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Virtanen HE, Rodprasert W, Toppari J. Deteriorating Semen Quality: The Role of the Environment. Semin Reprod Med 2023; 41:226-240. [PMID: 38499038 DOI: 10.1055/s-0044-1782151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Since the end of the last century, several reports have suggested that semen quality is declining, especially in Western countries. Furthermore, cross-sectional studies using similar protocols have suggested regional differences in semen quality of young and fertile men. Reasons for these regional differences and local adverse trends in semen quality are unknown, but environmental factors are suspected to have a role. Besides adulthood environmental exposures, those occurring during testicular development may also affect semen quality. Longitudinal follow-up studies and mixture risk analyses are needed to study the effect of fetal, childhood, and adult life environment on semen quality.
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Affiliation(s)
- Helena E Virtanen
- Research Centre for Integrative Physiology and Pharmacology and Centre for Population Health Research, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Wiwat Rodprasert
- Research Centre for Integrative Physiology and Pharmacology and Centre for Population Health Research, Institute of Biomedicine, University of Turku, Turku, Finland
| | - Jorma Toppari
- Research Centre for Integrative Physiology and Pharmacology and Centre for Population Health Research, Institute of Biomedicine, University of Turku, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
- Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
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2
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Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Jolles M, Pinotti R, Swan SH. Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Hum Reprod Update 2023; 29:157-176. [PMID: 36377604 DOI: 10.1093/humupd/dmac035] [Citation(s) in RCA: 167] [Impact Index Per Article: 167.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/29/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Numerous studies have reported declines in semen quality and other markers of male reproductive health. Our previous meta-analysis reported a significant decrease in sperm concentration (SC) and total sperm count (TSC) among men from North America-Europe-Australia (NEA) based on studies published during 1981-2013. At that time, there were too few studies with data from South/Central America-Asia-Africa (SAA) to reliably estimate trends among men from these continents. OBJECTIVE AND RATIONALE The aim of this study was to examine trends in sperm count among men from all continents. The broader implications of a global decline in sperm count, the knowledge gaps left unfilled by our prior analysis and the controversies surrounding this issue warranted an up-to-date meta-analysis. SEARCH METHODS We searched PubMed/MEDLINE and EMBASE to identify studies of human SC and TSC published during 2014-2019. After review of 2936 abstracts and 868 full articles, 44 estimates of SC and TSC from 38 studies met the protocol criteria. Data were extracted on semen parameters (SC, TSC, semen volume), collection year and covariates. Combining these new data with data from our previous meta-analysis, the current meta-analysis includes results from 223 studies, yielding 288 estimates based on semen samples collected 1973-2018. Slopes of SC and TSC were estimated as functions of sample collection year using simple linear regression as well as weighted meta-regression. The latter models were adjusted for predetermined covariates and examined for modification by fertility status (unselected by fertility versus fertile), and by two groups of continents: NEA and SAA. These analyses were repeated for data collected post-2000. Multiple sensitivity analyses were conducted to examine assumptions, including linearity. OUTCOMES Overall, SC declined appreciably between 1973 and 2018 (slope in the simple linear model: -0.87 million/ml/year, 95% CI: -0.89 to -0.86; P < 0.001). In an adjusted meta-regression model, which included two interaction terms [time × fertility group (P = 0.012) and time × continents (P = 0.058)], declines were seen among unselected men from NEA (-1.27; -1.78 to -0.77; P < 0.001) and unselected men from SAA (-0.65; -1.29 to -0.01; P = 0.045) and fertile men from NEA (-0.50; -1.00 to -0.01; P = 0.046). Among unselected men from all continents, the mean SC declined by 51.6% between 1973 and 2018 (-1.17: -1.66 to -0.68; P < 0.001). The slope for SC among unselected men was steeper in a model restricted to post-2000 data (-1.73: -3.23 to -0.24; P = 0.024) and the percent decline per year doubled, increasing from 1.16% post-1972 to 2.64% post-2000. Results were similar for TSC, with a 62.3% overall decline among unselected men (-4.70 million/year; -6.56 to -2.83; P < 0.001) in the adjusted meta-regression model. All results changed only minimally in multiple sensitivity analyses. WIDER IMPLICATIONS This analysis is the first to report a decline in sperm count among unselected men from South/Central America-Asia-Africa, in contrast to our previous meta-analysis that was underpowered to examine those continents. Furthermore, data suggest that this world-wide decline is continuing in the 21st century at an accelerated pace. Research on the causes of this continuing decline and actions to prevent further disruption of male reproductive health are urgently needed.
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Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Niels Jørgensen
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | | | - Jaime Mendiola
- Division of Preventive Medicine and Public Health, University of Murcia School of Medicine and Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), Murcia, Spain
| | - Dan Weksler-Derri
- Clalit Health Services, Kiryat Ono, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Maya Jolles
- Braun School of Public Health and Community Medicine, Hadassah Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Rachel Pinotti
- Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Belladelli F, Chen T, Basran S, Greenberg DR, Del Giudice F, Mulloy E, Chen CH, Cheng YS, Salonia A, Eisenberg ML. The Association between Monthly, Yearly, and Lifetime Cannabis Use, and Semen Parameters in Asian-American Men. World J Mens Health 2022:40.e61. [PMID: 36047080 DOI: 10.5534/wjmh.220106] [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: 05/23/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Medicinal and recreational cannabis use has grown exponentially, however, its effect on testicular function and spermatogenesis remains uncertain. The aim of this study was to evaluate the association between cannabis use and semen parameters in a cohort of Asian-American men with unknown fertility. MATERIALS AND METHODS Asian men were recruited to complete an online survey and submit a semen sample. Semen analysis, demographic data, lifestyle factors, and cannabis use habits were collected. Linear and logistic regression analyses were used to determine. RESULTS Among the 112 men included in this study, 51 used cannabis at least once in their lifetime, 30 men used cannabis at least once in the last 12 months, and 26 men used cannabis at least once in the last 30 days. Adjusted linear regression analyses identified an association between cannabis use in the previous 30 days and worse sperm morphology (β: -0.45, p=0.025) and sperm motility (β: -1.64, p=0.016). However, when stratifying by subfertile semen quality (i.e., WHO criteria), no association was identified between semen quality and cannabis use. Lower sperm morphology and motility are partially associated with recent cannabis use, while all other semen parameters are not. CONCLUSIONS We did not observe any consistent associations between cannabis use on any semen parameters in Asian-American men. Further studies within the field are needed to explore racial and ethnic differences in semen quality and lifestyle factors.
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Affiliation(s)
- Federico Belladelli
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy.,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.,Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Tony Chen
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Satvir Basran
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Daniel R Greenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Francesco Del Giudice
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA.,Department of Urology, University Sapienza, Rome, Italy
| | - Evan Mulloy
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Che-Hong Chen
- Department of Chemical and Systems Biology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Yu-Sheng Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy.,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA.
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Auger J, Eustache F, Chevrier C, Jégou B. Spatiotemporal trends in human semen quality. Nat Rev Urol 2022; 19:597-626. [PMID: 35978007 PMCID: PMC9383660 DOI: 10.1038/s41585-022-00626-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/09/2022]
Abstract
Over the past four decades, studies of various designs have reported spatial and temporal trends in human semen quality. Several standardized-methodology studies in homogeneous populations that compare specific cities within a country or a continent provide clear evidence of geographical differences in sperm production, even over short distances within the same country. Human sperm production is widely believed to be declining over time, but evidence from the scientific literature is less clear. Studies based on repeated cross-sectional data from a single centre have shown mixed results. Among the numerous retrospective studies conducted in a single centre, only some included homogeneous groups of men and appropriate methods, and most of them suggest a temporal decrease in human sperm production in the geographical areas considered. Conclusions reporting temporal trends in sperm production that came from existing retrospective multicentre studies based on individual semen data and those using means, medians or estimates of sperm production are questionable, owing to intrinsic limitations in the studies performed. Regardless of study design, studies on the percentage of motile or morphologically normal spermatozoa are still limited by the inherent variability in assessment. Overall, available data do not enable us to conclude that human semen quality is deteriorating worldwide or in the Western world, but that a trend is observed in some specific areas. To understand these trends and contrasts in sperm and semen quality, prospective studies should be encouraged and combined with assessment of the male exposome. Several studies over the past few decades have suggested that sperm quality varies by geographical region and might be subject to a temporal decline worldwide. However, the data supporting these conclusions have come from studies of various methodologies and heterogeneous populations, making them unreliable. In this in-depth Review, Chevrier and colleagues discuss the data surrounding discussion of spatiotemporal trends in semen parameters and consider how these trends and the factors promoting them interact. The vast literature on human semen quality trends is extremely heterogeneous in terms of the populations studied and study designs, and so these studies have been unable to draw firm conclusions. Understanding the data around spatiotemporal semen trends requires a focus on the methodological choices and application of criteria to filter findings from the studies with optimal design. Numerous appropriately designed studies suggest unambiguous geographical contrasts in human sperm production; however, evidence of a decline in sperm production is reliable only in specific populations and cities in which studies with a complete set of quality criteria have been conducted. By contrast, suggestions of a worldwide drop in human semen quality on the basis of retrospective multicentre studies cannot be substantiated, owing to intrinsic limitations in the studies performed. Many and varied factors of variation, in particular the diverse modalities of assessment, do not enable us to conclude that clear temporal trends of sperm motility and normal morphology are present. Progress in our understanding of the highlighted trends and their causal factors requires prospective studies that minimize all known biases combined with the assessment of men’s exposome.
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Affiliation(s)
- Jacques Auger
- INSERM U1016-Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes-Paris, Paris, France
| | - Florence Eustache
- INSERM U1016-Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes-Paris, Paris, France.,CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Jean Verdier and Service de Biologie de la Reproduction, Hôpitaux Universitaires Paris Nord Val de Seine, Hôpital Bichat, Paris, France
| | - Cécile Chevrier
- Université Rennes, INSERM, EHESP, IRSET-UMR_S 1085, Rennes, France.
| | - Bernard Jégou
- Université Rennes, INSERM, EHESP, IRSET-UMR_S 1085, Rennes, France
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5
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Andersen E, Juhl CR, Kjøller ET, Lundgren JR, Janus C, Dehestani Y, Saupstad M, Ingerslev LR, Duun OM, Jensen SBK, Holst JJ, Stallknecht BM, Madsbad S, Torekov SS, Barrès R. Sperm count is increased by diet-induced weight loss and maintained by exercise or GLP-1 analogue treatment: a randomized controlled trial. Hum Reprod 2022; 37:1414-1422. [PMID: 35580859 PMCID: PMC9247415 DOI: 10.1093/humrep/deac096] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 03/25/2022] [Indexed: 01/11/2023] Open
Abstract
STUDY QUESTION Does diet-induced weight loss improve semen parameters, and are these possible improvements maintained with sustained weight loss? SUMMARY ANSWER An 8-week low-calorie diet-induced weight loss was associated with improved sperm concentration and sperm count, which were maintained after 1 year in men who maintained weight loss. WHAT IS KNOWN ALREADY Obesity is associated with impaired semen quality. Weight loss improves metabolic health in obesity, but there is a lack of knowledge on the acute and long-term effects of weight loss on semen parameters. STUDY DESIGN, SIZE, DURATION This is a substudy of men with obesity enrolled in a randomized, controlled, double-blinded trial (the S-LITE trial). The trial was conducted between August 2016 and November 2019. A total of 56 men were included in the study and assigned to an initial 8-week low-calorie diet (800 kcal/day) followed by randomization to 52 weeks of either: placebo and habitual activity (placebo), exercise training and placebo (exercise), the Glucagon Like Peptide 1 (GLP-1) analogue liraglutide and habitual activity (liraglutide) or liraglutide in combination with exercise training (combination). PARTICIPANTS/MATERIALS, SETTING, METHODS Inclusion criteria were men who delivered semen samples, 18 to 65 years of age, and a body mass index between 32 and 43 kg/m2, but otherwise healthy. The study was carried out at Hvidovre Hospital and at the University of Copenhagen, and the participants were from the Greater Copenhagen Area. We assessed semen parameters and anthropometrics and collected blood samples before (T0), after the 8-week low-calorie dietary intervention (T1), and after 52 weeks (T2). MAIN RESULTS AND THE ROLE OF CHANCE The men lost on average 16.5 kg (95% CI: 15.2-17.8) body weight during the low-calorie diet, which increased sperm concentration 1.49-fold (95% CI: 1.18-1.88, P < 0.01) and sperm count 1.41-fold (95% CI: 1.07-1.87, P < 0.01). These improvements were maintained for 52 weeks in men who maintained the weight loss, but not in men who regained weight. Semen volume, sperm motility and motile sperm count did not change. LIMITATIONS, REASONS FOR CAUTION The S-LITE trial was a randomized controlled trial of weight loss maintenance. Analysis of semen was preregistered to explore the effects of weight loss and weight loss maintenance on semen parameters, but definite inferences cannot be made. WIDER IMPLICATIONS OF THE FINDINGS This study shows that sperm concentration and sperm count were improved after a diet-induced weight loss in men with obesity. Our findings indicate that either or both liraglutide and exercise as weight maintenance strategies may be used to maintain the improvements in sperm concentration and count. STUDY FUNDING/COMPETING INTEREST(S) This work is supported by an excellence grant from the Novo Nordisk Foundation (NNF16OC0019968), a Challenge Programme Grant from the Novo Nordisk Foundation (NNF18OC0033754) and a grant from Helsefonden. The Novo Nordisk Foundation Center for Basic Metabolic Research is an independent research centre at the University of Copenhagen, partially funded by an unrestricted donation from the Novo Nordisk Foundation (NNF18CC0034900). Saxenda (liraglutide) and placebo pens were provided by Novo Nordisk. Cambridge Weight Plan diet products for the 8-week low-calorie diet were provided by Cambridge Weight Plan. E.A.: shareholder, employee of ExSeed Health Ltd. Grant Recipient from ExSeed Health Ltd and listed on Patents planned, issued or pending with ExSeed Health Ltd; J.J.H.: consultant for Eli Lilly A/S and Novo Nordisk A/S. Lecture fees for Novo Nordisk A/S. Listed on Patents planned, issued or pending with the University of Copenhagen, Advocacy group for Antag Therapeutics and Bainan Biotech; S.M.: lecture fees for Novo Nordisk A/S. Recipient of Support for attending meetings from Novo Nordisk A/S. Advisory boards of Novo Nordisk A/S; Sanofi Aventis and Merck Sharp & Dohme. S.S.T.: research grant recipient Novo Nordisk. The remaining authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER The trial was approved by the Ethical Committee of the Capital Region of Denmark (H-16027082) and the Danish Medicines Agency (EudraCT Number: 2015-005585-32). ClinicalTrials.gov identifier (NCT number): NCT04122716. TRIAL REGISTRATION DATE 11 May 2016. DATE OF FIRST PATIENT’S ENROLMENT August 2016.
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Affiliation(s)
| | | | - Emma T Kjøller
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Julie R Lundgren
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Janus
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Yasmin Dehestani
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Marte Saupstad
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Lars R Ingerslev
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Olivia M Duun
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Simon B K Jensen
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jens J Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark,Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Bente M Stallknecht
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sten Madsbad
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Signe S Torekov
- Correspondence address. Mærsk Tower 7.7, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. Tel: +45-35-33-72-88; E-mail: (R.B.); Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Panum 12.4.08, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark. Tel: +45-22-98-38-27; E-mail: (S.S.T.)
| | - Romain Barrès
- Correspondence address. Mærsk Tower 7.7, Blegdamsvej 3B, 2200 Copenhagen N, Denmark. Tel: +45-35-33-72-88; E-mail: (R.B.); Department of Biomedical Sciences, Faculty of Health Sciences, University of Copenhagen, Panum 12.4.08, Blegdamsvej 3B, DK-2200 Copenhagen N, Denmark. Tel: +45-22-98-38-27; E-mail: (S.S.T.)
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6
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Del Giudice F, Eisenberg ML. Does semen analysis testing reveal disparities? Nat Rev Urol 2021; 18:515. [PMID: 34075226 DOI: 10.1038/s41585-021-00485-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy.,Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA. .,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
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7
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Sato Y, Asahina K, Yoshiike M, Nozawa S, Otoi T, Iwamoto T. A change in the steroid metabolic pathway in human testes showing deteriorated spermatogenesis. Reprod Biol 2020; 20:210-219. [PMID: 32151535 DOI: 10.1016/j.repbio.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/23/2020] [Accepted: 02/25/2020] [Indexed: 11/27/2022]
Abstract
During androgen biosynthesis, the human testes normally produce only small quantities of Δ4-C21 steroids as these are products of the Δ4-pathway and healthy human testes preferentially use the Δ5-pathway. However, the Δ4-C21 steroid progesterone accumulates in the thickened lamina propria of the seminiferous tubules in testes with deteriorated spermatogenesis. The objectives of this study were to analyse the pregnenolone metabolites in testes with deteriorated spermatogenesis and to establish whether the androgen biosynthesis pathway changes in this condition. Biopsied or orchiectomised testicular samples were obtained from patients with varicocele, non-obstructive azoospermia, obstructive azoospermia, testicular cancer, and cryptorchidism. The samples were segregated into spermatogenesis related Johnsen's score groups: Low-JS (< 5.0) and High-JS (> 7.8). Higher levels of progesterone and 17α-hydroxyprogesterone were metabolised under in vitro conversion in the Low-JS testes than the High-JS testes when cell-free homogenates from each group were separately incubated with 14C-labelled pregnenolone. Nevertheless, the serum hormone levels did not differ between groups. Two novel pregnenolone metabolites 5β-pregnan-3β-ol-20-one and 5α-pregnan-3α, 21diol-20-one were identified from in vitro conversion in Low-JS testes and by recrystallisation. Immunohistochemistry revealed the higher βHSD expression in the Low-JS than the High-JS testes. However, the CYP17A1 expression levels did not differ between groups. Infertile testes increase the relative βHSD levels in their Leydig cells and synthesised testosterone from pregnenolone via the Δ4- rather than the Δ5-pathway. A new insight into a change of metabolites in Low-JS testes will be relevant to understand the mechanism of the deteriorated spermatogenesis under the normal range of testosterone level.
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Affiliation(s)
- Yoko Sato
- Department of Urology, St. Marianna University of Medicine, 2 -16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan.
| | - Kiyoshi Asahina
- College of Bioresource Sciences, Nihon University, 1866 Kameino, Fujisawa, Kanagawa 252-0890, Japan
| | - Miki Yoshiike
- Department of Urology, St. Marianna University of Medicine, 2 -16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | - Shiari Nozawa
- Department of Urology, St. Marianna University of Medicine, 2 -16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
| | - Takeshige Otoi
- Laboratory of Animal Reproduction, Faculty of Bioscience and Bioindustry, Tokushima University, Ishii, Myozai-gun, Tokushima, 779-3233, Japan
| | - Teruaki Iwamoto
- Department of Urology, St. Marianna University of Medicine, 2 -16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan
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8
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Palani A, Sengupta P, Agarwal A, Henkel R. Geographical differences in semen characteristics: Comparing semen parameters of infertile men of the United States and Iraq. Andrologia 2020; 52:e13519. [DOI: 10.1111/and.13519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 12/03/2019] [Accepted: 12/18/2019] [Indexed: 12/28/2022] Open
Affiliation(s)
- Ayad Palani
- Department of Chemistry College of Science University of Garmian Kalar Iraq
| | - Pallav Sengupta
- Department of Physiology Faculty of Medicine MAHSA University Jenjarom Malaysia
| | - Ashok Agarwal
- American Center for Reproductive Medicine Cleveland Clinic Cleveland OH USA
| | - Ralf Henkel
- American Center for Reproductive Medicine Cleveland Clinic Cleveland OH USA
- Department of Medical Bioscience University of the Western Cape Bellville South Africa
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9
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Barrera N, Ordoqui R, Montes JM, Canepa M, Bonelli C, Surka C, Torrens A, Cantú L, Du Plessis SS. The Uruguayan semen donor population: A twenty-eight-year retrospective study. Andrologia 2019; 52:e13502. [PMID: 31876046 DOI: 10.1111/and.13502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/10/2019] [Accepted: 11/19/2019] [Indexed: 11/28/2022] Open
Abstract
Several studies have reported a global decline in seminal quality over the years. The objective of this study was to describe the semen donor population of Uruguay through comparing data of successive samples banked by the same donors and the analysis of their semen and physical characteristics, ancestry origin and educational level. A total of 3,449 ejaculated samples collected from 71 donors, cryobanked between 1989 and March 2017 at Fertilab, were analysed. Results revealed a mean age of 23.90 ± 3.98 years, an average weight of 74.95 ± 1.09 kg and a mean height of 1.78 ± 0.06 m. The majority of the donors trace their origin to Europe (74.65%, 53/71) and 66.19% (47/71) have a level of education higher than secondary school. We observed longitudinal differences in two parameters, that is sperm concentration and semen volume. Sperm concentration declined, while semen volume increased significantly over the 28-year period. The results of the present study are in accordance with that of previous articles that also reported a decline in sperm concentration over time. However, no differences were observed in total sperm number per ejaculate due to the increase in semen volume values, thus reflecting no real changes in sperm production over time.
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Affiliation(s)
- Natalibeth Barrera
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay.,IVF Laboratory, Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Rosina Ordoqui
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - José M Montes
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Mariel Canepa
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Carla Bonelli
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay.,IVF Laboratory, Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Carolina Surka
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Andrea Torrens
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Lidia Cantú
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay.,IVF Laboratory, Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Stefan S Du Plessis
- Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Department of Basic Medical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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Punjani N, Nayan M, Jarvi K, Lo K, Lau S, Grober ED. The effect of ethnicity on semen analysis and hormones in the infertile patient. Can Urol Assoc J 2019; 14:31-35. [PMID: 31348744 DOI: 10.5489/cuaj.5897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to study the association of ethnicity on semen parameters and hormones in patients presenting with infertility. METHODS Data from men presenting for infertility assessment were prospectively collected and retrospectively reviewed. Demographic and clinical history was self-reported. Semen analysis included volume, count, motility, morphology, and vitality. The 2010 World Health Organization cutoffs were used. Baseline total testosterone and follicle-stimulating hormone (FSH) levels were recorded. Ethnicity data was classified as Caucasian, African Canadian, Asian, Indo-Canadian, Native Canadian, Hispanic, and Middle Eastern. All patients with complete data were included and statistical analysis was performed. RESULTS A total of 9079 patients were reviewed, of which 3956 patients had complete data. Of these, 839 (21.2%) were azoospermic. After adjusting for age, African Canadians (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.28-2.25) and Asians (1.34; 95% CI 1.11-1.62) were more likely to be azoospermic compared to Caucasians. Similarly, African Canadians (OR 1.75; 95% CI 1.33-2.29) were more likely to be oligospermic and Asians (OR 0.82; 95% CI 0.70-0.97) less likely to be oligospermic. Low volume was found in African Canadian (OR 1.42; 95% CI 1.05-1.91), Asians (OR 1.23; 95% CI 1.01-1.51), and Indo-Canadians (OR 1.47; 95% CI 1.01-2.13). Furthermore, Asians (OR 0.73; 95% CI 0.57-0.93) and Hispanics (OR 0.58; 95% CI 034-0.99) were less likely to have asthenospermia. Asians (OR 0.73; 95% CI 0.57-0.94) and Indo-Canadians (OR 0.58; 95% CI 0.35-0.99) were less likely to have teratozospermia. No differences were seen for vitality. No differences were seen for FSH levels, however, Asians (p<0.01) and Indo-Canadians (p<0.01) were more likely to have lower testosterone. CONCLUSIONS Our study illustrates that variations in semen analyses and hormones exist in men with infertility. This may provide insight into the workup and management for infertile men from different ethnicities.
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Affiliation(s)
- Nahid Punjani
- Division of Urology, Western University, London, ON, Canada
| | - Madhur Nayan
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Keith Jarvi
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Kirk Lo
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Susan Lau
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Ethan D Grober
- Division of Urology, University of Toronto, Toronto, ON, Canada
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11
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Husain S, Izhar R, Masood Z, Tahir S, Mataa-E-Masood. The effect of suboptimal semen parameters on male partner's ability to conceive. Is he really subfertile because the test says so? J Hum Reprod Sci 2019; 12:294-298. [PMID: 32038078 PMCID: PMC6937768 DOI: 10.4103/jhrs.jhrs_29_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/15/2019] [Accepted: 09/11/2019] [Indexed: 11/14/2022] Open
Abstract
Context: In many developing countries, subfertility treatment is not covered by government-funded institutions. It is observed that healthcare providers incriminate male factor for subfertility even when only a slight deviation from presumed normal criteria is observed. Aim: This study aims to provide scientific evidence that pregnancies are possible at semen parameters that are below the generally accepted lower limits of normal. Setting and Design: This was a retrospective cohort study conducted from January 2014 to December 2018. Materials and Methods: During the study period, couples who conceived without any treatment of male partner were included. The World Health Organization (WHO) reference values for semen analysis were utilized to assess the reports. The primary outcome measure was conception despite abnormal semen parameters. Statistical Analysis Used: Data were analyzed using the SPSS software program, version 15.0 (IBM, Armonk, USA). Results: Of the 332 couples included, 233 (70.1%) couples conceived despite suboptimal semen parameters, The most common criterion not satisfied was rapid linear motility –200 (85.8%), 87 (37.3%) men were oligozoospermic, 94 (40.3%) were asthenozoospermic, and 21 (9%) were teratozoospermic. The abnormalities were more common in men having primary subfertility (71.7% vs. 28.3%, P = 0.002). The abnormalities were most common in the age group 40–44 years (n = 91, 39.1%) and those who were overweight (n = 110, 47%). Conclusions: A consensus for defining poor semen criteria is the need of the hour so that these males can be counseled satisfactorily. WHO criteria are a standard commonly employed, but they do not necessarily predict the fertility potential.
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12
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Efrat M, Stein A, Pinkas H, Unger R, Birk R. Dietary patterns are positively associated with semen quality. Fertil Steril 2018; 109:809-816. [PMID: 29778381 DOI: 10.1016/j.fertnstert.2018.01.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/28/2017] [Accepted: 01/09/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To study association of semen quality with a priori whole dietary pattern indexes, which reflect real-world dietary practices and the numerous combinations by which foods are consumed: Healthy Eating Index (HEI), Dietary Approaches to Stop Hypertension (DASH), alternate Mediterranean Diet score (aMED), and Alternative Healthy Eating Index (AHEI). DESIGN A cross-sectional single-center study. SETTING Hospital fertility center and university. PATIENT(S) A total of 280 men attending fertility center from 2012 to 2015. INTERVENTION(S) Food frequency questionnaire (FFQ) and semen and sperm analysis. MAIN OUTCOME MEASURE(S) Food consumption with the use of FFQ and HEI, AHEI, aMED, DASH nutritional individual scoring indexes. Semen parameters, including semen volume, sperm concentration, motility, total count, and morphology. RESULT(S) Comparing the highest and lowest quartiles of the nutritional indexes, men in the highest quartiles of HEI, AHEI, aMed, and DASH indexes had significantly higher adjusted means of sperm concentration (by 10%, 45%, and 24% for HEI, AHEI, and DASH, respectively), normal sperm morphology (by 21% and 8% for AHEI and DASH, respectively), total sperm count (by 29% for AHEI), and sperm motility (by 6% and 11% for aMed and HEI, respectively). CONCLUSION(S) Adherence to any of the four dietary indexes is associated with better overall sperm quality, with AHEI best associated. Following our novel findings, we recommend using AHEI as a clinical and practical tool for public whole nutritional recommendation for semen quality.
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Affiliation(s)
- Michal Efrat
- Department of Nutrition, Faculty of Health Sciences, Ariel University, Ariel, West Bank, Israel; Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Anat Stein
- Department of Obstetrics and Gynecology, Beilinson Medical Center, Infertility and In Vitro Fertilization Unit, Petah Tikva, Israel; Beilinson Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Haim Pinkas
- Department of Obstetrics and Gynecology, Beilinson Medical Center, Infertility and In Vitro Fertilization Unit, Petah Tikva, Israel; Beilinson Medical Center, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Unger
- Mina and Everard Goodman Faculty of Life Sciences, Bar Ilan University, Ramat Gan, Israel
| | - Ruth Birk
- Department of Nutrition, Faculty of Health Sciences, Ariel University, Ariel, West Bank, Israel.
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13
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Levine H, Jørgensen N, Martino-Andrade A, Mendiola J, Weksler-Derri D, Mindlis I, Pinotti R, Swan SH. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update 2018; 23:646-659. [PMID: 28981654 DOI: 10.1093/humupd/dmx022] [Citation(s) in RCA: 738] [Impact Index Per Article: 123.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 06/28/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Reported declines in sperm counts remain controversial today and recent trends are unknown. A definitive meta-analysis is critical given the predictive value of sperm count for fertility, morbidity and mortality. OBJECTIVE AND RATIONALE To provide a systematic review and meta-regression analysis of recent trends in sperm counts as measured by sperm concentration (SC) and total sperm count (TSC), and their modification by fertility and geographic group. SEARCH METHODS PubMed/MEDLINE and EMBASE were searched for English language studies of human SC published in 1981-2013. Following a predefined protocol 7518 abstracts were screened and 2510 full articles reporting primary data on SC were reviewed. A total of 244 estimates of SC and TSC from 185 studies of 42 935 men who provided semen samples in 1973-2011 were extracted for meta-regression analysis, as well as information on years of sample collection and covariates [fertility group ('Unselected by fertility' versus 'Fertile'), geographic group ('Western', including North America, Europe Australia and New Zealand versus 'Other', including South America, Asia and Africa), age, ejaculation abstinence time, semen collection method, method of measuring SC and semen volume, exclusion criteria and indicators of completeness of covariate data]. The slopes of SC and TSC were estimated as functions of sample collection year using both simple linear regression and weighted meta-regression models and the latter were adjusted for pre-determined covariates and modification by fertility and geographic group. Assumptions were examined using multiple sensitivity analyses and nonlinear models. OUTCOMES SC declined significantly between 1973 and 2011 (slope in unadjusted simple regression models -0.70 million/ml/year; 95% CI: -0.72 to -0.69; P < 0.001; slope in adjusted meta-regression models = -0.64; -1.06 to -0.22; P = 0.003). The slopes in the meta-regression model were modified by fertility (P for interaction = 0.064) and geographic group (P for interaction = 0.027). There was a significant decline in SC between 1973 and 2011 among Unselected Western (-1.38; -2.02 to -0.74; P < 0.001) and among Fertile Western (-0.68; -1.31 to -0.05; P = 0.033), while no significant trends were seen among Unselected Other and Fertile Other. Among Unselected Western studies, the mean SC declined, on average, 1.4% per year with an overall decline of 52.4% between 1973 and 2011. Trends for TSC and SC were similar, with a steep decline among Unselected Western (-5.33 million/year, -7.56 to -3.11; P < 0.001), corresponding to an average decline in mean TSC of 1.6% per year and overall decline of 59.3%. Results changed minimally in multiple sensitivity analyses, and there was no statistical support for the use of a nonlinear model. In a model restricted to data post-1995, the slope both for SC and TSC among Unselected Western was similar to that for the entire period (-2.06 million/ml, -3.38 to -0.74; P = 0.004 and -8.12 million, -13.73 to -2.51, P = 0.006, respectively). WIDER IMPLICATIONS This comprehensive meta-regression analysis reports a significant decline in sperm counts (as measured by SC and TSC) between 1973 and 2011, driven by a 50-60% decline among men unselected by fertility from North America, Europe, Australia and New Zealand. Because of the significant public health implications of these results, research on the causes of this continuing decline is urgently needed.
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Affiliation(s)
- Hagai Levine
- Braun School of Public Health and Community Medicine, Hadassah-Hebrew University, the Hebrew University Center of Excellence in Agriculture and Environmental Health, Ein Kerem Campus, PO BOX 12272, Jerusalem 9110202, Israel.,Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Niels Jørgensen
- University Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, CopenhagenDK-2100, Denmark
| | - Anderson Martino-Andrade
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.,Department of Physiology, Federal University of Parana, Curitiba 81531-980, Brazil
| | - Jaime Mendiola
- Division of Preventive Medicine and Public Health, University of Murcia School of Medicine and Biomedical Research Institute of Murcia (IMIB-Arrixaca-UMU), Murcia30100, Spain
| | - Dan Weksler-Derri
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva6676814, Israel
| | - Irina Mindlis
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY10029, USA
| | - Rachel Pinotti
- Gustave L. and Janet W. Levy Library, Icahn School of Medicine at Mount Sinai, New York, NY10029, USA
| | - Shanna H Swan
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY10029, USA
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Kurobe M, Kawai K, Suetomi T, Iwamoto T, Waku N, Kawahara T, Kojima T, Joraku A, Miyazaki J, Nishiyama H. High prevalence of hypogonadism determined by serum free testosterone level in Japanese testicular cancer survivors. Int J Urol 2018; 25:457-462. [PMID: 29478250 DOI: 10.1111/iju.13537] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 01/18/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Hypogonadism is a major complication in testicular cancer survivors, but its prevalence varies among studies. In Japan, free testosterone has been used for diagnosis of late-onset hypogonadism syndrome. In the present study, we evaluated the hormone level of testicular cancer survivors and its impact on their quality of life. METHODS Overall, 50 testicular cancer survivors treated from 1990 to 2013 were enrolled. The median age was 44 years. The serum levels of free testosterone, total testosterone and luteinizing hormone were measured. All patients completed the Aging Males' Symptom scale and International Index of Erectile Function-15. The hormone levels of 337 healthy volunteers were used as the control. RESULTS A total of 32 (64%) patients showed free testosterone levels <8.5 pg/mL. In contrast, just 26% of 50 patients showed total testosterone levels <3.5 ng/mL. Testicular cancer survivors had significantly lower free testosterone and higher luteinizing hormone compared with healthy controls. In contrast, there was no difference in total testosterone between patients and controls. The prevalence of late-onset hypogonadism symptoms of any grade (Aging Males' Symptom total score ≥27) was 60%. Overall, 64% were defined as having moderate erectile dysfunction (International Index of Erectile Function-Erectile Function domain score <17). However, Aging Males' Symptom, International Index of Erectile Function-15 and Erectile Function domain scores did not differ by free testosterone or total testosterone level. CONCLUSIONS This is the first report on the prevalence of hypogonadism determined by free testosterone level in Japanese testicular cancer survivors. Because Aging Males' Symptom and International Index of Erectile Function-15 scores do not necessarily reflect the hormone level, measuring free testosterone is also important in the follow up of these patients.
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Affiliation(s)
- Masahiro Kurobe
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Urology, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Koji Kawai
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takahiro Suetomi
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Teruaki Iwamoto
- Division of Male Infertility Center for Human Reproduction, Sanno Hospital, Tokyo, Japan
| | - Natsui Waku
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takashi Kawahara
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takahiro Kojima
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Akira Joraku
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Jun Miyazaki
- Department of Urology, School of Medicine, International University of Health and Welfare, Narita, Chiba, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Mahmud N, Sharmin E, Mamun MA, Shamayeen Z, Rivadeneira N, Rochat R, Mehta A. Decline in semen parameters from 2000 to 2016 among Bangladeshi men attending a tertiary care hospital. Indian J Urol 2018; 34:28-33. [PMID: 29343909 PMCID: PMC5769245 DOI: 10.4103/iju.iju_30_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: The objective of this study was to analyze longitudinal changes in sperm parameters of Bangladeshi men. We hypothesized that semen parameters declined for this population. Methods: We retrospectively analyzed semen data from men aged 18-64 years who sought care for general sperm quality or updates on fertility status at an infertility clinic in Dhaka, Bangladesh, from January 2000 to June 2016 (n = 13,953). Samples with incomplete data were excluded (n = 143). The WHO normal criteria and semen analysis procedures were used to evaluate parameters of the remaining 13,810 specimens. Samples with missing values on sperm concentration (n = 6187) were excluded from concentration analyses. Age and duration of abstinence at testing were recorded and adjusted for. Data were imported into SAS® 9.4 statistical software. Temporal significance was investigated using one-way ANOVA for motility parameters and Chi-square test for raw concentration. Logistic regression analyzed the effects of confounders on azoospermia and raw concentration, while median regression modeling adjusted confounders for concentration, total motility, and rapid linear (RL) motility. Results: Age distribution was significantly correlated with annual parameter changes (concentration, total motility, and RL motility [P < 0.0001]). Adjusted total motility and RL motility declined by 20% from their maximum values to end of the study (P < 0.0001). Raw concentration lacked clear trends and was unaffected by adjustment. Azoospermia increased by 18% between the 2000–2010 and 2011–2016 participants (odds ratio = 0.16 [0.14–0.16]). Conclusion: In agreement with the hypothesis, Bangladeshi males attending this clinic have experienced decline in semen parameters (total motility and RL motility) and increased frequency of azoospermia.
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Affiliation(s)
- Nusrat Mahmud
- Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Eshita Sharmin
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Md Arif Mamun
- Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | | | - Natalie Rivadeneira
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Roger Rochat
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Akanksha Mehta
- Department of Urology, School of Medicine, Emory University, Atlanta, GA, USA
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Khandwala YS, Zhang CA, Li S, Behr B, Guo D, Eisenberg ML. Racial Variation in Semen Quality at Fertility Evaluation. Urology 2017; 106:96-102. [DOI: 10.1016/j.urology.2017.03.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/23/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
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18
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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: 6.8] [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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Woodward B, Gossen N, Meadows J, Tomlinson M. Uncertainty associated with assessing semen volume: are volumetric and gravimetric methods that different? HUM FERTIL 2016; 19:249-253. [DOI: 10.1080/14647273.2016.1223356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Sengupta P, Dutta S, Krajewska-Kulak E. The Disappearing Sperms: Analysis of Reports Published Between 1980 and 2015. Am J Mens Health 2016; 11:1279-1304. [PMID: 27099345 DOI: 10.1177/1557988316643383] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Reports regarding the changes in sperm concentration in different counties of the world are inconsistent. Furthermore, the reports that sprung up from specific epidemiological and experimental examinations did not include data of prior studies or geographical variations. The current study, following a previous report of massive fall in semen volume over the past 33 years, attempts to delineate the trend of altering sperm concentrations and factors responsible for this by reviewing article published from 1980 to July 2015 with geographic differences. The current study identified an overall 57% diminution in mean sperm concentration over the past 35 years ( r = -.313, p = .0002), which, when analyzed for each geographical region, identified a significant decline in North America, Europe, Asia, and Africa. An increasing trend of sperm concentration was identified only in Australia. The association of male age with such a trend ( R2 = .979) is reported. The authors also correlated male fertility with sperm concentration. Thus, this comprehensive, evidence-based literature review aims to concisely and systematically present the available data on sperm concentration from 1980 to 2015, as well as to statistically analyze the same and correlate male health with the declining pattern of sperm count in a single scientific review to serve the scientific research zone related to reproductive health. It points to the threat of male infertility in times ahead.
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Affiliation(s)
| | - Sulagna Dutta
- 2 Ex-guest Teacher, Serampore College, University of Calcutta, Kolkata, West Bengal, India
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21
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Kolesnikova LI, Kolesnikov SI, Kurashova NA, Osadchuk LV, Osadchuk AV, Dolgikh MI, Dashiev BG, Shantanova LN. Reproductive Health and Peculiarities of Lipid Peroxidation-Antioxidant Defense System in Men of the Main Ethnic Groups of the Baikal Region. Bull Exp Biol Med 2015; 160:32-4. [PMID: 26601842 DOI: 10.1007/s10517-015-3091-6] [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: 02/18/2015] [Indexed: 10/22/2022]
Abstract
Quality of sperm and some parameters of LPO reflecting primary and end stages of oxidation and levels of α-tocopherol and total antioxidant activity were studied in ejaculate samples from 130 men (mean age of 24 years) living in Ulan-Ude, Buryatia Republic. All participants took a part in survey and were examined by an andrologist. The observed peculiarities of LPO and antioxidant defense in Russian men, such as decreased level of substrate supply for the processes of LPO and α-tocopherol, attest to specificity of metabolic processes and development of compensatory reactions of the organism under physiological conditions. LPO processes were more active in Buryat men, which can indicate exposure of cell membranes to toxic oxygen species. However, the observed in these patients significant increase in α-tocopherol concentration reflects adequate functioning of the adaptive and protective mechanisms of the body.
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Affiliation(s)
- L I Kolesnikova
- Research Center of Family Health and Reproduction, Irkutsk, Russia
| | - S I Kolesnikov
- Research Center of Family Health and Reproduction, Irkutsk, Russia
| | - N A Kurashova
- Research Center of Family Health and Reproduction, Irkutsk, Russia.
| | - L V Osadchuk
- Institute of Cytology and Genetic, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A V Osadchuk
- Institute of Cytology and Genetic, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - M I Dolgikh
- Institute of Cytology and Genetic, Siberian Division of the Russian Academy of Sciences, Novosibirsk, Russia
| | - B G Dashiev
- Republican Perinatal Center, Uzbekistan, Russia
| | - L N Shantanova
- Institute of General and Experimental Biology, Siberian Division of the Russian Academy of Sciences, Ulan-Ude, Republic of Buryatia, Russia
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Li X, Li H, Jia L, Li X, Rahman N. Oestrogen action and male fertility: experimental and clinical findings. Cell Mol Life Sci 2015; 72:3915-30. [PMID: 26160724 PMCID: PMC11113595 DOI: 10.1007/s00018-015-1981-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 06/05/2015] [Accepted: 06/29/2015] [Indexed: 12/24/2022]
Abstract
A proper balance between androgen and oestrogen is fundamental for normal male reproductive development and function in both animals and humans. This balance is governed by the cytochrome P450 aromatase, which is expressed also under spatio-temporal control. Oestrogen receptors ERα and/or ERβ, together with the membrane-associated G-protein-coupled functional ER (GPER), mediate the effects of oestrogen in the testis. Oestrogen action in male reproduction is more complex than previously predicted. The androgen/oestrogen balance and its regulation in the masculinisation programming window (MPW) during foetal life is the most critical period for the development of the male reproductive system. If this balance is impaired during the MPW, the male reproductive system may be negatively affected. Recent data from genetically modified mice and human infertile patients have shown that oestrogens may promote the engulfment of live Leydig cells by macrophages leading to male infertility. We also discuss recent data on environmental oestrogen exposure in men and rodents, where a rodent-human distinction is crucial and analyse some aspects of male fertility potentially related to impaired oestrogen/androgen balance.
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Affiliation(s)
- Xiangdong Li
- State Key Laboratory of the Agro-Biotechnology, Faculty of Biological Sciences, China Agricultural University, Beijing, China.
| | - Haiwen Li
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
| | - Lina Jia
- State Key Laboratory of the Agro-Biotechnology, Faculty of Biological Sciences, China Agricultural University, Beijing, China
| | - Xiru Li
- Department of General Surgery, The 301th Hospital of PLA, Beijing, China
| | - Nafis Rahman
- Department of Physiology, Institute F Biomedicine, University of Turku, Turku, Finland
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Cutillas-Tolín A, Mínguez-Alarcón L, Mendiola J, López-Espín JJ, Jørgensen N, Navarrete-Muñoz EM, Torres-Cantero AM, Chavarro JE. Mediterranean and western dietary patterns are related to markers of testicular function among healthy men. Hum Reprod 2015; 30:2945-55. [PMID: 26409012 DOI: 10.1093/humrep/dev236] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 08/27/2015] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Are there any associations of dietary patterns with semen quality, reproductive hormone levels, and testicular volume, as markers of testicular function? SUMMARY ANSWER These results suggest that traditional Mediterranean diets may have a positive impact on male reproductive potential. WHAT IS KNOWN ALREADY The Mediterranean diet has been related to lower risk of multiple chronic diseases, but its effects on reproduction potential are unclear. STUDY DESIGN, SIZE, DURATION Cross-sectional sample of 215 male university students recruited from October 2010 to November 2011 in Murcia Region (Spain). PARTICIPANTS/MATERIALS, SETTING, METHODS Two hundred and nine healthy men aged 18-23 years were finally included in this analysis. Diet was assessed using a validated food frequency questionnaire, and dietary patterns were identified by factor analysis. Linear regression was used to analyze the relation between diet patterns with semen quality parameters, reproductive hormone levels and testicular volume adjusting for potential confounders. MAIN RESULTS AND THE ROLE OF CHANCE We identified two dietary patterns: a Mediterranean (characterized by high intakes of vegetables, fruits and seafood) and a Western pattern (characterized by high intakes of processed meats, French fries and snacks). The Mediterranean pattern was positively associated with total sperm count (P, trend = 0.04). The Western pattern was positively related to the percentage of morphologically normal sperm (P, trend = 0.008). We found an inverse association between adherence to the Western pattern and sperm concentration among overweight or obese men (P, trend = 0.04). LIMITATIONS, REASONS FOR CAUTION As with all cross-sectional studies, causal inference is limited. However, participants were blinded to the study outcomes thus reducing the potential influenced their report of diet. Although we adjusted for a large number of known and suspected confounders, we cannot exclude the possibility of residual confounding or chance findings. WIDER IMPLICATIONS OF THE FINDINGS This study was carried out on healthy and young men, so it is difficult to predict whether and how the observed differences in semen quality translate into reproductive success for men in couples trying to conceive. These results suggest that traditional Mediterranean diets may have a positive impact on male reproductive potential.
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Affiliation(s)
- A Cutillas-Tolín
- Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain
| | - L Mínguez-Alarcón
- Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain
| | - J Mendiola
- Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain
| | - J J López-Espín
- Center of Operations Research, Miguel Hernandez University, Elche Campus, Elche 03202, Spain
| | - N Jørgensen
- University Department of Growth and Reproduction, University of Copenhagen, Rigshospitalet, Copenhagen DK-20100, Denmark
| | - E M Navarrete-Muñoz
- CIBER de Epidemiología y Salud Pública (CIBERESP), Institute of Health Carlos III (ISCIII), Madrid 28029, Spain Department of Public Health, Miguel Hernández University, San Joan d'Alacant, Alicante 03550, Spain
| | - A M Torres-Cantero
- Department of Health and Social Sciences, Division of Preventive Medicine and Public Health, University of Murcia School of Medicine, Espinardo Campus, Vía perimetral s/n, IMIB-Arrixaca, Murcia 30100, Spain Regional Campus of International Excellence 'Campus Mare Nostrum', University of Murcia, Murcia 30100, Spain Department of Preventive Medicine, Reina Sofía University Hospital, Murcia 30003, Spain
| | - J E Chavarro
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
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Le Moal J, Sharpe RM, Jϕrgensen N, Levine H, Jurewicz J, Mendiola J, Swan SH, Virtanen H, Christin-Maître S, Cordier S, Toppari J, Hanke W. Toward a multi-country monitoring system of reproductive health in the context of endocrine disrupting chemical exposure. Eur J Public Health 2015; 26:76-83. [PMID: 26330492 DOI: 10.1093/eurpub/ckv153] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Worrying trends regarding human reproductive endpoints (e.g. semen quality, reproductive cancers) have been reported and there is growing circumstantial evidence for a possible causal link between these trends and exposure to endocrine disrupting chemicals (EDCs). However, there is a striking lack of human data to fill the current knowledge gaps. To answer the crucial questions raised on human reproductive health, there is an urgent need for a reproductive surveillance system to be shared across countries. METHODS A multidisciplinary network named HUman Reproductive health and Global ENvironment Network (HURGENT) was created aiming at designing a European monitoring system for reproductive health indicators. Collaborative work allowed setting up the available knowledge to design such a system. Furthermore we conducted an overview of 23 potential indicators, based upon a weight of evidence (WoE) approach according to their potential relation with EDC exposure. RESULTS The framework and purposes of the surveillance system are settled as well as the approach to select suitable reproductive indicators. The indicators found with the highest scores according to the WoE approach are prostate and breast cancer incidence, sex ratio, endometriosis and uterine fibroid incidence, indicators related to the testicular dysgenesis syndrome, precocious puberty incidence and reproductive hormone levels. CONCLUSION Not only sentinel health endpoints, but also diseases with high burdens in public health are highlighted as prior indicators in the context of EDC exposure. Our work can serve as a basis to construct, as soon as possible, the first multi-country reproductive monitoring system.
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Affiliation(s)
- Joëlle Le Moal
- 1 Environmental Health Department, French Institute for Public Health Surveillance (InVS), Saint Maurice, France
| | - Richard M Sharpe
- 2 MRC Centre for Reproductive Health, The Queen's Medical Research Institute, The University of Edinburgh, Edinburgh, UK
| | - Niels Jϕrgensen
- 3 Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark
| | - Hagai Levine
- 4 Braun School of Public Health and Community Medicine, Hebrew University-Hadassah and The Hebrew University Center of Excellence in Agriculture and Environmental Health, Jerusalem, Israel 5 Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joanna Jurewicz
- 6 Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Jaime Mendiola
- 7 Division of Preventive Medicine and Public Health, Department of Health and Social Sciences, University of Murcia School of Medicine, Murcia, Spain
| | - Shanna H Swan
- 5 Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Helena Virtanen
- 8 Department of Physiology, University of Turku, Turku, Finland
| | | | - Sylvaine Cordier
- 11 Inserm U.1085, Institut de Recherche en santé, environnement et travail (IRSET), University of Rennes, Rennes, France
| | - Jorma Toppari
- 8 Department of Physiology, University of Turku, Turku, Finland 9 Department of Pediatrics, University of Turku, Turku, Finland
| | - Wojciech Hanke
- 6 Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
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Barazani Y, Agarwal A, Sabanegh ES. Functional Sperm Testing and the Role of Proteomics in the Evaluation of Male Infertility. Urology 2014; 84:255-61. [DOI: 10.1016/j.urology.2014.04.043] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 04/28/2014] [Accepted: 04/29/2014] [Indexed: 11/26/2022]
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Kocks JEM, Broekhuijse MLWJ. The practical use of density of whole bull semen to determine the volume of an ejaculate at AI laboratories. Anim Reprod Sci 2014; 146:98-102. [PMID: 24656170 DOI: 10.1016/j.anireprosci.2014.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 02/03/2014] [Accepted: 02/20/2014] [Indexed: 11/24/2022]
Abstract
Determining the volume of an ejaculate is an important part of processing semen in bovine AI laboratory practice. A multi-AI laboratory study was performed to estimate the density of whole bull semen, and whether the use of this value as a standard is suitable for practical use when semen of different breeds is processed at different AI laboratories. The density of whole bull semen had been determined for 90 ejaculates at five AI laboratories (five breeds). The results showed no effect of bull (p=0.766), breed (p=0.279) and laboratory (p=0.183). All duplicate measurements within the same sample were within the level of agreement (5%). Using the mean value of 1.053g/ml as a golden standard for the density of whole bull semen is therefore suitable for use in routine bovine AI laboratory practice.
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Affiliation(s)
- J E M Kocks
- CRV B.V., P.O. Box 454, 6800 AL Arnhem, the Netherlands.
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Semen analysis standardization: is there any problem in Polish laboratories? Asian J Androl 2013; 15:616-21. [PMID: 23817502 DOI: 10.1038/aja.2013.48] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 03/06/2013] [Accepted: 03/27/2013] [Indexed: 11/08/2022] Open
Abstract
The aim of the study was to determine the degree of compliance of Polish laboratories with World Health Organization (WHO) recommendations, with regard to semen analysis methodology. A survey requesting information about methods of semen analysis was distributed to employees of 55 laboratories. Respondents who had participated in external seminological workshops (31%) were termed certified respondents (CR), the remaining (69%)-non-certified respondents (NCR). Only one laboratory (6%) in the CR group and none in the NCR were compliant with WHO guidelines for methods and equipment used to evaluate seminal volume, sperm motility, concentration, vitality and morphology. Most problems were of volume measurement (weighing method was reported by 17% of CR and 10% of NCR) and staining method for sperm morphology (Papanicolau or Diff-Quik were found in 33% of CR and 23% of NCR). A three- or four-point grading of sperm motility was used by the majority of respondents; however, 17% of CR and 37% of NCR did not use a laboratory counter to tally spermatozoa. Although a haemocytometer method was used by 80% of laboratories in each group, the improved Neubauer chamber was used only by 42% of CR and 19% of NCR. In each group, 24% of laboratories did not perform a vitality test. Procedural errors and the interchangeable utilization of two or even three methods to analyse a given parameter was observed in both groups. The results indicate a need for standardisation of the methods and continuous, unified training in semen analysis in Polish laboratories.
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Levitas E, Lunenfeld E, Weisz N, Friger M, Har-Vardi I. Seasonal variations of human sperm cells among 6455 semen samples: a plausible explanation of a seasonal birth pattern. Am J Obstet Gynecol 2013; 208:406.e1-6. [PMID: 23395928 DOI: 10.1016/j.ajog.2013.02.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Revised: 01/27/2013] [Accepted: 02/04/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To compare the different sperm parameters according to season of the year on sperm production day and the season 70 days prior (during spermatogenesis). STUDY DESIGN Retrospective Andrology Laboratory data comparison. A total of 6455 consecutive semen samples were collected as part of the basic fertility evaluation of 6447 couples. According to sperm concentration, the samples were classified as Normozoospermic or Oligozoospermic and analyzed in relation to the season. RESULTS The sperm concentration and percentage of fast motility showed a significant decrease from spring toward summer and fall (P < .001) with recovery noticed during the winter. As well, the highest percentage of normal sperm morphology was observed during the winter months. CONCLUSION Seasonal sperm pattern seems to be a circannual-rhythmic phenomenon. The winter and spring semen patterns are compatible with increased fecundability and may be a plausible explanation of the peak number of deliveries during the fall.
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Ford WCL. Ignorance but not bliss: too little is known about the determinants of semen quality. Asian J Androl 2013; 15:174-8. [PMID: 23314655 PMCID: PMC3739160 DOI: 10.1038/aja.2012.158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 11/21/2012] [Accepted: 11/22/2012] [Indexed: 11/08/2022] Open
Affiliation(s)
- W C L Ford
- Division of Reproductive & Child Health, University of Birmingham, Birmingham, UK.
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Iwamoto T, Nozawa S, Yoshiike M, Namiki M, Koh E, Kanaya J, Okuyama A, Matsumiya K, Tsujimura A, Komatsu K, Tsukamoto T, Itoh N, Mieno MN, Vierula M, Toppari J, Skakkebæk NE, Jørgensen N. Semen quality of fertile Japanese men: a cross-sectional population-based study of 792 men. BMJ Open 2013; 3:bmjopen-2012-002223. [PMID: 23355656 PMCID: PMC3563117 DOI: 10.1136/bmjopen-2012-002223] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES To establish a base line for future studies on temporal trends, to describe potential geographical differences in semen quality and reference values for studies of men from the general population. DESIGN Cross-sectional study of fertile men from four areas in Japan. Inclusion criteria were: age 20-45 years at the time of invitation, and both the man and his mother had to be born in Japan. Additionally, the current pregnancy of the female partner had to be achieved by normal sexual relations without any fertility treatment. SETTING Four Japanese study centres at urban areas located in Sapporo, Osaka, Kanazawa and Fukuoka. PARTICIPANTS 792 men, median age 31.4 years, included from 1999 to 2002. OUTCOME MEASURES Semen volume, sperm concentration, total sperm count, sperm motility and sperm morphology. RESULTS Semen volumes, percentages of motile spermatozoa and morphologically normal spermatozoa differed slightly between the four groups, whereas no differences in sperm concentrations or total sperm counts were found. In total, 1.2% of men had a sperm concentration below 5 million/ml, 2.1% below 10 million/ml, 3.5% below 15 million/ml and 16.3% below 40 million/ml. For morphology, 14.7% had less than 5% normal spermatozoa. Reproductive hormone levels varied significantly, however, only little from a biological point of view. CONCLUSIONS This is the first cross-sectional study on semen quality covering fertile men from the major regions of Japan. It showed that semen quality of fertile Japanese men is comparable to that of the best in European regions. The results may serve as reference values for studies of men from the general population.
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Affiliation(s)
- Teruaki Iwamoto
- Department of Urology, St Marianna University School of Medicine, Kawasaki, Japan
- Division of Male Infertility, Centre for Infertility and IVF, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Shiari Nozawa
- Department of Urology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Miki Yoshiike
- Department of Urology, St Marianna University School of Medicine, Kawasaki, Japan
| | - Mikio Namiki
- Department of Urology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Eitetsu Koh
- Department of Urology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Jiro Kanaya
- Department of Urology, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Akihiko Okuyama
- Department of Urology, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
| | - Kiyomi Matsumiya
- Department of Urology, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
| | - Akira Tsujimura
- Department of Urology, Graduate School of Medicine, Faculty of Medicine, Osaka University, Osaka, Japan
| | - Kiyoshi Komatsu
- Department of Urology, Harasanshinkai Hospital, Fukuoka, Japan
| | - Taiji Tsukamoto
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Naoki Itoh
- Department of Urology, Sapporo Medical University, Sapporo, Japan
| | - Makiko Naka Mieno
- Department of Medical Informatics, Centre for Information, Jichi Medical University, Shimotsuke, Japan
| | - Matti Vierula
- Departments of Physiology and Paediatrics, University of Turku, Turku, Finland
| | - Jorma Toppari
- Departments of Physiology and Paediatrics, University of Turku, Turku, Finland
| | - Niels E Skakkebæk
- University Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- University Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Nordkap L, Joensen UN, Blomberg Jensen M, Jørgensen N. Regional differences and temporal trends in male reproductive health disorders: semen quality may be a sensitive marker of environmental exposures. Mol Cell Endocrinol 2012; 355:221-30. [PMID: 22138051 DOI: 10.1016/j.mce.2011.05.048] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2011] [Revised: 05/19/2011] [Accepted: 05/25/2011] [Indexed: 11/22/2022]
Abstract
The decline in semen quality has been the subject of an animated debate. A recent prospective study now irrefutably shows a decline in semen quality in men from Finland, a country that previously boasted good semen quality. Semen quality has, in some countries, reached a level where a considerable fraction of young men are at risk of fertility problems. Impaired semen quality, testicular cancer, cryptorchidism and hypospadias are risk factors for each other, and the testicular dysgenesis syndrome (TDS) has been put forward to explain the observations. This syndrome implies that the four disease entities share the same patho-physiological etiology caused by disturbed testicular development in early fetal life. It seems likely that the rapid rise in TDS-associated conditions can, at least partly, be explained by environmental factors. Animal studies provide strong evidence that manmade chemicals can disrupt the hormone dependent pathways responsible for fetal gonadal development, subsequently leading to TDS-like symptoms. In humans, fetal exposure to endocrine disrupting substances may play a role, although genetic factors are probably also involved. Recent studies indicate that exposure to endocrine disrupters also in adulthood may affect semen quality and reproductive hormones. Causal relationships are inherently difficult to establish in humans, and a clear connection between the disorders and specific toxicants has not been established. It seems likely that the cumulative effects of various low-dose exposures to endocrine disrupters in our environment are responsible for the adverse effects in the male reproductive system. Semen quality may be the most sensitive marker of adverse environmental exposures, and we suggest that standardized surveillance studies of semen quality are continued or initiated to monitor the combined effects of various preventive actions.
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Affiliation(s)
- Loa Nordkap
- University Department of Growth and Reproduction, Rigshospitalet, Section 5064, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
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Nakahori Y, Sato Y, Ewis AA, Iwamoto T, Shinka T, Nozawa S, Yoshiike M, Yang XJ, Sei M, Namiki M, Kou E, Ito N, Komatsu K, Matsumiya K, Nakagome Y. Climatic influence on the reproductive characteristics of Japanese males. J Hum Genet 2012; 57:375-8. [PMID: 22534769 DOI: 10.1038/jhg.2012.38] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We previously performed a survey of the sperm characteristics of the partners of pregnant women in four cities in Japan. In the present study, we analyzed the sperm characteristics of these subjects and the correlations between these sperm characteristics and climatic changes or Y chromosome haplogroups. Our results showed that more haplogroup D2a1 males than O2b1 males were born in the first half of the year (January to June), whereas more O2b1 males were born in the last half of the year (July to December) (P<0.05). This was agreed and correlated with the seasonal variations in their mean sperm concentrations. The haplogroup C, D* and D2a1 males displayed lower sperm concentrations from March to May, followed by an increase in their sperm concentrations starting in June or July, while the O2b1 males displayed higher sperm concentrations in the first half of the year followed by a sudden decrease from July to August (P<0.05). We hypothesize that the Japanese climate has different effects on the sperm characteristics and reproductive seasonality of males from different lineages; and therefore, has influenced the modern population of Japan.
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Affiliation(s)
- Yutaka Nakahori
- Department of Human Genetics and Public Health, Graduate School of Medical Science, University of Tokushima, Tokushima, Japan
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Testicular volume discrepancy is associated with decreased semen quality in infertile Japanese males with varicoceles. Reprod Med Biol 2012; 11:117-121. [PMID: 29662361 DOI: 10.1007/s12522-011-0118-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 12/28/2011] [Indexed: 10/14/2022] Open
Abstract
Purpose We retrospectively reviewed infertile Japanese males for testicular volume discrepancies (D) and semen parameters to evaluate whether left grade II-III varicoceles (V) cause testicular damage. Methods Seventy-seven patients who had idiopathic male infertility and 88 who had V without other causes of infertility were examined. We excluded cases of azoospermia. Testicular volume was measured using a punched-out orchidometer. D was defined as a size difference of at least 3 ml. The frequency of D was compared between the patients with and without V. The semen parameters were reviewed in association with D and V. Results The mean left and right testicular volumes were 19.4 and 20.1 ml, respectively (p < 0.001). D with a smaller left testis was more common in V+ cases than in V- cases (26.1 vs. 13.0%, p = 0.0351). The sperm count and motility were also significantly lower (p = 0.0213 and p = 0.0217, respectively) in the D+ patients with a smaller left testicular volume. Conclusions In the patients with V, D was more common than in those without V. The semen parameters were worse if D was present in the patients with V. These results indicated that V could induce testicular atrophy and negatively affect semen quality. Therefore, the ipsilateral reduced testicular volume is considered to be a sign of persisting testicular damage by V.
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Sk A, V J, G K, D U, P K. Declining semen quality among south Indian infertile men: A retrospective study. J Hum Reprod Sci 2011; 1:15-8. [PMID: 19562058 PMCID: PMC2700673 DOI: 10.4103/0974-1208.38972] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2007] [Revised: 01/05/2008] [Accepted: 01/07/2008] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND: Male reproductive function has recently attracted increasing attention due to reports on time-related decline in semen quality. Furthermore, regional differences in the semen quality have also been reported. AIM: To investigate the semen quality among large cohort of infertile individuals at a regional level, in terms of the sperm concentration, total sperm motility, sperm morphology and incidence of azoospermia over a period of 13 years. SETTING: University infertility clinic at Kasturba Hospital, Manipal which is a tertiary healthcare centre serving the general population. DESIGN: Retrospective analysis. MATERIALS AND METHODS: This includes a total of 7770 subjects who presented for semen analysis from 1993 to 2005. The data regarding ejaculate volume, sperm density, motility, morphology and the incidence of azoospermia were collected. STATISTICAL ANALYSIS USED: One way analysis of variance (ANOVA), regression analysis and Chi square analysis. RESULTS: The average sperm density among infertile men during 2004-2005 was 26.61 ± 0.71 millions/mL which was significantly lower than the average sperm density observed in 1993-1994 (38.18 ± 1.46 millions/mL). Similar trend was also observed for sperm motility (47.14% motile sperms vs. 61.16%) and normal sperm morphology (19.75% vs. 40.51%). Interestingly, the incidence of severe oligospermia (mean sperm density <10 millions/mL) observed in 2002-2005 and 1993-1997 demonstrated a significant inverse relationship (P < 0.001). CONCLUSION: Our study provides the first evidence that the quality of human semen evaluated for infertility is deteriorating in the southern part of the India over the years, probably due to environmental, nutritional, life style or socioeconomic causes.
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Affiliation(s)
- Adiga Sk
- Division of Reproductive Medicine, Kasturba Medical College, Manipal University, Manipal, India
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Auger J. Les différentes anomalies de la reproduction masculine sont-elles en augmentation ? Faits et controverses, possibles facteurs en cause: une analyse actualisée des données de la littérature et des registres. Basic Clin Androl 2011. [DOI: 10.1007/s12610-010-0115-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Résumé
Au cours des dernières décennies, de nombreuses observations dans la faune sauvage d’anomalies relatives à l’appareil génital et à la fonction de reproduction mâle, certaines évoquant les données de la toxicologie expérimentale, ont conduit à s’interroger sur la toxicité de facteurs environnementaux pour la reproduction de l’homme. De plus, un certain nombre d’études suggère une augmentation de la prévalence des troubles de la reproduction de l’homme adulte au cours des dernières décennies dans de nombreux pays développés. Les données les mieux documentées concernent le cancer du testicule, son rythme de croissance suggérant le rôle de facteurs environnementaux et/ou de mode de vie. Toutefois, des différences régionales et ethniques considérables dans les taux d’incidence absolue pourraient impliquer des facteurs génétiques concomitants. Parallèlement, il semble que la qualité du sperme a diminué dans de nombreux pays, à en juger aussi bien par des méta-analyses que par des analyses statistiques de données d’un seul centre. Au début des années 2000, Skakkebæk et al. à Copenhague ont formulé l’hypothèse d’une origine commune à ces différentes anomalies lors du développement du testicule durant la gestation. Existe-t-il pour ces différentes conditions des données indiquant un lien de causalité avec une exposition environnementale/professionnelle à des composés reprotoxiques ? Ne serait-ce plutôt l’exposition chronique à de très nombreux composés chimiques à faible dose qui pourrait être impliquée ? Les facteurs de style de vie jouent-ils un rôle ? L’ensemble de ces questions se fondant sur une somme d’études, dont les résultats sont loin d’être univoques, a été la source de nombreux débats aussi bien au sein de la communauté scientifique que dans les médias. Les meilleures réponses possibles à ces questions complexes sont naturellement fondamentales pour les instances en charge de l’évaluation du risque et les politiques de santé publique qu’il convient d’adopter. La présente revue donne un état des lieux actualisé de ces questions.
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Toppari J, Skakkebaek NE. Adverse Trends of Male Reproductive Health in Two Nordic Countries Indicate Environmental Problems. RESEARCH AND PERSPECTIVES IN ENDOCRINE INTERACTIONS 2011. [DOI: 10.1007/978-3-642-22775-2_10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Huang XF. Reference limits: limited references in laboratories worldwide. Asian J Androl 2010; 12:447-8. [PMID: 20436513 DOI: 10.1038/aja.2010.30] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Matson PL, Myssonski K, Yovich S, Morrison L, Irving J, Bakos HW. The density of human semen and the validation of weight as an indicator of volume: a multicentre study. Reprod Biol 2010; 10:141-53. [DOI: 10.1016/s1642-431x(12)60056-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HG, Behre HM, Haugen TB, Kruger T, Wang C, Mbizvo MT, Vogelsong KM. World Health Organization reference values for human semen characteristics*‡. Hum Reprod Update 2009; 16:231-45. [DOI: 10.1093/humupd/dmp048] [Citation(s) in RCA: 1747] [Impact Index Per Article: 116.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Abstract
Semen quality appears to have declined in recent decades in some populations, e.g. north-western Europe. At the same time, couple fertility may have increased. Hypotheses are suggested for this apparent inconsistency. Alongside the deterioration of spermatogenesis there is clear evidence of an increase in other related problems, notably testicular cancer. The sharply rising trend in this condition started a century ago--decades earlier than sometimes thought. This and other evidence clearly indicates an environmental origin, but there is also a definite genetic component. The relationship of genetics and environment is discussed in the context of the puzzle that infertility is inherited, which appears to be impossible from an evolutionary standpoint. Poor semen quality is related not only to testicular cancer but also to zygote development, in which cancer-like disruption of the genetic apparatus is observed, with serious implications for offspring health. This needs to be seen in the context that human reproduction is prone to a higher degree of impairment than that of other mammalian species, in relation to spermatogenesis, couple fertility, early pregnancy loss and embryonic aneuploidy; female- and male-mediated pathways are both implicated. It is unclear whether such human specificity originated on an evolutionary/genetic or a historico-social timescale, which is important in relation to pathogenesis. The evidence clearly indicates that the currently most popular explanation for male reproductive system impairment, the endocrine disruption hypothesis, cannot explain the main features of the descriptive epidemiology. An alternative pathogenesis is outlined, and some possible exposures considered that could be responsible.
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Affiliation(s)
- Michael Joffe
- Department of Epidemiology and Public Health, Imperial College, London W2 1PF, UK.
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Stewart T, Liu D, Garrett C, Brown E, Baker H. Recruitment bias in studies of semen and other factors affecting pregnancy rates in fertile men. Hum Reprod 2009; 24:2401-8. [DOI: 10.1093/humrep/dep215] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Stewart TM, Liu DY, Garrett C, Jørgensen N, Brown EH, Baker HWG. Associations between andrological measures, hormones and semen quality in fertile Australian men: inverse relationship between obesity and sperm output. Hum Reprod 2009; 24:1561-8. [PMID: 19351657 DOI: 10.1093/humrep/dep075] [Citation(s) in RCA: 91] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The World Health Organization developed a time to pregnancy (TTP) study (number of menstrual cycles taken to conceive) to determine whether the average TTP is increasing and semen quality decreasing with time. The present study describes clinical, semen and hormone characteristics obtained from male partners of pregnant women in Melbourne, Australia, and examines the associations between these characteristics. METHODS Male partners (n = 225) of pregnant women (16-32 weeks) who conceived naturally had physical examination, health and lifestyle questionnaires, semen and hormone (FSH, LH, sex hormone-binding globulin, testosterone and Inhibin B) analyses. RESULTS Previously known associations between semen, hormone and clinical variables were confirmed as significant: sperm numbers (concentration and total sperm count) correlated positively with Inhibin B and inversely with FSH and left varicocele, while total testicular volume correlated positively with sperm numbers and Inhibin B and inversely with FSH. However, only abstinence, total testicular volume, varicocele grade and obesity (BMI > 30 kg/m2) were independently significantly related to total sperm count. Compared with those with BMI < 30 (n = 188), obese subjects (n = 35) had significantly lower total sperm count (mean 324 versus 231 million, P = 0.013) and Inhibin B (187 versus 140 pg/ml, P < 0.001) but not FSH (3.4 versus 4.0 IU/l, P = 0.6). CONCLUSIONS Obese fertile men appear to have reduced testicular function. Whether this is cause or effect, i.e. adiposity impairing spermatogenesis or reduced testicular function promoting fat deposition, remains to be determined.
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Affiliation(s)
- T M Stewart
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne IVF Reproductive Services, The Royal Women's Hospital, Melbourne, Australia.
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Cavallini G, Crippa A, Magli MC, Cavallini N, Ferraretti AP, Gianaroli L. A Study to Sustain the Hypothesis of the Multiple Genesis of Oligoasthenoteratospermia in Human Idiopathic Infertile Males. Biol Reprod 2008; 79:667-73. [DOI: 10.1095/biolreprod.107.067330] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Akutsu K, Takatori S, Nozawa S, Yoshiike M, Nakazawa H, Hayakawa K, Makino T, Iwamoto T. Polybrominated diphenyl ethers in human serum and sperm quality. BULLETIN OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2008; 80:345-350. [PMID: 18320132 DOI: 10.1007/s00128-008-9370-4] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2007] [Accepted: 01/28/2008] [Indexed: 05/26/2023]
Abstract
Polybrominated diphenyl ethers (PBDEs) are widely used flame retardants; currently, they are identified as ubiquitous environmental contaminants. Several studies indicate that PBDEs might affect male fertility. We present the results of a pilot study on the relationship between human serum PBDEs and sperm quality. The PBDE levels in Japan are comparable to those found in European countries. Strong inverse correlations were observed between the serum concentration of 2,2',4,4',5,5'-hexabromodiphenyl ether and sperm concentration (r = -0.841, p = 0.002) and testis size (r = -0.764, p = 0.01). Extensive studies on the relationship between PBDEs and sperm quality are required.
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Affiliation(s)
- K Akutsu
- Division of Food Chemistry, Osaka Prefectural Institute of Public Health, Osaka, 537-0025, Japan.
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Abstract
After the controversial report by Carlsen et al. in 1992 showing a possible decline in human semen quality over the past 50 years, many laboratories investigated their own records of semen findings that had been kept for the past decades, and a significant decrease in sperm quality was reported from some laboratories, but not others. At the beginning of the 21st century, a definitive interpretation of this issue has not yet been offered; however, it seems plausible that there are large regional differences in semen quality. Decreases in semen quality have been reported from various regions around the world, and a concurrent rise in the incidence of other reproductive problems, such as testicular cancer and genital abnormalities, has been observed in many regions. However, most of the reports showing regional differences were from Western or Western-derived countries, despite the fact that Asia is the region with the highest population on earth. Recently we undertook a cross-sectional study on fertile men in Japan to describe the current status of semen quality of Japanese men. We took confounders into consideration to allow a comparison with a previous European study. Japanese fertile men proved to have a semen quality at the level of Danish men, who were reported to have the lowest level among the men examined in the European study. This low level of sperm concentration in fertile Japanese men may result from differences in lifestyle or other environmental factors, but we cannot rule out the possibility of ethnic differences caused by different genetic variation or combination. To address this issue we need more information on the reproductive function in Asian men, who have been reported to have certain differences in reproductive characteristics from Caucasian men. This article is an attempt to review our present knowledge concerning the current status of semen quality in healthy Asian men on the basis of the limited publications from Asia. (Reprod Med Biol 2007; 6: 185-193).
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Affiliation(s)
- Teruaki Iwamoto
- Department of Urology, St Marianna University School of Medicine, Kawasaki, and
- Center for Infertility and IVF, International University of Health and Welfare Hospital, Nasushiobara, Japan
| | - Shiari Nozawa
- Department of Urology, St Marianna University School of Medicine, Kawasaki, and
| | - Miki Yoshiike
- Department of Urology, St Marianna University School of Medicine, Kawasaki, and
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Inhibition of estrogen action by 2-phenylchromone as AhR agonist in MCF-7 cells. Life Sci 2007; 81:1446-51. [PMID: 17950758 DOI: 10.1016/j.lfs.2007.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2007] [Revised: 09/05/2007] [Accepted: 09/06/2007] [Indexed: 11/22/2022]
Abstract
Large amounts of phytoestrogen, a group of estrogen derived from plant sources, are taken from the diet by Asians, but a sign of feminization has not been fully recognized. In this study, we found that some flavonoids inhibited an effect on estrogen action without estrogen receptor (ER) binding. Considering the report that dioxin, an aryl hydrocarbon receptor (AhR) agonist, disrupts the transcriptional activity of ER without binding to the ER, 14 flavonoids were examined for the transcriptional activity of AhR by the yeast reporter assay (AhR). Among them, 2-phenylchromone (flavone, FLA) showed the highest activity. FLA increased the expression of CYP1A1 mRNA, and inhibited the expression of progesterone receptor and pS2 mRNA in MCF-7 cells via non-ER-mediated pathway. Further studies showed that FLA had agonist activity for AhR and enhanced the proteosome-dependent degradation of ERalpha protein. Thus, FLA inhibited the estrogen action without binding to the ER by acting as a competitive agonist for AhR, which meaning that there can be anti-estrogenic flavonoids such as FLA as well as estrogenic ones such as isoflavones.
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Abstract
Traditionally, the diagnosis of male infertility has relied upon microscopic assessment and biochemical assays to determine human semen quality. The conventional parameters given most importance have been the concentration, motility, and morphology of sperm in the ejaculate. Most laboratories also include ‘sperm suitability’ tests where the subpopulations of sperm more likely to finish the marathon journey to the oocyte are separated by density centrifugation. These tests are essential to provide the fundamental information on which clinicians base their initial diagnosis. However, none of these parameters addresses sperm function and their clinical value in predicting fertility is questionable. The advent of intracytoplasmic sperm injection (ICSI) has further reduced the significance and perceived need for sperm quality tests since ICSI requires only one sperm, not subject to classic, or indeed any, tests for the procedure to be successful. Over the past decade, a number of laboratory tests have been developed to determine properties of sperm function. These include quantitative sperm motion parameters, capacitation, basal and induced acrosome reactions, sperm–zona pellucida interactions and nuclear and mitochondrial sperm DNA but few have been adopted into routine clinical use. International collaborations should be initiated to develop clinically relevant molecular and functional tests with agreed protocols and clinical thresholds as a matter of urgency.
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Affiliation(s)
- Sheena E M Lewis
- School of Medicine, Obstetrics and Gynaecology, Queen's University Belfast, Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BA, UK.
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Current World Literature. Curr Opin Obstet Gynecol 2007; 19:289-96. [PMID: 17495648 DOI: 10.1097/gco.0b013e3281fc29db] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Soares PMF, Borba EF, Bonfa E, Hallak J, Corrêa AL, Silva CAA. Gonad evaluation in male systemic lupus erythematosus. ACTA ACUST UNITED AC 2007; 56:2352-61. [PMID: 17599762 DOI: 10.1002/art.22660] [Citation(s) in RCA: 81] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess gonad function in male patients with systemic lupus erythematosus (SLE). METHODS Thirty-five consecutive male patients with SLE according to the criteria of the American College of Rheumatology were prospectively evaluated for demographic and clinical features as well as previous and current treatment. Patients underwent urologic evaluation and testicular Doppler ultrasound. We obtained a hormone profile and performed a semen analysis including morphology and testing for the presence of antisperm antibodies. Patients were compared with 35 age-matched healthy controls. RESULTS Compared with controls, SLE patients had lower median testicular volumes in both testes, a lower median total sperm count, and a lower median total motile sperm count. The mean sperm volume and percentage of normally formed sperm were lower in SLE patients than in controls. Since all SLE patients had semen alterations, they were further subdivided into 2 groups according to the severity of these abnormalities (group 1, with teratozoospermia [n = 18], and group 2, with azoospermia or teratozoospermia in combination with oligozoospermia and/or asthenozoospermia [n = 17]). The frequency of treatment with intravenous cyclophosphamide (IV CYC) after the first ejaculation was higher in group 2 than in group 1. The median testicular volumes measured by ultrasound in both testicles were lower in group 2 than in group 1. Follicle-stimulating hormone levels were higher in group 2 than in group 1. The overall frequency of antisperm antibodies in SLE patients was 40%. The apparent higher frequency of antisperm antibodies in group 1 than in group 2 did not reach significance. CONCLUSION SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume. Postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.
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