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Bolouki A, Zal F. Impact of War on Fertility and Infertility. ARCHIVES OF IRANIAN MEDICINE 2020; 23:S16-S22. [PMID: 32349503 DOI: 10.34172/aim.2020.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 10/12/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND War causes more death and disability than many major diseases. There are few studies in the context of the deleterious impact of war on fertility potential; therefore, in this study, we tried to review articles about the adverse effects of war on male/ female fertility potential. METHODS In this study, a total of 183 articles related to the effects of war on fertility potential were examined by a systematic search using known international medical databases. RESULTS Among these studies, there were limited studies on the effects of war on female infertility and most studies examined the effects of war on sperm parameters and male infertility. The physical and psychological trauma of war can increase the risk of infertility in men and women. Presence of reproductive system toxins in weapons, stressful periods of war and direct damage to the reproductive system can impair the fertility of men and women. The way war affects male fertility is not clear, but the higher degree of stress during wartime seems to play an important role. Using reproductive toxicants during the war also increases the risk of impairment in reproductive function in men. Some studies have shown the harmful effects of Sulfur mustard as a war chemical toxin especially on sperm quality and male infertility. Oxidative stress induced by free radicals is a major mechanism for the direct effects of Sulfur mustard on male infertility. CONCLUSION The study of past research suggests that exposure to war may be an independent risk factor for reproductive disorders and infertility in men. For female infertility, war leads to menstrual dysfunction.
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Affiliation(s)
- Ayeh Bolouki
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Zal
- Biochemistry Department, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.,Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Wesselink AK, Hatch EE, Rothman KJ, Weuve JL, Aschengrau A, Song RJ, Wise LA. Perceived Stress and Fecundability: A Preconception Cohort Study of North American Couples. Am J Epidemiol 2018; 187:2662-2671. [PMID: 30137198 DOI: 10.1093/aje/kwy186] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/16/2018] [Indexed: 11/14/2022] Open
Abstract
While some epidemiologic studies support the hypothesis that stress can adversely affect fertility, few prospective studies have assessed the association in couples from the general population. We used data from Pregnancy Study Online, a web-based preconception cohort study of pregnancy planners from the United States and Canada (2013-2018), to examine the association between women's and men's perceived stress levels prior to conception and fecundability. Women (aged 21-45 years) and their male partners (aged ≥21 years) who were attempting conception without fertility treatment were eligible. We measured perceived stress using the 10-item Perceived Stress Scale (PSS). We ascertained pregnancy information using bimonthly follow-up questionnaires of female participants. We followed 4,769 couples until self-reported pregnancy, initiation of fertility treatment, loss to follow-up, or 12 menstrual cycles of attempt time, whichever came first. We used proportional probabilities regression models to estimate fecundability ratios and 95% confidence intervals, adjusting for potential confounders. Higher PSS scores among the women were associated with slight reductions in fecundability (comparing PSS scores of ≥25 vs. <10, fecundability ratio = 0.87, 95% confidence interval: 0.74, 1.02). PSS scores among the men were not substantially associated with fecundability.
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Affiliation(s)
- Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
- RTI International, Research Triangle Park, North Carolina
| | - Jennifer L Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Ann Aschengrau
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Rebecca J Song
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
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García-Vázquez FA, Gadea J, Matás C, Holt WV. Importance of sperm morphology during sperm transport and fertilization in mammals. Asian J Androl 2017; 18:844-850. [PMID: 27624988 PMCID: PMC5109874 DOI: 10.4103/1008-682x.186880] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
After natural or artificial insemination, the spermatozoon starts a journey from the site of deposition to the place of fertilization. However, only a small subset of the spermatozoa deposited achieves their goal: to reach and fertilize the egg. Factors involved in controlling sperm transport and fertilization include the female reproductive tract environment, cell-cell interactions, gene expression, and phenotypic sperm traits. Some of the significant determinants of fertilization are known (i.e., motility or DNA status), but many sperm traits are still indecipherable. One example is the influence of sperm dimensions and shape upon transport within the female genital tract towards the oocyte. Biophysical associations between sperm size and motility may influence the progression of spermatozoa through the female reproductive tract, but uncertainties remain concerning how sperm morphology influences the fertilization process, and whether only the sperm dimensions per se are involved. Moreover, such explanations do not allow the possibility that the female tract is capable of distinguishing fertile spermatozoa on the basis of their morphology, as seems to be the case with biochemical, molecular, and genetic properties. This review focuses on the influence of sperm size and shape in evolution and their putative role in sperm transport and selection within the uterus and the ability to fertilize the oocyte.
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Affiliation(s)
- Francisco A García-Vázquez
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research "Campus Mare Nostrum", University of Murcia, Murcia 30100, Spain.,Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Joaquín Gadea
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research "Campus Mare Nostrum", University of Murcia, Murcia 30100, Spain.,Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - Carmen Matás
- Department of Physiology, Faculty of Veterinary Science, International Excellence Campus for Higher Education and Research "Campus Mare Nostrum", University of Murcia, Murcia 30100, Spain.,Institute for Biomedical Research of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - William V Holt
- Department of Human Metabolism, Academic Unit of Reproductive and Developmental Medicine, Sheffield S10 2SF, UK
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Schrader SM, Marlow KL. Assessing the reproductive health of men with occupational exposures. Asian J Androl 2014; 16:23-30. [PMID: 24369130 PMCID: PMC3901877 DOI: 10.4103/1008-682x.122352] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 08/24/2013] [Accepted: 08/28/2013] [Indexed: 12/16/2022] Open
Abstract
The earliest report linking environmental (occupational) exposure to adverse human male reproductive effects dates back to1775 when an English physician, Percival Pott, reported a high incidence of scrotal cancer in chimney sweeps. This observation led to safety regulations in the form of bathing requirements for these workers. The fact that male-mediated reproductive harm in humans may be a result of toxicant exposures did not become firmly established until relatively recently, when Lancranjan studied lead-exposed workers in Romania in 1975, and later in 1977, when Whorton examined the effects of dibromochloropropane (DBCP) on male workers in California. Since these discoveries, several additional human reproductive toxicants have been identified through the convergence of laboratory and observational findings. Many research gaps remain, as the pool of potential human exposures with undetermined effects on male reproduction is vast. This review provides an overview of methods used to study the effects of exposures on male reproduction and their reproductive health, with a primary emphasis on the implementation and interpretation of human studies. Emphasis will be on occupational exposures, although much of the information is also useful in assessing environmental studies, occupational exposures are usually much higher and better defined.
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Affiliation(s)
- Steven M Schrader
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Applied Research and Technology, Cincinnati, OH, USA
| | - Katherine L Marlow
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Applied Research and Technology, Cincinnati, OH, USA
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6
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Oberson D, Lafon D. Pollutions environnementales et effets sur la reproduction : un regard sur le passé. ARCH MAL PROF ENVIRO 2010. [DOI: 10.1016/j.admp.2010.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
There is accumulating evidence that workplace exposure to toxic substances contributes to male infertility. Men suffering from infertility problems may do well to look at their occupations, where exposure to certain substances may be a contributory factor, if not a direct cause, of infertility. Most of the studies to date are either case reports or epidemiological studies (population-based, case-control, or cohort studies). Additional, controlled studies need to be done to ascertain the effects of occupational toxins on male infertility. Until then, men and their employers should work together to minimize exposure to these substances.
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Affiliation(s)
- Paul Claman
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, University of Ottawa Faculty of Medicine, Ottawa Hospital, Ottawa, Ontario, Canada.
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Doyle P, Maconochie N, Ryan M. Reproductive health of Gulf War veterans. Philos Trans R Soc Lond B Biol Sci 2006; 361:571-84. [PMID: 16687262 PMCID: PMC1569619 DOI: 10.1098/rstb.2006.1817] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
In this review we summarize the scientific literature on reproductive health following deployment to the first Gulf war by armed service personnel. All the studies examined had methodological limitations, making interpretation difficult. Nonetheless we conclude that for male veterans there is no strong or consistent evidence to date for an effect of service in the first Gulf war on the risk of major, clearly defined, birth defects or stillbirth in offspring conceived after deployment. Effects on specific rare defects cannot be excluded at this stage since none of the studies had the statistical power to examine them. For miscarriage and infertility, there is some evidence of small increased risks associated with service, but the role of bias is likely to be strong. For female veterans, there is insufficient information to make robust conclusions, although the weight of evidence to date does not indicate any major problem associated specifically with deployment to the Gulf. None of the studies have been able to examine risk according particular exposures, and so possible associations with specific exposures for smaller groups of exposed veterans cannot be excluded. We suggest that the way forward to address the question of veterans' reproductive health with confidence in the future is prospective surveillance following deployment. Anything less will result in further problems of interpretation and continued anxiety for parents, as well as prospective parents, in the armed forces.
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Affiliation(s)
- Patricia Doyle
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, UK.
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Boone WR, Jones JM, Shapiro SS. Using videotaped specimens to test quality control in a computer-assisted semen analysis system. Fertil Steril 2000; 73:636-40. [PMID: 10689026 DOI: 10.1016/s0015-0282(99)00575-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To determine the feasibility of using semen samples previously recorded on videotape for intralaboratory and interlaboratory quality control of computer-assisted semen analysis (CASA) systems. DESIGN Blinded, controlled study. SETTING Pooled semen specimens from two normal human volunteers in an academic research environment. PATIENT(S) None. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Semen parameters from a videotape analyzed internally and by four external laboratories. RESULT(S) Preliminary experiments designed to examine intralaboratory variation by repeated analysis of semen samples recorded on videotape revealed some significant differences for every variable examined. When these data were analyzed by using the larger biologic error caused by subsampling, no significant differences were found for any of the variables examined. When either a standard set or the specific laboratories' sets of parameters were used to analyze the same videotaped semen specimen, no statistically significant differences were detected for sperm concentration for motility among the five laboratories after the biological error caused by subsampling was applied to results. CONCLUSION(S) These data strongly suggest that videotaped semen specimens can serve as quality control for intralaboratory and interlaboratory testing of CASA equipment as long as the biologic error caused by subsampling is used to compare results.
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Affiliation(s)
- W R Boone
- Department of Obstetrics and Gynecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Ecochard R, Cottinet D, Mathieu C, Rabilloud M, Czyba JC. The mean of sperm parameters in semen donations from the same donor. An important prognostic factor in insemination. INTERNATIONAL JOURNAL OF ANDROLOGY 1999; 22:163-72. [PMID: 10367236 DOI: 10.1046/j.1365-2605.1999.00164.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We analysed 12,100 consecutive cycles of artificial insemination by donor spermatozoa in 1901 infertile couples. In our analysis, particular attention was given to finding an appropriate way of taking into account the respective effects of female and male factors on the pregnancy success rate and the level at which these factors act (cycle vs. woman and donation vs. donor). A total of 1213 pregnancies occurred. The pregnancy rate per cycle was lower as the age of the woman increased (p < 0.0001) and varied with the type of infertility: fecundity was higher (p = 0.03) in the case of azoospermia than of severe oligozoospermia. After taking into account these factors, significant unexplained variation in likelihood to conceive remained. A part of this heterogeneity was shown to be due to variation in fecundability between semen donors. In order to explain this heterogeneity between donors, compositional covariates were used, particularly the mean of results of the semen analysis performed for donations from the same donor. For each semen characteristic, the overall mean of the different donations of a donor was an important predictive factor of successful insemination: after taking into account all of the other factors, the odds ratios for an increase of 50 x 10(6)/mL spermatozoa, of a 20% increase in sperm motility and of a 2 point increase in the post-thaw quality index, were, respectively, 1.13, 1.37 and 1.56. After adjustment for these factors, the specific characteristics of each semen donation were no longer significantly predictive of successful insemination. This observation has a biological interpretation: sperm with low parameters but produced by a normally fertile man can have a satisfactory success rate.
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Affiliation(s)
- R Ecochard
- Département d'Information Médicale, Hospices Civils de Lyon, France
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12
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Abstract
The rate of morphologically normal and abnormal spermatozoa plays a role in the prediction of male fertility and in the description of the integrity of spermatogenesis. It is thus important to estimate sperm morphology with reproducible results. For this purpose, several systems using computer-assisted image analysis were developed, similar to those used for the determination of sperm motility, which are known as CASA-systems. We tested an advanced CASA-system using a neuronal network, which could be trained for the determination of classes of morphology defined by the WHO group. For the first time, this system also provided the automatic determination of midpieces and sperm tails. The system revealed no significant differences of the percentage of normal forms when compared to the direct microscopical estimation. However, nearly all the classes of pathological sperm heads were estimated by the two methods as being significantly different. Concerning midpieces, the neuronal net was unable to classify the normal forms correctly. The estimation of normal sperm tails by the two methods led to a sufficient correlation of values. Other classes of sperm tails, like curled or kinked tails, were not recognized by the software. The investigation time with the CASA system was twice as long as with the direct microscopical evaluation. Since functional characteristics of spermatozoa cannot be read from morphological parameters, it would be of use to measure the functional parameters directly. The main advantages of a CASA-system for sperm morphometry concerns laboratory quality controls.
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Affiliation(s)
- P Steigerwald
- Department of Andrology, Faculty of Medicine, Philipps-Universität, Marburg a.d. Lahn, Germany
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Casey PJ, Gravance CG, Davis RO, Chabot DD, Liu IK. Morphometric differences in sperm head dimensions of fertile and subfertile stallions. Theriogenology 1997; 47:575-82. [PMID: 16728009 DOI: 10.1016/s0093-691x(97)00015-0] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/1995] [Accepted: 06/13/1996] [Indexed: 10/17/2022]
Abstract
Gross morphological evaluation of stallion spermatozoa is of clinical value in assessing male fertility in the horse. While of value, methods of subjective sperm classification yield highly variable results. Recent development of computer-assisted sperm morphometry analysis (ASMA) technology has allowed for the objective analysis of sperm head morphometry. In the current study, ASMA was employed to determine morphometric differences in sperm head dimensions between fertile and subfertile stallions. At least 200 spermatozoa from each of 10 fertile and 10 subfertile stallions were analyzed by a commercial ASMA instrument. The mean measurements for length, width, area, perimeter, and width/length for each stallion were recorded and group means compared by a two-sample t-test. The mean measurements for length, area and perimeter were significantly larger in the subfertile than the fertile group (5.77 microm vs 5.33 microm, 12.66 microm vs 11.37 microm and 14.59 microm vs 13.64 microm, respectively). The width of sperm heads from stallions in the subfertile group also tended to be larger than those of fertile stallions. The data suggest that differences in the dimensions of sperm heads may exist between fertile and subfertile stallions.
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Affiliation(s)
- P J Casey
- Department of Obstetrics and Gynecology, Research Centre in Reproductive Medicine, National Women's Hospital, University of Auckland, Auckland, New Zealand
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Davis RO, Bain DE, Siemers RJ, Thal DM, Andrew JB, Gravance CG. Accuracy and precision of the CellForm-Human**CellForm-Human automated sperm morphometry instrument (Motion Analysis Corp., Santa Rosa, California). automated sperm morphometry instrument††Presented at the 17th Annual Meeting of the American Society of Andrology, Bethesda, Maryland, March 27 to 30, 1992.‡‡Supported, in part, by grant RO1-HD25907 from the National Institutes of Health, Bethesda, Maryland. Fertil Steril 1992. [DOI: 10.1016/s0015-0282(16)55325-4] [Citation(s) in RCA: 47] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Eskenazi B, Wyrobek AJ, Fenster L, Katz DF, Sadler M, Lee J, Hudes M, Rempel DM. A study of the effect of perchloroethylene exposure on semen quality in dry cleaning workers. Am J Ind Med 1991; 20:575-91. [PMID: 1793101 DOI: 10.1002/ajim.4700200502] [Citation(s) in RCA: 52] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The purpose of this investigation was to determine the effects of perchloroethylene (PCE) exposure on human semen quality. We compared the semen quality of 34 dry cleaners with that of 48 laundry workers. We examined the relationships of 17 semen parameters to expired air levels of PCE and to an index of exposure based on job tasks in the last three months. The average sperm concentration was over 80 million for both dry cleaners and laundry workers, but approximately one-quarter of each group was oligospermic. The overall percentage of abnormal forms was similar for the two groups; however, sperm of dry cleaners were significantly more likely to be round (t = -3.29, p = 0.002) and less likely to be narrow (t = 2.35, p = 0.02) than the sperm of laundry workers. These effects were dose-related to expired air levels and to the exposure index after controlling for potential confounders (e.g., heat exposure). The average percent motile sperm for both groups was slightly over 60%; however, sperm of dry cleaners tended to swim with greater amplitude of lateral head displacement (ALH) than those of laundry workers (t = -1.73, p = 0.09), and level of PCE in expired air was a significant predictor of ALH in the multiple regression model (t = 2.00, p = 0.05). In addition, exposure index was a significant negative predictor of the sperm linearity parameter (t = -2.57, p = 0.01). These results suggest that occupational exposures to PCE can have subtle effects on sperm quality. Additional analyses are required to determine whether these effects are associated with changes in fertility.
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Affiliation(s)
- B Eskenazi
- Program of Maternal and Child Health, School of Public Health, University of California, Berkeley 94720
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