factors and sperm parameters, offering promising directions for future research in male infertility diagnostics and therapeutics.

Effectiveness of Herbal medicines on male reproductive system: Evidence from meta-analysis

BackgroundThe increasing prevalence of male infertility has become a global concern. Traditional Chinese and Asian medicines have long been using herbal remedies to promote spermatogenesis. This study aimed to systematically explore the potential of herbal medicines and formulations to enhance the male reproductive function in humans. MethodsTwo prominent databases, MEDLINE and EMBASE, as well as scientific journals indexed in the Web of Science, were used for the literature search until October 2023. The studies included in the analysis focused on the impact of herbal medicines (Mucuna pruriens, Withania somnifera, Eurycoma longifolia, Panax ginseng, Lycopersicon esculentum, Crocus sativus, Vitis vinifera, Nigella sativa, Sesamum indicum, Curcuma longa, Lepidium peruvianum) and Chinese and Korean Polyherbal formulations (Shao-Fu-Zhu-Yu-Tang; 少腹逐瘀汤) on human serum reproductive hormone levels, semen parameters, and antioxidant enzymes. ResultsA total of 23 articles were deemed eligible for the review and meta-analysis, which included 1,194 men from seven countries (China, Korea, Iran, Peru, Japan, Malaysia, and India). Of these, 19 articles were analyzed for semen parameters. The use of herbal medicine increased seminal parameters, including semen volume during each ejaculation (standardized mean difference (SMD) = 0.89; 95 % CI: 0.52, 1.26), sperm concentration (SMD = 1.97; 95 % CI: 1.30, 2.64), total sperm count (SMD = 2.28; 95 % CI: 1.44, 3.11), sperm motility (SMD = 1.07; 95 % CI: 0.68, 1.46), and normal morphology (SMD = 1.47; 95 % CI: 0.62, 2.32). Additionally, 18 articles that analyzed sex hormone levels showed that treatment with herbal medicines favorably reduced serum prolactin (SMD = -0.70; 95 % CI: -1.13, -0.28) and FSH levels (SMD = -1.07; 95 % CI: -1.56, -0.56). Meanwhile, herbal medicines did not affect testosterone levels (SMD = 0.41; 95 % CI: -0.24, 1.06) and LH levels (SMD = 0.45; 95 % CI: -0.33, 1.23). Finally, six articles were analyzed for seminal biochemical and antioxidant profiles, and the results showed that herbal medicine increased the levels of ascorbic acid (SMD = 1.19; 95 % CI: 0.51, 1.86), corrected seminal fructose (SMD = 1.32; 95 % CI: 0.89, 1.76), superoxide dismutase activity (SOD) (SMD = 1.06; 95 % CI: 0.45, 1.68), and catalase activity (SMD = 0.91; 95 % CI: 0.69, 1.44) in seminal plasma. ConclusionHerbal remedies have been found to promote spermatogenesis by optimizing semen parameters, sex hormone levels, and antioxidant profiles. As a result, these treatments should be regarded as complementary approaches to male infertility.

Effect of treatment of chronic hepatitis c virus patients with direct-acting anti-retroviral drugs on semen and hormonal parameters

Objective: Hepatitis C virus (HCV) infection is known to influence the seminal and hormonal parameters of infected men. This study was performed to assess the effects of HCV clearance using direct-acting antiviral (DAA) agents on semen and hormonal parameters. Methods: A total of 50 patients with chronic HCV were enrolled, and conventional semen analysis was performed according to World Health Organization guidelines. Basal levels of total testosterone, free testosterone (FT), follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin, and sex hormone-binding globulin (SHBG) were assessed before and 3 months after treatment with DAAs.Results: Following DAA treatment, statistically significant increases were observed in sperm motility and the proportion of grade A sperm. Additionally, the percentage of abnormal forms was significantly decreased after treatment (p=0.000). However, no significant differences were observed in semen volume, concentration, or total sperm count. Sex hormone analysis of patients after DAA treatment revealed significant increases in FT, LH, and FSH levels, along with significant decreases in SHBG, prolactin, and E2 levels.Conclusion: Following HCV clearance, we noted an improvement in sperm motility and an increase in the percentage of sperm with normal morphology. Treatment with DAAs was also associated with increased levels of FT and LH, along with decreased levels of SHBG, prolactin, and E2.

Recent decline in sperm motility among donor candidates at a sperm bank in Denmark.

Has there been variation in semen quality among men applying to be sperm donors (i.e. donor candidates) in Denmark in recent years (2017-2022)? The motile sperm concentration and total motile sperm count (TMSC) in ejaculates-both measures of sperm quality-declined by as much as 22% from 2019 to 2022. Questions remain about whether human semen quality has declined in recent years. Whilst some studies provide evidence for a decline in human semen quality, these findings have been disputed owing to potential biases in the populations studied or in the methods used to measure semen quality. Resolution of this issue has important implications for human fertility, as well as for those involved in the recruitment of sperm donors for use in medically assisted reproduction. We obtained data on the semen quality of ejaculates previously collected from 2017 to 2022 at sperm bank locations in four cities in Denmark: Aarhus, Aalborg, Copenhagen, and Odense. Our study focuses on the single semen samples provided by 6758 donor candidates aged between 18 and 45 years old to determine whether their sperm quality met a minimum criterion for them to be accepted as sperm donors. All ejaculates were analyzed within 1 hour of production. Semen volume (ml) was estimated by weight and both the concentration (106/ml) of sperm as well as the concentration of motile sperm (World Health Organization grades a and b) were measured using the same protocols and computer-assisted semen analysis system across all years at each site. Statistical analyses of the semen variables were controlled for age and donation site, as well as the average monthly high temperature when the ejaculate was produced. From 2017 to 2019, semen volume, sperm concentration, and total sperm count in the ejaculates of donor candidates increased by 2-12%. Then, from 2019 to 2022, sperm concentration and total sperm count changed by 0.1-5% from year to year, but none of those changes were statistically significant. In contrast, both motile sperm concentration and TMSC declined significantly, by 16% and 22%, respectively, between 2019 and 2022. Thus, the concentration of motile sperm in donor candidates declined from 18.4 [95% CL: 17.0, 20.0] million/ml in 2019 to 15.5 [14.4, 16.7] million/ml in 2022, and TMSC declined from 61.4 [55.8, 67.5] million per ejaculate in 2019 to 48.1 [44.1, 52.4] million in 2022. We cannot determine from the available data the causes of the decline in semen quality of donor candidates from 2019 to 2022. However, as this period coincides with lockdowns and changes in work patterns during the coronavirus disease 2019 pandemic, it is possible that changes in motile sperm concentration and TMSC were the result of changes in the lifestyles of the men whose semen was analyzed. Men providing initial semen samples at sperm banks, when applying to be sperm donors, are a useful population in which to monitor changes in human semen quality over time. Our results have implications for human fertility and the recruitment of sperm donors for medically assisted reproduction, where motile sperm concentration is an essential selection criterion because it influences fertility. We suggest that gathering health and lifestyle data on donor candidates at sperm banks might help to identify causal factors for the decline of sperm quality that could be addressed and intervention, if desired, could be personalized for each accepted donor. No external funding was obtained for this study. E.L. and A.-B.S. are employees of Cryos International. AP reports paid consultancy for Cryos International, Cytoswim Ltd, Exceed Health, and Merck Serono in the last 2 years of this study, but all monies were paid to the University of Sheffield (former employer). AP is also an unpaid trustee of the Progress Educational Trust (Charity Number 1139856). RM declares support from Cryos International to present results of this research at ESHRE 2023. None of the authors were directly involved in the collection or physical analysis of semen samples. N/A.

Baseline Characterization of Semen from Philippine Native Chickens: Banaba, Joloano, and Paraoakan

The study aimed to characterize and establish baseline data on the quantity and quality of fresh avian semen utilizing a sample of Philippine native roosters. Twenty-two heads each were acquired from breeds Banaba, Joloano, and Paraoakan. The baseline data analysis revealed significant variations in semen volume among different genetic groups, with Banaba displaying the highest volume, followed by Joloano and Paraoakan. Banaba also exhibited the highest semen pH value of 7.27 when compared to the other two genetic groups (P &lt; 0.05). Across various genetic groups of native chickens, the majority of semen samples demonstrated a thick and creamy consistency and color (42.6%), followed by thin and creamy (32.9%), with a statistical significance of P &lt; 0.05. Furthermore, variations in sperm concentration were observed among genetic groups, with Paraoakan having the highest sperm concentration, followed by Banaba and Joloano (P &lt; 0.05). When the semen from Banaba and Joloano native roosters were extended in Ringer’s solution, it exhibited good motility, with more than 50% of spermatozoa in motion, even after six hours of extension. In contrast, the pooled extended semen from Paraoakan native roosters displayed poor motility, particularly after eight hours of extension (P &lt; 0.05). The study also showed that storage temperatures did not significantly affect all the sperm quality parameters of Banaba and Joloano. However, for Paraoakan, samples stored at low temperatures of 5 – 10oC had significantly higher percent motile and progressive sperm, and lower percent static sperm than those stored at room temperature (22 – 25oC) (P &lt; 0.05).

Fertility preservation in male adolescents with cancer (2011-2020): A retrospective study in China.

According to the studies, more than 80% of pediatric patients with cancer can achieve a survival rate greater than 5 years; however, long-term chemotherapy and/or radiation therapy may seriously affect their reproductive ability. Fertility preservation in adolescents with cancer in China was initiated late, and related research is lacking. Analyze data to understand the current situation and implement measures to improve current practices. From 2011 to 2020, data on 275 male adolescents with cancer whose age ranged from 0 to 19 years old were collected from 16 human sperm banks for this retrospective study. Methods include comparing the basic situation of male adolescents with cancer, the distribution of cancer types, and semen quality to analyze the status of fertility preservation. The mean age was 17.39 ± 1.46 years, with 13 cases (4.7%) aged 13-14 years and 262 cases (95.3%) aged 15-19 years. Basic diagnoses included leukemia (55 patients), lymphomas (76), germ cell and gonadal tumors (65), epithelial tumors (37), soft tissue sarcomas (14), osteosarcoma (7), brain tumors (5), and other cancers (16). There are differences in tumor types in different age stages and regions. The tumor type often affects semen quality, while age affects semen volume. Significant differences were found in sperm concentration and progressive motility before and after treatment (p < 0.001). Moreover, 90.5% of patients had sperm in their semen and sperm were frozen successfully in 244 patients (88.7%). The aim of this study is to raise awareness of fertility preservation in male adolescents with cancer, to advocate for fertility preservation prior to gonadotoxic therapy or other procedures that may impair future fertility, and to improve the fertility status of future patients.

Development of a machine learning-based prediction model for clinical pregnancy of intrauterine insemination in a large Chinese population.

This study aimed to evaluate the effectiveness of a random forest (RF) model in predicting clinical pregnancy outcomes from intrauterine insemination (IUI) and identifying significant factors affecting IUI pregnancy in a large Chinese population. RESULTS: A total of 11 variables, including eight from female (age, body mass index, duration of infertility, prior miscarriage, and spontaneous abortion), hormone levels (anti-Müllerian hormone, follicle-stimulating hormone, luteinizing hormone), and three from male (smoking, semen volume, and sperm concentration), were identified as the significant variables associated with IUI clinical pregnancy in our Chinese dataset. The RF-based prediction model presents an area under the receiver operating characteristic curve (AUC) of 0.716 (95% confidence interval, 0.6914-0.7406), an accuracy rate of 0.6081, a sensitivity rate of 0.7113, and a specificity rate of 0.505. Importance analysis indicated that semen volume was the most vital variable in predicting IUI clinical pregnancy. The machine learning-based IUI clinical pregnancy prediction model showed a promising predictive efficacy that could provide a potent tool to guide selecting targeted infertile couples beneficial from IUI treatment, and also identify which parameters are most relevant in IUI clinical pregnancy.

Mean platelet volume might be an effective indicator of poor semen quality in varicocele patients

ObjectiveTo delve into the relationship between mean platelet volume (MPV) and semen quality in patients with varicocele.Materials and methodsA total of 246 varicocele patients and 120 healthy adult males were enrolled. Physical examinations and the color Doppler ultrasonography were conducted on patients with varicocele to confirm the diagnosis. Venous blood samples and semen samples were collected from all participants for subsequent analysis. A series of statistical analyses were conducted to assess the relationship between their MPV levels and semen quality. A series of statistical analyses were performed to assess the relationship between MPV and semen quality.ResultsNo statistically significant differences were found between body mass index (BMI), sexual hormones, semen volume, platelet count, and right testicular volume in all three groups (health subjects, varicocele without symptoms, and varicocele with infertility). When conducting regression analysis on two groups with varicocele, the results indicated that a lower MPV is associated with a reduced risk of varicocele accompanied by infertility (OR = 0.557 95% CI: 0.432–0.719, P < 0.001). Further correlation analysis in varicocele patients revealed that high MPV had a statistically negative impact on the occurrence of poor semen quality, affecting sperm concentration, progressive motility, and morphology (all P < 0.001). More importantly, when predicting varicocele associated with infertility, MPV demonstrated high diagnostic sensitivity (AUC = 0.745, P < 0.001).ConclusionOur results indicate that MPV is higher in varicocele with infertility and is closely related to semen quality, which may suggest an accompanying decline in semen quality associated with varicocele. However, these conclusions require further experimental validation.

Don't wait any longer, conceive in time: a systematic review and meta-analysis based on semen parameters after varicocelectomy

BackgroundVaricocelectomy was considered to be beneficial to patients with varicocele-related infertility. However, there are only a few researchers who have explored the relationship between better timing and postoperative semen improvement in patients.MethodsWe conducted this meta-analysis by enrolling published prospective studies to find out the best waiting time after varicocelectomy to wait for better improvement of semen quality. An extensive search was conducted in PubMed, Web of Science, and Cochrane Library to identify eligible studies. The included studies were then analyzed comprehensively using STATA software and standardized mean differences (SMDs) and their corresponding 95% confidence intervals were calculated.ResultsOur comprehensive analysis showed that after varicocelectomy, follow-up results within 3 months or longer showed a significant improvement in semen parameters compared to the preoperative period. Notably, no further improvement in semen parameters was observed when the follow-up period reached six months or longer (semen volume: WMD: − 0.07 (− 0.29, 0.16); sperm concentration: WMD: − 1.33 (− 2.33, − 4.99); sperm motility: WMD: 2.31 (− 0.55, 5.18); sperm morphology: WMD: 1.29 (− 0.66, 3.24); sperm total motile count: WMD: 3.95 (− 6.28, 14.19)).ConclusionsThree months after varicocelectomy may be the optimal time for semen parameters compared to six months or even longer, which means it is also the preferable time for conception. However, more well-designed prospective studies are needed in the future to validate our conclusion.

Patterns of alteration in boar semen quality from 9 to 37 months old and improvement by protocatechuic acid

BackgroundComprehending the patterns of alteration in boar semen quality and identifying effective nutritional interventions are crucial for enhancing the productivity of commercial pig systems. This study aimed to examine the alteration in semen quality in boars, and assess the impact of protocatechuic acid (PCA) on semen quality during the phase of declining semen quality.MethodsIn Exp. 1, a total of 38 Pig Improvement Company (PIC) boars were selected and their semen quality data were recorded from the age of 9 to 37 months. In Exp. 2, 18 PIC boars (28 months old) were randomly assigned into three groups (n = 6) and fed a basal diet, a basal diet containing 500 or 1,000 mg/kg PCA, respectively. The experiment lasted for 12 weeks.ResultsThe semen volume, concentration, and total number of spermatozoa in boars exhibited an increase from 9 to 19 months old and showed a significant linear decreased trend in 28, 24, and 22 months old. Sperm motility displayed an upward trajectory, reaching its peak at 20 months of age, and showed a significant linear decreased trend at 20 months old. Dietary supplementation of PCA demonstrated an effect to mitigate the decrease in semen volume, concentration of spermatozoa, total number of spermatozoa (P > 0.05), and significantly increased the sperm motility (P < 0.05). Moreover, supplementation of 1,000 mg/kg PCA significantly increased the sperm viability (P < 0.05). Analysis on cellular signaling pathways revealed that PCA restored serum testosterone levels and alleviated oxidative damage by upregulating the expression of HO-1, SOD2, and NQO1 in testicular stromal cells. Notably, PCA can enhance phosphorylation by selectively binding to AMP-activated protein kinase (AMPK) protein, thereby improving sperm mitochondrial function and augmenting sperm motility via PGC-1/Nrf1.ConclusionsThese data elucidated the pattern of semen quality variation in boars within the age range of 9 to 37 months old, and PCA has the potential to be a natural antioxidant to enhance sperm quality through modulation of the AMPK/PGC-1/Nrf1 signaling pathway.