Nitric oxide produced in the testis is involved in dilatation of the internal spermatic vein that compromises spermatogenesis in infertile men with varicocele

Effect of moxa smoke on sperm parameters and oxidative stress in rats with asthenozoospermia

Asthenozoospermia is a leading cause of male infertility, characterized by reduced sperm motility. In this study, we determined sperm motility and the activities of antioxidant enzymes and oxidation products in the testis of rats with ornidazole (ORN)-induced asthenozoospermia and further examined and compared the differential effects of moxa smoke (MS) and cigarette smoke (CS) on sperm motility and oxidative stress (OS) of asthenozoospermic rats. The smoke intervention was initiated 11 days after intragastric administration of ORN, followed by the examination of testis index, sperm parameters, OS-related gene levels, and testicular histopathology. Sperm motility and antioxidant enzyme activities, as well as oxidation products significantly decreased in ORN-induced rats compared with MS-treated rats (p < .05-.001). MS treatment restored the reduced sperm motility and activities of glutathione peroxidase, superoxide dismutase, and catalase, but increased the malondialdehyde and nitric oxide synthetase levels in ORN-induced rats (p < .05-.001). Also, the histopathological changes in the testis of ORN-induced rats were improved by MS treatment. The study highlighted that MS was an effective factor in moxibustion therapy, which notably improved the sperm motility of asthenozoospermic rats by inhibiting OS in the reproductive system.

Genetic variants in varicocele-related male infertility: a systematic review and future directions

Genetic association studies (GAS) may have the capability to probe the genetic susceptibility alleles in many disorders. This systemic review aimed to assess whether an association exists between gene(s)/allelic variant(s), and varicocele-related male infertility (VRMI). This review included 19 GAS that investigated 26 genes in 1,826 men with varicocele compared to 2,070 healthy men, and 263 infertile men without varicocele. These studies focussed on candidate genes and relevant variants, with glutathione S-transferase gene being the most frequently studied (n = 5) followed by the nitric oxide synthase 3 (NOS3) gene (n = 3) and the phosphoprotein tyrosine phosphatase 1 gene (n = 2). In one study the genes for NAD(P)H quinone oxidoreductase 1, sperm protamine, human 8-oxoguanine DNA glycosylase 1, methylenetetrahydrofolate reductase, polymerase gamma, heat shock protein 90, mitochondrial DNA, superoxide dismutase 2, transition nuclear protein 1, and transition nuclear protein 2, were assessed. There is no clear indication that any of these polymorphisms are sturdily associated with VRMI. However, three studies established that the polymorphic genotype (GT + TT) for rs1799983 polymorphism of the NOS3 gene is more frequent in varicocele patients. Further endeavours such as standardising reporting, exploring complementary designs, and the use of GWAS technology are justified to help replicate these early findings.

Reactive Nitrogen Species and Male Reproduction: Physiological and Pathological Aspects

Reactive nitrogen species (RNS), like reactive oxygen species (ROS), are useful for sustaining reproductive processes such as cell signaling, the regulation of hormonal biosynthesis, sperm capacitation, hyperactivation, and acrosome reaction. However, endogenous levels of RNS beyond physiological limits can impair fertility by disrupting testicular functions, reducing gonadotropin production, and compromising semen quality. Excessive RNS levels cause a variety of abnormalities in germ cells and gametes, particularly in the membranes and deoxyribonucleic acid (DNA), and severely impair the maturation and fertilization processes. Cell fragmentation and developmental blockage, usually at the two-cell stage, are also connected with imbalanced redox status of the embryo during its early developmental stage. Since high RNS levels are closely linked to male infertility and conventional semen analyses are not reliable predictors of the assisted reproductive technology (ART) outcomes for such infertility cases, it is critical to develop novel ways of assessing and treating oxidative and/or nitrosative stress-mediated male infertility. This review aims to explicate the physiological and pathological roles of RNS and their relationship with male reproduction.

Effect of low energy shock wave on testicular microenvironment homeostasis in rats

OBJECTIVE

To further investigate whether two sets of low-energy extracorporeal shock waves (LESWs) impulse parameters, i.e., 0.02 mJ/mm² for 500 impulses and 0.04 mJ/mm² for 500 impulses, which have been shown to directly affect the testes, can promote testicular spermatogenesis or positively regulate homeostasis of the testicular microenvironment.

METHODS

(1) Twenty-four experimental rats were randomly divided into a 0.02 mJ/mm² 500 impulses group (L1 group), a 0.04 mJ/mm² 500 impulses group (M1 group), a sham intervention group (S group) and a blank control group (N group). The experiment period was 8 weeks. (2) Apoptosis of the spermatogenic cells in the left testicle was detected by the TUNEL method, VEGF and eNOs protein expression was detected by immunohistochemistry, and histomorphological changes were observed in PAS-stained sections. Moreover, the morphologies of the spermatogenic tubules and testicular stroma were quantitatively analyzed by stereological analysis. The right testicle was used for Western blot detection of the protein expression levels of Bax, Cytochrome C, Caspase-3, Bcl-2, VEGF and eNOs.

RESULTS

Compared with the other three groups, the rate of M1 testicular germ cell apoptosis induced by shock treatment was higher, the expression levels of proapoptotic proteins increased significantly while that of the antiapoptotic protein was lower, and the suppression of cell proliferation correlated with the protein expression levels. Additionally, with respect to the absolute volume of the seminiferous tubules, the absolute interstitial testicular volume notably increased, producing a series of biological effects working against testicular sperm production and function. However, there was no significant difference between the L1 group and the N and S groups.

CONCLUSIONS

LESWs treatment with impulse parameters of 0.02 mJ/mm² for 500 impulses showed a better protective effect on testicular spermatic function in rats and has a positive regulatory biological effect.

Physiological role of reactive oxygen species in testis and epididymal spermatozoa

The reactive oxygen species (ROS) play an important role in various aspects of male reproductive function, for spermatozoa to acquire the ability to fertilize. However, the increase in ROS generation, both due to internal and external factors, can induce oxidative stress, causing alterations in the structure and function of phospholipids and proteins. In the nucleus, ROS attack DNA, causing its fragmentation and activation of apoptosis, thus altering gene and protein expression. Accumulating evidence also reveals that endogenously produced ROS can act as second messengers in regulating cell signalling pathways and in the transduction of signals that are responsible for regulating spermatogonia self-renewal and proliferation. In the epididymis, they actively participate in the formation of disulphide bridges required for the final condensation of chromatin, as well as in the phosphorylation and dephosphorylation of proteins contained in the fibrous sheath of the flagellum, stimulating the activation of progressive motility in epididymal spermatozoa. In this review, the role of small amounts of ROS during spermatogenesis and epididymal sperm maturation was discussed.

Evaluation of patient compliance with the use of scrotal cooling devices

Objective

To evaluate the compliance of infertile men with the use of scrotal cooling devices. As a secondary objective, sperm parameters, deoxyribonucleic acid fragmentation, and hormone profiles were examined.

Design

This exploratory study on scrotal cooling provided scrotal cooling devices to men with primary infertility and abnormal semen parameters. Feedback on the devices after their use was gathered in the form of a questionnaire, and semen parameters were examined after device use.

Setting

Single center infertility clinic in Toronto, Ontario, Canada.

Patient(s)

Patients with primary infertility and abnormal semen parameters were prospectively evaluated before and after scrotal cooling.

Intervention(s)

One of two scrotal cooling devices (Underdog or Snowballs) was used, on the basis of patient preference.

Main Outcome Measure(s)

Questionnaires were completed by patients on compliance with device use and concerns about and recommendations for improving the cooling devices. Baseline deoxyribonucleic acid fragmentation index, sperm parameters, and hormones were measured at the initial visit (t = 0) and at subsequent visits (t = 4–12 weeks). Statistical comparison of values before and after scrotal cooling was performed.

Result(s)

Forty patients were enrolled in the study, and the questionnaire was completed by 65.0% (n = 26). Most respondents (76.9%) used scrotal cooling less than the recommended duration. Respondents believed that the devices were uncomfortable (31.5%), impeded work (21.0%), and lost cooling rapidly (14.3%). Significant increases in sperm motility and vitality (from 25.4 % to 29.0% and from 64.8% to 71.7%, respectively) were demonstrated after scrotal cooling.

Conclusion(s)

Most patients were not compliant with the recommended use of the scrotal cooling devices because of issues of comfort, convenience, and concealability. Further work on improving scrotal cooling devices is necessary to enhance their potential as a therapeutic tool for men with abnormal sperm parameters and infertility.

Effects of Dietary Crude Glycerin Concentration on Testicular Morphology and Oxidative Stress Markers and on Plasma Testosterone Concentrations

We evaluated the effects of feeding 6%, 12% or 18% crude glycerin, containing 80.5% glycerol, on testicular histomorphometry and markers of oxidative stress and on plasma testosterone concentrations in lambs. Body weight, testicular biometric measurements, gonadosomatic index and net weight of the testicles were higher for the treated groups (P <0.05) compared with a control group that did not receive dietary glycerin. The mean total length of seminiferous tubules was higher in the 6% group (P <0.05), while the mean total tubular and seminiferous epithelium volumes increased in all treated groups (P <0.05). The volume of Leydig cells increased in the 12% group, while their number per gram of testicle decreased (P <0.05). There was a decrease in mean nuclear diameter and mean volume of Leydig cells, and an increase in the mean number of these cells per gram of testicle, in the 18% group (P <0.05). Plasma testosterone concentrations were unaffected. There was desquamation of seminiferous epithelium and vacuolation of Sertoli cells in the treated groups. Variable degrees of spermatocyte necrosis and the presence of giant cells were seen in all groups and there was intense vacuolation of Sertoli cells in the 12% and 18% groups. Superoxide dismutase and catalase production increased most in the 12% and 18% groups (P <0.05), while glutathione production was higher in the 18% group (P <0.05). Mean nitric oxide concentration decreased in all treated groups (P <0.05), while malondialdehyde production was higher in the 18% group than in the control and 6% groups (P <0.05). We conclude that the inclusion of 6% glycerin in the diet of lambs results in changes in testicular morphology that have been previously associated with improved reproductive function, but without evidence of oxidative stress.

Effects of HIF-1α on Spermatogenesis of Varicocele Rats by Regulating VEGF/PI3K/Akt Signaling Pathway

Hypoxia-inducible factor-1α (HIF-1α) participates in the regulation of spermatogenic function in rats with varicocele (VC), and the PI3K/Akt pathway plays an important role in it. In the present research, we applied the CRISPR/Cas9 gene editing technique to silence the HIF-1α gene of VC rat testis, to explore the effect of HIF-1α on apoptosis of spermatogenic cells in VC rats through the PI3K/Akt pathway. Sprague Dawley rats were randomly assigned to four groups, including the normal rat group (group N), VC model group (group V), VC + HIF-1α-lentivirus group (group H), and VC + luciferase-lentivirus group (group L). Apoptosis of spermatogenic cells in rat testis was tested by TUNEL Kit. The morphologic changes of seminiferous tubules were viewed by a light microscope. Expressions of VEGF, Akt, p-Akt, p70S6K, and p-p70S6K were detected by means of Western blot, immunofluorescence, or immunohistochemistry methods. One-way ANOVA was applied to analyze the diverseness between groups. Compared with group N, the distribution of germ cells was disordered, apoptosis of spermatogenic cells increased significantly, and the expression of VEGF, p-Akt, and p-p70S6K was also increased in group V. Compared with group V, the damage of seminiferous epithelium in group H was improved, and the arrangement of the seminiferous epithelium was almost orderly. Apoptosis of spermatogenic cells decreased significantly, and the expression of VEGF, p-Akt, and p-p70S6K protein was decreased (P < 0.05). There was no significant difference between group N and group H (P > 0.05).In conclusion, HIF-1α is regulated by hypoxia in rats with varicocele to regulate its downstream gene VEGF which regulates spermatogenesis, and the PI3K/Akt signaling pathway plays a regulatory role in this process.

Relationship between aryl hydrocarbon receptor and spermatogenic dysfunction in male patients with varicocele

The main purpose of this project is to verify whether there is a difference in the expression of aryl hydrocarbon receptor (AhR) between varicocele (VC) and normal male semen, and determine whether there is a connection with the parameters of semen analysis. The risk factors of infertility in patients with VC were also studied. Semen samples were collected for semen analysis and Western blot. Logistic regression was used to investigate the risk factors associated with infertility in patients with VC. Men with VC had lower AhR expression compared to healthy men; correlation analysis results showed that: AhR expression in patients with VC group was significantly positively correlated with sperm concentration and sperm motility; significantly negatively correlated with the diameter of spermatic veins during Valsalva and the percentage of abnormal sperm morphology; the research results of related risk factors show that the risk of infertility of patients with grade III is 1.67 times that of patients with grades I and II. For each unit of abnormal sperm morphology, the risk of infertility increases 1.04 times. Sperm concentration, total sperm viability and each unit the expression of AhR protein decreases the risk of infertility by 3%, 9% and 11% respectively.

Effect of Anthocleista djalonensis A. Chev Root Extract on Testis of Matured Rats

OBJECTIVE

To investigate the effects of different extracts of Anthocleista djalonensis on the testis and epididymal sperms of rats.

METHODS

Fifty male Wistar rats were randomly divided into 10 groups (n=5 in each group) and orally treated with 50, 100 and 200 mg/kg body weight each of methanol, aqueous ethanol (H-EtOH) and chloroform extracts of A. djalonensis. Corn oil was used as vehicle (2 mL/kg). After 60 days of treatment, testosterone (T) and cholesterol (CHOL) concentrations, catalase (CAT), lactate dehydrogenase (LDH), 3β-hydroxysteroid dehydrogenase (3β-HSD) and superoxide dismutase (SOD) activities in the testes along with myeloperoxidase (MPO) activities and nitrite concentrations (NO) in the serum and testes as well as sperm quality were measured.

RESULTS

T and CHOL concentrations along with 3β-HSD activity were significantly higher in the animals treated with the low dose than in those treated with the high dose of the chloroform extract (P<0.05). Furthermore, the chloroform extract was more effective than the methanol extract that had the most marginal effect on T level at the high dose and the H-EtOH extract that was only effective at the medium dose. LDH activity was dose-dependently increased by the extracts in all groups. The CAT-SOD antioxidant system was increased in the treated animals at all doses compared to the control values, but the increase in glutathione level reached significant level in those treated with the low dose H-EtOH aqueous ethanol extract (P<0.05). Only the high dose of chloroform extract had significant inhibitory effects on MPO activity (P<0.05). Serum NO concentration was decreased at all doses of the extracts. The inhibitory effects of the extracts on testicular NO concentrations follow this order, chloroform extract > H-EtOH > methanol. Although all extracts at all doses showed excellent stimulatory effects on sperm quality (count, motility and morphology), the methanol extract at the high dose was the most effective on sperm count (P<0.05).

CONCLUSION

The chloroform extract of A. djalonensis has better androgen-like and anti-inflammatory effects whereas the methanol extract has the best effect on sperm count.

[Venous wall weackness pathogenesis in varicose vein disease]

Varicose veins of lower extremities, varicocele and varicose dilation of pelvic veins including ovaricovaricocele are the most common non-inflammatory diseases of venous system. The same mechanisms determined varicose dilatation regardless localization of the vein. First of all, these are wall weakness and valvular insufficiency combined with hereditary collagen fiber defectiveness in case of undifferentiated connective tissue syndrome. Imbalance between different types of collagen in vascular wall (especially types I and III) also results wall weakness. Other important mechanisms are smooth muscle cells dysfunction followed by excessive intracellular synthesis and intramuscular fibrosis and imbalance of protease system due to overproduction of metalloproteinases. We consider that different forms of varicose veins (varicose veins of lower extremities, varicocele, ovaricovaricocele) may be unified within one pathology (varicose vein disease).

Significant alterations of 6-keto prostaglandin F1a and NO levels in spermatic vein plexus patients with varicocele

To investigate the level variation of correlative factors between the spermatic vein plexus and peripheral blood in patients with varicocele, a total of 22 patients diagnosed with varicocele were enrolled in the study. All patients were performed a testicular artery-sparing microsurgical varicocelectomy. During the operation, a blood sample from the left spermatic vein plexus and a peripheral blood sample were collected. A radioimmunoassay was used to determine the 6-keto prostaglandin F1a (6-keto-PGF1a ). A colorimetric method was performed to determine the NO. The enzyme immunoassay method was used to determine the creatinine, urea nitrogen, adrenaline, noradrenaline, dopamine and 5-HT. The mean age of all patients was 29.3 ± 7.8 years. Compared with the level of 6-keto-PGF1a and NO in the peripheral blood, 6-keto-PGF1a and NO were significantly increased in left spermatic vein plexus (347.3 (230.8-415.1) versus 99.7 (80.4-119.9) pg/ml and 192.3 ± 178.5 versus 107.1 ± 73.6 μmol/L, p < .05). There were no differences in the level of creatinine, urea nitrogen, adrenaline, noradrenaline, dopamine and 5-HT between the peripheral blood and left spermatic vein plexus (p > .05). The 6-keto-PGF1a and NO concentrations in left spermatic vein plexus were significantly higher than that in peripheral blood patients with varicocele.

Dilating venous disease: Pathophysiology and a systematic aspect to different vascular territories

Venous disease is a common but overlooked clinical problem and is an important mortality and morbidity factor depending on the effected vascular territory. Different contributing factors play role on the clinical manifestation of the disease. Peripheral varices of lower extremities, hemorrhoids, varicoceles, pelvic varicose veins are the vasculopathy of veins running toward heart but against gravity. We hypothesize that all these clinical entities share common pathophysiologic steps in terms of vascular wall remodeling and vessel wall damage. A systematic approaches to both arterial and venous dilating disease in further studies and research would increase our understanding on the pathophysiology of dilating vascular disease and would provoke to find out new treatment modalities. Varicose remodeling of veins occurs by a complex interplay of various factors including both physical forces and extracellular matrix remodeling mechanisms. This article focuses on the systematic aspects of dilating venous disease with a focus on pathophysiology under the term of "Dilating Venous Disease".

Increase in the expression of inducible nitric oxide synthase on exposure to bisphenol A: a possible cause for decline in steroidogenesis in male mice

Bisphenol A (BPA) is a well-known plasticizer and xenoestrogen that is responsible for many acquired reproductive difficulties, especially in men. Despite the prevalence of BPA in society, the mechanism behind reproductive deficits remains elusive. The present study investigates the mode of BPA's action by evaluating its effect on the expression of inducible nitric oxide synthase (iNOS) and steriodogenic acute regulatoryprotein (StAR) in male mice testis. Swiss albino mice were treated with a range BPA concentrations of 0.5, 50 and 100μg/kg body weight/day intraperitoneally for 60 days. Several markers of oxidative stress and male fertility were investigated. Nitrite levels, malondialdehyde levels and testicular injury scores were elevated whereas the sperm count, serum testosterone levels and catalase activity were reduced in the BPA groups. Mechanistically, an increase in iNOS expression was observed in the testis whereas the expression of the StAR was down regulated in the BPA treated mouse. These results suggest that BPA induces oxidative stress by altering the expression of iNOS, which consequently leads to the down regulation of StAR expression in the testis of male mouse.

Role of reactive nitrogen species in male infertility

Reactive nitrogen species (RNS) is a subset of free oxygen radicals called reactive oxygen species (ROS). Physiological levels of ROS are necessary to maintain the reproductive functions such as cell signaling, tight junction regulation, production of hormones, capacitation, acrosomal reaction, sperm motility, and zona pellucida binding. However, an excess of RNS can adversely affect reproductive potential by causing testicular dysfunction, decreased gonadotropin secretion, and abnormal semen parameters. Because such levels of RNS have been demonstrated in males with fertility problems and routine semen analysis has not been able to accurately predict IVF outcomes, it is imperative that novel strategies be developed in order to both assess and treat oxidative stress. This article describes both physiological and pathological roles of this unique subset of ROS.

Insight into oxidative stress in varicocele-associated male infertility: part 2

Varicocele, the leading cause of male infertility, can impair spermatogenesis through several pathophysiological mechanisms. Of these, current evidence suggests that oxidative stress is the central element contributing to infertility in men with varicocele, to which the testis responds by way of heat stress, ischaemia or production of vasodilators, such as nitric oxide. Surgical varicocele repair (varicocelectomy) is beneficial not only for alleviating oxidative stress-associated infertility, but also for preventing and protecting against the progressive character of varicocele and its consequent upregulations of systemic oxidative stress. However, antioxidant therapy in infertile men with surgically treated and those with untreated varicocele is poorly studied, and well-designed trials are needed.

Insight into oxidative stress in varicocele-associated male infertility: part 1

Varicocele is recognized as the leading cause of male infertility because it can impair spermatogenesis through several distinct pathophysiological mechanisms. Current evidence supports oxidative stress as a key element in the pathophysiology of varicocele-related infertility, although these mechanisms have not yet been fully described. Measurement of the reactive oxygen species and other markers of oxidative stress, including the levels of the antioxidant enzymes catalase and superoxide dismutase, can provide valuable information on the extent of oxidative stress and might guide therapeutic management strategies. The testis can respond to varicocele-associated cell stressors, such as heat stress, ischaemia or production of vasodilators (for example, nitric oxide) at the expense of the generation of excessive reactive oxygen species. These responses have their own implications in exacerbating the underlying oxidative stress and on the subsequent infertility.

Disturbed relaxin signaling pathway and testicular dysfunction in mouse offspring upon maternal exposure to simazine

Simazine is a triazine herbicide that is being widely applied worldwide and commonly detected in surface and groundwater. Despite its popular use in controlling weeds and algae, very limited information is available regarding its toxicity. In the present study, pregnant mice were orally exposed to low doses (0, 5, 50, or 500 µg/kg body weight per day) of simazine during gestation and lactation, during which no overt maternal toxic response was detected, and their offspring was assessed. Simazine-exposed male offspring showed decreased body, testicular, and epididymis weight, increased testicular apoptosis, and decreased sperm concentrations. Differentially-expressed genes in the testes of male offspring exposed to simazine were identified by DNA microarray, revealing 775 upregulated and 791 downregulated genes; among these, the relaxin-family peptide receptor 1 (Rxfp1), which is the receptor for relaxin hormone, was significantly downregulated. In addition, the expression of target genes in the relaxin pathway, including nitric oxide synthase 2 (Nos2) and Nos3, was significantly decreased in simazine-exposed F1 testes. Moreover, simazine inhibited NO release, and knockdown of Rxfp1 blocked the inhibitory action of simazine on NO production in testicular Leydig cells. Therefore, the present study provides a better understanding of the toxicities associated with the widely used herbicide simazine at environmentally relevant doses by demonstrating that maternal exposure interferes with the pleotropic relaxin-NO signaling pathway, impairing normal development and reproductive activity of male offspring.

Expression of NOS isoforms in internal spermatic veins of infertile men with varicocele

Although varicocele is a relatively common entity encountered in the evaluation of infertile men, the exact pathophysiology still remains unclear. Recently, as previously widely investigated in various parts of human circulatory system, nitric oxide synthase (NOS) and its product, nitric oxide (NO) have been thought to play a role in the development of varicocele and thus male infertility. In this study, we determined the concentration of NO metabolite and the expression of NOS isoforms in the internal spermatic (ISV) and superficial branch of inferior epigastric veins of infertile men with varicocele. The study included 60 infertile men with clinically unilateral or bilateral varicocele. Expression of inducible and endothelial NOS (iNOS and eNOS) isoforms were investigated in tissue arrays of internal spermatic and superficial branch of inferior epigastric veins with immunohistochemistry. NO metabolite (nitrite) levels were measured using the calorimetric method. A significantly higher expression of eNOS was observed in the varicose veins (mean score: 2.25 and 1.55, respectively; p = 0.0001). However, statistically, there was no significant difference for expression of iNOS between varicose and control veins (p = 0.094). The nitrite concentration and NOS expression were not found to be correlated with clinical variables (varicocele grade, maximum varicose vein diameter, and sperm concentration, motility, and morphology) (p > 0.05). As a result, the significantly higher expression of eNOS in ISV may be responsible for the development of varicocele, although this finding is not accompanied by an increase in NO concentration. Still, the pattern of the relationship between varicocele and increased eNOS expression warrants further investigation.

Reactive oxygen species in the internal spermatic and brachial veins of patients with varicocele-induced infertility

Purpose

The aim of this study was to evaluate the relationship between the levels of reactive oxygen species (ROS) and the clinical characteristics of varicoceles among patients with varicocele-induced infertility.

Materials and Methods

Ninety-eight patients with infertile varicocele and 22 control subjects without varicocele were enrolled. Blood samples were drawn from the brachial vein (BV) and the dilated internal spermatic vein (ISV) on the side of the varicocele during surgery. ROS levels were determined by spectrophotometry, and comparisons between the varicocele and control groups were performed. In addition, the ROS levels were analyzed according to the characteristics of the varicocele, and ROS levels in the ISV and the BV were compared.

Results

The ROS levels measured in the ISV of men with varicocele were higher than in the control group regardless of the varicocele grade except for subclinical grade; however, in the BV, a difference was noted only for grade III. When the difference in testis volume between sides was greater than 3 ml, and the varicocele had been present for more than 3 years, ROS levels were higher in the ISV than in the BV. Sperm viability was significantly associated with ROS levels. Serum hormone levels were not correlated with ROS levels.

Conclusions

Serum ROS levels were higher in infertile men with a varicocele than in controls. They were correlated with varicocele grade, varicocele duration, the degree of testicular hypotrophy, and sperm viability. In addition, ROS levels and their associations with clinical characteristics were higher in the ISV than in the BV.

Immunology of the Testis and Male Reproductive Tract

A large body of evidence points to the existence of a close, dynamic relationship between the immune system and the male reproductive tract, which has important implications for our understanding of both systems. The testis and the male reproductive tract provide an environment that protects the otherwise highly immunogenic spermatogenic cells and sperm from immunological attack. At the same time, secretions of the testis, including androgens, influence the development and mature functions of the immune system. Activation of the immune system has negative effects on both androgen and sperm production, so that systemic or local infection and inflammation compromise male fertility. The mechanisms underlying these interactions have begun to receive the attention from reproductive biologists and immunologists that they deserve, but many crucial details remain to be uncovered. A complete picture of male reproductive tract function and its response to toxic agents is contingent upon continued exploration of these interactions and the mechanisms involved.

Predictors of improved seminal parameters and fertility after varicocele repair in young adults

The aim of our study was to determine hormonal or biochemical markers in patients with clinically palpable left varicocele but without a history of infertility, with especial emphasis on nitric oxide, related with improved seminal parameters after varicocelectomy. Semen samples were obtained from 202 patients with left varicocele grade II or III. Nitric oxide levels in seminal plasma were determined by the Griess technique. Testicular volume was determined ultrasonographically in both testes and hormonal profile was measured. The post-operative sperm concentration increased significantly in patients with normal sperm count or moderate oligozoospermia, but we did not find an increment in sperm count in patients with mild and severe oligozoospermia after surgery. The mean percentage of normal motility significantly increased after surgery, but we did not observe a significant increment in morphologically normal sperm count and testicular volume after varicocele repair. Moreover, we did not find any correlation between nitric oxide concentrations and severity of oligozoospermia, asthenozoospermia or abnormal sperm morphology in this population. It is concluded that in the general male population, varicocele repair is not associated with an improved semen profile in all cases. We did not observe a significant correlation between nitric oxide concentrations and semen profile.