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Belladelli F, Fallara G, Pozzi E, Corsini C, Raffo M, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Capogrosso P, Boeri L, Ventimiglia E, Matloob R, Pagliardini L, Montorsi F, Salonia A. The effect of historical CMV infection on sperm parameters in white-European infertile men: Findings from a real-life cross-sectional study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00885-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Capogrosso P, Ventimiglia E, Fallara G, Costa A, Pellegrino F, Candela L, Pozzi E, Belladelli F, De Angelis M, Colandrea G, Cazzaniga W, Cignoli D, Schifano N, Matloob R, Degò F, Scattoni V, Salonia A, Montorsi F. Risk of orgasmic function impairment after HoLEP – findings of a prospective real-life trial (ExpHo). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00626-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Boeri L, Pozzi E, Belladelli F, Fallara G, Raffo M, Corsini C, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Ventimiglia E, Capogrosso P, Dehó F, Mirone V, Pagliardini L, Papaleo E, Montorsi F, Salonia A. The impact of different WHO reference criteria for semen analysis in clinical practice: Who will benefit from the new 2021 cutoffs for normal sperm parameters? Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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29
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Boeri L, Belladelli F, Pozzi E, Fallara G, Raffo M, Corsini C, Candela L, Costa A, Cignoli D, Schifano N, D'Arma A, Capogrosso P, Ventimiglia E, Pagliardini L, Papaleo E, Mirone V, Dehó F, Montorsi F, Salonia A. Low birth weight is associated with sperm dna fragmentation and assisted reproductive technology outcomes in primary infertile men – results of a cross-sectional study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00889-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Fallara G, Boeri L, Candela L, Costa A, Capogrosso P, Belladelli F, Pozzi E, Raffo M, Corsini C, Cignoli D, Schifano N, Cazzaniga W, Colandrea G, D'Arma A, Matloob R, Mirone V, Montorsi F, Salonia A. Impact of urinary incontinence on sexual function in patients presenting for lower urinary tract symptoms. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00914-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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Boeri L, Capogrosso P, Fallara G, Cazzaniga W, Candela L, Belladelli F, Pozzi E, Massimiliano R, Costa A, Christian C, Daniele C, Nicolò S, Gianmarco C, Alessia D, Ventimiglia E, Matloob R, Dehò F, Montorsi F, Salonia A. Hyperestrogenism is associated with sexual function impairment in men – findings from a cross-sectional, real-life study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00481-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Schifano N, Capogrosso P, Fallara G, Pozzi E, Belladelli F, Candela L, Corsini C, Raffo M, Costa A, Cignoli D, D'Arma A, Boeri L, Ventimiglia E, Matloob R, Mirone V, Deho' F, Montorsi F, Salonia A. Predictors of phosphodiesterase type 5 Inhibitors (PDE5I)-discontinuation – Is a previous PDE5I-exposure at first clinical evaluation related with a higher PDE5I-drop-out risk? Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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33
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Capogrosso P, Candela L, Cazzaniga W, Costa A, Fallara G, Boeri L, Pozzi E, Belladelli F, Schifano N, Cignoli D, Costantino A, Montosi F, Salonia A. Are patients really willing to undergo surgery for Peyronie’s disease? EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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De Gobbi A, Aiello G, Pozzi E, Agostini A, Andrisano A, Fulcoli V, Guttilla A, Invidiato F, Massari D, Costa G, Fiorello M. Self-removal double J stent proposal after endourological procedures during Sars-Cov-2 emergency. EUR UROL SUPPL 2021. [PMCID: PMC8487691 DOI: 10.1016/s2666-1683(21)00739-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Ventimiglia E, Boeri L, Pozzi E, Belladelli F, Fallara G, Candela L, Capogrosso P, Schifano N, Cignoli D, Colandrea G, Cornelius J, Mattei A, Abbate C, Montorsi F, Salonia A. P–089 Paternal age affects the performance of EAU guidelines for genetic testing in infertile men: implications for candidate selection. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
We aimed at challenge EAU Guidelines for genetic testing performance in infertile men according to normal vs. advanced paternal age (APA).
Summary answer
EAU Guidelines perform better in karyotype analysis (KA) and Y-chromosome microdeletions (YCM) investigation in men above 35 years of age.
What is known already
EAU Guidelines for genetic testing in infertile men recommend specific threshold for candidate selection for both KA (<10 million spermatozoa/ml) and YCM (<5 million spermatozoa/ml). However, paternal age is not taken into account for candidate selection in this setting.
Study design, size, duration
Data from 2188 infertile men (according to WHO definition) consecutively evaluated at a single academic centre were analysed.
Participants/materials, setting, methods
Demographic, clinical and laboratory data were analysed. Semen analyses were based on 2010 WHO criteria. Advanced age was defined as above 35. All men underwent KA and YCM testing. EAU Guidelines were validated in our cohort and according to APA. Specificity, sensitivity, and AUC were estimated for all scenarios. A Wald-type test compared AUC according to APA for KA and YCM. Decision curve analysis (DCA) estimated the benefit of using EAU Guidelines according to APA.
Main results and the role of chance
Median (IQR) paternal age was 37 (34–41) years. Advanced paternal age was found in 1306 (60%) of included men. Prevalence of KA and YCM was 4% (48 men) and 1% (13 men), respectively. EAU Guidelines sensitivity, specificity and AUC in the overall population were 85%, 47% and 66% for KA, whereas they were 100%, 57% and 80% for YCM. When stratifying according to APA, EAU Guidelines performed better in men over 35 both in terms of KA and YCM detection. Specifically, AUC for KA detection in men with APA was 70% vs. 63% in younger men (p = 0.04). AUC for YCM detection in men with APA was 82% vs. 79% in younger men (p = 0.03). DCA confirmed higher net benefit in using EAU Guidelines in old vs. young men for the detection of both KA and YCM.
Limitations, reasons for caution
It is a retrospective analysis at a single, tertiary-referral academic centre, thus raising the possibility of selection biases.
Wider implications of the findings: EAU Guidelines for genetic testing in infertile men perform differentially according to APA. KA and YCM are better detected in older men, likely due to a wider pool of confounding etiological factors in young men. These results suggest the implementation of more accurate predictive models in younger men.
Trial registration number
Not applicable
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Boeri L, Candela L, Pozzi E, Belladelli F, Capogrosso P, Cazzaniga W, Costa A, Fallara G, Schifano N, Cignoli D, Ventimiglia E, Alfano M, Abbate C, Montorsi F, Salonia A. O-151 Detailed characterization of infertile men with idiopathic versus unexplained infertility: a single-center experience. Hum Reprod 2021. [DOI: 10.1093/humrep/deab127.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
We aimed to investigate the rate of and the clinical characteristics of men with idiopathic versus unexplained infertility from a cohort of white-European men.
Summary answer
Approximately 20% and 5% of men evaluated for primary couple’s infertility depicted characteristics suggestive for idiopathic and unexplained infertility, respectively.
What is known already
Male factor infertility (MFI) can be associated with clinical, hormonal and genetic diseases, but MFI is idiopathic in almost 30% of cases.
Study design, size, duration
Data from 3098 infertile men (according to WHO definition) consecutively evaluated between 2003-2020 at a single academic centre were analysed and compared with those of 103 fertile controls. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Idiopathic infertility was defined for pathological semen analysis but normal physical examination and endocrine, genetic and biochemical laboratory testing. Unexplained infertility is defined as infertility of unknown origin with normal sperm parameters.
Participants/materials, setting, methods
Testicular volume (TV) was assessed with a Prader’s orchidometer. Serum hormones and sperm DNA fragmentation index (SDF) were measured in every patient. Vitamin D3 (VitD) deficiency was considered for vitD levels <20 ng/mL. Semen analyses were based on the 2010 WHO reference criteria. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI).
Main results and the role of chance
Overall, 570 (18.5%) and 154 (5.0%) patients depicted criteria suggestive for either idiopathic or unexplained primary infertility, respectively. Groups were similar in terms of age, BMI, CCI, recreational habits, circulating serum hormones and SDF. Testicular volume was lower in men with idiopathic vs. unexplained infertility [median (IQR) 20 (15-25) vs. 20 (17-25); p < 0.001]; more idiopathic than unexplained infertile men depicted TV < 15ml (23.4% vs. 12%; p < 0.01). Similarly, vitD levels were lower [22 (17-28) vs. 27 (21-42) ng/mL; p < 0.001] in idiopathic vs. unexplained infertile men, with a higher rate of pathologic VitD levels in the same group (42.1% vs. 10%; p = 0.04). When compared to fertile controls, groups were similar in terms of age, BMI, CCI and serum hormones values. TV was larger in fertile controls than idiopathic and unexplained infertile men (all p < 0.01). At multivariable logistic regression analysis only vitD deficiency (OR 8.1, p = 0.03) was found to be associated with idiopathic infertility after accounting for age, BMI, testosterone values and TV.
Limitations, reasons for caution
The small number of fertile controls may raise the possibility of biases.
Wider implications of the findings
Idiopathic and unexplained infertility were identified in approximately 20% and 5% of men evaluated, respectively. Idiopathic infertile men showed lower TV and lower vitD values compared to men with unexplained infertility. Future studies are needed to develop a more tailored management to these difficult MFI cases.
Trial registration number
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37
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Boeri L, Capogrosso P, Pozzi E, Candela L, Belladelli F, Cazzaniga W, Fallara G, Cignoli D, Schifano N, Ventimiglia E, Alfano M, Colandrea G, Abbate C, Montorsi F, Salonia A. P–108 Which infertile men with normal semen analysis deserve a second semen analysis in the real-life setting? Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
Guidelines suggest that one semen analysis is sufficient during the diagnostic work-up of an infertile man in the case of normality as for WHO criteria.
Summary answer
We investigated the rate and the clinical features of men with abnormal sperm parameters at a second test, after a normal first semen analysis.
What is known already
A second test is recommended when the first semen analysis depicted abnormal sperm parameters.
Study design, size, duration
Complete demographic, clinical and laboratory data from 1358 consecutive primary infertile men (infertility as for WHO definition) were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Serum hormones were measured in every patient. Patients underwent two consecutive semen analyses at the same laboratory, which followed 2010 WHO reference criteria.
Participants/materials, setting, methods
Descriptive statistics and logistic regression models tested the association between clinical variables and semen parameters. Receiver operative characteristic (ROC) curves were used to assess the relationship between clinical variables and to create a composite risk score for pathological sperm parameters at a second test.
Main results and the role of chance
At first analysis, 212 (15.6%) infertile men had normal semen parameters. Of 212, 87 (41.0%) had a second normal semen analysis, while 80 (37.7%), 35 (16.5%) and 10 (4.7%) men showed 1, 2 and 3 pathological sperm parameters at second test. Men with a pathological second semen analysis had higher CCI scores (p < 0.001), smaller testicular volume (p < 0.001) and higher FSH values (p < 0.01) than those with normal second samples. Overall, despite being within normal ranges, sperm concentration was lower [34 (23–57) vs. 62 (35–94); p < 0.01] in men with an abnormal second sample compared to those with confirmed normality. At multivariable logistic regression analysis, smaller testicular volume (OR 0.9, p = 0.03), FSH (OR 1.2, p < 0.01), and lower sperm concentration (OR 0.9, p < 0.01) were associated with pathological second semen analyses, after accounting for age and CCI. ROC curves showed that testicular volume <15 ml, FSH values >6 mUI/ml and sperm concentration <40 mil/ml had good predictive ability for pathologic second sperm parameters (all AUC >0.8). Considering 1-point for each of the previous variables, the chances of a pathological second analysis increased from 38.8% to 74.6%, 77.3% and 100% among patients with risk scores of 0, 1, 2 and 3, respectively (p < 0.001).
Limitations, reasons for caution
It is a retrospective analysis at a single, tertiary-referral academic centre, thus raising the possibility of selection biases. In spite of this, all patients have been consistently analysed over time with a rigorous follow-up, thus limiting potential heterogeneity in terms of data reporting.
Wider implications of the findings: Approximately 60% of infertile men with a normal semen analysis depicted a pathological second test. Smaller testicles, higher FSH, lower sperm concentrations were independently associated with a pathologic second test. These features could be useful to identify those infertile men with a normal semen analysis who deserve a second test.
Trial registration number
Not applicable
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Fallara G, Boeri L, Candela L, Pozzi E, Belladelli F, Capogrosso P, Cazzaniga W, Ventimiglia E, Schifano N, Costa A, Cignoli D, Cornelius J, Mattei A, Montorsi F, Salonia A. P–094 Kidney function impairment in primary infertile men. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
We investigated the prevalence of kidney function impairment in a homogeneous cohort of white-European primary infertile men.
Summary answer
Mild kidney function impairment characteristics were found in 9% of asymptomatic and unaware patients presenting for primary infertility investigation.
What is known already
Infertile men have shown a worse overall health status compared to the fertile counterpart. We investigated the prevalence of kidney function impairment in a homogeneous cohort of white-European primary infertile men.
Study design, size, duration
In this corss-sectional study, complete clinical and laboratories data from a cohort of 557 consecutive men aged >18 years, presenting for primary infertility investigation were analyzed.
Participants/materials, setting, methods
Comorbidities (as scored with the Charlson Comorbidity Index (CCI)) were collected in each patient. Primary outcome was the presence of functional impairment of the kidney (defined as an estimated glomerular filtration rates <90 ml/min/1.73m², according to the Kidney Outcomes Quality Initiative). The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) function was used for eGFR calculation. Logistic regression analyses tested the association between kidney function impairment and clinical and semen features.
Main results and the role of chance
Of 557, 51 (9.3%) patients depicted at least a mild loss of kidney function (eGFR<90 ml/min /1.73m²). Median [interquartile (IQR)] age was 38 (35–42) years for normal kidney function group vs. 41 (36–46.5) years for those with impaired renal function (p < 0.001). Those with impaired renal function had also a higher BMI [26.1 (24.4–27.8) vs. 24.9 (23.2–26.8); p = 0.002] and higher numbers of comorbidities [CCI≥ 1 in 11 (21.5%) vs. 40 (7.9%) patients (p < 0.001)]. Of note, they had more frequently history of hypertension [10 (19.6%) vs. 31 (6.1%), p = 0.001]. Groups did not differ in terms of hormonal and semen features. At logistic regression analysis, older age and CCI≥1 were associated with a higher risk of impaired eGFR (OR 1.06; 95%CI 1.01–1.11; p = 0.016 and OR 2.41; 95%CI 1.06–5.15; p = 0.028, respectively)(table). No association was found between sperm parameters and eGFR impairment (all p > 0.05), after accounting for age, CCI, BMI, FSH, testicular volume, and varicocele.
Limitations, reasons for caution
Mild kidney function impairment characteristics were found in 9% of asymptomatic and unaware patients presenting for primary infertility investigation. Age and the rate of comorbidities are associated with reduced eGFR. Wider implications of the findings: This novel finding confirms growing data on a significant association of male infertility with a poorer overall male health status.
Trial registration number
Not applicable
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Pozzi E, Boeri L, Candela L, Cignoli D, Colandrea G, Raffo M, Cazzaniga W, Schifano N, Capogrosso P, Ventimiglia E, Abbate C, Montorsi F, Salonia A. O-207 Which infertile patients mostly deserve to have a sperm DNA fragmentation index done? Findings from a cross-sectional study. Hum Reprod 2021. [DOI: 10.1093/humrep/deab128.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Current scientific guidelines do not clearly suggest which patients would benefit the most from a sperm DNA fragmentation (SDF) test.
Summary answer
We aimed to investigate potential predictive factors for altered SDF in a homogenous cohort of white-European men presenting for primary couple’s infertility.
What is known already
High SDF has been associated with reduced fertilization rates, reduced chances of natural conception and an increased risk of early pregnancy loss.
Study design, size, duration
Data from 478 consecutive men with normal or altered SDF were analysed. Infertility was defined according to the WHO criteria. Semen analysis, SDF (according to SCSA) and serum hormones were measured in every patient. Health significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Altered SDF was considered with a threshold of > 30%.
Participants/materials, setting, methods
Descriptive statistics compared the overall characteristics of patients with normal SDF and altered SDF. Logistic regression analysis tested potential predictors of altered SDF. ROC curve was used to test the accuracy of the model in predicting SDF alteration
Main results and the role of chance
Of 478 patients, 253 (57.7%) had altered SDF. Median (IQR) age and BMI of the whole cohort were 38 (35-42) years and 25.1 (23.3-27.1) kg/m2 respectively. Patients with altered SDF were older (median (IQR) age: 39 (36-43) vs. 37 (34-38) years, p < 0.0001), had lower sperm concentration (5 (1.1–18) vs. 17 x106/mL (6–38.8), p < 0.0001), testicular volume (15.1 (12 –20) vs. 16.8 (12 – 25) Prader, p = 0.0005), and total motile sperm count (TMSC) (1.8 (0.21–10.71) vs. 11.8x106 (2–37.26), p < 0.0001). Conversely, men with altered SDF had higher FSH (6.1 (3.85–9.7) vs. 4.8 (3.85 – 7.9) mIU/mL, p < 0.0001) and prolactin levels (9.8 (7.43–14.04) vs. 8.3 (6.6–11.3) pg/mL, p = 0.0004) than those with normal SDF. At multivariable logistic regression analysis, patients’ age >35 years (OR: 2.45, p = 0.0009), FSH > 8.0 mIU/mL (OR: 2.23, p < 0.0001) and lower TMSC (OR: 2.04, p = 0.002) were identified as indipendent predictors of altered SDF, after adjusting for testicular volume and CCI≥1. ROC curve (Figure 1) revealed that the model has a good predictive ability to identify patients with SDF alteration (AUC: 0.72, 95%CI: 0.67 - 0.77).
Limitations, reasons for caution
It is a retrospective analysis at a single, tertiary-referral academic centre, thus raising the possibility of selection biases. In spite of this, all patients have been consistently analysed over time with a rigorous follow-up, thus limiting potential heterogeneity in terms of data reporting
Wider implications of the findings
Primary infertile men older than 35 years, with high serum FSH and low TMSC at baseline are the ones who mostly deserve a SDF test over their diagnostic work-up and that would potentially benefit the most of certain treatments to improve SDF value, thus increasing chances of conceiving.
Trial registration number
Not applicable
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Belladelli F, Pozzi E, Boeri L, Fallara G, Capogrosso P, Cignoli D, Candela L, Schifano N, Raffo M, Colandrea A, Montorsi F, Salonia A. P–027 Does air pollution impact on semen parameters? Findings from a real-life cross-sectional study in white-European infertile men. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Study question
We aimed to investigate the association between air pollutants levels and semen parameters in a cohort of white-European men seeking medical attention for couple’s infertility.
Summary answer
We found that Pm10, Pm 2.5, and NO2 levels were negatively associated with sperm morphology.
What is known already
Air pollutants levels have been monitored closely for environmental and research issues in industrialized countries.
Study design, size, duration
Data from 156 infertile men consecutively assessed between 01/2019 and 12/2020 were analysed.
Participants/materials, setting, methods
Semen analyses were based on 2010 WHO reference criteria. We analysed the annual average level of the main markers of air pollution (Pm10, Pm2.5, and NO2) between 2014–2018 (Legambiente, 2020, Annual dossier series on air quality in Italy) relative to patients’ addresses of the last 5 years. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Descriptive statistics and linear regression analyses were used to test the association between air pollutants and semen parameters.
Main results and the role of chance
Overall, median (IQR) age and BMI were 37 (33–41) years and 25.1 (23.4–27.3) kg/m2, respectively. A CCI≥1 was found in 12 (7.7%) men, and 47 (30.1%) participants were smokers. As for sperm parameters, semen volume, sperm concentration, sperm progressive motility and normal sperm morphology were 3 (2–4) ml, 18 (5–45.5) x106/ml, 32 (22–45)% and 2 (1–3)%, respectively. Pm10 was negatively associated with sperm morphology (ß: –0.580, p = 0.001). Furthermore, Pm10 was found to be an independent predictor for sperm morphology worsening (ß: –0.729, p = 0.006) (Fig.1A), after adjusting for age, BMI, CCI and smoking status. Similarly, Pm2.5 levels were negatively associated with sperm morphology (ß: –0.595, p = 0.009) (Fig.1B). After adjusting for the same variables, the association between Pm2 and sperm morphology remained significant (ß: –0.724, p = 0.015) (Fig.1C). NO2 levels were found to be associated with sperm morphology worsening after adjusting for age, BMI, CCI, and smoking status (ß: –0.471, p = 0.006).
Limitations, reasons for caution
It is a retrospective analysis at a single, tertiary-referral academic centre, thus raising the possibility of selection biases. Moreover, markers of air pollutions divided by residence may not completely evaluated the single patient exposure.
Wider implications of the findings: In this cross-sectional study we found that Pm10, Pm 2.5, and NO2 levels were negatively associated with sperm morphology, while they were not consistently associated with an increased risk of other abnormal sperm parameters in infertile men. Further studies are needed to characterize air pollution effects on sperm parameters.
Trial registration number
Not applicable
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Saracino L, Bortolotto C, Tomaselli S, Fraolini E, Bosio M, Accordino G, Agustoni F, Abbott DM, Pozzi E, Eleftheriou D, Morbini P, Rinaldi P, Primiceri C, Lancia A, Comoli P, Filippi AR, Stella GM. Integrating data from multidisciplinary Management of Malignant Pleural Mesothelioma: a cohort study. BMC Cancer 2021; 21:762. [PMID: 34210265 PMCID: PMC8252222 DOI: 10.1186/s12885-021-08532-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 06/23/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Malignant pleural mesothelioma (MPM) is a rare and aggressive malignancy that most commonly affects the pleural layers. MPM has a strong association with asbestos, mainly caused by exposure to its biopersistent fibers in at least 80% of cases. Individuals with a chronic exposure to asbestos might develop disease with a 20-40-year latency with few or no symptoms. Such has been the case in the Italian regions of Piedmont and Lombardy, where industrial production of materials laden with asbestos, mainly cements, has been responsible for the onset of a large epidemic. Since 2018, a multidisciplinary team at San Matteo hospital in Pavia has been collecting data on over 100 patients with MPM. The main goal of this project is to define and describe an integrated profile for each MPM case at diagnosis by using data mining and partition analysis. METHODS Here we bring together exhaustive epidemiologic, histologic and radiologic data of 88 MPM patients that came to our observation and draw correlations with predictive and prognostic significance. RESULTS The median overall survival (OS) was 15.6 months. Most patients presented with pleural effusion, irrespective of disease stage. Quite unexpectedly, no statistically significant association was demonstrated between OS and TNM disease stage at diagnosis. Although average OS is similar in male and female patients, partition analysis of data underlined a significant differential hierarchy of predictor categories based on patient gender. In females with no smoking history, full chemotherapeutic regimens are associated with better outcomes. Moreover, concerning second line treatments, vinorelbine emerged as the most advantageous choice for female patients, whereas in the male subgroup no statistically significant difference resulted between gemcitabine and vinorelbine. CONCLUSION A multidisciplinary approach to MPM is mandatory to define better therapeutic approaches, personalize the management and improve patient outcomes.
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Pozzi E, Fallara G, Candela L, Costa A, Boeri L, Capogrosso P, Schifano N, Belladelli F, Cignoli D, Colandrea G, Raffo M, Cornelius J, Costantino A, Mattei A, Montorsi F, Salonia A. Primary organic vs. primary psychogenic erectile dysfunction: A cross-sectional study on patient’s characteristics and sexual function from a tertiary referral centre. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00866-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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43
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Ventimiglia E, Boeri L, Pozzi E, Belladelli F, Fallara G, Candela L, Capogrosso P, Schifano N, Cignoli D, Colandrea G, Raffo M, Cornelius J, Mattei A, Abbate C, Montorsi F, Salonia A. Paternal age affects the performance of EAU guidelines for genetic testing in infertile men: Implications for candidate selection. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Boeri L, Capogrosso P, Cazzaniga W, Candela L, Fallara G, Pozzi E, Belladelli F, Schifano N, Cignoli D, Colandrea G, Raffo M, Abbate C, Montorsi F, Salonia A. Prevalence and predictors of unrecognized low sexual desire in men with new onset erectile dysfunction – Findings from a cross-sectional, real-life study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00865-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Capogrosso P, Candela L, Cazzaniga W, Costa A, Fallara G, Boeri L, Pozzi E, Belladelli F, Schifano N, Cignoli D, Abbate C, Montorsi F, Salonia A. Are patients really willing to undergo surgery for Peyronie’s disease? Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pozzi E, Cakir O, Castiglione F, Schifano N, Hadway P, Nigam R, Rees R, Albersen M, Parnham A, Lau M, Alnajjar H, Vijai S, Muneer A. Long term outcomes of Dynamic Sentinel Lymph Node Biopsy (DSNB) for clinically impalpable (cN0) penile cancer patients- an eUROGEN study. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01044-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Pozzi E, Ventimiglia E, Fallara G, Boeri L, Belladelli F, Cignoli D, Candela L, Capogrosso P, Schifano N, Raffo M, Colandrea G, Cornelius J, Mattei A, Abbate C, Montorsi F, Salonia A. Haemospermia in the real-life setting: Challenging the EAU guidelines. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00861-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Armani G, Pozzi E, Pagani A, Porta C, Rizzo M, Cicognini D, Rovati B, Moccia F, Pedrazzoli P, Ferraris E. The heterogeneity of cancer endothelium: The relevance of angiogenesis and endothelial progenitor cells in cancer microenvironment. Microvasc Res 2021; 138:104189. [PMID: 34062191 DOI: 10.1016/j.mvr.2021.104189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 05/18/2021] [Accepted: 05/22/2021] [Indexed: 01/02/2023]
Abstract
Tumor-associated vessels constitution is the result of angiogenesis, the hallmark of cancer essential for tumor to develop in dimension and to spread throughout the organism. Tumor endothelium is configured as an active functioning organ capable of determine interaction with the immune response and all the other components of the variegate cancer microenvironment, determining reciprocal influence. Angiogenesis is here analyzed in its molecular and cellular mechanisms, multiple mediators and principal players, represented by Endothelial Cells. It is discussed the striking heterogeneity of cancer endothelium, due to morphological and molecular aberrations that it often presents and its multiple origin. Among the cells that participate to the composition of tumor vasculature, Endothelial Progenitor Cells represent an important source for physical sustain and paracrine signaling in the process of angiogenesis. Treatment options are reviewed, with particular focus on novel therapeutic strategies for overcoming tumor resistance to anti-angiogenic agents.
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Candiloro F, Borioli V, Borsellino G, Picozza M, Pellini R, Cereda E, Gargano F, Caraccia M, Nardi MT, Bellu L, Tondulli L, Imarisio I, Pozzi E, Pedrazzoli P, Caccialanza R, Battistini L. Influence of different lipid emulsions on specific immune cell functions in head and neck cancer patients receiving supplemental parenteral nutrition: An exploratory analysis. Nutrition 2021; 86:111178. [PMID: 33631618 DOI: 10.1016/j.nut.2021.111178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/05/2021] [Accepted: 01/21/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The effect of diet on immune responses is an area of intense investigation. Dietary lipids have been shown to differently influence and fine-tune the reactivity of immune cell subsets, thus potentially affecting clinical outcomes. Patients with head and neck squamous cell carcinoma face malnutrition, due to swallowing impairment related to the tumor site or to treatment sequalae, and may need supplemental parenteral nutrition (SPN) in addition to oral feeding when enteral nutrition is not feasible. Additionally, immune depression is a well-known complication in these patients. Parenteral nutrition (PN) bags contain amino acids, minerals, electrolytes and mostly lipids that provide calories in a concentrated form and are enriched with essential fatty acids. The aim of this study was to investigate multiple parameters of the immune responses in a cohort of patients with head and neck squamous cell carcinoma undergoing supplemental PN with bags enriched in ω-3 or ω-9 and ω-6 fatty acids. METHODS To our knowledge, this was the first exploratory study to investigate the effects of two different PN lipid emulsions on specific immune cells function of patients with advanced head and neck squamous carcinoma. ω-3-enriched fish-oil-based- and ω-6- and ω-9-enriched olive-oil-basedSPN was administered to two groups of patients for 1 wk in the context of an observational multicentric study. Polychromatic flow cytometry was used to investigate multiple subsets of leukocytes, with a special focus on cellular populations endowed with antitumor activity. RESULTS Patients treated with olive-oil-based PN showed an increase in the function of the innate (natural killer cells and monocytes) and adaptive (both CD4 and CD8 cells) arms of the immune response. CONCLUSION An increase in the function of the innate and adaptive arms of the immune response may favor antitumoral responses.
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Boeri L, Capogrosso P, Cazzaniga W, Alfano M, Pederzoli F, Pozzi E, Belladelli F, Baudo A, Ventimiglia E, Abate C, Montanari E, Montorsi F, Salonia A. infertile men have higher PSA values than aged-matched fertile controls: Potential implications for personalized prevention strategies. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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