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Ma Y, Zhang B, Liu Z, Liu Y, Wang J, Li X, Feng F, Ni Y, Li S. IAS-FET: An intelligent assistant system and an online platform for enhancing successful rate of in-vitro fertilization embryo transfer technology based on clinical features. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2024; 245:108050. [PMID: 38301430 DOI: 10.1016/j.cmpb.2024.108050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Among all of the assisted reproductive technology (ART) methods, in vitro fertilization-embryo transfer (IVF-ET) holds a prominent position as a key solution for overcoming infertility. However, its success rate hovers at a modest 30% to 70%. Adding to the challenge is the absence of effective models and clinical tools capable of predicting the outcome of IVF-ET before embryo formation. Our study is dedicated to filling this critical gap by aiming to predict IVF-ET outcomes and ultimately enhance the success rate of this transformative procedure. METHODS In this retrospective study, infertile patients who received artificial assisted pregnancy treatment at Gansu Provincial Maternity and Child-care Hospital in China were enrolled from 2016 to 2020. Individual's clinical information were studied by cascade XGBoost method to build an intelligent assisted system for predicting the outcome of IVF-ET, called IAS-FET. The cascade XGBoost model was trained using clinical information from 2292 couples and externally tested using clinical information from 573 couples. In addition, several schemes which will be of help for patients to adjust their physical condition to improve their success rate on ART were suggested by IAS-FET. RESULTS The outcome of IVF-ET can be predicted by the built IAS-FET method with the area under curve (AUC) value of 0.8759 on the external test set. Besides, this IAS-FET method can provide several schemes to improve the successful rate of IVF-ET outcomes. The built tool for IAS-FET is addressed as a free platform online at http://www.cppdd.cn/ART for the convenient usage of users. CONCLUSIONS It suggested the significant influence of personal clinical features for the success of ART. The proposed system IAS-FET based on the top 27 factors could be a promising tool to predict the outcome of ART and propose a plan for the patient's physical adjustment. With the help of IAS-FET, patients can take informed steps towards increasing their chances of a successful outcome on their journey to parenthood.
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Affiliation(s)
- Ying Ma
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu 730030, China
| | - Bowen Zhang
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; School of Electronic Information and Communications, Huazhong University of Science and Technology, Wuhan, Hubei 430073, China
| | - Zhaoqing Liu
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Yujie Liu
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Jiarui Wang
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xingxuan Li
- School of Chemistry and Chemical Engineering, Lanzhou University, Lanzhou, Gansu 730030, China
| | - Fan Feng
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu 730030, China
| | - Yali Ni
- Gansu Provincial Maternity and Child-care Hospital, Lanzhou, Gansu 730030, China
| | - Shuyan Li
- School of Medical Information and Engineering, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
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Ranjith S, Dave A. Filling the Gaps in Oncofertility Care by Addressing Challenges Faced by Patients and Providers. Cureus 2023; 15:e50219. [PMID: 38192954 PMCID: PMC10773274 DOI: 10.7759/cureus.50219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024] Open
Abstract
With enhanced technology and upcoming treatment strategies in the cancer field, the survival rates of patients have increased. We have now reached a stage in the treatment of cancer where we not only address the disease but also address complications that arise due to the disease and the side effects that present in the post-survival population due to its treatment. One of the primary consequences after oncotherapy is infertility, which is a major reason for distress for patients' post-survival, as they are afraid they may be deemed as less desirable, be rejected by their existing partner, or cannot grapple with the fact that they cannot have children of their own. This can be avoided by the implementation of proper oncofertility practices. The subject of oncofertility involves interactions between experts in the domains of cancer diagnosis, therapy, fertility preservation, and reproductive health. It attempts to investigate and broaden the possibilities for cancer survivors' reproductive future in order to suit their needs according to their ethical religious and sociocultural beliefs. However, these practices are often not implemented effectively due to ineffective doctor-patient communication, lack of knowledge, or partial knowledge of clinicians themselves regarding fertility care. This leads to a feeling of insecurity among clinicians hence resulting in them not referring patients. Lack of awareness among doctors of different oncofertility procedures available especially for patient groups like women and younger patients, hence leading to reduced referral in these groups. Improper coordination across health departments, patient ignorance regarding procedures, financial instability especially in a country with a lower sociodemographic index like India, and neglect or less importance given to the related ethical, social, and legal issues. In this article, we cover the effects of cancer and cancer treatment on fertility, the options available to adult and pediatric cancer patients to preserve their fertility like oocyte/ovarian tissue cryopreservation in females and sperm cryopreservation in males, techniques undergoing experimental studies that could be implemented in the future like spermatogonial stem culture and transplantation of testicular tissue, the obstacles that we face that hinder the proper implementation of such practices and what measures can we take to overcome these obstacles to improve patient care and be better healthcare providers.
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Affiliation(s)
- Saanthwana Ranjith
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Apoorva Dave
- Obstetrics and Gynecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Gruhl SL, Ho LM, Sim MYX, Lee SN, Yu SL, Yong TT, Lim LS, Rajesh H. Seminal biomarkers and their correlations to semen parameters in subfertile men. Eur J Obstet Gynecol Reprod Biol X 2023; 19:100229. [PMID: 37700886 PMCID: PMC10493244 DOI: 10.1016/j.eurox.2023.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 06/01/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Research question To assess the levels of seminal biomarkers fructose, zinc and citrate and their correlations to semen parameters in infertile men. Design 200 infertile male participants undergoing fertility assessment at Singapore General Hospital (SGH), Singapore were recruited prospectively, from June 2020 to August 2021. Their semen samples were assessed for seminal parameters, biomarker levels of fructose, citrate and zinc, leukocyte concentrations and aerobic cultures. They were also assessed for their smoking habits. Results Sperm concentrations were negatively correlated to seminal fructose levels, r = -0.262, P < 0.001. Progressive motility were positively correlated to seminal citrate levels, r = 0.181, P = 0.014. Sperm morphology and total motile sperm count (TMSC) were positively correlated to seminal zinc and citrate levels, P < 0.05. Zinc and citrate levels were significantly reduced in teratozoospermia, asthenoteratozoospermia and oligoasthenoteratozoospermia groups compared to normozoospermia, P < 0.05. The presence of infection was associated with elevated leukocyte concentrations, lower sperm concentration (12.5 vs 55.8 million/mL, P = 0.024) and fructose levels (35.5 vs 49.2 µmol/ejaculate). Heavy smokers compared to light smokers, had lower sperm concentrations (35.3 vs 49.4 million/mL), TMSC (30.9 vs 47.5 million) and zinc levels (4.9 vs 6.7 µmol/ejaculate) and significantly lower citrate levels (52.6 vs 79.2 µmol/ejaculate, P = 0.029). Conclusions Higher zinc and citrate levels correlated with better progressive motility, sperm morphology and TMSC. Smoking negatively impacted zinc and citrate levels, thereby affecting sperm quality. In conclusion, the inclusion of biomarkers in basic male work-up assessment would assist in identifying common deficiencies and aid in adequate replacement therapy.
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Affiliation(s)
| | - Lee Mee Ho
- Department of Obstetrics and Gynaecology, Outram Rd, 169608, Singapore
| | | | - Shaw Ni Lee
- Department of Obstetrics and Gynaecology, Outram Rd, 169608, Singapore
| | - Su Ling Yu
- Department of Obstetrics and Gynaecology, Outram Rd, 169608, Singapore
| | - Tze Tein Yong
- Department of Obstetrics and Gynaecology, Outram Rd, 169608, Singapore
| | - Liqing Serene Lim
- Department of Obstetrics and Gynaecology, Outram Rd, 169608, Singapore
| | - Hemashree Rajesh
- Department of Obstetrics and Gynaecology, Outram Rd, 169608, Singapore
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Paira DA, Olivera C, Tissera AD, Molina RI, Olmedo JJ, Rivero VE, Saka HA, Motrich RD. Ureaplasma urealyticum and Mycoplasma hominis urogenital infections associate with semen inflammation and decreased sperm quality. J Leukoc Biol 2023; 113:18-26. [PMID: 36822158 DOI: 10.1093/jleuko/qiac006] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Indexed: 01/11/2023] Open
Abstract
Ureaplasma urealyticum and Mycoplasma hominis are among the most prevalent sexually transmitted infections proposed to induce urogenital inflammation and impair sperm quality. However, the topic remains controversial since contradictory findings have been reported. Herein, we performed a comprehensive analysis of U. urealyticum and M. hominis urogenital infections and their association with urogenital inflammation (i.e., leukocyte subsets and inflammatory cytokines in semen,) and sperm quality parameters in a cohort of men with couple's primary infertility undergoing initial infertility evaluation or with lower urinary tract symptoms and no infertility-related complaints. Overall, U. urealyticum and M. hominis infection was detected in 17.0% and 23.6% of patients, respectively, whereas the coinfection was detected in 3.8% of patients only. Remarkably, similar infection frequencies were found in the different patient subpopulations analyzed. Moreover, infections were associated with elevated semen levels of TNF, IL-1β, and IL-6 and/or increased counts of total leukocytes and their subsets, including CD4 and CD8 T lymphocytes and neutrophils. In addition, M. hominis infection and the coinfection with U. urealyticum were associated with impairments in sperm quality variables. Our results indicate that U. urealyticum and M. hominis male urogenital infections induce urogenital inflammation and decrease sperm quality, thus impairing male fertility potential. Screening for U. urealyticum and M. hominis infections and performing a comprehensive analysis of different leukocyte subsets and inflammatory cytokines in semen may be clinically helpful in the diagnosis and follow-up of male urogenital infection.
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Affiliation(s)
- Daniela A Paira
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, 5016, Córdoba, Argentina
| | - Carolina Olivera
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, 5016, Córdoba, Argentina
| | - Andrea D Tissera
- Laboratorio de Andrología y Reproducción (LAR), Blvd. Chacabuco 1123, 5000, Córdoba, Argentina
| | - Rosa I Molina
- Laboratorio de Andrología y Reproducción (LAR), Blvd. Chacabuco 1123, 5000, Córdoba, Argentina
| | - José J Olmedo
- Servicio de Urologia y Andrologia, Fundación Urológica Córdoba para la Docencia e Investigación Médica (FUCDIM), Bartolomé de las casas 3765, 5016, Córdoba, Argentina
| | - Virginia E Rivero
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, 5016, Córdoba, Argentina
| | - Héctor A Saka
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, 5016, Córdoba, Argentina
| | - Ruben D Motrich
- Centro de Investigaciones en Bioquímica Clínica e Inmunología (CIBICI-CONICET), Facultad de Ciencias Químicas, Universidad Nacional de Córdoba, Haya de la Torre esq. Medina Allende, 5016, Córdoba, Argentina
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Chi YN, Ye RJ, Yang JM, Hai DM, Liu N, Ren JW, Du J, Lan XB, Yu JQ, Ma L. Geniposide attenuates spermatogenic dysfunction via inhibiting endoplasmic reticulum stress in male mice. Chem Biol Interact 2022; 366:110144. [PMID: 36063855 DOI: 10.1016/j.cbi.2022.110144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/22/2022] [Accepted: 08/29/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Spermatogenesis dysfunction is common in clinically infertile patients. Geniposide (GP) is one of the important active ingredients extracted from Eucommia ulmoides. However, the protective effect and mechanism of GP in the treatment of spermatogenic dysfunction is not known yet. METHODS After cyclophosphamide-induced spermatogenic dysfunction was established in male mice, we gavaged GP for 4 weeks to evaluate spermatogenic function and anti-apoptotic effects by fertility, testicular weight, sperm quality, endoplasmic reticulum stress (ER stress), comet assay and serum testosterone level. RESULTS GP can improve the damage of fertility and reproductive organs induced by cyclophosphamide and increase the number and activity of sperm. In comet assay, it was found that GP administration could alleviate sperm DNA damage induced by cyclophosphamide. In addition, GP treatment can significantly reduce ThT fluorescence intensity and improve endoplasmic reticulum stress induced by cyclophosphamide. Besides, TUNEL staining and WB showed that GP could inhibit the excessive apoptosis of cells and protect testis. (p < 0.05, p < 0.01, p < 0.001). CONCLUSION The protective effect of Geniposide on cyclophosphamide-induced spermatogenic dysfunction in mice is related to the inhibition of endoplasmic reticulum stress.
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Affiliation(s)
- Yan-Nan Chi
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Rui-Juan Ye
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Jia-Mei Yang
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Dong-Mei Hai
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Ning Liu
- Key Laboratory of Hui Ethnic Medicine Modernization, The Ministry of Education, Ningxia Medical University, Yinchuan, 750004, China
| | - Jia-Wei Ren
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Juan Du
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Xiao-Bing Lan
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China
| | - Jian-Qiang Yu
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China; Ningxia Hui Medicine Modern Engineering Research Center and Collaborative Innovation Center, Ningxia Medical University, Yinchuan, 750004, China.
| | - Lin Ma
- Department of Pharmacology, Ningxia Medical University, Yinchuan, 750004, China.
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Shahroodian S, Mirshekar M, Talebi M, Torki A, Amirmozafari N. Association between virulence factors and biofilm formation in Enterococcus faecalis isolated from semen of infertile men. Am J Reprod Immunol 2022; 88:e13561. [PMID: 35499217 DOI: 10.1111/aji.13561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/09/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022] Open
Abstract
PROBLEM Enterococcus faecalis is a common microbial semen contaminant. Although virulence factors and biofilm formation have often been analyzed in Enterococcus spp., there is little information about these features in isolates obtained from the genitourinary tract. This study was intended to characterize and determine the relationship between biofilm-forming ability and the presence of E. faecalis virulence factors isolated from human semen. METHOD OF STUDY A total of 32 patients diagnosed with primary infertility and 28 healthy men were included in the study. Semen analyses were performed according to the WHO guidelines. PCR reactions were applied for the detection of ace, esp, efeA, gelE, asa1, and cylA genes. Microtiter plate assay, via measurement of OD560, was used to measure the biofilm-forming ability of the isolates. RESULTS Sixty E. faecalis isolates from semen of infertile and fertile men were characterized by phenotypic and genotypic methods. The prevalence of ace, esp, efeA, gelE, asa1 and cylA were reported to be 81.3%/100.0%, 81.3%/89.3%, 81.3%/85.7%, 71.9%/53.6%, 8.8%/75.0%, and 62.5%/67.9% in infertile/fertile groups; respectively. Strong, weak, and non-biofilm reactions were reported to be 50.0%/21.4%, 40.6%/64.3%, and 9.4%/14.3% in infertile and fertile groups; respectively. CONCLUSIONS There was a significant relationship between fertility and weak biofilm reaction and also between biofilm formation and possession of the esp gene (P < .05). It could be speculated that colonization with E. faecalis with a strong ability for biofilm formation could become a potential threat to men's fertility.
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Affiliation(s)
- Soheila Shahroodian
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Mirshekar
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Malihe Talebi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Torki
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Nour Amirmozafari
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Ferlin A, Calogero AE, Krausz C, Lombardo F, Paoli D, Rago R, Scarica C, Simoni M, Foresta C, Rochira V, Sbardella E, Francavilla S, Corona G. Management of male factor infertility: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS) : Endorsing Organization: Italian Society of Embryology, Reproduction, and Research (SIERR). J Endocrinol Invest 2022; 45:1085-1113. [PMID: 35075609 DOI: 10.1007/s40618-022-01741-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Infertility affects 15-20% of couples and male factors are present in about half of the cases. For many aspects related to the diagnostic and therapeutic approach of male factor infertility, there is no general consensus, and the clinical approach is not uniform. METHODS In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), endorsed by the Italian Society of Embryology, Reproduction, and Research (SIERR), we propose evidence-based recommendations for the diagnosis, treatment, and management of male factor infertility to improve patient and couple care. RESULTS Components of the initial evaluation should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, and imaging are suggested in most men and recommended when specific risk factors for infertility exist or first-step analyses showed abnormalities. Full examination including genetic tests, testicular cytology/histology, or additional tests on sperm is clinically oriented and based on the results of previous investigations. For treatment purposes, the identification of the specific cause and the pathogenetic mechanism is advisable. At least, distinguishing pre-testicular, testicular, and post-testicular forms is essential. Treatment should be couple-oriented, including lifestyle modifications, etiologic therapies, empirical treatments, and ART on the basis of best evidence and with a gradual approach. CONCLUSION These Guidelines are based on two principal aspects: they are couple-oriented and place high value in assessing, preventing, and treating risk factors for infertility. These Guidelines also highlighted that male infertility and in particular testicular function might be a mirror of general health of a man.
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Affiliation(s)
- A Ferlin
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35121, Padua, Italy.
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - C Krausz
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - F Lombardo
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank "Loredana Gandini", University of Rome "La Sapienza", Rome, Italy
| | - D Paoli
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank "Loredana Gandini", University of Rome "La Sapienza", Rome, Italy
| | - R Rago
- Department of Gender, Parenting, Child and Adolescent Medicine, Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - C Scarica
- European Hospital, Centre for Reproductive Medicine, Rome, Italy
| | - M Simoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35121, Padua, Italy
| | - V Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - E Sbardella
- Department of Experimental Medicine, University of Rome "La Sapienza", Rome, Italy
| | - S Francavilla
- Department of Life, Health and Environmental Sciences, Unit of Andrology, University of L'Aquila, L'Aquila, Italy
| | - G Corona
- Medical Department, Endocrinology Unit, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
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Choksi A, Harnisch B, Honig S. What Every Provider Should Know About the 2020–2021 Updated AUA/ASRM Guidelines on Male Factor Infertility. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Ou HT, Cheng YS, Lin HT, Wu MH, Wu WL, Tsai LC, Chen YY, Hung KH, Wu PH, Chen TS. Incorporating sperm DNA fragmentation index with computer-assisted semen morphokinematic parameters as a better window to male fertility. CHINESE J PHYSIOL 2022; 65:143-150. [DOI: 10.4103/cjp.cjp_12_22] [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] Open
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10
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Oud MS, Houston BJ, Volozonoka L, Mastrorosa FK, Holt GS, Alobaidi BKS, deVries PF, Astuti G, Ramos L, Mclachlan RI, O’Bryan MK, Veltman JA, Chemes HE, Sheth H. Exome sequencing reveals variants in known and novel candidate genes for severe sperm motility disorders. Hum Reprod 2021; 36:2597-2611. [PMID: 34089056 PMCID: PMC8373475 DOI: 10.1093/humrep/deab099] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 03/30/2021] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION What are the causative genetic variants in patients with male infertility due to severe sperm motility disorders? SUMMARY ANSWER We identified high confidence disease-causing variants in multiple genes previously associated with severe sperm motility disorders in 10 out of 21 patients (48%) and variants in novel candidate genes in seven additional patients (33%). WHAT IS KNOWN ALREADY Severe sperm motility disorders are a form of male infertility characterised by immotile sperm often in combination with a spectrum of structural abnormalities of the sperm flagellum that do not affect viability. Currently, depending on the clinical sub-categorisation, up to 50% of causality in patients with severe sperm motility disorders can be explained by pathogenic variants in at least 22 genes. STUDY DESIGN, SIZE, DURATION We performed exome sequencing in 21 patients with severe sperm motility disorders from two different clinics. PARTICIPANTS/MATERIALS, SETTING, METHOD Two groups of infertile men, one from Argentina (n = 9) and one from Australia (n = 12), with clinically defined severe sperm motility disorders (motility <5%) and normal morphology values of 0-4%, were included. All patients in the Argentine cohort were diagnosed with DFS-MMAF, based on light and transmission electron microscopy. Sperm ultrastructural information was not available for the Australian cohort. Exome sequencing was performed in all 21 patients and variants with an allele frequency of <1% in the gnomAD population were prioritised and interpreted. MAIN RESULTS AND ROLE OF CHANCE In 10 of 21 patients (48%), we identified pathogenic variants in known sperm assembly genes: CFAP43 (3 patients); CFAP44 (2 patients), CFAP58 (1 patient), QRICH2 (2 patients), DNAH1 (1 patient) and DNAH6 (1 patient). The diagnostic rate did not differ markedly between the Argentinian and the Australian cohort (55% and 42%, respectively). Furthermore, we identified patients with variants in the novel human candidate sperm motility genes: DNAH12, DRC1, MDC1, PACRG, SSPL2C and TPTE2. One patient presented with variants in four candidate genes and it remains unclear which variants were responsible for the severe sperm motility defect in this patient. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION In this study, we described patients with either a homozygous or two heterozygous candidate pathogenic variants in genes linked to sperm motility disorders. Due to unavailability of parental DNA, we have not assessed the frequency of de novo or maternally inherited dominant variants and could not determine the parental origin of the mutations to establish in all cases that the mutations are present on both alleles. WIDER IMPLICATIONS OF THE FINDINGS Our results confirm the likely causal role of variants in six known genes for sperm motility and we demonstrate that exome sequencing is an effective method to diagnose patients with severe sperm motility disorders (10/21 diagnosed; 48%). Furthermore, our analysis revealed six novel candidate genes for severe sperm motility disorders. Genome-wide sequencing of additional patient cohorts and re-analysis of exome data of currently unsolved cases may reveal additional variants in these novel candidate genes. STUDY FUNDING/COMPETING INTEREST(S) This project was supported in part by funding from the Australian National Health and Medical Research Council (APP1120356) to M.K.O.B., J.A.V. and R.I.M.L., The Netherlands Organisation for Scientific Research (918-15-667) to J.A.V., the Royal Society and Wolfson Foundation (WM160091) to J.A.V., as well as an Investigator Award in Science from the Wellcome Trust (209451) to J.A.V. and Grants from the National Research Council of Argentina (PIP 0900 and 4584) and ANPCyT (PICT 9591) to H.E.C. and a UUKi Rutherford Fund Fellowship awarded to B.J.H.
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Affiliation(s)
- M S Oud
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B J Houston
- School of Biological Sciences, Monash University, Monash, Australia
- School of BioSciences, Faculty of Science, The University of Melbourne, Parkville, Australia
| | - L Volozonoka
- Scientific Laboratory of Molecular Genetics, Riga Stradins University, Riga, Latvia
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - F K Mastrorosa
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - G S Holt
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - B K S Alobaidi
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - P F deVries
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - G Astuti
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L Ramos
- Department of Gynaecology and Obstetrics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - R I Mclachlan
- Hudson Institute of Medical Research, Monash University, Clayton, Melbourne, Australia
| | - M K O’Bryan
- School of Biological Sciences, Monash University, Monash, Australia
- School of BioSciences, Faculty of Science, The University of Melbourne, Parkville, Australia
| | - J A Veltman
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - H E Chemes
- Centro de Investigaciones Endocrinológicas “Dr. César Bergadá” CEDIE-CONICET-FEI, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - H Sheth
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Foundation for Research in Genetics and Endocrinology, Institute of Human Genetics, Ahmedabad, India
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11
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Zheng W, Zhang S, Jiang S, Huang Z, Chen X, Guo H, Li M, Zheng S. Evaluation of immune status in testis and macrophage polarization associated with testicular damage in patients with nonobstructive azoospermia. Am J Reprod Immunol 2021; 86:e13481. [PMID: 34192390 DOI: 10.1111/aji.13481] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 06/08/2021] [Accepted: 06/28/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Immune cells residing in the testicular interstitial space form the immunological microenvironment of the testis. They are assumed to play a role in maintaining testicular homeostasis and immune privilege. However, the immune status and related cell polarization in patients with nonobstructive azoospermia (NOA) remains poorly characterized. System evaluation of the testis immunological microenvironment in NOA patients may help to reveal the mechanisms of idiopathic azoospermia. STUDY DESIGN The gene expression patterns of immune cells in normal human testes were systematically analyzed by single-cell RNA sequencing (scRNA-seq) and preliminarily verification by the human protein atlas (HPA) online database. The immune cell infiltration profiles and immune status of patients with NOA was analyzed by single-sample gene set enrichment analysis (ssGSEA) and gene set variation analysis (GSVA) based on four independent public microarray datasets (GSE45885, GSE45887, GSE9210, and GSE145467), obtained from Gene Expression Omnibus (GEO) online database. The relationship between immune cells and spermatogenesis score was further analyzed by Spearman correlation analysis. Finally, immunohistochemistry (IHC) staining was performed to identify the main immune cell types and their polarization status in patients with NOA. RESULTS Both scRNA-seq and HPA analysis showed that testicular macrophages represent the largest pool of immune cells in the normal testis, and also exhibit an attenuated inflammatory response by expressing high levels of tolerance proteins (CD163, IL-10, TGF-β, and VEGF) and reduced expression of TLR signaling pathway-related genes. Correlation analysis revealed that the testicular immune score and macrophages including M1 and M2 macrophages were significantly negatively correlated with spermatogenesis score in patients with NOA (GSE45885 and GSE45887). In addition, the number of M1 and M2 macrophages was significantly higher in patients with NOA (GSE9210 and GSE145467) than in normal testis. GSVA analysis indicated that the immunological microenvironment in NOA tissues was manifested by activated immune system and pro-inflammatory status. IHC staining results showed that the number of M1 and M2 macrophages was significantly higher in NOA tissues than in normal testis and negatively correlated with the Johnson score. CONCLUSION Testicular macrophage polarization may play a vital role in NOA development and is a promising potential therapeutic target.
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Affiliation(s)
- Wenzhong Zheng
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Shiqiang Zhang
- Department of Urology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China
| | - Shaoqin Jiang
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zhangcheng Huang
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaobao Chen
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huan Guo
- Department of Urology, Shenzhen University General Hospital & Shenzhen University Clinical Medical Academy Center, Shenzhen University, Shenzhen, China
| | - Mengqiang Li
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Song Zheng
- Department of Urology, Fujian Medical University Union Hospital, Fuzhou, China
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12
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Impact of Moriamin Forte on Testicular and Epididymal Damage in Rats with Oligoasthenospermia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:4059248. [PMID: 34211561 PMCID: PMC8208844 DOI: 10.1155/2021/4059248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 05/11/2021] [Accepted: 06/01/2021] [Indexed: 11/18/2022]
Abstract
To investigate the effect and mechanism of action of Moriamin Forte (MF) on oligoasthenospermia (OA) in rats exposed to multiglycosides of Tripterygium wilfordii (GTW), forty male Sprague Dawley rats were randomly divided into four groups. Rats in the control group were treated with 0.5% sodium carboxymethyl cellulose. The remaining rats were administered GTW (30 mg/kg/d) for 40 d to establish an OA model. Concurrently, the groups were treated with normal saline and low-dose (100 mg/kg/d) and high-dose (200 mg/kg/d) MF, respectively. After treatment, the number and motility of sperm cells were examined. Testicular and epididymal histomorphology changes were observed. Antioxidant indicators (SOD, CAT, MDA, TAC, and Nrf2) in testicular and epididymal tissues were detected. Apoptotic and antiapoptotic indicators (Bax and Bcl2 expression) in the testicular tissue were measured by immunohistochemistry. GTW decreased sperm count and motility, damaged testicular and epididymis tissues, impaired antioxidase activity, and increased tissue MDA levels. Meanwhile, GTW upregulated the expression of Bax and downregulated the expression of Bcl2. Western blot analysis demonstrated a decrease in the Nrf2 expression in the model group. Treatment with MF improved sperm count and motility, as well as inhibited the rate of apoptosis in the rat reproductive system. Moreover, MF improved the activity of antioxidants and increased the relative expression of the antioxidant pathway-related protein Nrf2. In conclusion, MF may reverse the GTW-induced OA by modulating the expression of apoptotic and antioxidant pathway-related proteins. This study may provide a pharmacological foundation for the use of MF in OA treatment.
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13
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Liu Q, Guo Q, Guo W, Song S, Wang N, Chen X, Sun A, Yan L, Qiao J. Loss of CEP70 function affects acrosome biogenesis and flagella formation during spermiogenesis. Cell Death Dis 2021; 12:478. [PMID: 33980814 PMCID: PMC8116340 DOI: 10.1038/s41419-021-03755-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 02/03/2023]
Abstract
The spermatogenesis process is complex and delicate, and any error in a step may cause spermatogenesis arrest and even male infertility. According to our previous transcriptomic data, CEP70 is highly expressed throughout various stages of human spermatogenesis, especially during the meiosis and deformation stages. CEP70 is present in sperm tails and that it exists in centrosomes as revealed by human centrosome proteomics. However, the specific mechanism of this protein in spermatogenesis is still unknown. In this study, we found a heterozygous site of the same mutation on CEP70 through mutation screening of patients with clinical azoospermia. To further verify, we deleted CEP70 in mice and found that it caused abnormal spermatogenesis, leading to male sterility. We found that the knockout of CEP70 did not affect the prophase of meiosis I, but led to male germ-cell apoptosis and abnormal spermiogenesis. By transmission electron microscopy (TEM) and scanning electron microscopy (SEM) analysis, we found that the deletion of CEP70 resulted in the abnormal formation of flagella and acrosomes during spermiogenesis. Tandem mass tag (TMT)-labeled quantitative proteomic analysis revealed that the absence of CEP70 led to a significant decrease in the proteins associated with the formation of the flagella, head, and acrosome of sperm, and the microtubule cytoskeleton. Taken together, our results show that CEP70 is essential for acrosome biogenesis and flagella formation during spermiogenesis.
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Affiliation(s)
- Qiang Liu
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Qianying Guo
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Wei Guo
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Shi Song
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Nan Wang
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Xi Chen
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Andi Sun
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Liying Yan
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China
| | - Jie Qiao
- grid.411642.40000 0004 0605 3760Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China ,grid.411642.40000 0004 0605 3760National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China ,grid.419897.a0000 0004 0369 313XKey Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China ,grid.411642.40000 0004 0605 3760Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing, China ,grid.506261.60000 0001 0706 7839Research Units of Comprehensive Diagnosis and Treatment of Oocyte Maturation Arrest, Chinese Academy of Medical Sciences, Beijing, China
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14
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Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SEM, Sharma R, Humaidan P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia 2021; 53:e13874. [PMID: 33108829 PMCID: PMC7988559 DOI: 10.1111/and.13874] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/06/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022] Open
Abstract
We herein summarise the evidence concerning the impact of sperm DNA fragmentation in various clinical infertility scenarios and the advances on sperm DNA fragmentation tests. The collected evidence was used to formulate 41 recommendations. Of these, 13 recommendations concern technical aspects of sperm DNA fragmentation testing, including pre-analytical information, clinical thresholds and interpretation of results. The remaining 28 recommendations relate to indications for sperm DNA fragmentation testing and clinical management. Clinical scenarios like varicocele, unexplained infertility, idiopathic infertility, recurrent pregnancy loss, intrauterine insemination, in vitro fertilisation/intracytoplasmic sperm injection, fertility counselling for men with infertility risk factors and sperm cryopreservation have been contemplated. The bulk evidence supporting the recommendations has increased in recent years, but it is still of moderate to low quality. This guideline provides clinicians with advice on best practices in sperm DNA fragmentation testing. Also, recommendations are provided on possible management strategies to overcome infertility related to sperm DNA fragmentation, based on the best available evidence. Lastly, we identified gaps in knowledge and opportunities for research and elaborated a list of recommendations to stimulate further investigation.
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Affiliation(s)
- Sandro C. Esteves
- ANDROFERT, Andrology and Human Reproduction ClinicReferral Center for Male ReproductionCampinasSPBrazil
- Department of Surgery (Division of Urology)University of Campinas (UNICAMP)CampinasSPBrazil
- Faculty of HealthAarhus UniversityAarhusDenmark
| | - Armand Zini
- Division of UrologyDepartment of SurgerySt. Mary's HospitalMcGill UniversityMontrealQuébecCanada
| | - Robert Matthew Coward
- Department of UrologyUniversity of North CarolinaChapel HillNCUSA
- UNC FertilityRaleighNCUSA
| | - Donald P. Evenson
- SCSA DiagnosticsBrookingsSDUSA
- Sanford Medical SchoolUniversity of South DakotaSioux FallsSDUSA
| | - Jaime Gosálvez
- Unit of GeneticsDepartment of BiologyUniversidad Autónoma de MadridMadridSpain
| | | | - Rakesh Sharma
- American Center for Reproductive MedicineCleveland ClinicClevelandOHUSA
| | - Peter Humaidan
- Faculty of HealthAarhus UniversityAarhusDenmark
- Fertility Clinic SkiveSkive Regional HospitalSkiveDenmark
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15
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Esteves SC. Time has come to provide infertile men with an optimal fertility pathway. Int Braz J Urol 2021; 47:627-630. [PMID: 33621012 PMCID: PMC7993967 DOI: 10.1590/s1677-5538.ibju.2019.0362.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 01/10/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Clínica de Andrologia e Reprodução Humana, Centro de Referência para Re-produção Masculina, Campinas, SP, Brasil.,Departamento de Cirurgia (Disciplina de Urologia), Universidade Estadual de Campinas - UNICAMP, Campinas, SP, Brasil.,Faculty of Health, Aarhus University, Aarhus, Denmark
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16
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Tuncay G, Karaer A, Tanrikut E, Ozgul O. The effect of seminal plasma cadmium and lead levels on semen parameters in male subjects of infertile couples: a prospective cohort study. J OBSTET GYNAECOL 2020; 41:946-950. [PMID: 33226271 DOI: 10.1080/01443615.2020.1820459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this prospective study was to investigate whether there is a relationship between seminal plasma cadmium (Cd) and lead (Pb) levels and semen parameters in male partners of infertile couples. Two hundred fifty one (251) men recruited with no history of occupational exposure to toxic metals. After semen analysis, seminal Cd and Pb levels were measured using atomic absorption spectrometry. Cadmium levels in men with hypospermia was significantly higher than men with normal semen volume (p = .049). In contrast, there was no statistically significant difference in median seminal Pb levels between men with hypospermia and men with normal semen volume (p = .13). There was no statistically significant association between seminal plasma Cd and Pb levels sperm concentration, motility, morphology and total progressively motile sperm count. These findings suggest that environmental Cd exposure may contribute to low semen volume in male partners of infertile couples.IMPACT STATEMENTWhat is already known on this subject? Toxic metals may adversely affect both male and female reproductive system.What the results of this study add? Seminal plasma cadmium levels in men with hypospermia were statistically significantly higher than men with normal semen volume.What the implications are of these findings for clinical practice and/or further research? Patients should be informed about possible adverse effects of toxic metals.
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Affiliation(s)
- Gorkem Tuncay
- Departments of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, School of Medicine, Inonu University, Malatya, Turkey
| | - Abdullah Karaer
- Departments of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, School of Medicine, Inonu University, Malatya, Turkey
| | - Emrullah Tanrikut
- Departments of Obstetrics and Gynecology, Malatya State Hospital, Malatya, Turkey
| | - Onur Ozgul
- Laboratory of Atomic Absorption Spectrometer, Scientific and Technological Research Center, Inonu University, Malatya, Turkey
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17
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Increased Sperm DNA Fragmentation in Infertile Men with Varicocele: Relationship with Apoptosis, Seminal Oxidative Stress, and Spermatic Parameters. Reprod Sci 2020; 28:909-919. [PMID: 32909188 DOI: 10.1007/s43032-020-00311-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/02/2020] [Indexed: 10/23/2022]
Abstract
This study intends to determine the extent of nuclear sperm injury in patients with varicocele and to investigate its relationship with apoptosis and oxidative stress (OS). Ejaculated sperm samples from 51 patients diagnosed with varicocele and 29 fertile men were examined. According to the guidelines, the patient's sperm samples were classified into varicocele with normal semen parameters (n = 11) and varicocele with abnormal semen parameters (n = 40). Sperm DNA fragmentation was assessed using terminal deoxynucleotidyl transferase dUTP nick end labeling assay. The proportion of both viable and dead spermatozoa with externalized phosphatidylserine (PS) was detected by the bivariate annexin V/6-CFDA staining method. Seminal malondialdehyde (MDA) amounts and antioxidant enzymes activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured spectrophotometrically. Sperm DNA fragmentation, viable spermatozoa with externalized PS, and MDA levels were significantly higher in studied subgroups of patients with varicocele, either with normal or with abnormal semen parameters than controls. The seminal antioxidant enzymes activities were significantly reduced in both subgroups of patients with varicocele compared to the controls. The percentage of spermatozoa with fragmented DNA was positively correlated to the MDA level as well as the proportion of viable spermatozoa with externalized PS. However, the decreased seminal antioxidant status was negatively correlated with the increased proportion of sperm DNA fragmentation and apoptotic spermatozoa. Impaired seminal antioxidant profile and increased seminal level of lipid peroxidation may be involved in the pathophysiological mechanisms of cell death-mediated DNA breaks in patients with varicocele.
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18
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Farsimadan M, Motamedifar M. Bacterial infection of the male reproductive system causing infertility. J Reprod Immunol 2020; 142:103183. [PMID: 32853846 DOI: 10.1016/j.jri.2020.103183] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 06/03/2020] [Accepted: 07/29/2020] [Indexed: 12/13/2022]
Abstract
Bacterial infections play a disruptive and hidden role in male reproductive failure. Different kinds of bacteria are often able to interfere with reproductive function in both sexes and lead to infertility. In this study, to further evaluate the role of bacterial infections in male reproduction we provided an extensive overview of so far researches investigating the effects of bacterial infections on male fertility. We searched Medline, PubMed, Scopus and Google scholar databases to identify the potentially relevant studies on bacterial infections and their implications in male infertility. All the bacteria included in this article have negative effects on the male reproductive function; however, there is ample evidence to blame bacteria such as Escherichia coli, Chlamydia trachomatis, Ureaplasma, Mycoplasma and Staphylococcus aureus for reduced fertility and deterioration of sperm parameters. More studies are needed to clarify the molecular mechanisms by which different bacteria exert their detrimental effects on male reproductive system. Getting more insight into probable mechanisms, would significantly facilitate the production of new, advanced, and effective remedies in the future. In view of all evidence, we strongly suggest increasing awareness among people and considering screening programs for patients seeking fertility both to avoid transmission and to improve fertility outcomes among them.
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Affiliation(s)
- Marziye Farsimadan
- Department of Biology, Faculty of Sciences, University of Guilan, Rasht, Iran.
| | - Mohammad Motamedifar
- Department of Bacteriology and Virology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, Iran.
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19
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Xu HY, Jiang H, Feng GS, Feng Y, Han Y, Tang WH, Zhang HX, Chen FH, Zhang HX, Liu DF, Li R, Qiao J. Establishing the lower limits of total serum testosterone among Chinese proven fertile men who received treatment of assisted reproductive technology. Asian J Androl 2020; 22:396-400. [PMID: 31571639 PMCID: PMC7406106 DOI: 10.4103/aja.aja_100_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 07/04/2019] [Indexed: 11/15/2022] Open
Abstract
Testosterone (T) plays a crucial role in spermatogenesis because extremely low levels of intratesticular T lead to correspondingly low serum levels of total T (tT), severe disorders of spermatogenesis, and male sterility. However, there is little consensus on the lower limits of serum tT in proven fertile men undergoing assisted reproductive technology treatments in Chinese or other Asian populations. We aimed to establish the reference range of serum tT based on a population of 868 fertile Chinese men undergoing in vitro fertilization or intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET) treatments. We defined a fertile man as having had a live baby with his partner as recorded in our IVF registration system. The lower limits of serum tT were established using a Siemens IMMULITE 2000 chemiluminescent system. The 1st, 2.5th, and 5th percentiles and their 95% confidence intervals (CIs) were 3.6 (95% CI: 2.7-4.1) nmol l-1, 4.3 (95% CI: 4.1-5.0) nmol l-1, and 5.6 (95% CI: 4.8-5.8) nmol l-1, respectively. Using the linear correlation of serum tT between the Siemens platform and a liquid chromatography-tandem mass spectrometry platform, the calculated lower limits of serum tT were also established for fertile Chinese men undergoing IVF/ICSI-ET treatments, which will benefit the clinical diagnosis and treatment of male infertility during such procedures.
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Affiliation(s)
- Hui-Yu Xu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Hui Jiang
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Guo-Shuang Feng
- Center for Clinical Epidemiology and Evidence-Based Medicine Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
| | - Ying Feng
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Yong Han
- Clinical Research Institute, Zhejiang Provincial People's Hospital, Hangzhou 310014, China
| | - Wen-Hao Tang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Hong-Xian Zhang
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Feng-Hua Chen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Hong-Xia Zhang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - De-Feng Liu
- Department of Urology, Peking University Third Hospital, Beijing 100191, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing 100191, China
- National Clinical Research Center for Obstetrics and Gynecology, Beijing 100191, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
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20
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Infertility: Practical Clinical Issues for Routine Investigation of the Male Partner. J Clin Med 2020; 9:jcm9061644. [PMID: 32486230 PMCID: PMC7356539 DOI: 10.3390/jcm9061644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/25/2020] [Accepted: 05/27/2020] [Indexed: 02/06/2023] Open
Abstract
About one-fifth of couples has fertility problems in Western countries. Male factors are present in about half of them, either alone or in combination with female causes. Therefore, both partners should be evaluated simultaneously. The fertility status and/or specific conditions of each partner influence the clinical and treatment approach. This article summarizes in a practical way when, how, and why the male partner of an infertile couple should be investigated. The available evidence and international guidelines were used, interpreting, discussing, and expanding them from personal decades-long experience in this field. The aim is to delineate the most appropriate clinical approach for the male partner of infertile couples, considering traditional and emerging technologies and laboratory analyses in the context of their clinical significance. Components of the initial evaluation in men without known risk factors for infertility should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, scrotal ultrasound, and transrectal ultrasound are suggested in most men and are mandatory when specific risk factors for male infertility are known to be present or when the initial screening demonstrated abnormalities. Full examination, including genetic tests, testicular histology, or additional tests on sperm, is clinically oriented and/or suggested after the results of initial investigations.
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Chen R, Fussell C, Austin JP, May SE, Wang Q. How Therapists Should Work with Infertile Couples: A Literature Review. JOURNAL OF COUPLE & RELATIONSHIP THERAPY 2020. [DOI: 10.1080/15332691.2020.1757545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Ruoxi Chen
- College of Health Sciences, University of Louisiana at Monroe, Monroe, Louisiana, USA
| | - Cierra Fussell
- College of Health Sciences, University of Louisiana at Monroe, Monroe, Louisiana, USA
| | - Jason P. Austin
- College of Health Sciences, University of Louisiana at Monroe, Monroe, Louisiana, USA
| | - Stephen E. May
- College of Health Sciences, University of Louisiana at Monroe, Monroe, Louisiana, USA
| | - Qilin Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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Halpern JA, Das A, Faw CA, Brannigan RE. Oncofertility in adult and pediatric populations: options and barriers. Transl Androl Urol 2020; 9:S227-S238. [PMID: 32257863 PMCID: PMC7108982 DOI: 10.21037/tau.2019.09.27] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Cancer and its treatments can affect fertility in a variety of ways, and recent advances in cancer detection and treatment have led to an increasing number of cancer survivors for whom future fertility is a primary concern. Oncofertility is the study of interactions between cancer, anti-cancer therapy, fertility, and reproductive health. Fertility preservation aims to optimize fertility potential before initiation of gonadotoxic therapies. Sperm cryopreservation from an ejaculated sample is the gold standard for adults and post-pubertal adolescents, though added maneuvers such as medical therapy, penile vibratory stimulation, and electroejaculation can be employed when appropriate. When all these approaches fail, testicular sperm extraction can be used to obtain and cryopreserve testicular sperm from the azoospermic patient. Fertility preservation in the pre-pubertal pediatric patient is still experimental, but recent scientific breakthroughs with use of spermatogonial stem cells and testicular tissue transplantation offer great promise for the future. While there may be several practical, cultural, religious, and other barriers to fertility preservation, the establishment of a dedicated fertility preservation team can help to overcome these obstacles and optimize the utilization of fertility preservation in cancer patients of all ages.
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Affiliation(s)
- Joshua A Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arighno Das
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Cory A Faw
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Esteves SC, Santi D, Simoni M. An update on clinical and surgical interventions to reduce sperm DNA fragmentation in infertile men. Andrology 2019; 8:53-81. [DOI: 10.1111/andr.12724] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 09/17/2019] [Accepted: 10/08/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Sandro C. Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic Referral Center for Male Reproduction Campinas Brazil
- Department of Surgery (Division of Urology) University of Campinas (UNICAMP) Campinas Brazil
- Faculty of Health Aarhus University Aarhus Denmark
| | - Daniele Santi
- Department of Biomedical, Metabolic, and Neural Sciences University of Modena and Reggio Emilia Modena Italy
- Unit of Endocrinology Department of Medical Specialties Azienda Ospedaliero Universitaria Modena Italy
| | - Manuela Simoni
- Department of Biomedical, Metabolic, and Neural Sciences University of Modena and Reggio Emilia Modena Italy
- Unit of Endocrinology Department of Medical Specialties Azienda Ospedaliero Universitaria Modena Italy
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24
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Li WN, Jia MM, Peng YQ, Ding R, Fan LQ, Liu G. Semen quality pattern and age threshold: a retrospective cross-sectional study of 71,623 infertile men in China, between 2011 and 2017. Reprod Biol Endocrinol 2019; 17:107. [PMID: 31815629 PMCID: PMC6902580 DOI: 10.1186/s12958-019-0551-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to provide information on the semen quality pattern of infertile men and age thresholds for semen parameters in China. METHODS This was a retrospective cross-sectional study investigating 71,623 infertile men from the Reproductive and Genetic Hospital of CITIC Xiangya in Hunan, China, from 2011 to 2017. The Kruskal-Wallis test, Mann-Kendall test, linear regression model and joinpoint regression were used. RESULTS Although erratic changes were observed in the median semen parameters (sperm concentration 40.1-52.1 × 106/ml, total sperm count 117.8-153.1 × 106, sperm progressive motility 33.4-38.1%) during the 7 years of observation, no significant decrease in semen quality was found, and 47.88% of infertile men showed normal semen parameters according to the World Health Organization (WHO) criteria. According to the joinpoint regression analysis, sperm progressive motility appeared to decrease earlier than the sperm concentration and total sperm count (at 28, 58, and 42 years of age, respectively). CONCLUSIONS There is no evidence of a deterioration in semen quality among infertile men in Hunan, China. Semen parameters decreased with increasing age, with turning points noted at different ages. Semen parameters are not absolute evidence for the assessment of male fertility potential. Therefore, we believe that, among semen parameters, the sperm concentration is the best predictor of fertility for ART, followed by motility. Decreased sperm motility may affect natural pregnancy, but it is not necessary for successful IVF.
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Affiliation(s)
- W N Li
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Xiangya Road 84, Kaifu District, Changsha, 410008, Hunan, China
| | - M M Jia
- Northwest Women's and Children's Hospital, Houzaimen Street, Xincheng District, Xi'an, 710000, Shanxi Province, China
| | - Y Q Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Xiangya Road 84, Kaifu District, Changsha, 410008, Hunan, China
| | - R Ding
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China
| | - L Q Fan
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Xiangya Road 84, Kaifu District, Changsha, 410008, Hunan, China
| | - G Liu
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China.
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Fainberg J, Hayden RP, Schlegel PN. Fertility management of Klinefelter syndrome. Expert Rev Endocrinol Metab 2019; 14:369-380. [PMID: 31587581 DOI: 10.1080/17446651.2019.1671821] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
Introduction: Klinefelter syndrome (KS) represents the most common chromosomal abnormality in the general population, and one of the most common genetic etiologies of nonobstructive azoospermia (NOA) and in severe oligospermia. Once considered untreatable, men with KS and NOA now have a variety of treatment options to obtain paternity.Areas covered: The cornerstone of treatment for both KS and NOA patients remains the surgical retrieval of viable sperm, which can be used for intracytoplasmic sperm injection to obtain pregnancy. Although the field has advanced significantly since the early 1990s, approximately half of men with KS will ultimately fail fertility treatments. Presented is a critical review of the available evidence that has attempted to identify predictive factors for successful sperm recovery. To optimize surgical success, a variety of treatment modalities have also been suggested and evaluated, including hormonal manipulation and timing of retrieval.Expert opinion: Individuals with KS have a relatively good prognosis for sperm recovery compared to other men with idiopathic NOA. Surgical success is heavily dependent upon surgical technique and the experience of the andrology/embryology team tasked with the identification and use of testicular sperm.
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Affiliation(s)
| | - Russell P Hayden
- Department of Urology, Weill Cornell Medicine, New York, NY, USA
| | - Peter N Schlegel
- Department of Urology, Weill Cornell Medicine, New York, NY, USA
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Soltani N, Yazarlou F, Akhondi MM, Sobhani M, Modarressi MH, Ghafouri-Fard S. Certain TSGA10 polymorphisms are not associated with male infertility in Iranian population. GENE REPORTS 2019. [DOI: 10.1016/j.genrep.2019.100462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Ahadi M, Aliakbari F, Latifi S, Hosseini SJ, Gharib A, Movafagh A, Abdolalian Z, Dehghan A, Moradi A, Kazeminejad B, Rakhshan A, Jamali E, Allameh F, Moradi A. Evaluation of the Standardization in Semen Analysis Performance According to the WHO Protocols Among Laboratories in Tehran, Iran. IRANIAN JOURNAL OF PATHOLOGY 2019; 14:142-147. [PMID: 31528171 PMCID: PMC6679670 DOI: 10.30699/ijp.14.2.142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 01/14/2019] [Indexed: 11/25/2022]
Abstract
Background and Objective: Infertility refers to the failure in achieving pregnancy of a couple after one year of regular sexual intercourse without using a protection method. The purpose of this research work was to evaluate the current status of the test and quality control performance in semen analysis in selected laboratories. Material and Methods: The semen analysis was performed in the Laboratory of Andrology in terms of macroscopic examination which include volume, color, viscosity, pH and acidity, and in terms of microscopy: the rate of sperm movement, the exact number of sperms per ml of semen, the percentage of sperm viability and movement, the presence of germ cells and white blood cells. Several questions for each part of the test were selected and answered by the director of the laboratories or andrology section supervisor. Results: There was a wide range in the performance of selected medical laboratories in Tehran regarding the standards of semen analysis according to the World Health Organization (WHO) Laboratory Manual for the examination and processing of human semen, fifth edition in 2010. They followed the instructions related to the sample collection in about 70% of the evaluated parameters, initial macroscopic examination in about 87% of the selected subjects, and the microscopic evaluation of sperm in about 65% of the test parameters. Conclusion: some laboratories do not follow the instructions of the WHO in performing semen analysis, and most of them do not follow the suggested methods in all parts of the test.
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Affiliation(s)
- Masha Ahadi
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereshte Aliakbari
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeedeh Latifi
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Jalil Hosseini
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Atossa Gharib
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abolfazl Movafagh
- Department of Medical Genetics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Abdolalian
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arash Dehghan
- Department of Pathology, Hamedan University of Medical Sciences, Hamedan, Iran
| | - Arsham Moradi
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Behrang Kazeminejad
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Rakhshan
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elena Jamali
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Allameh
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Afshin Moradi
- Infertility & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Farquhar CM, Bhattacharya S, Repping S, Mastenbroek S, Kamath MS, Marjoribanks J, Boivin J. Female subfertility. Nat Rev Dis Primers 2019; 5:7. [PMID: 30679436 DOI: 10.1038/s41572-018-0058-8] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Subfertility is common and affects one in six couples, half of whom lack an explanation for their delay in conceiving. Developments in the diagnosis and treatment of subfertility over the past 50 years have been truly remarkable. Indeed, current generations of couples with subfertility are more fortunate than previous generations, as they have many more opportunities to become parents. The timely access to effective treatment for subfertility is important as many couples have a narrow window of opportunity before the age-related effects of subfertility limit the likelihood of success. Assisted reproduction can overcome the barriers to fertility caused by tubal disease and low sperm count, but little progress has been made in reducing the effect of increasing age on ovarian function. The next 5-10 years will likely see further increases in birth rates in women with subfertility, a greater awareness of lifestyle factors and a possible refinement of current assisted reproduction techniques and the development of new ones. Such progress will bring challenging questions regarding the potential benefits and harms of treatments involving germ cell manipulation, artificial gametes, genetic screening of embryos and gene editing of embryos. We hope to see a major increase in fertility awareness, access to safe and cost-effective fertility care in low-income countries and a reduction in the current disparity of access to fertility care.
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Affiliation(s)
- Cynthia M Farquhar
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand.
| | - Siladitya Bhattacharya
- College of Biomedical and Life Sciences, Cardiff University School of Medicine, Cardiff, UK
| | - Sjoerd Repping
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Sebastiaan Mastenbroek
- Amsterdam UMC, University of Amsterdam, Center for Reproductive Medicine, Amsterdam Reproduction & Development research institute, Amsterdam, Netherlands
| | - Mohan S Kamath
- Department of Reproductive Medicine, Christian Medical College, Vellore, India
| | - Jane Marjoribanks
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Jacky Boivin
- School of Psychology, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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Wang H, Ji ZG. Microsurgery Versus Laparoscopic Surgery for Varicocele: A Meta-Analysis and Systematic Review of Randomized Controlled Trials. J INVEST SURG 2018; 33:40-48. [PMID: 30339469 DOI: 10.1080/08941939.2018.1474979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: The goal of this meta-analysis and systematic review is to evaluate the overall effect and safety of microsurgery versus laparoscopic surgery in the treatment of varicocele according to qualified randomized controlled trials (RCTs). Methods: The following electronic databases were searched including PubMed, Cochrane, Embase to identify the qualified studies and publications that were associated with this meta-analysis updated to February 2018 based on index words. The qualified studies only included RCTs. We analyzed the main outcomes through mean difference (MD) and relative risk (RR) along with 95% confidence interval (95% CI). Results: Totally, the current meta-analysis included 23 studies with 1178 patients in the group with microsurgery and 1069 patients in the group with laparoscopic surgery. The results indicated that compared with the laparoscopic surgery group, the microsurgery group could significantly decrease the complication rate (RR: 0.40, 95% CI: 0.21-0.75), as well as the hospital stay (WMD: -0.53, 95% CI: -0.85 to -0.21), increase the sperm concentration after the surgery (WMD: 3.00, 95% CI: 1.23-4.76), and decrease the recurrence rate (RR: 0.35, 95% CI: 0.22-0.55). Besides, there was no significant difference of operation time (SMD: 1.61, 95% CI: 0.71-2.51) and sperm motility (WMD: 2.38, 95% CI: 0.39-4.37) between the two groups. Conclusion: The results demonstrated microsurgery would significantly decrease the complication, hospital stay, and recurrence rate and increase the sperm concentration when compared with laparoscopic surgery. In conclusion, microsurgery is prone to be a better alternative therapy for the treatment of varicocele than laparoscopic surgery.
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Affiliation(s)
- Hai Wang
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhi-Gang Ji
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
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31
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Cao X, Cui Y, Zhang X, Lou J, Zhou J, Bei H, Wei R. Proteomic profile of human spermatozoa in healthy and asthenozoospermic individuals. Reprod Biol Endocrinol 2018; 16:16. [PMID: 29482568 PMCID: PMC5828484 DOI: 10.1186/s12958-018-0334-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 02/22/2018] [Indexed: 01/11/2023] Open
Abstract
Asthenozoospermia is considered as a common cause of male infertility and characterized by reduced sperm motility. However, the molecular mechanism that impairs sperm motility remains unknown in most cases. In the present review, we briefly reviewed the proteome of spermatozoa and seminal plasma in asthenozoospermia and considered post-translational modifications in spermatozoa of asthenozoospermia. The reduction of sperm motility in asthenozoospermic patients had been attributed to factors, for instance, energy metabolism dysfunction or structural defects in the sperm-tail protein components and the differential proteins potentially involved in sperm motility such as COX6B, ODF, TUBB2B were described. Comparative proteomic analysis open a window to discover the potential pathogenic mechanisms of asthenozoospermia and the biomarkers with clinical significance.
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Affiliation(s)
- Xiaodan Cao
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China
| | - Yun Cui
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China
| | - Xiaoxia Zhang
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China
| | - Jiangtao Lou
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China
| | - Jun Zhou
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China
| | - Huafeng Bei
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China
| | - Renxiong Wei
- Department of Clinical Laboratory, Ningbo Municipal Hospital of Traditional Chinese Medicine, Ningbo, 315000, China.
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Esteves SC, Agarwal A, Majzoub A. Best practice statements are not intended to dictate an exclusive course of management. Transl Androl Urol 2017; 6:S683-S684. [PMID: 29082970 PMCID: PMC5643713 DOI: 10.21037/tau.2017.03.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sandro C Esteves
- Androfert, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, Brazil
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, USA
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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33
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Ferlin A. Sperm DNA fragmentation testing as a diagnostic and prognostic parameter of couple infertility. Transl Androl Urol 2017; 6:S618-S620. [PMID: 29082189 PMCID: PMC5643723 DOI: 10.21037/tau.2017.06.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 12/16/2022] Open
Affiliation(s)
- Alberto Ferlin
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
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34
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Esteves SC, Majzoub A, Agarwal A. Further evidence supports the clinical utility of sperm DNA fragmentation testing in male infertility workup and assisted reproductive technology. Transl Androl Urol 2017; 6:S428-S436. [PMID: 29082932 PMCID: PMC5643628 DOI: 10.21037/tau.2017.06.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.,Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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Agarwal A, Cho CL, Majzoub A, Esteves SC. Is National Institute of Clinical Excellence (NICE) guideline a nice guideline? Transl Androl Urol 2017; 6:S615-S617. [PMID: 29082961 PMCID: PMC5643718 DOI: 10.21037/tau.2017.05.21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
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Agarwal A, Cho CL, Majzoub A, Esteves SC. The missing piece in management of infertile couple-clinical andrology. Transl Androl Urol 2017; 6:S481-S483. [PMID: 29082966 PMCID: PMC5643711 DOI: 10.21037/tau.2017.05.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
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37
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Esteves SC, Agarwal A, Cho CL, Majzoub A. A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios. Transl Androl Urol 2017; 6:S734-S760. [PMID: 29082207 PMCID: PMC5643602 DOI: 10.21037/tau.2017.08.20] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Sperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF. Methods A search of papers published in response to the CPG entitled “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” was performed within the Translational Andrology and Urology (TAU) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as “supportive without reservation”, “supportive with reservation”, “not supportive” or “neutral”. We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the ‘Strengths-Weaknesses-Opportunities-Threats’ (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice. Results Fifty-eight fertility experts from six continents and twenty-two countries contributed commentaries. Overall, participants (87.9%; n=51) were supportive of the recommendations provided by the CPG on the utility of SDF testing based on clinical scenarios. The majority of participants made explicit remarks about both the clinical scenarios and SDF assays’ characteristics. Among ‘not supportive’ and ‘supportive with reservation’ participants, 75% (n=30/40) and 77.5% (n=31/40) expressed concerns related to technical limitations of SDF testing methods and clinical utility of the test in one or more clinical scenarios discussed in the CPG, respectively. The SWOT analysis revealed that the CPG provides a reasonable evidence-based proposal for integration of SDF testing in the routine daily practice. It also uncovered gaps of knowledge and threats limiting the widespread application of SDF in everyday practice, thus allowing the identification of opportunities to further refine SDF testing and its clinical utility. Conclusions The understanding of the role of SDF in male infertility requires an in-depth analysis of the multifactorial pathophysiological processes and the theories involved. The SWOT analysis allowed an objective evaluation of CPG on the clinical utility of SDF testing based on clinical scenarios and its accompanying commentaries written by global experts in all possible angles. Implementation of SDF testing in the clinic may not only increase the outcome of ART but more importantly improve the health of both fathers to be and resulting offspring.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.,Division of Urology, Department of Surgery, Universtity of Campinas (UNICAMP), SP, Brazil.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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Esteves SC, Agarwal A, Majzoub A. An evidence-based perspective on the role of sperm chromatin integrity and sperm DNA fragmentation testing in male infertility. Transl Androl Urol 2017; 6:S665-S672. [PMID: 29082963 PMCID: PMC5643668 DOI: 10.21037/tau.2017.05.39] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil.,Division of Urology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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Esteves SC, Majzoub A, Agarwal A. The importance of quality control and quality assurance in SDF testing. Transl Androl Urol 2017; 6:S604-S606. [PMID: 29082943 PMCID: PMC5643611 DOI: 10.21037/tau.2017.05.03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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Esteves SC, Agarwal A, Majzoub A. Unraveling the utility and limitations of clinical practice guidelines. Transl Androl Urol 2017; 6:S506-S508. [PMID: 29082955 PMCID: PMC5643648 DOI: 10.21037/tau.2017.03.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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Esteves SC. Editorial - A missing vas deferens: practical implications for urologists performing vasectomies and managing infertile men. Int Braz J Urol 2017; 42:872-875. [PMID: 27716455 PMCID: PMC5066881 DOI: 10.1590/s1677-5538.ibju.2016.05.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, SP, Brasil
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Jin X, Man C, Gong D, Fan Y. Adjuvant Treatment with Qilin Pill for Men with Oligoasthenospermia: A Meta-Analysis of Randomized Controlled Trials. Phytother Res 2017. [PMID: 28635070 DOI: 10.1002/ptr.5854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Qilin pill has been used in the management of oligoasthenospermia. This meta-analysis aimed to evaluate the effects of Qilin pill as an adjunctive therapy on semen parameters in oligoasthenospermic men. A comprehensive literature search was conducted in PubMed, Embase, Cochrane Library, Wanfang, CNKI, and VIP databases until June 2016. Randomized controlled trials (RCTs) that evaluated Qilin pill as an adjunctive therapy in oligoasthenospermic were included. Dichotomous data and continuous data were calculated as the risk ratio (RR) and mean difference (MD) with their 95% confidence interval (CI), respectively. Eight RCTs involving 778 patients were identified. Adjunctive treatment with Qilin pill significantly improved the semen volume (MD 0.50 mL; 95% CI 0.42-0.59), sperm concentration (MD 5.01 × 106 /mL; 95% CI 3.28-6.75), sperm motility (MD 7.54%; 95% CI 5.64-9.45), grade A sperm (MD 9.75%; 95% CI 4.05-15.45), serum testosterone level (MD 1.66 nM; 95% CI 0.40-2.92), and pregnancy rate (RR 1.46; 95% CI 1.08-1.99) during follow-up. However, differences in the serum follicle-stimulating and luteinizing hormone levels were not significant. Adjunctive treatment with Qilin pill significantly improves the sperm quality in patients with oligoasthenospermia. However, further trials are necessary to investigate the efficacy of Qilin pill on oligoasthenospermia-induced male infertility. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Xin Jin
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Changfeng Man
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Dandan Gong
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
| | - Yu Fan
- Institute of Molecular Biology and Translational Medicine, The Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu, 212002, China
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43
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Rocher L, Glas L, Bellin MF, Ferlicot S, Izard V, Benoit G, Albiges L, Fizazi K, Correas JM. Burned-Out Testis Tumors in Asymptomatic Infertile Men: Multiparametric Sonography and MRI Findings. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:821-831. [PMID: 27914180 DOI: 10.7863/ultra.15.08037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 05/25/2016] [Indexed: 06/06/2023]
Abstract
Multiparametric testicular ultrasound and magnetic resonance imaging (MRI) findings were analyzed in a series of 10 infertile asymptomatic men presenting with pathologically confirmed burned-out testicular tumors. Color/power Doppler ultrasound (CDUS), shear wave elastography (SWE), contrast-enhanced ultrasonography (CEUS), and MRI were performed on 10, 5, 6, and 7 patients, respectively. All lesions appeared as a hypoechoic and hypovascular nodular area at CDUS, SWE, CEUS CDUS, and CEUS (if performed). Shear wave elastography showed a stiffer nodular area compared with the surrounding/contralateral tissues (13 versus 2 kPa); MRI revealed a well-delineated nodular area in hypointense signal on T2, a high apparent diffusion coefficient value, and a lack of enhancement.
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Affiliation(s)
- Laurence Rocher
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
- Paris South Medical University, Le Kremlin Bicêtre, France
| | - Ludivine Glas
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
| | - Marie France Bellin
- Department of Adult Diagnostic and Interventional Radiology, Bicetre University Hospital, Le Kremlin Bicêtre, France
- Paris South Medical University, Le Kremlin Bicêtre, France
| | - Sophie Ferlicot
- Paris South Medical University, Le Kremlin Bicêtre, France
- Department of Pathology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Vincent Izard
- Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Gerard Benoit
- Paris South Medical University, Le Kremlin Bicêtre, France
- Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France
| | - Laurence Albiges
- Paris South Medical University, Le Kremlin Bicêtre, France
- Department of Oncology, the Gustave Roussy Institute, Villejuif, France
| | - Karim Fizazi
- Paris South Medical University, Le Kremlin Bicêtre, France
- Department of Oncology, the Gustave Roussy Institute, Villejuif, France
| | - Jean-Michel Correas
- Department of Adult Radiology, Necker University Hospital, Paris, France
- Paris Descartes University, Paris, France
- Institut Langevin, ESPCI Paris, PSL Research University CNRS UMR 7587, INSERM ERL U-979, Paris, France
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Qu F, Li R, Sun W, Lin G, Zhang R, Yang J, Tian L, Xing GG, Jiang H, Gong F, Liang XY, Meng Y, Liu JY, Zhou LY, Wang SY, Wu Y, He YJ, Ye JY, Han SP, Han JS. Use of electroacupuncture and transcutaneous electrical acupoint stimulation in reproductive medicine: a group consensus. J Zhejiang Univ Sci B 2017; 18:186-193. [PMID: 28271655 PMCID: PMC5369245 DOI: 10.1631/jzus.b1600437] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 10/12/2016] [Indexed: 11/11/2022]
Abstract
With the rapid development of assisted reproductive technology, various reproductive disorders have been effectively addressed. Acupuncture-like therapies, including electroacupuncture (EA) and transcutaneous electrical acupoint stimulation (TEAS), become more popular world-wide. Increasing evidence has demonstrated that EA and TEAS are effective in treating gynecological disorders, especially infertility. This present paper describes how to select acupoints for the treatment of infertility from the view of theories of traditional Chinese medicine and how to determine critical parameters of electric pulses of EA/TEAS based on results from animal and clinical studies. It summarizes the principles of clinical application of EA/TEAS in treating various kinds of reproductive disorders, such as polycystic ovary syndrome (PCOS), pain induced by oocyte retrieval, diminished ovarian reserve, embryo transfer, and oligospermia/ asthenospermia. The possible underlying mechanisms mediating the therapeutic effects of EA/TEAS in reproductive medicine are also examined.
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Affiliation(s)
- Fan Qu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Rong Li
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital /Key Laboratory of Assisted Reproduction, Ministry of Education / Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Wei Sun
- Center of Reproductive Medicine, the Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan 250001, China
| | - Ge Lin
- Center of Reproductive Medicine, CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410008, China
| | - Rong Zhang
- Neuroscience Research Institute, Peking University /Department of Neurobiology, School of Basic Medical Sciences /Peking University Health Science Center / Key Lab for Neuroscience, Ministry of Education/Ministry of Health, Beijing 100083, China
| | - Jing Yang
- Center of Reproductive Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Li Tian
- Center of Reproductive Medicine, Peking University People’s Hospital, Beijing 100044, China
| | - Guo-gang Xing
- Neuroscience Research Institute, Peking University /Department of Neurobiology, School of Basic Medical Sciences /Peking University Health Science Center / Key Lab for Neuroscience, Ministry of Education/Ministry of Health, Beijing 100083, China
| | - Hui Jiang
- Center of Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital /Key Laboratory of Assisted Reproduction, Ministry of Education / Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Beijing 100191, China
| | - Fei Gong
- Center of Reproductive Medicine, CITIC Xiangya Reproductive and Genetic Hospital, Changsha 410008, China
| | - Xiao-yan Liang
- Center of Reproductive Medicine, the Sixth Affiliated Hospital of Zhongshan University, Guangzhou 510655, China
| | - Yan Meng
- Center of Reproductive Medicine, the Sixth Affiliated Hospital of Zhongshan University, Guangzhou 510655, China
| | - Jia-yin Liu
- Center of Reproductive Medicine, the Sixth Affiliated Hospital of Zhongshan University, Guangzhou 510655, China
| | - Li-ying Zhou
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Shu-yu Wang
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yan Wu
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Yi-jing He
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Jia-yu Ye
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
| | - Song-ping Han
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
- Neuroscience Research Institute, Peking University /Department of Neurobiology, School of Basic Medical Sciences /Peking University Health Science Center / Key Lab for Neuroscience, Ministry of Education/Ministry of Health, Beijing 100083, China
| | - Ji-sheng Han
- Neuroscience Research Institute, Peking University /Department of Neurobiology, School of Basic Medical Sciences /Peking University Health Science Center / Key Lab for Neuroscience, Ministry of Education/Ministry of Health, Beijing 100083, China
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45
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Esteves SC, Miyaoka R, Roque M, Agarwal A. Outcome of varicocele repair in men with nonobstructive azoospermia: systematic review and meta-analysis. Asian J Androl 2016; 18:246-53. [PMID: 26680033 PMCID: PMC4770494 DOI: 10.4103/1008-682x.169562] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The objective of this systemic review was to evaluate the benefit of repairing clinical varicocele in infertile men with nonobstructive azoospermia (NOA). The surgically obtained sperm retrieval rate (SRR) and pregnancy rates following assisted reproductive technology (ART) with the use of retrieved testicular sperm were the primary outcomes. The secondary outcomes included the presence of viable sperm in postoperative ejaculate to avoid the testicular sperm retrieval and pregnancy rates (both assisted and unassisted) using postoperative ejaculated sperm. An electronic search to collect the data was performed using the MEDLINE and EMBASE databases until April 2015. Eighteen studies were included in this systematic review and accounted for 468 patients who were diagnosed with NOA and varicocele. These patients were subjected to either surgical varicocele repair or percutaneous embolization. Three controlled studies evaluating sperm retrieval outcomes indicated that in patients who underwent varicocelectomy, SRR increased compared to those without varicocele repair (OR: 2.65; 95% CI: 1.69–4.14; P < 0.001). Although pregnancy rates with the use of testicular sperm favored the varicocelectomy group, results were not statistically significant (clinical pregnancy rate OR: 2.07; 95% CI: 0.92–4.65; P = 0.08; live birth rate OR: 2.19; 95% CI: 0.99–4.83; P = 0.05). The remaining fifteen studies reported postoperative semen analysis results. In 43.9% of the patients (range: 20.8%–55.0%), sperm were found in postoperative ejaculates. Pregnancy rates for unassisted and assisted (after IVF/ICSI) were 13.6% and 18.9% in the group of men with sperm in postoperative ejaculates, respectively. Our findings indicate that varicocelectomy in patients with NOA and clinical varicocele is associated with improved SRR. In addition, approximately 44% of the treated men will have enough sperm in the ejaculate to avoid sperm retrieval. Limited data on pregnancy outcomes with both postoperative ejaculated sperm and harvested testicular sperm preclude any firm conclusion with regard to the possible increased fertility potential in treated individuals. In conclusion, the results of our study indicate that infertile men with NOA and clinical varicocele benefit from varicocelectomy. Given the low/moderate quality of evidence available, it is advisable that doctors discuss with their patients with NOA the risks and benefits of varicocele repair.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Center for Male Reproduction, Av. Dr. Heitor Penteado 1464, Campinas, SP 13075-460, Brazil
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Shridharani A, Owen RC, Elkelany OO, Kim ED. The significance of clinical practice guidelines on adult varicocele detection and management. Asian J Androl 2016; 18:269-75. [PMID: 26806081 PMCID: PMC4770498 DOI: 10.4103/1008-682x.172641] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Varicoceles are the most common correctable etiology of male factor infertility. However, the detection and management of varicoceles have not been standardized. This has led to decades of debate regarding the effect of varicocele on male infertility and subsequently whether repair leads to an improved fertility status. The current body of evidence investigating the role of varicocele and varicocelectomy is weak and conflicting. The stance taken by the AUA and ASRM suggests that there is insufficient outcomes data to support evidenced-based guidelines, citing evidence used to provide current recommendations are generally of a low quality level. On the other hand, the EAU Guidelines give a level 1a of evidence for management of varicoceles that are clinically palpable, associated with subnormal semen analyses and having otherwise unexplained fertility. Besides aiding with clinical varicocele detection and management, clinical practice opinion statements and guidelines aim to direct and strengthen the infrastructure of future studies. We review the current status of opinion statements and guidelines in varicocele and management detection with focus on their application in practice.
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Affiliation(s)
- Anand Shridharani
- Department of Urology, University of Tennessee College of Medicine, Chattanooga, TN 37403, USA
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47
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Esteves SC. Novel concepts in male factor infertility: clinical and laboratory perspectives. J Assist Reprod Genet 2016; 33:1319-1335. [PMID: 27423664 PMCID: PMC5065546 DOI: 10.1007/s10815-016-0763-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 06/22/2016] [Indexed: 12/22/2022] Open
Abstract
In recent years, the management of male factor infertility has undergone important changes with the introduction of novel concepts, advanced testing, and therapeutic interventions. This review highlights some of these changes and discusses their impact to routine clinical practice. First, we discuss the recent changes in the World Health Organization (WHO) laboratory methods and reference values for the examination of human semen. Second, we examine the role of sperm chromatin integrity tests in light of increasing evidence of the detrimental effect of sperm DNA fragmentation on reproductive outcomes. Third, we summarize the main findings of varicocele-related infertility and the outcomes of microsurgical varicocele repair to different case scenarios. Lastly, we critically discuss the current management of men with nonobstructive azoospermia seeking fertility and the new opportunities that emerged to help these men achieve biological fatherhood.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Av. Dr. Heitor Penteado, 1464, Campinas, SP, 13075-460, Brazil.
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Simoni M, Santi D, Negri L, Hoffmann I, Muratori M, Baldi E, Cambi M, Marcou M, Greither T, Baraldi E, Tagliavini S, Carra D, Lombardo F, Gandini L, Pallotti F, Krausz C, Rastrelli G, Ferlin A, Menegazzo M, Pignatti E, Linari F, Marino M, Benaglia R, Levi-Setti PE, Behre HM. Treatment with human, recombinant FSH improves sperm DNA fragmentation in idiopathic infertile men depending on the FSH receptor polymorphism p.N680S: a pharmacogenetic study. Hum Reprod 2016; 31:1960-9. [DOI: 10.1093/humrep/dew167] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 06/07/2016] [Indexed: 12/16/2022] Open
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Esteves SC, Agarwal A, Sharma R, Harlev A. Reply to Eugenio Ventimiglia, Montorsi Francesco, and Andrea Salonia's Letter to the Editor re: Reecha Sharma, Avi Harlev, Ashok Agarwal, Sandro C. Esteves. Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol 2016;70:635-45. Eur Urol 2016; 71:e21-e22. [PMID: 27289568 DOI: 10.1016/j.eururo.2016.05.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 05/27/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Reecha Sharma
- Department of Health Services, Saint Joseph's University, Philadelphia, PA, USA
| | - Avi Harlev
- Fertility and IVF Unit, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
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50
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Zhao J, Dong X, Hu X, Long Z, Wang L, Liu Q, Sun B, Wang Q, Wu Q, Li L. Zinc levels in seminal plasma and their correlation with male infertility: A systematic review and meta-analysis. Sci Rep 2016; 6:22386. [PMID: 26932683 PMCID: PMC4773819 DOI: 10.1038/srep22386] [Citation(s) in RCA: 116] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 02/10/2016] [Indexed: 12/16/2022] Open
Abstract
Zinc is an essential trace mineral for the normal functioning of the male reproductive system. Current studies have investigated the relationship between seminal plasma zinc and male infertility but have shown inconsistent results. Hence, we systematically searched PubMed, EMBASE, Science Direct/Elsevier, CNKI and the Cochrane Library for studies that examined the relationship between seminal plasma zinc and male infertility, as well as the effects of zinc supplementation on sperm parameters. Twenty studies were identified, including 2,600 cases and 867 controls. Our meta-analysis results indicated that the seminal plasma zinc concentrations from infertile males were significantly lower than those from normal controls (SMD (standard mean differences) [95% CI] −0.64 [−1.01, −0.28]). Zinc supplementation was found to significantly increase the semen volume, sperm motility and the percentage of normal sperm morphology (SMD [95% CI]: −0.99 [−1.60, −0.38], −1.82 [−2.63, −1.01], and −0.75 [−1.37, −0.14], respectively). The present study showed that the zinc level in the seminal plasma of infertile males was significantly lower than that of normal males. Zinc supplementation could significantly increase the sperm quality of infertile males. However, further studies are needed to better elucidate the correlation between seminal plasma zinc and male infertility.
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Affiliation(s)
- Jiang Zhao
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Xingyou Dong
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Xiaoyan Hu
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Zhou Long
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Liang Wang
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Qian Liu
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Bishao Sun
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Qingqing Wang
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Qingjian Wu
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
| | - Longkun Li
- Department of Urology, Second Affiliated Hospital, Third Military Medical University, Chongqing, 400037, China
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