Correlation of lead and cadmium in human seminal plasma with seminal vesicle and prostatic markers

Exposure to potentially toxic elements (PTEs) and the risk of male infertility- A Systematic review and meta-analysis

BACKGROUND

Infertility has been defined as a failure to conceive for at least 12 months of regular unprotected sexual intercourse. The male factors are responsible for about 50 % of cases. Various factors such as endocrine, immunological, genetic, exposure to toxicants, and idiopathic factors are involved in male infertility. Recently, the role of PTEs in reproductive performance has been explored by various studies.

OBJECTIVES

Current systematic review and meta-analysis have been carried out to compile and statistically analyze the findings of relevant studies and reach some conclusion.

METHODOLOGY

A literature search was done according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines in three scientific literature databases; PubMed, Google Scholar, and Science Direct. Meta-analysis was performed using Review Manager 5.4 software. The study's protocol was registered in PROSPERO (CRD42023465776).

RESULTS

Meta-analysis of lead in the blood of infertile cases and healthy controls indicated a significant association with male infertility, observed standard mean difference (SMD) was 0.67 at 95 % confidence interval (CI) (0.07, 1.28), and p = 0.03. In the case of lead analysis in semen, the values are as follows: SMD = 1.19 at 95 % CI (0.42, 1.96) with p = 0.002. Significant association appears for cadmium in semen with SMD 0.92 at 95 % CI (0.54, 1.29) and p < 0.00001. No significant association was observed for arsenic, barium, and mercury in blood.

CONCLUSION

Most of the studies focus on the detection of PTE in semen samples followed by blood as sample type. Lead and cadmium exposure is significantly associated with male infertility. However, non-significant results for arsenic, barium, and mercury are observed.

Counteracting effects of heavy metals and antioxidants on male fertility

Infertility is regarded as a global health problem affecting 8-12% of couples. Male factors are regarded as the main cause of infertility in 40% of infertile couples and contribute to this condition in combination with female factors in another 20% of cases. Abnormal sperm parameters such as oligospermia, asthenospermia, and teratozoospermia result in male factor infertility. Several studies have shown the deteriorative impact of heavy metals on sperm parameters and fertility in human subjects or animal models. Other studies have pointed to the role of antioxidants in counteracting the detrimental effects of heavy metals. In the currents study, we summarize the main outcomes of studies that assessed the counteracting impacts of heavy metal and antioxidants on male fertility. Based on the provided data from animal studies, it seems rational to administrate appropriate antioxidants in persons who suffer from abnormal sperm parameters and infertility due to exposure to toxic elements. Yet, further human studies are needed to approve the beneficial effects of these antioxidants.

Environmental contaminants and male infertility: Effects and mechanisms

The escalating prevalence of male infertility and decreasing trend in sperm quality have been correlated with rapid industrialisation and the associated discharge of an excess of synthetic substances into the environment. Humans are inevitably exposed to these ubiquitously distributed environmental contaminants, which possess the ability to intervene with the growth and function of male reproductive organs. Several epidemiological reports have correlated the blood and seminal levels of environmental contaminants with poor sperm quality. Numerous in vivo and in vitro studies have been conducted to investigate the effect of various environmental contaminants on spermatogenesis, steroidogenesis, Sertoli cells, blood-testis barrier, epididymis and sperm functions. The reported reprotoxic effects include alterations in the spermatogenic cycle, increased germ cell apoptosis, inhibition of steroidogenesis, decreased Leydig cell viability, impairment of Sertoli cell structure and function, altered expression of steroid receptors, increased permeability of blood-testis barrier, induction of peroxidative and epigenetic alterations in spermatozoa resulting in poor sperm quality and function. In light of recent scientific reports, this review discusses the effects of environmental contaminants on the male reproductive function and the possible mechanisms of action.

Biomonitoring for exposure to multiple trace elements via analysis of urine from participants in the study of metals and assisted reproductive technologies (SMART)

Humans are exposed to concentrations of multiple trace elements through a variety of background sources; many are suspected reproductive toxicants. Prior to investigating associations between trace elements and human reproductive health, potential biomarkers of exposure should be characterized by sources of variability in the population at risk. Factors influencing elemental exposure should also be identified to ensure their consideration as potential confounding variables. The principal aim of this study is to characterize sources of variability for 19 trace elements measured in urine specimens collected from 55 women and 36 male partners completing a 1st cycle of in vitro fertilization (IVF). Urine specimens were analyzed using a biomonitoring method based on inductively coupled plasma-mass spectrometry (ICP-MS). Randomly selected urine specimens (∼6%) were analyzed in duplicate, and these data were used to characterize sources of variability. Nine trace elements including As, Ba, Cd, Cs, Co, Cu, Mn, Mo, and Zn, were quantified in most specimens, indicating their utility in future epidemiologic studies of trace elements exposure and IVF outcomes. With few exceptions, normalizing urine using the traditional creatinine-correction procedure, or an alternative approach based on a linear regression model, increased residual variability only slightly. Sex and race appear to be important factors to consider in epidemiologic studies conducted in this population. Urine concentrations for most elements are similar to those reported in the 2005-2006 National Health and Nutrition Examination Survey (NHANES); however, differences in others may indicate regional trends or a unique exposure history for this infertile study population.

Toxic trace metals and human oocytes during in vitro fertilization (IVF)

Trace exposures to the toxic metals mercury (Hg), cadmium (Cd) and lead (Pb) may threaten human reproductive health. The aim of this study is to generate biologically-plausible hypotheses concerning associations between Hg, Cd, and Pb and in vitro fertilization (IVF) endpoints. For 15 female IVF patients, a multivariable log-binomial model suggests a 75% reduction in the probability for a retrieved oocyte to be in metaphase-II arrest for each microg/dL increase in blood Pb concentration (relative risk (RR)=0.25, 95% confidence interval (CI) 0.03-2.50, P=0.240). For 15 male IVF partners, each microg/L increase in urine Cd concentration is associated with an 81% decrease in the probability for oocyte fertilization (RR=0.19, 95% CI 0.03-1.35, P=0.097). Because of the magnitude of the effects, these results warrant a comprehensive study with sufficient statistical power to further evaluate these hypotheses.

Exposure to heavy metals (lead, cadmium and mercury) and its effect on the outcome of in-vitro fertilization treatment

We investigated the effect of lead, cadmium and mercury exposure on pregnancy and fertilization rate outcome among 619 Saudi women (age 19-50 years) who sought in-vitro fertilization (IVF) treatment between 2002 and 2003. The concentrations of lead, cadmium and mercury were measured in both blood and follicular fluids. At levels well below the current US occupational exposure limit guidelines (40microg/dL) and even less than the current Centers for Disease Control and Prevention level of concern for preventing lead poisoning in children (10microg/dL), blood lead level was negatively associated with fertilization outcome in both adjusted and unadjusted logistic regression models. We found that among various demographic, socioeconomic and environmental factors, fish consumption was positively associated with blood lead levels. These results support the hypothesis that a raised blood lead level affects infertility and intervention to reduce the lead exposure might be needed for women of reproductive age. The present results also revealed unexpected finding - the positive relationship between follicular cadmium levels and fertilization outcome, which points to the necessity for further investigation. Though adverse effect of mercury on pregnancy outcome or fertilization rate was not evident in this study, mercury5.8microg/L (EPA safety limit) was found in the blood and follicular fluid of 18.7% and 8.3% of the women, respectively. Concerns about its possible adverse effects on the physiology of reproduction or fetal development cannot be ruled out. It should be noted that skin-lightening creams and dental amalgam were important contributors to mercury exposure. Such finding is alarming and priority for further studies are, urgently, needed.

Preliminary investigations on the standardization and quality control for the determination of acid phosphatase activity in seminal plasma

BACKGROUND

The determination of ACP in seminal plasma was considered as an appropriate biochemical marker to evaluate prostate function, as recommended by the WHO manual. However, few reports on the standardization and quality control for the determination of biochemical markers in seminal plasma have been documented.

METHODS

Two frozen samples of seminal plasma with or without phenylmethylsulfonyl fluoride were determined for their acid phosphatase (ACP) levels. The ACP level and sperm concentration of each of 72 samples of seminal plasma obtained at 1000xg for 10 min or 3000xg for 15 min centrifugation were assayed. ACP activity in 10 samples of seminal plasma was measured immediately or standing for 30 min after dilution. The ACP levels in seminal plasma with or without chymotrypsin were also assayed.

RESULTS

There was no significant difference of ACP levels (P=0.166) but of sperm concentrations (P=0.000) in seminal plasma obtained by centrifugation at different velocity. ACP activities in seminal plasma measured when standing for 30 min after dilution were significantly lower than those measured immediately after dilution (P=0.001). Both chymotrypsin and freezing-thawing had no apparent effect on the determination of ACP in seminal plasma.

CONCLUSION

The results indicated that standing time after dilution and centrifugation velocity should be standardized, and frozen seminal plasma could serve as the quality control products for the determination of ACP activity among different laboratories.

Effect of environmental contaminants on male reproduction

A substantial body of evidence has accumulated in recent years that consistently indicate various adverse effects of environmental contaminants on human health. Decreasing trend of male fertility in terms of sperm counts and sperm quality, along with other changes in male reproductive health, including congenital malformations and testicular cancer in humans, and similar problems in wildlife has been correlated to the exposure to environmental contaminants. Many environmental chemicals have been reported to cause these reproductive abnormalities by eliciting changes in endocrine control of reproduction; however the specific underlying mechanisms are poorly understood. The present review summarizes recent studies on environmental contaminants and associated possible mechanism leading to adverse effects on male reproduction. Numerous studies demonstrate the interaction of environmental toxicants with steroid receptors and thereby causing interference with developmental and functional aspects of testis, epididymis and accessory sex organs. Induction of reactive oxygen species (ROS) by environmental contaminants and associated oxidative stress also have role in defective sperm function and male infertility.

Correlation of chlorinated pesticides concentration in semen with seminal vesicle and prostatic markers

Semen samples of fertile and infertile men were analysed by gas liquid chromatography (GLC) for the presence of dichlorodiphenyltrichloroethane (DDT) and its metabolites (1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene) (pp'-DDE); (1,1,1-trichloro-2,2-bis(p-chlorophenyl ethane) (pp'-DDT); (1,1-dichloro-2,2 bis(p-chlorophenyl) ethane) (pp'-DDD); (1,1,1-trichloro-2-(o-chlorophenyl)-2-(p-chlorophenyl) ethane) (op'-DDT), hexachlorocyclohexane (HCH) and its isomers alpha (alpha), beta (beta), gamma (gamma), delta (delta) and aldrin. The biochemical analysis of seminal vesicle and prostatic marker was done by spectrophotometer. The concentrations of alpha-, beta-, gamma-HCH, pp'-DDE and pp'-DDD were higher in the semen of infertile than in that of fertile men. An elevation in the fructose level along with decrease in the gamma-glutamyl transpeptidase and acid phosphatase activity was noticed in infertile men as compared to fertile subjects. The data showed correlation between alpha-, beta-, gamma-HCH, pp'-DDE, pp'-DDD and seminal vesicle marker fructose and prostatic marker gamma-gluatamyl transpeptidase and acid phosphatase in infertile men. The study suggests that the chlorinated pesticides may influence the semen quality by affecting the seminal and prostatic functions in infertile men.