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Farhangnia P, Noormohammadi M, Delbandi AA. Vitamin D and reproductive disorders: a comprehensive review with a focus on endometriosis. Reprod Health 2024; 21:61. [PMID: 38698459 PMCID: PMC11064344 DOI: 10.1186/s12978-024-01797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/20/2024] [Indexed: 05/05/2024] Open
Abstract
Vitamin D is a fat-soluble steroid hormone that was initially known only for regulating calcium and phosphorus levels and maintaining bone health. However, it was later discovered that many organs express vitamin D metabolizing enzymes and have a ligand for vitamin D, which regulates the expression of an extensive assortment of genes. As a result, vitamin D is indispensable for the proper function of organs, and its deficiency is believed to be a critical factor in symptoms and disorders such as cardiovascular diseases, autoimmune diseases, and cancers. The significance of vitamin D in reproductive tissues was recognized later, and studies have revealed its crucial role in male and female fertility, as well as proper reproductive function during pregnancy. Vitamin D deficiency has been identified as a risk factor for infertility, gonadal cancers, pregnancy complications, polycystic ovary syndrome, and endometriosis. However, data investigating the association between vitamin D levels and reproductive disorders, including endometriosis, have encountered inconsistencies. Therefore, the present study aims to review existing research on the effect of vitamin D on proper reproductive function, and the role of deficiency in reproductive diseases and specifically focuses on endometriosis.
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Affiliation(s)
- Pooya Farhangnia
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran
- Immunology Board for Transplantation and Cell-Based Therapeutics (ImmunoTACT), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Reproductive Sciences and Technology Research Center, Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Morvarid Noormohammadi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Ali-Akbar Delbandi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
- Immunology Research Center, Institute of Immunology and Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran.
- Immunology Board for Transplantation and Cell-Based Therapeutics (ImmunoTACT), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Reproductive Sciences and Technology Research Center, Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Li N, Yang K, Zeng Y, Cao S, Deng L. Causal association between 25-Hydroxyvitamin D and risk of abnormal spermatozoa: A bidirectional Mendelian randomization study. Reprod Toxicol 2024; 126:108597. [PMID: 38643889 DOI: 10.1016/j.reprotox.2024.108597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 04/12/2024] [Accepted: 04/17/2024] [Indexed: 04/23/2024]
Abstract
Previous studies indicated conflicting findings regarding the association between vitamin D and abnormal spermatozoa. Herein, we assessed the causal association between circulating 25-Hydroxyvitamin D (25OHD) levels and the risk of abnormal spermatozoa by utilizing bidirectional Mendelian randomization (MR) analysis. Genome-wide association study summary statistics for 25OHD and abnormal spermatozoa were obtained from publicly accessible databases. Single nucleotide polymorphisms (SNPs) associated with 25OHD and SNPs associated with abnormal spermatozoa were used as instrumental variables (IVs) for forward MR analysis and reverse MR analysis, respectively. Inverse variance weighted (IVW) was the main MR approach, while weighted median, MR-Egger, and maximum likelihood methods were employed to supplement IVW. In addition, several sensitivity tests assessed the reliability of MR analysis. Forward MR analysis showed that elevated 25OHD levels significantly reduced abnormal spermatozoa risk (odds ratio [OR] = 0.75, 95 % confidence interval [CI]: 0.56-1.00, P = 4.98E-02), and the effect remained statistically significant after excluding SNPs associated with confounders (OR = 0.73, 95 % CI: 0.54-0.98, P = 3.83E-02) or only utilizing SNPs located near 25OHD-associated genes only as IVs (OR = 0.58, 95 % CI: 0.41-0.81, P = 1.67E-03). Reverse MR analysis indicated abnormal spermatozoa not affecting 25OHD level (P > 0.05). Sensitivity tests showed that MR analyses were not affected by heterogeneity and horizontal polytropy. Overall, the present MR study supports that elevated 25OHD levels reduce the risk of abnormal spermatozoa. Therefore, ensuring adequate vitamin D intake and maintaining stable levels of 25OHD may be effective strategies to optimize reproductive outcomes.
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Affiliation(s)
- Nannan Li
- The First Hospital of Changsha, Changsha 410005, China; The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha 410005, China
| | - Ke Yang
- The First Hospital of Changsha, Changsha 410005, China; The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha 410005, China
| | - Youjie Zeng
- Department of Anesthesiology, Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, China
| | - Si Cao
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-XIANGYA, Changsha, Hunan 410205, China
| | - Liang Deng
- The First Hospital of Changsha, Changsha 410005, China; The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha 410005, China.
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Holt R, Yahyavi SK, Wall-Gremstrup G, Jorsal MJ, Toft FB, Jørgensen N, Juul A, Blomberg Jensen M. Low-serum antimüllerian hormone is linked with poor semen quality in infertile men screened for participation in a randomized controlled trial. Fertil Steril 2024:S0015-0282(24)00193-6. [PMID: 38522503 DOI: 10.1016/j.fertnstert.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
OBJECTIVE To investigate possible associations between serum antimüllerian hormone (AMH) concentration and semen quality in infertile men. Studies investigating the associations between serum AMH concentration and semen quality in infertile men have shown conflicting results. DESIGN Infertile men were included during screening for participation in the First in Treating Male Infertility Study, a double-blinded, placebo-controlled, 1:1, single-center randomized controlled trial. SETTING Not applicable. PATIENTS At the screening visit, 400 participants produced a semen sample and had their serum analyzed for AMH concentration. INTERVENTION Not applicable. MAIN OUTCOME MEASURES Serum AMH concentration and semen quality. RESULTS All men were stratified according to serum AMH concentrations in quartiles (Q1-Q4). Men in the lowest quartile had a lower sperm concentration (1 × 106/mL) (Q1: 8.0 vs. Q2: 10.4 vs. Q3: 11.0 vs. Q4: 13.0), total sperm count (1 × 106) (Q1: 29.1 vs. Q2: 38.2 vs. Q3: 44.4 vs. Q4: 55.7), sperm motility (%) (Q1: 41 vs. Q2: 57 vs. Q3: 50 vs. Q4: 53), and progressive sperm motility (%) (Q1: 31 vs. Q2: 44 vs. Q3: 35 vs. Q4: 40) compared with the other quartiles. Moreover, men with a sperm concentration <2 million/mL had a lower serum AMH concentration compared with men having 2-16 × 106 /mL and >16 × 106/mL (31 pmol/L vs. 38 pmol/L vs. 43 pmol/L, respectively). In accordance, men with sperm motility <20% had a lower serum AMH concentration compared with men with sperm motility 20%-42%, and >42% (31 pmol/L vs. 43 pmol/L. vs. 39 pmol/L, respectively). CONCLUSION This study shows that low serum AMH concentration is associated with poor semen quality in infertile men, which implies that serum AMH concentration may have clinical value during the evaluation of male infertility. CLINICAL TRIAL REGISTRATION NUMBER NCT05212337.
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Affiliation(s)
- Rune Holt
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Sam Kafai Yahyavi
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Gustav Wall-Gremstrup
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Mads Joon Jorsal
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Frederikke Bay Toft
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Holt R, Jorsal MJ, Yahyavi SK, Qin S, Juul A, Jørgensen N, Blomberg Jensen M. High-dose cholecalciferol supplementation to obese infertile men is sufficient to reach adequate vitamin D status. Br J Nutr 2024; 131:642-647. [PMID: 37811573 DOI: 10.1017/s0007114523002222] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Obesity is associated with low vitamin D status, and the optimal supplement and dosage of cholecalciferol (vitamin D3) or calcidiol (25OHD) for individuals with obesity have been debated. We aimed to determine the effect of high-dose vitamin D3 supplementation on achieving adequate vitamin D levels among infertile men with normal weight v. obesity. Here, we present secondary end points from a single-centre, double-blinded, randomised clinical trial, comprising 307 infertile men randomised to active or placebo treatment for 150 days. Men in the active group initially received an oral bolus of 300 000 mg of vitamin D3, followed by daily supplementation with 1400 mg of vitamin D3 and 500 mg of calcium. Baseline BMI was listed as a predefined subgroup. At baseline, serum 25OHD was significantly higher in men with normal weight (BMI < 25 kg/m2) compared with men with overweight (BMI 25-30 kg/m2) and obesity (BMI > 30 kg/m2) (48 nmol/l v. 45 nmol/l and 39 nmol/l, respectively; P = 0·024). After the intervention, men with normal weight, overweight and obesity treated with vitamin D3 had a significantly higher serum 25OHD compared with corresponding placebo-treated men (BMI < 25 kg/m2: 92 nmol/l v. 53 nmol/l, BMI = 25-30 kg/m2: 87 nmol/l v. 49 nmol/l and BMI > 30 kg/m2: 85 nmol/l v. 48 nmol/l; P < 0·001 for all, respectively). In conclusion, we show that high-dose vitamin D3 supplementation to infertile men with obesity and low vitamin D status is sufficient to achieve adequate serum 25OHD levels.
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Affiliation(s)
- Rune Holt
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Mads Joon Jorsal
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Sam Kafai Yahyavi
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Simeng Qin
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
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Wall-Gremstrup G, Holt R, Yahyavi SK, Jorsal MJ, Juul A, Jørgensen N, Blomberg Jensen M. High-dose vitamin D 3 supplementation shows no beneficial effects on white blood cell counts, acute phase reactants, or frequency of respiratory infections. Respir Res 2024; 25:11. [PMID: 38178229 PMCID: PMC10765571 DOI: 10.1186/s12931-023-02642-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Vitamin D has been suggested to influence the immune system, and vitamin D metabolites and the vitamin D receptor (VDR) are generated and expressed in white blood cells (WBC). Moreover, vitamin D status has been associated with incidence and prognosis of some respiratory tract infections (RTI). Therefore, we investigated the effect of vitamin D3 supplementation on WBC, acute phase reactants (APR), and the risk of developing RTIs. METHODS A double-blinded, randomized, placebo-controlled clinical trial of 307 infertile men with multiple secondary immunological endpoints. The vitamin D3 group (n = 151) initially received 300,000 IU (7,500 µg) cholecalciferol once - followed by 1,400 IU (35 µg) daily for 150 days. The placebo group (n = 156) did not receive active ingredients. RESULTS At baseline, stratification into clinically relevant groups of vitamin D status (< 25; 25-50; 50-75; >75 nmol/L), showed an inverse association with total leucocyte concentrations (7.0 vs. 6.0 vs. 6.0 vs. 5.5 (109/L); p = 0.007), lymphocytes (2.4 vs. 2.1 vs. 2.0 vs. 2.0 (109/L); p = 0.048), CRP (2.0 vs. 1.7 vs. 1.2 vs. 1.2 (mg/L); p = 0.037), and orosomucoid (0.82 vs. 0.77 vs. 0.76 vs. 0.70 (g/L); p = 0.015). After 150 days, no differences were detected in WBC counts or APRs between the vitamin D3 and the placebo group. However, vitamin D3 treated men had a higher prevalence of self-reported RTIs compared with the placebo group (55% vs. 39%; p = 0.005). CONCLUSIONS High-dose vitamin D3 supplementation did not alter WBCs or APRs, but a higher prevalence of respiratory infections was observed in the vitamin D3 group. Serum 25(OH)D3 was negatively correlated with most WBCs, indicating that vitamin D status may be linked with inflammation and WBC turnover, but not an important determinant of developing RTIs. TRIAL REGISTRATION NCT01304927 (ClinicalTrials.gov). Registered February 20, 2011.
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Affiliation(s)
- Gustav Wall-Gremstrup
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Rune Holt
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Sam Kafai Yahyavi
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Mads Joon Jorsal
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
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Yahyavi SK, Boisen IM, Cui Z, Jorsal MJ, Kooij I, Holt R, Juul A, Blomberg Jensen M. Calcium and vitamin D homoeostasis in male fertility. Proc Nutr Soc 2023:1-14. [PMID: 38072394 DOI: 10.1017/s002966512300486x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Calcium and vitamin D have well-established roles in maintaining calcium balance and bone health. Decades of research in human subjects and animals have revealed that calcium and vitamin D also have effects on many other organs including male reproductive organs. The presence of calcium-sensing receptor, vitamin D receptor, vitamin D activating and inactivating enzymes and calcium channels in the testes, male reproductive tract and human spermatozoa suggests that vitamin D and calcium may modify male reproductive function. Functional animal models have shown that vitamin D deficiency in male rodents leads to a decrease in successful mating and fewer pregnancies, often caused by impaired sperm motility and poor sperm morphology. Human studies have to a lesser extent validated these findings; however, newer studies suggest a positive effect of vitamin D supplementation on semen quality in cases with vitamin D deficiency, which highlights the need for initiatives to prevent vitamin D deficiency. Calcium channels in male reproductive organs and spermatozoa contribute to the regulation of sperm motility and capacitation, both essential for successful fertilisation, which supports a need to avoid calcium deficiency. Studies have demonstrated that vitamin D, as a regulator of calcium homoeostasis, influences calcium influx in the testis and spermatozoa. Emerging evidence suggests a potential link between vitamin D deficiency and male infertility, although further investigation is needed to establish a definitive causal relationship. Understanding the interplay between vitamin D, calcium and male reproductive health may open new avenues for improving fertility outcomes in men.
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Affiliation(s)
- Sam Kafai Yahyavi
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ida Marie Boisen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Zhihui Cui
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Mads Joon Jorsal
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ireen Kooij
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Rune Holt
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Division of Translational Endocrinology, Department of Endocrinology and Internal Medicine, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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Alhamam A, Garabed LR, Julian S, Flannigan R. The association of medications and supplements with human male reproductive health: a systematic review. Fertil Steril 2023; 120:1112-1137. [PMID: 37898470 DOI: 10.1016/j.fertnstert.2023.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/20/2023] [Accepted: 10/23/2023] [Indexed: 10/30/2023]
Abstract
Some medications used to treat comorbidities and conditions in reproductive-aged individuals could have a negative impact on fertility. This may occur through hormonal disruption, toxicity to germ cells and spermatozoa, functional impact on the sperm, teratogenicity potential, or ejaculatory abnormalities. Having knowledge of these potential interactions between medications and reproductive potential is important for clinicians to be aware of and guide the patient, along with their treating clinicians, to reproductively favorable alternatives when available. This review aims to summarize the state of the literature regarding medication interactions with human male reproduction using the Anatomical Therapeutic Chemical Classification System of medications.
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Affiliation(s)
- Abdullah Alhamam
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Urology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Laurianne Rita Garabed
- Division of Urology, Department of Surgery, University of Montreal, Montreal, Quebec, Canada
| | - Sania Julian
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ryan Flannigan
- Department of Urologic Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Department of Urology, Weill Cornell Medicine, New York, New York.
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Purdue-Smithe AC, Langton CR, Manson JE. Vitamin D status during pregnancy: a role in intergenerational reproductive health? Eur J Epidemiol 2023; 38:465-467. [PMID: 37148409 DOI: 10.1007/s10654-023-01011-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/16/2023] [Indexed: 05/08/2023]
Affiliation(s)
- Alexandra C Purdue-Smithe
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 1620 Tremont Street, OBC-3, Boston, MA, 02120, USA.
| | - Christine R Langton
- Women's Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
| | - JoAnn E Manson
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Zafar MI, Mills KE, Baird CD, Jiang H, Li H. Effectiveness of Nutritional Therapies in Male Factor Infertility Treatment: A Systematic Review and Network Meta-analysis. Drugs 2023; 83:531-546. [PMID: 36943634 DOI: 10.1007/s40265-023-01853-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Nutritional therapies are effective alternative treatments for male infertility or subfertility. These are cost-effective and easily implementable, unlike other advanced invasive treatments. Even moderate improvements in sperm quality could improve spontaneous pregnancy. OBJECTIVE We aimed to compare the effectiveness of all nutritional therapies in male infertility/subfertility treatment and ranked their efficacy based on type and etiology. We intend to aid clinicians with an evidence-based approach to affordable and safer initial infertility treatment for those who mainly do not wish to have other advanced invasive treatments or could not afford or have access to them. METHODS We included 69 studies with 94 individual study arms identified from bibliographic databases and registries. We included studies in adult men with proven infertility or subfertility that investigated nutritional or dietary supplement therapies compared with control or placebo and at least reported on a sperm parameter. We undertook a network meta-analysis and performed a pairwise meta-analysis on all sperm parameter outcomes and meta-regression. No language or date restriction was imposed. A systematic article search was concluded on August 29, 2022. RESULTS Our network meta-analysis is the first to compare all dietary interventions in a single analysis, sub-grouped by intervention type and type of infertility. L-Carnitine with micronutrients, antioxidants, and several traditional herbal supplements showed statistically and clinically significant improvement in sperm quality. Meta-regression identified that improvement in the sperm count, motility and morphology translated into increased pregnancy rates (p < 0.001; p < 0.001; p < 0.002, respectively). In particular, L-carnitine with micronutrient therapy (risk ratio [RR]: 3.60, 95% CI 1.86, 6.98, p = 0.0002), followed by zinc (RR 5.39, 95% CI 1.26, 23.04, p = 0.02), significantly improved pregnancy rates. Men with oligozoospermia (RR 4.89), followed by oligoasthenozoospermia (RR 4.20) and asthenoteratozoospermia (RR 3.53), showed a significant increase in pregnancy rates. CONCLUSION We ranked nutritional therapies for their ability to improve sperm quality in men with infertility. Nutritional therapies, particularly L-carnitine alone or combined with micronutrients, significantly improved sperm parameters and pregnancy rates even under severe conditions. We believe these affordable solutions may be valuable for people without access to or who do not wish to undergo more invasive and costly fertility treatments.
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Affiliation(s)
- Mohammad Ishraq Zafar
- Institute of Reproductive Health/Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, 13 Hang Kong Road, Wuhan, 430030, China
- Reproductive Medicine Center, Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, China
| | - Kerry E Mills
- Department of Science and Technology, University of Canberra, Bruce 2617, Canberra, Australia.
- TruDataRx, White River Junction, Vermont, USA.
| | | | - Huahua Jiang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Honggang Li
- Institute of Reproductive Health/Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, 13 Hang Kong Road, Wuhan, 430030, China.
- Wuhan Huake Reproductive Hospital, Wuhan, China.
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10
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Holt R, Yahyavi SK, Kooij I, Andreassen CH, Andersson AM, Juul A, Jørgensen N, Blomberg Jensen M. Low serum anti-Müllerian hormone is associated with semen quality in infertile men and not influenced by vitamin D supplementation. BMC Med 2023; 21:79. [PMID: 36855109 PMCID: PMC9976369 DOI: 10.1186/s12916-023-02782-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Anti-Müllerian hormone (AMH) is released by testicular Sertoli cells and of great importance during fetal male sexual development, but less is known about the role of circulating AMH during adulthood. In vitro studies have shown that vitamin D may induce AMH transcription, but a controlled trial investigating the possible effect of vitamin D on serum AMH has not been conducted in men. METHODS A single-center, double-blinded, randomized placebo-controlled clinical trial (NCT01304927) conducted in Copenhagen, Denmark. A total of 307 infertile men were included and randomly assigned (1:1) to a single dose of 300,000 IU cholecalciferol followed by 1400 IU cholecalciferol + 500 mg of calcium daily (n = 151) or placebo (n = 156) for 150 days. Difference in serum AMH was a predefined secondary endpoint. Explorative outcomes were associations between serum AMH and gonadal function in infertile men. The primary endpoint was difference in semen quality and has previously been published. RESULTS Infertile men in the lowest AMH tertile had significantly lower sperm concentration (∆T3-1 16 mill/mL (228%); P < 0.001), sperm count (∆T3-1 55 million (262%); P < 0.001), motile sperm count (∆T3-1 28 million (255%); P < 0.001), progressive motile sperm count (∆T3-1 18 million (300%); P < 0.001), testis size (∆T3-1 2.7 mL (16%); P < 0.001), serum inhibin B (∆T3-1 72 pg/mL (59%); P < 0.001), inhibin B/FSH ratio (∆T3-1 48 (145%); P < 0.001), and higher FSH (∆T3-1 2.6 (38%); P < 0.001) than the tertile of infertile men with highest serum AMH. Vitamin D supplementation had no effect on serum AMH compared with placebo treatment. CONCLUSIONS In infertile men, low serum AMH is associated with severely impaired gonadal function illustrated by poor semen quality and lower testosterone/LH ratio. Serum AMH in infertile men was not influenced by vitamin D supplementation.
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Affiliation(s)
- Rune Holt
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sam Kafai Yahyavi
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ireen Kooij
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Christine Hjorth Andreassen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. .,Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, USA.
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11
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Tania C, Tobing ERPL, Tansol C, Prasetiyo PD, Wallad CK, Hariyanto TI. Vitamin D supplementation for improving sperm parameters in infertile men: A systematic review and meta-analysis of randomized clinical trials. Arab J Urol 2023; 21:204-212. [PMID: 38178948 PMCID: PMC10763592 DOI: 10.1080/2090598x.2023.2165232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 01/01/2023] [Indexed: 01/13/2023] Open
Abstract
Objective Vitamin D has been hypothesized to have a potential role in altering sperm motility and metabolism. However, experimental studies have demonstrated inconsistent results between vitamin D and sperm parameters. This study aims to investigate the role of vitamin D supplementation to improve sperm parameters in infertile men. Methods This is a systematic review and meta-analysis study. We comprehensively conducted a search on ClinicalTrials.gov, IRCT.ir, Europe PMC, and PubMed and collected published studies on vitamin D supplementation and sperm parameters for infertile men. The risk of bias was assessed by using Risk of Bias version 2 (RoB v2) and the statistical analysis was performed by using Review Manager 5.4 software. Results Five trials with a total of 648 infertile men were included. Our meta-analysis showed that supplementation with vitamin D may significantly improve total sperm motility [mean difference 4.96 (95% CI 0.38, 9.54), p = 0.03, I2 = 69%], progressive sperm motility [mean difference 4.14 (95% CI 0.25, 8.02), p = 0.04, I2 = 89%], and normal sperm morphology [mean difference 0.44 (95% CI 0.30, 0.57), p < 0.00001, I2 = 0%] better than placebo in infertile men. However, total sperm count (p = 0.15), sperm concentration (p = 0.82), and semen volume (p = 0.83) did not differ significantly between two groups. Conclusions Vitamin D supplementation may improve sperm motility, progressive sperm motility, and morphology in infertile men. Vitamin D supplementation may be considered in managing male fertility issue.
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Affiliation(s)
- Clarissa Tania
- Department of Urology, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
| | | | - Christiano Tansol
- Department of Urology, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia
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12
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Yuan C, Xiang L, Jian Z, Liao B. Vitamin D Levels and Risk of Male Factor Infertility: A Mendelian Randomization Study. World J Mens Health 2023:41.e5. [PMID: 36593707 DOI: 10.5534/wjmh.220109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/25/2022] [Accepted: 07/29/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE No consensus exists about the causal relationship between vitamin D (VD) and male factor infertility due to heterogeneity and confounding factors even in randomized controlled trials (RCTs). This study aimed to investigate the causal association between 25 hydroxyvitamin D (25OHD) levels and male factor infertility through Mendelian randomization (MR) and provide complementary information for optimization of future RCTs. MATERIALS AND METHODS Two-sample MR analyses with four steps were performed. Single-nucleotide polymorphisms (SNPs) for VD were extracted from 417,580 Europeans in the UK Biobank, and the summary-level data of male factor infertility (825 cases and 85,722 controls) were extracted from the FinnGen. RESULTS Totally 99 SNPs robustly associated with the 25OHD were included, and a 1-unit increase in genetically predicted natural-log transformed 25OHD levels was associated with decreased risk of male factor infertility (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.44-0.89; p=0.010), which was consistent in all three sensitivity analyses (MR-Egger, weighted median, and weighted mode methods). The conclusion still stands after removing SNPs which explained more variation in the male factor infertility than the 25OHD (OR, 0.61; 95% CI, 0.42-0.88; p=0.009; n=62), and which were associated with confounders (body mass index, type 2 diabetes, smoking, and coronary artery diseases) of male factor infertility (OR, 0.58; 95% CI, 0.39-0.85; p=0.005; n=55). CONCLUSIONS VD supplement to increase serum 25OHD levels may be clinically beneficial for male factor infertility in the general population. The well-designed RCTs should be performed in priority to address this question.
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Affiliation(s)
- Chi Yuan
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liyuan Xiang
- Department of Clinical Research Management, West China Hospital, Chengdu, Sichuan, China
| | - Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China.,West China Biomedical Big Data Center, Sichuan University, Chengdu, Sichuan, China.
| | - Banghua Liao
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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13
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Agarwal A, Cannarella R, Saleh R, Harraz AM, Kandil H, Salvio G, Boitrelle F, Kuroda S, Farkouh A, Rambhatla A, Zini A, Colpi G, Gül M, Kavoussi P, Hamoda TAAAM, Ko E, Calik G, Toprak T, Pinggera GM, Park HJ, Ghayda RA, Minhas S, Busetto GM, Bakırcıoğlu ME, Kadioglu A, Chung E, Russo GI, Calogero AE, Ambar RF, Jayasena CN, Shah R. Impact of Antioxidant Therapy on Natural Pregnancy Outcomes and Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. World J Mens Health 2023; 41:14-48. [PMID: 36102104 PMCID: PMC9826914 DOI: 10.5534/wjmh.220067] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/24/2022] [Accepted: 05/12/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS. MATERIALS AND METHODS Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases. Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines. RESULTS We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients. We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies. A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair. CONCLUSIONS The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Global Andrology Forum, Moreland Hills, OH, USA
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.,Ajyal IVF Center, Ajyal Hospital, Sohag, Egypt
| | - Ahmed M. Harraz
- Department of Urology, Mansoura University Urology and Nephrology Center, Mansoura, Egypt.,Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait.,Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
| | | | - Gianmaria Salvio
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.,Department of Biology, Reproduction, Epigenetics, Environment and Development, Pari. Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Shinnosuke Kuroda
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Ala’a Farkouh
- American Center for Reproductive Medicine, Global Andrology Forum, Moreland Hills, OH, USA
| | - Amarnath Rambhatla
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | | | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Taha Abo-Almagd Abdel-Meguid Hamoda
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Gokhan Calik
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea.,Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Ramy Abou Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Suks Minhas
- Division of Surgery, Department of Surgery and Cancer, Imperial College, London, UK
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy
| | | | - Ates Kadioglu
- Section of Andrology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
| | | | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rafael F. Ambar
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil.,Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Channa N. Jayasena
- Department of Reproductive Endocrinology and Andrology, Imperial College London, London, UK.,Department of Andrology, Hammersmith & St. Mary’s Hospitals, London, UK
| | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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14
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Patki A, Shelatkar R, Singh M, Agarwal S, M V, Umbardand S, Reddy A, Kannan P, Gorthi S, Khastgir G, Kulshreshtha A, Ganu G. Impact of antioxidants in improving semen parameters like count, motility and DNA fragmentation in sub-fertile males: a randomized, double-blind, placebo-controlled clinical trial. Transl Clin Pharmacol 2023; 31:28-39. [PMID: 37034126 PMCID: PMC10079508 DOI: 10.12793/tcp.2023.31.e6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/24/2023] [Accepted: 03/12/2023] [Indexed: 04/03/2023] Open
Abstract
Male infertility is solely responsible for 20-30% of infertility cases. Oxidative damage of sperm DNA is positively linked with oligoasthenoteratozoospermia (OAT), and male infertility. The antioxidants are being explored worldwide to combat OAT, sperm DNA fragmentation and reactive oxygen species. The objective of the study was to assess the effectiveness of an antioxidant blend in improving sperm count, semen parameters and reducing DNA fragmentation index (DFI) in sub-fertile males. A prospective, double-blind, randomized, placebo-controlled trial was conducted in 300 sub-fertile males (25-45 years) from ten study sites in India. Subjects were randomized in either the antioxidant blend treatment group or placebo group. We assessed changes in sperm count, motility, normal morphology, semen volume, and percent DFI before and after treatment (90 days). To further stratify data on different criteria post hoc analysis was performed. Statistical analysis was performed using SPSS 10.0 software. There were improvements in sperm count, semen volume, sperm motility, and sperm normal morphology in the treatment group. There was improvement in sperm count in severe oligospermia subjects (sperm count < 5 million/mL, 5-10 million/mL, 10.1-15 million/mL), and high-extremely higher baseline DFI (20-30%, 31-40% and above 40%), as per post hoc analysis. There was no premature discontinuation and adverse events were reported during the study, indicating safety and well-tolerability of treatment. Study results confirmed the well-researched fact of antioxidants being effective to reduce oxidative stress and thus improve sperm DNA integrity and also improved semen parameters in males aged 40 and above. Trial Registration Clinical Trials Registry-India Identifier: CTRI/2020/12/029590.
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Affiliation(s)
| | | | - Monica Singh
- Bhopal Test-Tube Baby Centre, Bhopal 462016, India
| | | | - Venugopal M
- ARMC IVF Fertility Centre, Thrissur 680003, India
| | | | | | - Priya Kannan
- Garbba Rakshambigai Fertility Centre, Chennai 600024, India
| | | | - Gautam Khastgir
- Bengal Infertility & Reproductive Therapy Hospital (BIRTH), Kolkata 700020, India
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15
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Adamczewska D, Słowikowska-Hilczer J, Walczak-Jędrzejowska R. The Association between Vitamin D and the Components of Male Fertility: A Systematic Review. Biomedicines 2022; 11:biomedicines11010090. [PMID: 36672602 PMCID: PMC9912266 DOI: 10.3390/biomedicines11010090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Previous systematic reviews of the effects of vitamin D on the components of male fertility have been inconclusive. This article systematically reviews the latest research to examine the relationship between vitamin D, semen quality parameters, and sex hormones production. METHODS MEDLINE, Cochrane, and Web of Science databases were searched using the appropriate keywords. RESULTS Observational studies indicate significant correlation between vitamin D levels and sperm parameters, with a particular emphasis on sperm motility, and partially suggest a relationship between higher serum testosterone and vitamin D levels. Additionally, interventional studies confirmed that vitamin D supplementation has a positive effect on sperm motility, especially progressive. However, most randomized clinical trials indicate that vitamin D treatment does not have any significant effect on testosterone or other hormone levels. CONCLUSIONS Although our findings add to the discussion regarding the effect of vitamin D on male fertility, there is still no solid evidence to support the use of vitamin D supplementation to improve the outcomes of patients with impaired sperm parameters and hormonal disorders. Additional dedicated clinical studies are needed to clarify the relationship between vitamin D and male fertility, along with its components.
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16
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Carlsson Humla E, Bergh C, Akouri R, Tsiartas P. Summer is not associated with higher live birth rates in fresh IVF/ICSI cycles: a population-based nationwide registry study. Hum Reprod Open 2022; 2022:hoac036. [PMID: 36101708 PMCID: PMC9464094 DOI: 10.1093/hropen/hoac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/16/2022] [Indexed: 11/16/2022] Open
Abstract
STUDY QUESTION Is summer associated with a higher live birth rate after fresh IVF/ICSI? SUMMARY ANSWER There was no support for a higher live birth rate after fresh IVF/ICSI when treatment was performed during the summer season. WHAT IS KNOWN ALREADY Seasonal variations in human natural conception and birth rates are well described. It has been hypothesized that serum vitamin D, levels of which are associated with sun exposure, may have a role in human natural conception rates. However, the association between seasons and IVF outcomes has not yet been clarified and conflicting reports have been published. Furthermore, it has been suggested that women with normal vitamin D levels have a better pregnancy outcome after ART compared to those with vitamin D insufficiency. STUDY DESIGN, SIZE, DURATION A nationwide, register-based cohort study including all first-time fresh IVF/ICSI treatments (n = 52 788) leading to oocyte retrieval in Sweden between 2009 and 2018 was carried out. PARTICIPANTS/MATERIALS, SETTING, METHODS All first-time fresh IVF/ICSI cycles leading to oocyte retrieval were identified in the National Quality Registry of Assisted Reproduction. Data collected included patient characteristics as well as information about the treatment cycle and pregnancy outcome. The patients were divided into season subgroups, (summer, autumn, winter and spring) based on the date of oocyte retrieval. The primary outcome was live birth rate, which was defined as the number of live births per oocyte retrieval and embryo transfer (ET). Other outcomes included clinical pregnancy per ET and miscarriage per clinical pregnancy. Logistic regression with multiple imputation was performed to evaluate whether there was an association between season and IVF/ICSI outcomes, with summer as reference. Adjustments were made for woman’s age, year of treatment, BMI, total FSH/hMG dose, type of treatment, fertilization type, embryonic stage at ET and number of embryos transferred. MAIN RESULTS AND THE ROLE OF CHANCE Live birth rate per oocyte retrieval ranged between 24% and 26% among seasons. A significantly higher live birth rate was seen for spring compared with summer, 26% versus 24%, respectively (adjusted odds ratio (OR) 1.08, 95% CI 1.02–1.16, P = 0.02). No significant association was seen when winter and autumn were compared with summer. Live birth rate per ET ranged between 29% and 31% among seasons. A significantly higher live birth rate was seen for spring and autumn compared with summer, at 31% and 31%, respectively versus 29% (adjusted OR 1.08, 95% CI 1.01–1.16, P = 0.04 and adjusted OR 1.09, 95% CI 1.01–1.16, P = 0.02), respectively. No significant association was seen when winter was compared with summer. Clinical pregnancy rate varied between 36% and 38% and miscarriage rate between 16% and 18%, with no significant seasonal associations. LIMITATIONS, REASONS FOR CAUTION Possible limitations are the retrospective design of the study and unmeasured confounders. Another limitation is that a generalized estimating equation (GEE) model was not used. The use of a GEE model would have made it possible to include all started fresh IVF/ICSI cycles since it allows for correction for any dependence between cycles within women. WIDER IMPLICATIONS OF THE FINDINGS The results of this large registry study give no support for the hypothesis that IVF/ICSI treatments performed during summer season, with the highest degree of sunlight and vitamin D synthesis, is associated with higher pregnancy and live birth rates. In fact, our results showed significantly lower live birth rates during summer compared with spring and autumn. However, the magnitude of this difference was small and unlikely of clinical value. We suggest that season should not be taken into consideration when planning and performing fresh IVF/ICSI treatments. STUDY FUNDING/COMPETING INTEREST(S) Financial support was received through the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (ALFGBG-70 940) and grants from the Hjalmar Svensson’s Research Foundation (HJSV2021019 and HJSV2021037). None of the authors declare any conflict of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Eva Carlsson Humla
- Sahlgrenska University Hospital Department of Obstetrics and Gynecology, Reproductive Medicine, , 413 45, Gothenburg, Sweden
| | - Christina Bergh
- Sahlgrenska University Hospital Department of Obstetrics and Gynecology, Reproductive Medicine, , 413 45, Gothenburg, Sweden
- University of Gothenburg Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, , 405 30, Sweden
| | - Randa Akouri
- Sahlgrenska University Hospital Department of Obstetrics and Gynecology, Reproductive Medicine, , 413 45, Gothenburg, Sweden
- University of Gothenburg Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, , 405 30, Sweden
| | - Panagiotis Tsiartas
- University of Gothenburg Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, , 405 30, Sweden
- Nordic IVF & Gynecology Stockholm , 171 54, Solna, Sweden
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17
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Calagna G, Catinella V, Polito S, Schiattarella A, De Franciscis P, D’Antonio F, Calì G, Perino A, Cucinella G. Vitamin D and Male Reproduction: Updated Evidence Based on Literature Review. Nutrients 2022; 14:nu14163278. [PMID: 36014783 PMCID: PMC9412569 DOI: 10.3390/nu14163278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to clarify the vitamin D (VD) effect on male infertility. Our research was conducted using the following electronic databases: MEDLINE, Embase, Web of Science, Scopus, ClinicalTrials.gov, and Cochrane Library. Selection criteria included all published randomized controlled trials and non-randomized studies, focusing on vitamin D and male reproductive function. The results showed that the effects of VD on male reproduction has been investigated in three different topics: the molecular mechanism underlying VD effects on semen quality (SQ), the relationship between VD levels and SQ, and the effect of VD supplementation on SQ. Results supported the hypothesis of a relevant interrelation between concentrations of male VD and semen parameters, with particular reference to sperm motility; on the contrary, evidence on the effect of VD on male sex steroid hormone levels was inconclusive. The results of this review hold up the thesis that VD plays a role in male reproduction. Most of the data highlighted a positive effect on semen quality, particularly in sperm motility, both in fertile and infertile men. Additional dedicated studies are required to elucidate the still controversial aspects of this topic.
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Affiliation(s)
- Gloria Calagna
- Obstetrics and Gynecology, “Villa Sofia Cervello” Hospital, IVF Unit, University of Palermo, Via Trabucco 180, 90145 Palermo, Italy
| | - Valeria Catinella
- Obstetrics and Gynecology, “Fondazione per gli Studi sulla Riproduzione Umana”–Clinica Candela, Via Valerio Villareale 54, 90141 Palermo, Italy
| | - Salvatore Polito
- Obstetrics and Gynecology, “Villa Sofia Cervello” Hospital, IVF Unit, University of Palermo, Via Trabucco 180, 90145 Palermo, Italy
| | - Antonio Schiattarella
- Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 1, 80138 Naples, Italy
- Correspondence: ; Tel.: +39-39-2165-3275
| | - Pasquale De Franciscis
- Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie, 1, 80138 Naples, Italy
| | - Francesco D’Antonio
- Center for High-Risk Pregnancy and Fetal Care, Department of Obstetrics and Gynecology, University of Chieti, Via dei Vestini 31, 66100 Chieti, Italy
| | - Giuseppe Calì
- Obstetrics and Gynecology, “Fondazione per gli Studi sulla Riproduzione Umana”–Clinica Candela, Via Valerio Villareale 54, 90141 Palermo, Italy
| | - Antonino Perino
- IVF Unit, Azienda Sanitaria Provinciale di Palermo, Via G. Cusmano 24, 90100 Palermo, Italy
| | - Gaspare Cucinella
- Obstetrics and Gynecology, “Villa Sofia Cervello” Hospital, IVF Unit, University of Palermo, Via Trabucco 180, 90145 Palermo, Italy
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Yahyavi SK, Holt R, Juel Mortensen L, Petersen JH, Jørgensen N, Juul A, Blomberg Jensen M. Effect of a single-dose denosumab on semen quality in infertile men (the FITMI study): study protocol for a randomized controlled trial. Trials 2022; 23:525. [PMID: 35733213 PMCID: PMC9214471 DOI: 10.1186/s13063-022-06478-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/11/2022] [Indexed: 11/25/2022] Open
Abstract
Background Infertility is a common problem globally and impaired semen quality is responsible for up to 40% of all cases. Almost all infertile couples are treated with either insemination or assisted reproductive techniques (ARTs) independent of the etiology of infertility because no medical treatment exists. Denosumab is an antibody that blocks RANKL signaling and inhibition of testicular RANKL signaling has been suggested to improve semen quality in a pilot study. This RCT aims to assess whether treatment with denosumab can improve spermatogenesis in infertile men selected by serum AMH as a positive predictive biomarker. This paper describes the design of the study. Methods/design FITMI is a sponsor-investigator-initiated, double-blinded, placebo-controlled 1:1, single-center, randomized clinical trial. Subjects will be randomized to receive either a single-dose denosumab 60 mg subcutaneous injection or placebo. The study will be carried out at the Department of Growth and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen. The primary outcome of the study is defined as the difference in sperm concentration (millions pr. mL) one spermatogenesis (80 days) after inclusion. Discussion We describe a protocol for a planned RCT aimed at evaluating whether treatment with denosumab can improve the semen quality in infertile men selected by using serum AMH as a positive predictive biomarker. The results will provide evidence crucial for future treatment in a patient group where there is a huge unmet need. Trial registration Clinical Trials.gov NCT05212337. Registered on 14 January 2022. EudraCT 2021–003,451-42. Registered on 23 June 2021. Ethical committee H-21040145. Registered on 23 December 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06478-4.
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Affiliation(s)
- Sam Kafai Yahyavi
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
| | - Rune Holt
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
| | - Li Juel Mortensen
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jørgen Holm Petersen
- International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Section of Biostatistics, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral, and Gonadal Endocrinology, Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark. .,Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, USA.
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Saberivand A, Sarvarzadeh F, Peighambarzadeh SZ, Saberivand M, Pakizehvand H, Rashidi S, Rahbar M, Khoshniyat M. The effect of Caulerpa sertularioides extract on bull sperm freezablity and subsequent embryo development. Theriogenology 2022; 189:167-76. [PMID: 35760028 DOI: 10.1016/j.theriogenology.2022.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 04/05/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022]
Abstract
Artificial insemination is a valuable and essential tool in genetic improvement programs, and its success requires proper semen collection, freezing, and thawing procedures. Nowadays, despite applying of advanced protocols for semen cryopreservation, post-thawing sperm quantitative and qualitative parameters are not satisfactorily comparable to fresh sperm. The present study was designed to evaluate the effects of the supplementation of an alcoholic extract of Caulerpa sertolarioides alga into the tris-egg yolk-based Simmental bull sperm freezing media. The pooled semen samples were divided into five groups, of which four were supplemented with 500, 1000, 1500, and 2000 ppm alga extract and one allocated as a control. Total motility, progressive motility, plasma membrane integrity, DNA integrity, apoptosis, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, and total antioxidant capacity (TAC) of sperm were measured. The frozen sperm from each group were used for IVF on the slaughterhouse-derived oocytes. Fertilization, cleavage, and blastocyst rates were assessed for all groups. Total motility, progressive motility, and velocity curvilinear (VCL) parameters were higher (p ≤ 0.05) in group 1000 ppm than the control group. Velocity in a straight path (VSL) was higher (p ≤ 0.05) in all treatment groups except in 500 ppm compared to the control group. Average path velocity (VAP) was higher (p ≤ 0.05) in 1000 and 1500 ppm groups than in the control group. Straightness (STR) showed a higher value (p ≤ 0.05) in 1000 and 2000 ppm than the control group. Groups 500 and 1000 ppm showed more viable sperm than the control group (p ≤ 0.05). DNA damage was lower (p ≤ 0.05) in group 1000 ppm than in the control group. HOST was higher (p ≤ 0.05) in all groups than in the control group. SOD, GPx, and TAC were higher (p ≤ 0.05) in 1000 ppm than the control and all other groups. Apoptosis was not significantly different among the treatment and control groups. In conclusion, supplementation of alcoholic extract of Caulerpa sertularioides into the Simmental bull freezing extender ameliorated the sperm parameters after the freeze-thawing process. Moreover, the results of this study indicated that the best dose to achieve the antioxidant properties of the alga extract in Simmental bull sperm freezing media was 1000 ppm. It was also evident that 1000 ppm alga extract supplementation into the bull sperm improved fertilization, cleavage, and blastocyst rates.
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20
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Abstract
BACKGROUND The inability to have children affects 10% to 15% of couples worldwide. A male factor is estimated to account for up to half of the infertility cases with between 25% to 87% of male subfertility considered to be due to the effect of oxidative stress. Oral supplementation with antioxidants is thought to improve sperm quality by reducing oxidative damage. Antioxidants are widely available and inexpensive when compared to other fertility treatments, however most antioxidants are uncontrolled by regulation and the evidence for their effectiveness is uncertain. We compared the benefits and risks of different antioxidants used for male subfertility. OBJECTIVES To evaluate the effectiveness and safety of supplementary oral antioxidants in subfertile men. SEARCH METHODS The Cochrane Gynaecology and Fertility (CGF) Group trials register, CENTRAL, MEDLINE, Embase, PsycINFO, AMED, and two trial registers were searched on 15 February 2021, together with reference checking and contact with experts in the field to identify additional trials. SELECTION CRITERIA We included randomised controlled trials (RCTs) that compared any type, dose or combination of oral antioxidant supplement with placebo, no treatment, or treatment with another antioxidant, among subfertile men of a couple attending a reproductive clinic. We excluded studies comparing antioxidants with fertility drugs alone and studies that included men with idiopathic infertility and normal semen parameters or fertile men attending a fertility clinic because of female partner infertility. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. The primary review outcome was live birth. Clinical pregnancy, adverse events and sperm parameters were secondary outcomes. MAIN RESULTS We included 90 studies with a total population of 10,303 subfertile men, aged between 18 and 65 years, part of a couple who had been referred to a fertility clinic and some of whom were undergoing medically assisted reproduction (MAR). Investigators compared and combined 20 different oral antioxidants. The evidence was of 'low' to 'very low' certainty: the main limitation was that out of the 67 included studies in the meta-analysis only 20 studies reported clinical pregnancy, and of those 12 reported on live birth. The evidence is current up to February 2021. Live birth: antioxidants may lead to increased live birth rates (odds ratio (OR) 1.43, 95% confidence interval (CI) 1.07 to 1.91, P = 0.02, 12 RCTs, 1283 men, I2 = 44%, very low-certainty evidence). Results in the studies contributing to the analysis of live birth rate suggest that if the baseline chance of live birth following placebo or no treatment is assumed to be 16%, the chance following the use of antioxidants is estimated to be between 17% and 27%. However, this result was based on only 246 live births from 1283 couples in 12 small or medium-sized studies. When studies at high risk of bias were removed from the analysis, there was no evidence of increased live birth (Peto OR 1.22, 95% CI 0.85 to 1.75, 827 men, 8 RCTs, P = 0.27, I2 = 32%). Clinical pregnancy rate: antioxidants may lead to increased clinical pregnancy rates (OR 1.89, 95% CI 1.45 to 2.47, P < 0.00001, 20 RCTs, 1706 men, I2 = 3%, low-certainty evidence) compared with placebo or no treatment. This suggests that, in the studies contributing to the analysis of clinical pregnancy, if the baseline chance of clinical pregnancy following placebo or no treatment is assumed to be 15%, the chance following the use of antioxidants is estimated to be between 20% and 30%. This result was based on 327 clinical pregnancies from 1706 couples in 20 small studies. Adverse events Miscarriage: only six studies reported on this outcome and the event rate was very low. No evidence of a difference in miscarriage rate was found between the antioxidant and placebo or no treatment group (OR 1.46, 95% CI 0.75 to 2.83, P = 0.27, 6 RCTs, 664 men, I2 = 35%, very low-certainty evidence). The findings suggest that in a population of subfertile couples, with male factor infertility, with an expected miscarriage rate of 5%, the risk of miscarriage following the use of an antioxidant would be between 4% and 13%. Gastrointestinal: antioxidants may lead to an increase in mild gastrointestinal discomfort when compared with placebo or no treatment (OR 2.70, 95% CI 1.46 to 4.99, P = 0.002, 16 RCTs, 1355 men, I2 = 40%, low-certainty evidence). This suggests that if the chance of gastrointestinal discomfort following placebo or no treatment is assumed to be 2%, the chance following the use of antioxidants is estimated to be between 2% and 7%. However, this result was based on a low event rate of 46 out of 1355 men in 16 small or medium-sized studies, and the certainty of the evidence was rated low and heterogeneity was high. We were unable to draw conclusions from the antioxidant versus antioxidant comparison as insufficient studies compared the same interventions. AUTHORS' CONCLUSIONS In this review, there is very low-certainty evidence from 12 small or medium-sized randomised controlled trials suggesting that antioxidant supplementation in subfertile males may improve live birth rates for couples attending fertility clinics. Low-certainty evidence suggests that clinical pregnancy rates may increase. There is no evidence of increased risk of miscarriage, however antioxidants may give more mild gastrointestinal discomfort, based on very low-certainty evidence. Subfertile couples should be advised that overall, the current evidence is inconclusive based on serious risk of bias due to poor reporting of methods of randomisation, failure to report on the clinical outcomes live birth rate and clinical pregnancy, often unclear or even high attrition, and also imprecision due to often low event rates and small overall sample sizes. Further large well-designed randomised placebo-controlled trials studying infertile men and reporting on pregnancy and live births are still required to clarify the exact role of antioxidants.
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Affiliation(s)
- Wiep de Ligny
- Department of Gynaecology and Obstetrics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Roos M Smits
- Department of Gynaecology and Obstetrics, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Vanessa Jordan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kathrin Fleischer
- Department of Gynaecology and Obstetrics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jan Peter de Bruin
- Department of Obstetrics and Gynaecology, Jeroen Bosch Hospital, 's-Hertogenbosch, Netherlands
| | - Marian G Showell
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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De Leo V, Tosti C, Morgante G, Ponchia R, Luddi A, Governini L, Piomboni P. Positive Effect of a New Combination of Antioxidants and Natural Hormone Stimulants for the Treatment of Oligoasthenoteratozoospermia. J Clin Med 2022; 11:jcm11071991. [PMID: 35407599 PMCID: PMC8999819 DOI: 10.3390/jcm11071991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 02/04/2023] Open
Abstract
Oligoasthenoteratozoospermia (OAT) accounts for about 90% of male infertility; in many cases this disorder may be associated with oxidative stress, a condition that decreases the success of fertilization. Therefore, the empirical treatment of male infertility is often based on the use of antioxidants. The aim of the present study was to assess the effectiveness of three months’ administration of a new nutraceutical preparation on hormone profile, sperm parameters and fertilization capability in men undergoing in vitro fertilization (IVF). A total of 36 OAT patients were daily treated for 3 months with a dose of a formulation containing: Inositol, L-Carnitine, Vitamins C, D, E, Coenzyme Q10 and Selenium. Selected parameters were analysed before (T0) and after (T1) treatment, and IVF outcomes were evaluated. We observed an improvement of sperm concentration, motility, morphology and vitality; blood level of testosterone also showed an increase. A significant increase of fertilization rate was detected in 14 couples, whose male partner were treated with the nutraceutical preparation. The present results indicate that a formulation containing antioxidant and energy supply substances was effective in the treatment of sperm alterations and led to significant recovery of fertilizing capacity.
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Affiliation(s)
- Vincenzo De Leo
- Department of Molecular and Developmental Medicine, Siena University, 53100 Siena, Italy; (V.D.L.); (G.M.); (R.P.); (P.P.)
- Assisted Reproduction Unit, Siena University Hospital, 53100 Siena, Italy;
| | - Claudia Tosti
- Assisted Reproduction Unit, Siena University Hospital, 53100 Siena, Italy;
| | - Giuseppe Morgante
- Department of Molecular and Developmental Medicine, Siena University, 53100 Siena, Italy; (V.D.L.); (G.M.); (R.P.); (P.P.)
- Assisted Reproduction Unit, Siena University Hospital, 53100 Siena, Italy;
| | - Rosetta Ponchia
- Department of Molecular and Developmental Medicine, Siena University, 53100 Siena, Italy; (V.D.L.); (G.M.); (R.P.); (P.P.)
- Assisted Reproduction Unit, Siena University Hospital, 53100 Siena, Italy;
| | - Alice Luddi
- Department of Molecular and Developmental Medicine, Siena University, 53100 Siena, Italy; (V.D.L.); (G.M.); (R.P.); (P.P.)
- Correspondence: (A.L.); (L.G.); Tel.: +39-0577-233521 (A.L.); +39-0577-586810 (L.G.)
| | - Laura Governini
- Department of Molecular and Developmental Medicine, Siena University, 53100 Siena, Italy; (V.D.L.); (G.M.); (R.P.); (P.P.)
- Correspondence: (A.L.); (L.G.); Tel.: +39-0577-233521 (A.L.); +39-0577-586810 (L.G.)
| | - Paola Piomboni
- Department of Molecular and Developmental Medicine, Siena University, 53100 Siena, Italy; (V.D.L.); (G.M.); (R.P.); (P.P.)
- Assisted Reproduction Unit, Siena University Hospital, 53100 Siena, Italy;
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22
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Rimmer MP, Howie RA, Subramanian V, Anderson RA, Bertolla RP, Beebeejaun Y, Bortoletto P, Sunkara SK, Mitchell RT, Pacey A, van Wely M, Farquhar CM, Duffy JMN, Niederberger C. Outcome reporting across randomized controlled trials evaluating potential treatments for male infertility: a systematic review. Hum Reprod Open 2022; 2022:hoac010. [PMID: 35386119 PMCID: PMC8982407 DOI: 10.1093/hropen/hoac010] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 02/18/2022] [Indexed: 11/12/2022] Open
Abstract
STUDY QUESTION What are the primary outcomes and outcome measures used in randomized controlled trials (RCTs) evaluating potential treatments for male infertility in the last 10 years? SUMMARY ANSWER Outcome reporting across male infertility trials is heterogeneous with numerous definitions and measures used to define similar outcomes. WHAT IS KNOWN ALREADY No core outcome set for male infertility trials has been developed. Male infertility trials are unique in that they have potentially three participants, a man, a female partner and their offspring and this will likely lead to significant variation in outcome reporting in randomized trials. STUDY DESIGN SIZE DURATION A systematic review of RCTs mapping outcomes and outcome measures evaluating potential treatments for men with infertility registered in the Cochrane Register of Controlled Trials (CENTRAL) between January 2010 and July 2021. PARTICIPANTS/MATERIALS SETTING METHODS Abstract screening and study selection was undertaken in duplicate using a review protocol that was developed prior to commencing the review. No risk of bias assessment was undertaken as this review aims to report on outcome reporting only. MAIN RESULTS AND THE ROLE OF CHANCE One hundred and seventy-five RCTs were identified, and given the large number of studies we limited our review to the 100 largest trials. Seventy-nine different treatments were reported across the 100 largest RCTs including vitamin and dietary supplements (18 trials), surgical treatments (18 trials) and sperm selection techniques (22 trials). When considering the largest 100 trials (range: 80-2772 participants), 36 primary and 89 secondary outcomes were reported. Forty-seven trials reported a primary outcome and 36 trials clearly defined their primary outcome. Pregnancy outcomes were inconsistently reported and included pregnancy rate (51 trials), pregnancy loss including miscarriage, ectopic pregnancy, stillbirth (9 trials) and live birth (13 trials). Trials consistently reporting the same outcome frequently used different definitions. For example, semen quality was reported by 75 trials and was defined in 7 different ways, including; the World Health Organization (WHO) 2010 criteria (32 trials), WHO 1999 criteria (18 trials), WHO 1992 criteria (3 trials), WHO 1999 and 1992 criteria (1 trial) and the Kruger strict morphology criteria (1 trial). LIMITATIONS REASONS FOR CAUTION We only evaluated the 100 largest trials published in the last 10 years and did not report outcomes on the remaining 75. An outcome was included as a primary outcome only if clearly stated in the manuscript and we did not contact authors to clarify this. As our review mapped outcomes and outcome measures, we did not undertake an integrity assessment of the trials included in our review. WIDER IMPLICATIONS OF THE FINDINGS Most randomized trials evaluating treatments for male infertility report different outcomes. Only half of the RCTs reported pregnancy rate and even fewer reported live birth; furthermore, the definitions of these outcomes varies across trials. Developing, disseminating and implementing a minimum data set, known as a core outcome set, for male infertility research could help to improve outcome selection, collection and reporting. STUDY FUNDING/COMPETING INTERESTS A.P.-chairman of external scientific advisory committee of Cryos International Denmark ApS, member of the scientific advisory board for Cytoswim LDT and ExSeed Health. Guest lecture at the 'Insights for Fertility Conference', funded by MERK SERONO Limited. M.v.W.-holds a ZON-MW research grant. No external funding was obtained for this study.
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Affiliation(s)
| | | | - Venkatesh Subramanian
- King’s Fertility, The Fetal Medicine Research Unit, King’s College London, London, UK
| | - Richard A Anderson
- MRC Centre for Reproductive Health, Queens Medical research Institute, University of Edinburgh, Edinburgh, UK,Edinburgh Fertility Centre, Simpsons Centre for Reproductive Health, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - Ricardo Pimenta Bertolla
- Division of Urology, Department of Surgery, Universidade Federal de Sao Paulo, São Paulo, Brazil
| | - Yusuf Beebeejaun
- King’s Fertility, The Fetal Medicine Research Unit, King’s College London, London, UK
| | - Pietro Bortoletto
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Sesh K Sunkara
- Division of Women’s Health, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, Queens Medical research Institute, University of Edinburgh, Edinburgh, UK
| | - Allan Pacey
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Madelon van Wely
- Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Cindy M Farquhar
- Cochrane Gynaecology and Fertility Group, Auckland, New Zealand,Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - James M N Duffy
- Correspondence address. King’s Fertility, The Fetal Medicine Research Unit, King’s College London, London, UK. Tel: +44-7949-066806; E-mail:
| | - Craig Niederberger
- Department of Urology, University of Illinois at Chicago, Chicago, IL, USA,Department of Bioengineering, University of Illinois at Chicago College of Engineering, Chicago, IL, USA
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23
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Holzer M, Massa E, Ghersevich S. Relationship between serum vitamin D concentration and parameters of gonadal function in infertile male patients. Curr Urol 2022; Publish Ahead of Print. [DOI: 10.1097/cu9.0000000000000075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Dashti G, Pooladi M, Sharifi M, Abbasi Y. Correlation of obesity and serum vitamin D levels with sperm DNA integrity, sperm quality, and sperm viability in normozoospermia men. Adv Biomed Res 2022; 11:80. [DOI: 10.4103/abr.abr_261_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/28/2021] [Accepted: 12/28/2021] [Indexed: 11/04/2022] Open
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Krog MC, Madsen ME, Bliddal S, Bashir Z, Vexø LE, Hartwell D, Hugerth LW, Fransson E, Hamsten M, Boulund F, Wannerberger K, Engstrand L, Schuppe-Koistinen I, Nielsen HS. OUP accepted manuscript. Hum Reprod Open 2022; 2022:hoac015. [PMID: 35441092 PMCID: PMC9014536 DOI: 10.1093/hropen/hoac015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/11/2022] [Indexed: 11/23/2022] Open
Abstract
STUDY QUESTION What is the microbiome profile across different body sites in relation to the normal menstrual cycle (with and without hormonal contraception), recurrent pregnancy loss (RPL) (before and during pregnancy, pregnancy loss or birth) and endometriosis (before, during and after surgery)? How do these profiles interact with genetics, environmental exposures, immunological and endocrine biomarkers? WHAT IS KNOWN ALREADY The microbiome is a key factor influencing human health and disease in areas as diverse as immune functioning, gastrointestinal disease and mental and metabolic disorders. There is mounting evidence to suggest that the reproductive microbiome may be influential in general and reproductive health, fertility and pregnancy outcomes. STUDY DESIGN, SIZE, DURATION This is a prospective, longitudinal, observational study using a systems biology approach in three cohorts totalling 920 participants. Since microbiome profiles by shot-gun sequencing have never been investigated in healthy controls during varying phases of the menstrual cycle, patients with RPL and patients with endometriosis, no formal sample size calculation can be performed. The study period is from 2017 to 2024 and allows for longitudinal profiling of study participants to enable deeper understanding of the role of the microbiome and of host–microbe interactions in reproductive health. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants in each cohort are as follows: Part 1 MiMens—150 healthy women with or without hormonal contraception; Part 2 MiRPL—200 couples with RPL, 50 healthy couples with prior uncomplicated pregnancy and 150 newborns; Part 3 MiEndo—120 patients with endometriosis requiring surgery with or without hormonal treatment. Microbiome profiles from saliva, faeces, rectal mucosa, vaginal fluid and endometrium will be studied, as well as the Omics profile, endocrine disrupting chemicals and endocrine and immune factors in blood, hair, saliva and urine. Pregnancy loss products, seminal microbiome, HLA types, endometriotic tissue and genetic risk and comprehensive questionnaire data will also be studied, where appropriate. Correlations with mental and physical health will be evaluated. STUDY FUNDING/COMPETING INTEREST(S) This work is supported by funding from Ferring Pharmaceuticals ([#MiHSN01] to H.S.N., M.C.K., M.E.M., L.E.V., L.E., I.S.-K., F.B., L.W.H., E.F. and M.H.), Rigshospitalet’s Research Funds ([#E-22614-01 and #E-22614-02] to M.C.K. and [#E-22222-06] to S.B.), Niels and Desiree Yde’s Foundation (S.B., endocrine analyses [#2015-2784]), the Musikforlæggerne Agnes and Knut Mørk’s Foundation (S.B., endocrine and immune analyses [#35108-001]) and Oda and Hans Svenningsen’s Foundation ([#F-22614-08] to H.S.N.). Medical writing assistance with this manuscript was provided by Caroline Loat, PhD, and funded by Ferring Pharmaceuticals. H.S.N. reports personal fees from Ferring Pharmaceuticals, Merck Denmark A/S, Ibsa Nordic, Astra Zeneca and Cook Medical outside the submitted work. K.W. is a full-time employee of Ferring Pharmaceuticals. No other conflicts are reported. TRIAL REGISTRATION NUMBER N/A TRIAL REGISTRATION DATE N/A DATE OF FIRST PATIENT’S ENROLMENT N/A
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Affiliation(s)
- Maria Christine Krog
- Correspondence address. The Recurrent Pregnancy Loss Unit, The Fertility Clinic 4071, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. E-mail:
| | | | - Sofie Bliddal
- The Department of Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
- Institute for Inflammation Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Zahra Bashir
- The Recurrent Pregnancy Loss Unit, The Capital Region, The Fertility Clinic, Copenhagen University Hospitals Rigshospitalet and Hvidovre, Copenhagen, Denmark
- Department of Obstetrics and Gynecology, Slagelse Hospital, Slagelse, Denmark
| | - Laura Emilie Vexø
- The Recurrent Pregnancy Loss Unit, The Capital Region, The Fertility Clinic, Copenhagen University Hospitals Rigshospitalet and Hvidovre, Copenhagen, Denmark
- Department of Gynecology, The Endometriosis Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Dorthe Hartwell
- Department of Gynecology, The Endometriosis Unit, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Luisa W Hugerth
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Emma Fransson
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Marica Hamsten
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Fredrik Boulund
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | | | - Lars Engstrand
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Ina Schuppe-Koistinen
- Centre for Translational Microbiome Research (CTMR), Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Henriette Svarre Nielsen
- The Recurrent Pregnancy Loss Unit, The Capital Region, The Fertility Clinic, Copenhagen University Hospitals Rigshospitalet and Hvidovre, Copenhagen, Denmark
- Department of Clinical Medicine, Copenhagen University, Copenhagen N, Denmark
- Department of Obstetrics and Gynecology, Copenhagen University Hospital, Hvidovre, Denmark
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26
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Tian M, Zeng S, Cai S, Reichetzeder C, Zhang X, Yin C, Kuang W, Cheng K, Jiang Y, Tao M, Zeng Y, Lin G, Li J, Gong F, Hocher B. 25(OH)VitD and human endocrine and functional fertility parameters in women undergoing IVF/ICSI. Front Endocrinol (Lausanne) 2022; 13:986848. [PMID: 36105399 PMCID: PMC9464865 DOI: 10.3389/fendo.2022.986848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Vitamin D plays an important role in reproduction. Evidence shown that free 25-hydroxyvitamin D (25(OH)VitD) was more accurate than total 25(OH)VitD in reflecting the status of 25(OH)VitD during pregnancy. However, the relationship between free 25(OH)VitD and female fertility parameters has not been reported yet. Therefore, this study aims to compare the correlation of free and total 25(OH)VitD with fertility parameters in infertility females undergoing in vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI). METHODS According to the inclusion and exclusion criteria, 2569 infertility patients who received IVF-ET or ICSI treatment for the first time participated in this study. Five milliliter peripheral blood samples of the patients were collected on the day before embryo transfer (ET). Enzyme linked immunosorbent assay (ELISA) kits was used to detect free 25(OH)VitD and total 25(OH)VitD, and clinical information was collected. Spearman's rho was used to evaluate the association between the variables. RESULTS The median (IQR) of free 25(OH)VitD was 4.71 (4.11-5.31) pg/mL and total 25(OH)VitD was 19.54 (16.52-22.83) ng/m. The correlation between them, however, was week (rho=0.311). Compared to total 25(OH)VitD, free 25(OH)VitD was slightly better correlated with basal follicle-stimulating hormone (FSH) (rho=0.041, P=0.036), basal estradiol (E2) (rho=0.089, P<0.001), anti-Müllerian hormone (AMH) (rho=-0.057, P=0.004), antral follicle count (AFC) (rho=-0.053, P=0.007), E2 (rho=-0.080, P<0.001), number of oocytes retrieval (rho=-0.079, P<0.001) and progesterone (P)/E2 on hCG trigger day (rho=0.081, P<0.001). CONCLUSIONS Overall, there was only a rather weak correlation of free as well as total 25(OH)VitD with human endocrine and functional fertility parameters in women undergoing IVF/ICSI. Neither free nor total 25(OH)VitD seems to play a major role in human embryo implantation.
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Affiliation(s)
- Mei Tian
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Suimin Zeng
- Department of Pathology, The First Hospital of Traditional Chinese Medicine, Yiyang, China
| | - Sufen Cai
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Christoph Reichetzeder
- Department of Nutritional Toxicology, Institute for Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Xiaoli Zhang
- Institute of Pharmacy, Freie Universität Berlin, Berlin, Germany
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
| | - Chenjun Yin
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Weihong Kuang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Kexin Cheng
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yao Jiang
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Mingqiu Tao
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Yuan Zeng
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Ge Lin
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
| | - Jian Li
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
| | - Fei Gong
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, Hunan, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Key Laboratory of Stem Cells and Reproductive Engineering, Ministry of Health, Changsha, China
- *Correspondence: Berthold Hocher, ; Fei Gong,
| | - Berthold Hocher
- Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
- Fifth Department of Medicine (Nephrology/Endocrinology/Rheumatology), University Medical Centre Mannheim, University of Heidelberg, Mannheim, Germany
- Institute of Medical Diagnostics, IMD, Berlin, Germany
- *Correspondence: Berthold Hocher, ; Fei Gong,
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Holt R, Petersen JH, Dinsdale E, Knop FK, Juul A, Jørgensen N, Blomberg Jensen M. Vitamin D Supplementation Improves Fasting Insulin Levels and HDL Cholesterol in Infertile Men. J Clin Endocrinol Metab 2022; 107:98-108. [PMID: 34508607 DOI: 10.1210/clinem/dgab667] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Vitamin D has been linked with glucose and lipid metabolism. Men with impaired gonadal function have a higher risk of metabolic syndrome and mortality, and vitamin D status may be a reversible modulator. OBJECTIVE This work aimed to determine the effect of daily vitamin D and calcium supplementation for 150 days on glucose and lipid homeostasis in infertile men. METHODS A single-center, double-blinded, randomized clinical trial (NCT01304927) was conducted. A total of 307 infertile men were randomly assigned (1:1) to a single dose of 300 000 IU cholecalciferol followed by 1400 IU cholecalciferol + 500 mg of calcium daily (n = 151) or placebo (n = 156) for 150 days. Reported metabolic parameters including fasting plasma glucose, glycated hemoglobin A1c, fasting serum insulin, homeostatic model assessment of insulin resistance (HOMA-IR), fasting plasma cholesterols, and triglycerides were secondary end points. The primary end point semen quality has previously been reported. RESULTS Men receiving vitamin D supplementation improved their vitamin D status, whereas vitamin D status was aggravated in the placebo group characterized by higher serum parathyroid hormone. At the end of the trial, men receiving vitamin D supplementation had 13% lower fasting serum insulin concentrations compared with the placebo-treated group (65 vs 74 pmol/L, P = .018) and 19% lower HOMA-IR (2.2 vs 2.7, P = .025). Moreover, men in the vitamin D group had higher high-density lipoprotein (HDL) cholesterol levels (1.38 vs 1.32 mmol/L, P = .008) compared with the placebo group. CONCLUSION High-dose vitamin D supplementation has beneficial effects on glucose homeostasis and HDL cholesterol levels in infertile men.
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Affiliation(s)
- Rune Holt
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, Copenhagen, 2100, Denmark
| | - Jørgen Holm Petersen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, 2100, Denmark
- Section of Biostatistics, Faculty of Health Sciences, University of Copenhagen, 1014, Denmark
| | - Elsa Dinsdale
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, Copenhagen, 2100, Denmark
| | - Filip Krag Knop
- Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, 2900, Denmark
- Steno Diabetes Center Copenhagen, Gentofte, 2820, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
| | - Anders Juul
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, 2100, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, 2100, Denmark
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, Copenhagen, 2100, Denmark
- Division of Bone and Mineral Research, Harvard School of Dental Medicine/Harvard Medical School, Harvard University, Boston, Massachusetts 02115, USA
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Mohamed DI, Abou-Bakr DA, Ezzat SF, El-Kareem HFA, Nahas HHA, Saad HA, Mehana AE, Saied EM. Vitamin D3 Prevents the Deleterious Effects of Testicular Torsion on Testis by Targeting miRNA-145 and ADAM17: In Silico and In Vivo Study. Pharmaceuticals (Basel) 2021; 14:1222. [PMID: 34959623 DOI: 10.3390/ph14121222] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 11/21/2022] Open
Abstract
Testicular torsion (TT) is the most common urological emergency in children and young adults that can lead to infertility in many cases. The ischemia-reperfusion (IR) injury due to TT has been implicated in the pathogenesis of testicular damage. The main pathological mechanisms of contralateral injury after ipsilateral TT are not fully understood. In the presented study, we investigated the molecular and microscopic basis of ipsilateral and contralateral testicular injury following ipsilateral testicular torsion detorsion (T/D) and explored the possible protective role of vitamin D3. The biochemical analysis indicated that IR injury following T/D significantly decreased the activity of testicular glutathione peroxidase (GPx) enzyme, level of serum testosterone, serum inhibin B, and expression of testicular miRNA145, while increased the activity of testicular myeloperoxidase (MPO) enzyme, level of testicular malondialdehyde (MDA), level of serum antisperm-antibody (AsAb), and expression of ADAM-17. The histological and semen analysis revealed that torsion of the testis caused damages on different tissues in testis. Interestingly, administration of vitamin D3 prior to the IR injury reversed the deterioration effect of IR injury on the testicular tissues as indicated by biochemical and histological analysis which revealed normal appearance of the seminiferous tubules with an apparent decrease in collagen fiber deposition in both ipsilateral and contralateral testes. Our results revealed that the protective effect of vitamin D3 treatment could be attributed to target miRNA145 and ADAM17 protein. To further investigate these findings, we performed a detailed molecular modelling study in order to explore the binding affinity of vitamin D3 toward ADAM17 protein. Our results revealed that vitamin D3 has the ability to bind to the active site of ADAM17 protein via a set of hydrophobic and hydrophilic interactions with high docking score. In conclusion, this study highlights the protective pharmacological application of vitamin D3 to ameliorate the damages of testicular T/D on the testicular tissues via targeting miRNA145 and ADAM17 protein.
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Maghsoumi-Norouzabad L, Zare Javid A, Mansoori A, Dadfar M, Serajian A. Vitamin D3 Supplementation Effects on Spermatogram and Oxidative Stress Biomarkers in Asthenozoospermia Infertile Men: a Randomized, Triple-Blind, Placebo-Controlled Clinical Trial. Reprod Sci 2021; 29:823-835. [PMID: 34664221 DOI: 10.1007/s43032-021-00769-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/02/2021] [Indexed: 11/28/2022]
Abstract
The objective is to evaluate the effects of vitamin D3 (VD3) on sperm parameters and seminal and serum oxidative stress (OS) biomarkers in asthenozoospermia infertile men. This randomized, triple-masking, placebo-controlled clinical trial conducted on 86 asthenozoospermia infertile men with serum 25 hydroxy vitamin D3 (25-OH-D3) < 30 ng/ml in the infertility clinic of Ahvaz Jahad Daneshgahi, Iran. Patients were randomly allocated to groups A and B, who received daily 4000 IU vitamin D3 (VD3) and matching placebo respectively for 3 months. Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum and seminal levels of MDA (Malondialdehyde), 8-hydroxy-2- Dioxy Guanosine (8-OHDG), total antioxidant capacity (TAC) and calcium, sperm DNA fragmentation index (DFI), serum 25-OH-D3, parathyroid hormone (PTH), phosphorus, and sperm parameters were assessed. VD3 supplementation had no significant effects on body weight, body mass index (BMI), waist circumference (WC), body fat (BF), 8-OHDG, DFI, semen volume, sperm count, and normal sperm morphology, but increased post-intervention mean and mean change of serum 25-OH-D3 (P < 0.001, P < 0.001), PTH (P < 0.001, P < 0.001) and phosphorus (P = 0.009, P = 0.049) and seminal calcium (P = 0.035, P = 0.038) and serum calcium (P = 0.008, P = 0.009), seminal TAC (P < 0.001, P < 0.001), and serum TAC (P = 0.007, P = 005), total sperm motility (P < 0.001, P < 0.001) and progressive sperm motility (P < 0.001, P < 0.001) and decreased seminal MDA (P = 0.017, P = 0.004) and serum MDA (P = 006, P = 0.005) significantly compared to the baseline and placebo group respectively. VD3 supplementation may modulate OS and affect sperm motility in men with asthenozoospermia and serum 25-OH-D3 < 30 ng/ml. Iran Clinical Trials Registry, ID: IRCT20151128025274N4, registered on 28 March 2018, URL of trial registry record: https://www.irct.ir/trial/29983.
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Affiliation(s)
- Leila Maghsoumi-Norouzabad
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Zare Javid
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Anahita Mansoori
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Dadfar
- Department of Urology, School of Medicine, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Asadpour R, Taravat M, Rahbar M, Khoshniyat M, Hamidian G. Effects of vitamin D supplementation in extender on sperm kinematics and apoptosis following the freeze-thaw process in normozoospermic and asthenozoospermic Holstein bulls. Basic Clin Androl 2021; 31:20. [PMID: 34348640 PMCID: PMC8340513 DOI: 10.1186/s12610-021-00137-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 06/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Asthenozoospermia is a usual male infertility factor, characterized by decreased semen quality. It has been revealed that antioxidants improve sperm function, enhance endogenous antioxidant activities, and protect spermatozoa against oxidative damage during cryopreservation. This aimed to evaluate the effects of vitamin D on sperm kinematics and apoptosis in the semen of bulls with normozoospermia and asthenozoospermia after the freeze-thaw process. For this purpose, 32 semen samples of four Holstein bulls (normozoospermic, progressive motility > 70 %) and 32 semen samples of four bull (asthenozoospermic progressive motility < 40 %) were collected and pooled separately (normozoospermic and asthenozoospermic). Samples were then diluted into four equal aliquots of extender containing different vitamin D concentrations (0, 5, 10, and 50 ng/mL) and aspirated into a 0.5 mL straw. Results The percentages of sperm progressive motility and viability were significantly higher (P < 0.05) in 50 ng/mL of vitamin D in normozoospermic group. Sperm kinematics parameters including curvilinear velocity (VCL), straight-line velocity (VSL), and average path velocity (VAP) were significantly higher in the high dose (50 ng/mL) vitamin D-treated group compared to the low dose vitamin D-treated group (5ng/mL) in normozoospermic bull semen samples. The supplementation of the semen extender with different concentrations of vitamin D could not increase the rate of acrosome integrity in normozoospermic bulls compared to the control group (P < 0.05). In the asthenozoospermic group, 10 ng/mL vitamin D-treated group could increase the rate of plasma membrane integrity compared to 5 ng/mL vitamin D-treated group (P < 0.05). The percentages of early-apoptosis (P = 0.049) and late-apoptosis (P = 0.005) were significantly higher in the asthenozoospermic than the normozoospermic group. Conclusions The present study revealed that a high dose (50 ng/mL) of vitamin D protected normozoospermic bulls’ sperms from the freezing procedure and lead to higher quality of frozen-thawed bull sperm.
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Affiliation(s)
- Reza Asadpour
- Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.
| | - Morteza Taravat
- Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | - Maryam Rahbar
- Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
| | | | - Gholamreza Hamidian
- Department of Clinical Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran.,Department of Basic Science, Faculty of Veterinary Medicine, University of Tabriz, Tabriz, Iran
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31
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Banks N, Sun F, Krawetz SA, Coward RM, Masson P, Smith JF, Trussell JC, Santoro N, Zhang H, Steiner AZ. Male vitamin D status and male factor infertility. Fertil Steril 2021; 116:973-979. [PMID: 34289935 DOI: 10.1016/j.fertnstert.2021.06.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility. DESIGN Secondary analysis of a randomized, controlled trial. SETTING Nine fertility centers in the United States. PATIENT(S) Men (n = 154) with sperm concentration between 5 and 15 million/mL, motility ≤40%, or normal morphology ≤4% were eligible. Female partners were ovulatory, ≤40 years old, and had documented tubal patency. INTERVENTION(S) Men provided semen and blood at baseline for semen analysis and 25-hydroxyvitamin D (25(OH)D) levels. They were randomly assigned to receive a vitamin formulation including vitamin D 2,000 IU daily or placebo for up to 6 months. Couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through 6. MAIN OUTCOME MEASURE(S) Primary: sperm concentration, motility, morphology, and DNA fragmentation at baseline. Secondary: cumulative pregnancy, miscarriage, and live birth rates. RESULT(S) Semen parameters and sperm DNA fragmentation were not statistically significantly different between men with vitamin D deficiency and men with 25(OH)D levels ≥20 ng/mL. In addition, clinical pregnancy and live birth rates were similar. Male 25(OH)D level <20 ng/mL was associated with a higher rate of pregnancy loss (adjusted odds ratio 9.0; 95% confidence interval 1.3 to 61.3). CONCLUSION(S) Vitamin D deficiency in the male partner did not significantly impact semen parameters or treatment outcomes. Further study is warranted to better characterize the rate of miscarriage in couples with male vitamin D deficiency.
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Affiliation(s)
- Nicole Banks
- Department of Obstetrics and Gynecology, Virginia Commonwealth University Health, Richmond, Virginia.
| | - Fangbai Sun
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology and Center for Molecular Medicine and Genetics, Wayne State University, Detroit, Michigan
| | - R Matthew Coward
- Department of Urology, University of North Carolina, Chapel Hill, North Carolina
| | - Puneet Masson
- Department of Urology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - James F Smith
- Department of Urology, University of California, San Francisco, California
| | - J C Trussell
- Department of Urology, Upstate University Hospital, Syracuse, New York
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, University of Colorado, Denver, Colorado
| | - Heping Zhang
- Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Anne Z Steiner
- Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina
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Maghsoumi-Norouzabad L, Zare Javid A, Mansoori A, Dadfar M, Serajian A. The effects of Vitamin D3 supplementation on Spermatogram and endocrine factors in asthenozoospermia infertile men: a randomized, triple blind, placebo-controlled clinical trial. Reprod Biol Endocrinol 2021; 19:102. [PMID: 34225767 PMCID: PMC8256550 DOI: 10.1186/s12958-021-00789-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 06/18/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Evaluate the effects of vitamin D3 (VD3) on sperm parameters and endocrine markers in infertile men with asthenozoospermia. MATERIALS AND METHODS This randomized, triple-masking, placebo-controlled clinical trial conducted on 86 asthenozoospermia infertile men with serum 25 hydroxy vitamin D3 (25(OH)VD3) < 30 ng/ml in the infertility clinic of Ahvaz Jahad daneshgahi, Iran. Patients were randomly allocated to groups A and B, who received daily 4000 IU VD3 and matching placebo respectively for 3 months. Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum 25(OH)VD3, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), estradiol (E2),, sex hormone-binding globulin (SHBG), free androgen index (FAI = T/SHBG. 100), T/LH and T/E2 ratios, prolactin (PRO), parathyroid hormone (PTH), osteocalcin (OCN), phosphorus and sperm parameters were assessed. RESULTS Three months VD3 supplementation with 4000 IU/day had no significant effects body weight, body mass index (BMI), waist circumference (WC), body fat (BF), serum, OCN, LH, FSH, T, E2, SHBG, PRO, T/E2 ratio, FAI, semen volume, sperm count and normal sperm morphology. It increases serum 25(OH)VD3, PTH and phosphorus and seminal and serum calcium, T/LH ratio and total and progressive sperm motility and decreased significantly compared to the baseline and placebo group. CONCLUSION VD3 supplementation may affect sperm motility in men with asthenozoospermia and serum 25(OH)VD3 < 30 ng/ml. TRIAL REGISTRATION Iran Clinical Trials Registry, ID: IRCT20151128025274N4, registered on 28 March 2018, URL of trial registry record: https://www.irct.ir/trial/29983.
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Affiliation(s)
- Leila Maghsoumi-Norouzabad
- Department of Nutrition, School of Allied Medical Sciences and Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Zare Javid
- Department of Nutrition, School of Allied Medical Sciences and Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Anahita Mansoori
- Department of Nutrition, School of Allied Medical Sciences and Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Dadfar
- Department of Urology, Imam Khomeini Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Pyrgidis N, Sokolakis I, Palapelas V, Tishukov M, Mykoniatis I, Symeonidis EN, Zachariou A, Kaltsas A, Sofikitis N, Hatzichristodoulou G, Tsiampali C, Dimitriadis F. The Effect of Antioxidant Supplementation on Operated or Non-Operated Varicocele-Associated Infertility: A Systematic Review and Meta-Analysis. Antioxidants (Basel) 2021; 10:1067. [PMID: 34356300 DOI: 10.3390/antiox10071067] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/28/2021] [Accepted: 06/29/2021] [Indexed: 02/05/2023] Open
Abstract
In patients with varicocele-associated infertility, the effect of antioxidant supplementation on fertility is unknown. We performed a systematic review and meta-analysis to explore their role in patients with operated or non-operated varicocele. We searched major databases and sources of grey literature until May 2021 (PROSPERO: CRD42021248195). We included 14 studies (980 individuals) in the systematic review. Of the 14 studies, 2 explored the effect of antioxidant supplementation in patients with non-operated varicocele, 1 compared antioxidants versus surgical repair of varicocele, while 11 explored antioxidants after surgical repair of varicocele and were also included in the meta-analysis. Regarding pregnancy rates, no significant differences were demonstrated after treatment with antioxidants versus no treatment at three (OR: 2.28, 95% CI: 0.7-7.48) and six months (OR: 1.88, 95% CI: 0.62-5.72). Accordingly, contradictory findings were reported in sperm concentration, morphology, and motility, as well as DNA fragmentation. Our findings indicate that antioxidant supplementation does not improve pregnancy rates and semen parameters in patients with varicocele-associated infertility, in the absence of previous screening for oxidative stress. Based on the previous notion, most included studies also raised methodological concerns. Therefore, definitive conclusions about the efficacy of antioxidant supplementation in this setting cannot be drawn and further research on the field is mandatory.
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34
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Maghsoumi-Norouzabad L, Zare Javid A, Mansoori A, Dadfar M, Serajian A. Evaluation of the effect of vitamin D supplementation on spermatogram, seminal and serum levels of oxidative stress indices in asthenospermia infertile men: a study protocol for a triple-blind, randomized controlled trial. Nutr J 2021; 20:49. [PMID: 34078367 PMCID: PMC8173907 DOI: 10.1186/s12937-021-00711-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is suggested that vitamin D may have a beneficial role in male reproduction. The male reproductive system is a target tissue for vitamin D. This study will aim to evaluate the effects of vitamin D supplementation on sperm parameters, seminal and serum levels of oxidative stress and serum endocrine factors in asthenospermia infertile men. METHODS/DESIGN This randomized, triple-blind, placebo-controlled clinical trial will be conducted on 86 infertile men with idiopathic asthenozoospermia (the mobility of sperm < 40% and rapid progressive sperm motility < 32%), with serum levels of vitamin D less than 30 ng / ml in the "Infertility Clinic of Ahvaz Jahad daneshgahi", Iran. MAIN OUTCOMES MEASURE (S) Demographic data, dietary intake, physical activity, sun exposure, anthropometric indices, serum and seminal levels of MDA (Malondialdehyde), 8-hydroxy-2- Dioxy Guanosine (8-OHDG), Total Antioxidant Capacity (TAC) and calcium, sperm DNA fragmentation index (DFI), serum 25-OHD, luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (T), estradiol (E2), sex hormone-binding globulin (SHBG), free androgen index (FAI = T/SHBG. 100), T/LH and T/E2 ratios, prolactin (PRO), parathyroid hormone (PTH), osteocalcin (OCN), phosphorus and sperm parameters. DISCUSSION The deficiency of vitamin D as an antioxidant is common all over the world. Numerous observational studies have shown a positive association between vitamin D levels and semen quality. However, few clinical studies have been conducted in this area. So considering with the high prevalence of this antioxidant deficiency specifically in infertile men, it seems that the supplementation of vitamin D in infertile men with insufficient levels or deficiency may improve the status of oxidative stress and thereby may affect sperm parameters and endocrine factors involved in male fertility. TRIAL REGISTRATION Iran Clinical Trials Registry, ID: IRCT20151128025274N4 , registered on 28 March 2018.
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Affiliation(s)
- Leila Maghsoumi-Norouzabad
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Zare Javid
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. .,Nutrition and Metabolic Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Anahita Mansoori
- Department of Nutrition, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammadreza Dadfar
- Department of Urology, Imam Khomeini Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Tsampoukas G, Gkeka K, Dellis A, Brown D, Katsouri A, Alneshawy A, Moussa M, Papatsoris A, Buchholz N. Vitamins as primary or adjunctive treatment in infertile men with varicocele: A systematic review. Arab J Urol 2021; 19:264-273. [PMID: 34552778 PMCID: PMC8451598 DOI: 10.1080/2090598x.2021.1932124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/08/2021] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To investigate the usage and the efficacy of vitamins as primary or adjuvant treatment in infertile men with varicocele. METHODS A systematic search in PubMed, the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cochrane Library with the terms (varicocele) AND (vitamins) was performed. We searched for studies: a) reporting the administration of vitamins (individually or as part of a complex) in men with varicocele and infertility, b) primarily or adjuvant to invasive treatment, and c) reporting the impact on semen parameters and/or pregnancy rates. Exclusion criteria were animal, adolescent and non-English studies, grey literature and trials reporting abstracts only. RESULTS Seven studies were identified eligible for qualitative analysis. All studies were randomised except one (case series). Vitamins were administered dominantly as part of antioxidant complex and only two studies used vitamins (C and E, respectively) as sole agent. In two studies, vitamin monotherapy resulted in improvement in semen quality, but the effect on pregnancy rates is unknown. One study reported no efficacy of adjuvant multivitamin treatment after embolisation in terms of both semen quality and pregnancy rates. Finally, four studies reported a positive effect of vitamins on semen parameters after varicocelectomy, but the effect on pregnancy rates is conflicting; one study reported improved pregnancy rates with adjuvant treatment, two studies did not evaluate the pregnancy rates, and in one study the outcome was unclear due to missing data. CONCLUSIONS Vitamins have been used mostly as part of an antioxidant panel for the management of infertile men with varicocele. Most studies have found a positive impact on semen parameters in selected men with varicocele and infertility, as primary or adjuvant treatment. However, the clinical benefit of vitamins administration on pregnancy rate is under-evaluated and should be the target of future research.
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Affiliation(s)
- Georgios Tsampoukas
- U-merge Ltd. (Urology for Emerging Countries), London, UK
- Department of Urology, Princess Alexandra Hospital, Harlow, UK
| | - Kristiana Gkeka
- Department of Urology, General Hospital of Patras, Patras, Greece
| | - Athanasios Dellis
- U-merge Ltd. (Urology for Emerging Countries), London, UK
- Department of Urology, Aretaieion Academic Hospital, Athens, Greece
| | - Dominic Brown
- Department of Urology, Princess Alexandra Hospital, Harlow, UK
| | | | - Ahmed Alneshawy
- U-merge Ltd. (Urology for Emerging Countries), London, UK
- Department of Urology, Princess Alexandra Hospital, Harlow, UK
| | - Mohamad Moussa
- Al Zahraa Hospital, University Medical Center, Lebanese University, Beirut, Lebanon
| | - Athanasios Papatsoris
- U-merge Ltd. (Urology for Emerging Countries), London, UK
- Second Department of Urology, University Hospital of Athens, Athens, Greece
| | - Noor Buchholz
- U-merge Ltd. (Urology for Emerging Countries), London, UK
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Blomberg Jensen M, Andreassen CH, Jørgensen A, Nielsen JE, Juel Mortensen L, Boisen IM, Schwarz P, Toppari J, Baron R, Lanske B, Juul A. RANKL regulates male reproductive function. Nat Commun 2021; 12:2450. [PMID: 33893301 PMCID: PMC8065035 DOI: 10.1038/s41467-021-22734-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 03/23/2021] [Indexed: 11/08/2022] Open
Abstract
Infertile men have few treatment options. Here, we demonstrate that the transmembrane receptor activator of NF-kB ligand (RANKL) signaling system is active in mouse and human testis. RANKL is highly expressed in Sertoli cells and signals through RANK, expressed in most germ cells, whereas the RANKL-inhibitor osteoprotegerin (OPG) is expressed in germ and peritubular cells. OPG treatment increases wild-type mouse sperm counts, and mice with global or Sertoli-specific genetic suppression of Rankl have increased male fertility and sperm counts. Moreover, RANKL levels in seminal fluid are high and distinguishes normal from infertile men with higher specificity than total sperm count. In infertile men, one dose of Denosumab decreases RANKL seminal fluid concentration and increases serum Inhibin-B and anti-Müllerian-hormone levels, but semen quality only in a subgroup. This translational study suggests that RANKL is a regulator of male reproductive function, however, predictive biomarkers for treatment-outcome requires further investigation in placebo-controlled studies.
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Affiliation(s)
- Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
- Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, MA, USA.
| | - Christine Hjorth Andreassen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anne Jørgensen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - John Erik Nielsen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Li Juel Mortensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, MA, USA
| | - Ida Marie Boisen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, MA, USA
| | - Peter Schwarz
- Department of Endocrinology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jorma Toppari
- Institute of Biomedicine, Research Centre for Integrated Physiology and Pharmacology, and Centre for Population Health Research, University of Turku, and Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Roland Baron
- Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, MA, USA
| | - Beate Lanske
- Division of Bone and Mineral Research, HSDM/HMS, Harvard University, Boston, MA, USA
| | - Anders Juul
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
Background Hypovitaminosis D has been linked with poor semen parameters and endocrinological factors in male infertility. This study aimed to analyze the association of serum vitamin D levels and reproductive hormones such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), and total testosterone (TT) with the semen parameters in a cohort of infertile men. Methodology In this study, 224 infertile men (aged 18-45 years) were recruited after applying inclusion and exclusion criteria. Semen analysis was performed as per the 2010 World Health Organization (WHO) criteria. The patients were divided into two groups on the basis of semen parameters: normozoospermic men and men with one or more altered semen parameters as per the WHO 2010 guidelines for all the analysis. Vitamin D and hormone levels were evaluated by quantitative competitive immunoassay by chemiluminescent microparticle immunoassay technology with flexible assay protocols (Architect, Abbott Diagnostics, Lake Forest, IL, USA). The patients were further divided into three groups on the basis of vitamin D levels: Sufficient (>20 ng/mL), insufficient (12-20 ng/mL), and deficient (<12 ng/mL). These groups were compared for different semen and hormonal parameters. Results Out of the 224 infertile men included, 124 were normozoospermic while 100 patients had one or more altered semen parameters. The median age of the participants was 30 years (minimum = 18 years, maximum = 45 years). The serum vitamin D and TT levels were significantly lower (p < 0.0001) and FSH (p = 0.001) and LH levels (p < 0.0001) were significantly higher in those with one or more altered semen parameters compared to the normozoospermic men. The sperm concentration, total motility, linear progressive motility, percentage normal morphology, and serum TT levels were significantly lower in the patients with serum vitamin D levels of <12 ng/mL in both the normozoospermic men and those with one or more altered semen parameters compared to patients with higher vitamin D levels. Semen parameters such as sperm concentration, total motility, linear progressive motility, and morphology were positively correlated with the levels of serum vitamin D and TT. Conclusions Vitamin D deficiency was examined in a large proportion of infertile men. Serum vitamin D and TT levels were positively associated with semen parameters evident from lower levels of vitamin D and TT in men with altered semen parameters compared to normozoospermic men. However, further comprehensive studies with larger sample sizes should be conducted to further validate the role of vitamin D in male infertility by checking the effect of vitamin D supplementation on semen parameters.
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Affiliation(s)
- Sangeeta Kumari
- Reproductive Medicine, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, IND
| | - Kalpana Singh
- Reproductive Medicine, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, IND
| | - Shubhanti Kumari
- Reproductive Medicine, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, IND
| | - Huma Nishat
- Reproductive Medicine, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, IND
| | - Bhawana Tiwary
- Reproductive Medicine, Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, IND
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Juel Mortensen L, Lorenzen M, Jørgensen A, Albrethsen J, Jørgensen N, Møller S, Andersson AM, Juul A, Blomberg Jensen M. Possible Relevance of Soluble Luteinizing Hormone Receptor during Development and Adulthood in Boys and Men. Cancers (Basel) 2021; 13:cancers13061329. [PMID: 33809538 PMCID: PMC7999540 DOI: 10.3390/cancers13061329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/12/2021] [Accepted: 03/13/2021] [Indexed: 11/21/2022] Open
Abstract
Simple Summary The reproductive hormones luteinizing hormone (LH) and human chorionic gonadotropin (hCG) are both agonists for the luteinizing hormone receptor (LHCGR) and essential for male reproduction during development and adulthood. LHCGR is expressed and stimulates testosterone production from the testicular Leydig cells. In this study, we demonstrate the presence of soluble LHCGR in blood, urine, and seminal fluid in both healthy boys and men, and patients with aberrations in sex-chromosomes. We show how circulating levels of sLHCGR are associated with pubertal development, testicular function, and semen quality and demonstrate that LHCGR is released from fetal human non-gonadal tissue. sLHCGR is released into serum by testis and other organs, which suggests possible extra-gonadal effects of LH or hCG in boys and men. Abstract Luteinizing hormone (LH) and human chorionic gonadotropin (hCG) are agonists for the luteinizing hormone receptor (LHCGR) which regulates male reproductive function. LHCGR may be released into body fluids. We wish to determine whether soluble LHCGR is a marker for gonadal function. Cross-sectional, longitudinal, and intervention studies on 195 healthy boys and men and 396 men with infertility, anorchia, or Klinefelter Syndrome (KS) were used to correlate LHCGR measured in serum, seminal fluid, urine, and hepatic/renal artery and vein with gonadal function. LHCGR was determined in fluids from in vitro and in vivo models of human testicular tissue and cell lines, xenograft mouse models, and human fetal kidney and adrenal glands. Western blot showed LHCGR fragments in serum and gonadal tissue of similar size using three different antibodies. The LHCGR-ELISA had no species cross-reactivity or unspecific reaction in mouse serum even after human xenografting. Instead, sLHCGR was released into the media after the culture of a human fetal kidney and adrenal glands. Serum sLHCGR decreased markedly during puberty in healthy boys (p = 0.0001). In healthy men, serum sLHCGR was inversely associated with the Inhibin B/FSH ratio (β −0.004, p = 0.027). In infertile men, seminal fluid sLHCGR was inversely associated with serum FSH (β 0.006, p = 0.009), sperm concentration (β −3.5, p = 0.003) and total sperm count (β −3.2, p = 0.007). The injection of hCG lowered sLHCGR in serum and urine of healthy men (p < 0.01). In conclusion, sLHCGR is released into body-fluids and linked with pubertal development and gonadal function. Circulating sLHCGR in anorchid men suggests that sLHCGR in serum may originate from and possibly exert actions in non-gonadal tissues. (ClinicalTrials: NTC01411527, NCT01304927, NCT03418896).
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Affiliation(s)
- Li Juel Mortensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, University Department of Growth and Reproduction, Rigshospitalet, 2100 Copenhagen, Denmark; (L.J.M.); (M.L.)
| | - Mette Lorenzen
- Group of Skeletal, Mineral and Gonadal Endocrinology, University Department of Growth and Reproduction, Rigshospitalet, 2100 Copenhagen, Denmark; (L.J.M.); (M.L.)
| | - Anne Jørgensen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; (A.J.); (J.A.); (N.J.); (A.-M.A.); (A.J.)
| | - Jakob Albrethsen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; (A.J.); (J.A.); (N.J.); (A.-M.A.); (A.J.)
| | - Niels Jørgensen
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; (A.J.); (J.A.); (N.J.); (A.-M.A.); (A.J.)
| | - Søren Møller
- Center for Functional and Diagnostic Imaging and Research, Department of Clinical Physiology and Nuclear Medicine 260, Hvidovre Hospital, 2650 Copenhagen, Denmark;
- Department of Clinical Medicine, Faculty of Health Sciences, Copenhagen University, 2200 Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; (A.J.); (J.A.); (N.J.); (A.-M.A.); (A.J.)
| | - Anders Juul
- Department of Growth and Reproduction and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark; (A.J.); (J.A.); (N.J.); (A.-M.A.); (A.J.)
- Department of Clinical Medicine, Faculty of Health Sciences, Copenhagen University, 2200 Copenhagen, Denmark
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, University Department of Growth and Reproduction, Rigshospitalet, 2100 Copenhagen, Denmark; (L.J.M.); (M.L.)
- Division of Bone and Mineral Research, Harvard School of Dental Medicine/Harvard Medical School, Boston, MA 02115, USA
- Correspondence: ; Tel.: +45-3545-5064
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Tiosano D, Abrams SA, Weisman Y. Lessons Learned from Hereditary 1,25-Dihydroxyvitamin D-Resistant Rickets Patients on Vitamin D Functions. J Nutr 2021; 151:473-481. [PMID: 33438017 DOI: 10.1093/jn/nxaa380] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/25/2020] [Accepted: 11/04/2020] [Indexed: 01/08/2023] Open
Abstract
We summarize here lessons learned from studies on skeletal and extra-skeletal functions of vitamin D in hereditary 1,25-dihydroxyvitamin D-resistant rickets (HVDRR) patients with a mutant, nonfunctioning vitamin D receptor (VDR). During childhood, HVDRR patients are dependent on intestinal VDR, demonstrate low intestinal fraction calcium absorption, and have a bone calcium accretion rate that leads to hypocalcemia and rickets. After puberty, there is recovery in intestinal calcium absorption and in bone calcium accretion and structure. HVDRR monocytes and lymphocytes show impairment in the expression of antimicrobial proteins and demonstrate a proinflammatory cytokine profile. However, HVDRR patients do not exhibit increased rates of infections or inflammatory diseases. Vitamin D deficiency is associated with asthmatic exacerbations. Surprisingly, HVDRR patients do not usually develop asthma. They have normal allergic tests and lung functions and are protected against provoked bronchial hyperactivity. HVDRR patients have decreased IL-5 levels in their exhaled breath condensate. Given that IL-5 is a key cytokine in the development of airway inflammation and hyperactivity and that VDR is important for IL-5 generation, it is plausible that low lung IL-5 protects HVDRR patients from asthma. Vitamin D metabolites have suppressive effects on the renin angiotensin system. However, no HVDRR patient showed hypertension or echocardiographic pathology, and their renin angiotensin metabolites were normal. The VDR is expressed throughout the reproductive system, suggesting a role in reproduction. However, the reproductive history of HVDRR patients is normal despite the lack of a normal VDR. HVDRR patients provide a unique opportunity to study the role of the VDR and the role of vitamin D in various human systems.
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Affiliation(s)
- Dov Tiosano
- Pediatric Endocrinology Unit, Ruth Rappaport Children's Hospital, Rambam Healthcare Campus, Haifa, Israel
| | - Steven A Abrams
- Department of Pediatrics, Dell Medical School at the University of Texas-Austin, Austin, TX, USA
| | - Yoseph Weisman
- Department of Pediatrics, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Vanderhout SM, Rastegar Panah M, Garcia-Bailo B, Grace-Farfaglia P, Samsel K, Dockray J, Jarvi K, El-Sohemy A. Nutrition, genetic variation and male fertility. Transl Androl Urol 2021; 10:1410-1431. [PMID: 33850777 PMCID: PMC8039611 DOI: 10.21037/tau-20-592] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Infertility affects nearly 50 million couples worldwide, with 40-50% of cases having a male factor component. It is well established that nutritional status impacts reproductive development, health and function, although the exact mechanisms have not been fully elucidated. Genetic variation that affects nutrient metabolism may impact fertility through nutrigenetic mechanisms. This review summarizes current knowledge on the role of several dietary components (vitamins A, B12, C, D, E, folate, betaine, choline, calcium, iron, caffeine, fiber, sugar, dietary fat, and gluten) in male reproductive health. Evidence of gene-nutrient interactions and their potential effect on fertility is also examined. Understanding the relationship between genetic variation, nutrition and male fertility is key to developing personalized, DNA-based dietary recommendations to enhance the fertility of men who have difficulty conceiving.
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Affiliation(s)
| | | | | | | | - Konrad Samsel
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Judith Dockray
- Murray Koffler Urologic Wellness Centre, Department of Urology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Keith Jarvi
- Murray Koffler Urologic Wellness Centre, Department of Urology, Mount Sinai Hospital, Toronto, ON, Canada
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
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Chronopoulou E, Seifalian A, Stephenson J, Serhal P, Saab W, Seshadri S. Preconceptual care for couples seeking fertility treatment, an evidence-based approach. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.xfnr.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Ciccone IM, Costa EM, Pariz JR, Teixeira TA, Drevet JR, Gharagozloo P, Aitken RJ, Hallak J. Serum vitamin D content is associated with semen parameters and serum testosterone levels in men. Asian J Androl 2021; 23:52-58. [PMID: 32341213 PMCID: PMC7831823 DOI: 10.4103/aja.aja_9_20] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 11/20/2019] [Indexed: 02/07/2023] Open
Abstract
The present study aimed to evaluate the influence of serum vitamin D levels on semen quality and testosterone levels. This is a cross-sectional study conducted at Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory in Sao Paulo, Brazil, with 508 male patients, aged 18-60 years, from 2007 to 2017. Seminal parameters and serum sexual hormones were correlated with serum vitamin D concentrations in 260 men selected by strict selection criteria. Patients were divided into normozoospermic group (NZG, n = 124) and a group with seminal abnormalities (SAG, n = 136). Evaluation included complete physical examination, past medical history, habits and lifestyle factors, two complete seminal analysis with sperm functional tests, serum levels of 25-hydroxy-vitamin D3(25(OH)VD3), total and free testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), total cholesterol, homeostatic model assessment of insulin resistance (HOMA-IR) index, and karyotype. The mean concentration of 25(OH)VD3was significantly lower in the SAG (P < 0.001) and positively correlated with all baseline seminal parameters and total testosterone levels. In addition, serum vitamin D3concentration was found to be positively correlated with sperm concentration (β= 2.103; P < 0.001), total number of spermatozoa with progressive motility (β = 2.069; P = 0.003), total number of motile spermatozoa (β = 2.571; P = 0.015), and strict morphology (β = 0.056; P = 0.006), regardless of other variables. This is the first comparative study to address the issue of serum vitamin D3content between normozoospermic patients and those with sperm abnormalities. It clearly demonstrates a direct and positive relationship between serum vitamin D level and overall semen quality, male reproductive potential, and testosterone levels.
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Affiliation(s)
- Inari M Ciccone
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, Sao Paulo 04534-011, Brazil
- Division of Urology, University of Sao Paulo, Sao Paulo 05403-000, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of Sao Paulo, Sao Paulo 05508-060, Brazil
| | - Elaine Mf Costa
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, Sao Paulo 04534-011, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of Sao Paulo, Sao Paulo 05508-060, Brazil
- Division of Endocrinology, University of Sao Paulo, Sao Paulo 05403-000, Brazil
| | - Juliana R Pariz
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, Sao Paulo 04534-011, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of Sao Paulo, Sao Paulo 05508-060, Brazil
| | - Thiago A Teixeira
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, Sao Paulo 04534-011, Brazil
- Division of Urology, University of Sao Paulo, Sao Paulo 05403-000, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of Sao Paulo, Sao Paulo 05508-060, Brazil
- School of Medicine, Urology Department, Federal University of Amapa, Macapa 68903-419, Brazil
| | - Joel R Drevet
- Faculty of Medicine, GReD Laboratory, Université Clermont Auvergne, 49, Bd François-Mitterrand - CS 60032, 63001 Clermont-Ferrand Cedex, France
| | | | - Robert J Aitken
- CellOxess LLC, Ewing, NJ 08628, USA
- School of Environmental and Life Sciences, Priority Research Centre for Reproductive Sciences, University of Newcastle, Callaghan, NSW 2308, Australia
| | - Jorge Hallak
- Androscience, Science and Innovation Center in Andrology and High-Complex Clinical and Andrology Laboratory, Sao Paulo 04534-011, Brazil
- Division of Urology, University of Sao Paulo, Sao Paulo 05403-000, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of Sao Paulo, Sao Paulo 05508-060, Brazil
- Reproductive Toxicology Unit, Department of Pathology, University of Sao Paulo, Sao Paulo 05403-000, Brazil
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Gorelova IV, Popova PV, Rulev MV. [Vitamin D and reproductive health]. ACTA ACUST UNITED AC 2020; 66:96-101. [PMID: 33369377 DOI: 10.14341/probl12468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/22/2020] [Accepted: 10/02/2020] [Indexed: 12/27/2022]
Abstract
Vitamin D insufficiency and deficiency in women with infertility is more common than in the population. However, we still do not know the exact mechanisms for the participation of vitamin D in the regulation of reproductive function. The purpose of this study is to analyze actual literature data on the role of vitamin D in the regulation of reproductive system and its influence on using of assisted reproductive technologies for the treatment of infertility. A search was carried out for literary sources published in the NSBI database PubMed, Medline, and others with a search depth of up to 20 years. 135 sources on this topic were studied, of which 54 were included in the analysis. The review presents data obtained in animal studies, in vitro and in clinical studies. Thus, the absence of vitamin D resulted in a dramatical decrease in fertility in both female and male rats and mice, due to the development of hypocalcemia. In vitro studies describe its involvement in the receptive transformation of the endometrium and in the regulation of the immune response during embryo implantation. However, clinical studies often show conflicting results. There is no unequivocal data on the effect of vitamin D levels on spermogram parameters, but a decrease in the pregnancy rate was shown when ovulation was induced in pairs, where a vitamin D deficiency was revealed in men. A meta-analysis published in 2017 showed a decrease in the pregnancy and live birth rate in women with low levels of vitamin D after the use of assisted reproductive technologies (ART). It was not possible to establish whether this decrease depends on oocyte quality or endometrium. There is an opportunity that the effect of vitamin D deficiency on fertility will not come with all forms of infertility. For example, in women with anovulation due to polycystic ovary syndrome, vitamin D deficiency is demonstrated to decrease pregnancy rate in ovulation induction cycles and in ART. Such relationship was not found in women with unexplained infertility.Thus, the role of vitamin D in the pathogenesis of infertility requires further study, as well as the possibilities of therapy in order to increase the effectiveness of infertility treatment methods and assisted reproductive technology programs.
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Affiliation(s)
- I V Gorelova
- Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics
| | - P V Popova
- Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics
| | - M V Rulev
- Almazov National Medical Research Centre, Institute of Perinatology and Pediatrics
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Fleet JC, Bernal-Mizrachi C, Hewison M, Jorde R, White J, Cantorna M, Schoenmakers I, Erben R. Highlights from the 22nd workshop on vitamin D in New York City, May 2019. J Steroid Biochem Mol Biol 2020; 203:105747. [PMID: 32858157 DOI: 10.1016/j.jsbmb.2020.105747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- James C Fleet
- Department of Nutrition Science, College of Health and Human Sciences, Purdue University, 700 West State St., West Lafayette, IN 47906-2059, USA.
| | - Carlos Bernal-Mizrachi
- Division of Endocrinology, Metabolism & Lipid Research, School of Medicine, Washington University, 660 S. Euclid Ave. Campus Box 8127, St. Louis, MO 63110, USA.
| | - Martin Hewison
- Institute of Metabolism and Systems Research, Centre for Endocrinology, Diabetes, and Metabolism, Birmingham Health Partners, Level 2, IBR, Rom 225, The University of Birmingham, Birmingham, B15 2TT, UK.
| | - Rolf Jorde
- Endocrine Research Group, Department of Clinical Medicine, UiT The Arctic University of Norway, 9037 Tromsø, Norway.
| | - John White
- Department of Physiology, Department of Medicine, McGill University, 3655 Drummond St. Room 1112, Montreal, QC H3G 1Y6, Canada.
| | - Margherita Cantorna
- Department of Veterinary and Biomedical Sciences, College of Agricultural Sciences, 125 Henning Building, University Park, PA 16802, USA.
| | - Inez Schoenmakers
- Department of Medicine, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4, 7TJ, UK.
| | - Reinhold Erben
- Institute of Physiology, Pathophysiology, and Biophysics, Unit of Physiology, Pathophysiology, and Experimental Endocrinology, Veterinärplatz 1, 1210 Wien, Vienna, Austria.
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Amini L, Mohammadbeigi R, Vafa M, Haghani H, Vahedian-Azimi A, Karimi L, Jahanfar S, Jamialahmadi T, Talebi A, Sahebkar A. Evaluation of the effect of vitamin D3 supplementation on quantitative and qualitative parameters of spermograms and hormones in infertile men: A Randomized controlled trial. Complement Ther Med 2020; 53:102529. [PMID: 33066859 DOI: 10.1016/j.ctim.2020.102529] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/27/2020] [Accepted: 07/27/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND 25-Hydroxy Vitamin D3 is known to have an effect on reproductive system in both genders and may change the semen parameters in men. OBJECTIVE Our study aimed to evaluate the effect of oral vitamin D3 supplementation on spermogram quantitative and qualitative parameters in infertile men. MATERIALS AND METHODS This study was a triple-blind randomized controlled trial involving 62 infertile men with impaired spermatogonial tests. They were randomly divided into placebo and D3-supplemented groups. Spermograms and tests for LH (Luteinizing Hormone), FSH (Follicle Stimulating Hormone), TT (Total Testosterone), FT (Free Testosterone), SHBG (Sex Hormone Bonding Globulin), FAI (Free Androgen Index) and vitamin D3 levels were performed before and after the intervention. RESULTS There were no significant differences between the two groups in parameters of the spermograms or serum levels of LH, FSH, TT, and FAI. In the intervention group, SHBG was significantly decreased after intervention (p = 0.01) and there was a significant increase in FT in the placebo group (p = 0.03). CONCLUSION The intake of vitamin D3 did not change the quality and quantity of spermograms and serum levels of LH, FSH, TT, and FAI but affected FT and SHBG. Further studies are still needed to clarify the biological role of vitamin D3 on fertility particularly on male fertility. This study lays a foundation for more extensive studies on male infertility.
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Affiliation(s)
- Leila Amini
- Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Robabe Mohammadbeigi
- Clinical Research Development Unit (ShACkRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Vafa
- School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Haghani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Amir Vahedian-Azimi
- Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Leila Karimi
- Behavioral Sciences Research Center, Life Style Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | | | - Tannaz Jamialahmadi
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Food Science and Technology, Quchan Branch, Islamic Azad University, Quchan, Iran; Department of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Afsaneh Talebi
- Department of Midwifery, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran.
| | - Amirhossein Sahebkar
- Halal Research Center of IRI, FDA, Tehran, Iran; Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad 9177948564, Iran; Polish Mother's Memorial Hospital Research Institute (PMMHRI), 93338 Lodz, Poland.
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Bøllehuus Hansen L, Kaludjerovic J, Nielsen JE, Rehfeld A, Poulsen NN, Ide N, Skakkebaek NE, Frederiksen H, Juul A, Lanske B, Blomberg Jensen M. Influence of FGF23 and Klotho on male reproduction: Systemic vs direct effects. FASEB J 2020; 34:12436-12449. [PMID: 32729975 DOI: 10.1096/fj.202000061rr] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/29/2020] [Accepted: 07/06/2020] [Indexed: 01/05/2023]
Abstract
Currently, no treatment exists to improve semen quality in most infertile men. Here, we demonstrate systemic and direct effects of Fibroblast growth factor 23 (FGF23) and Klotho, which normally regulate vitamin D and mineral homeostasis, on testicular function. Direct effects are plausible because KLOTHO is expressed in both germ cells and spermatozoa and forms with FGFR1 a specific receptor for the bone-derived hormone FGF23. Treatment with FGF23 increased testicular weight in wild-type mice, while mice with global loss of either FGF23 or Klotho had low testicular weight, reduced sperm count, and sperm motility. Mice with germ cell-specific Klotho (gcKL) deficiency neither had a change in sperm count nor sperm motility. However, a tendency toward fewer pregnancies was detected, and significantly fewer Klotho heterozygous pups originated from gcKL knockdown mice than would be expected by mendelian inheritance. Moreover, gcKL mice had a molecular phenotype with higher testicular expression of Slc34a2 and Trpv5 than wild-type littermates, which suggests a regulatory role for testicular phosphate and calcium homeostasis. KLOTHO and FGFR1 were also expressed in human germ cells and spermatozoa, and FGF23 treatment augmented the calcium response to progesterone in human spermatozoa. Moreover, cross-sectional data revealed that infertile men with the highest serum Klotho levels had significantly higher serum Inhibin B and total sperm count than men with the lowest serum Klotho concentrations. In conclusion, this translational study suggests that FGF23 and Klotho influence gonadal function and testicular mineral ion homeostasis both directly and indirectly through systemic changes in vitamin D and mineral homeostasis.
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Affiliation(s)
- Lasse Bøllehuus Hansen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Division of Bone and Mineral Research, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, USA
| | - Jovana Kaludjerovic
- Division of Bone and Mineral Research, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, USA
| | - John Erik Nielsen
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Rehfeld
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Nadia Nicholine Poulsen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Noriko Ide
- Division of Bone and Mineral Research, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, USA
| | - Niels Erik Skakkebaek
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Frederiksen
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anders Juul
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Beate Lanske
- Division of Bone and Mineral Research, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, USA
| | - Martin Blomberg Jensen
- Group of Skeletal, Mineral and Gonadal Endocrinology, Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,Division of Bone and Mineral Research, Harvard School of Dental Medicine, Harvard Medical School, Boston, MA, USA
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Chen Y, Liu D, Zeng L, Xu H, Jiang H, Yang R, Wang H, Yan L, Li R, Qiao J, Zhi X. Effect of serum 25-hydroxyvitamin D levels on sperm quality and assisted reproductive technology outcomes for men of infertile Chinese couples. Andrology 2020; 8:1277-1286. [PMID: 32412142 DOI: 10.1111/andr.12818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 05/03/2020] [Accepted: 05/08/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Vitamin D insufficiency/deficiency is highly prevalent in China, but its effect on sperm quality and outcomes of assisted reproductive technology (ART) in men from infertile couples is not clear. This study aimed to explore the association of serum 25-hydroxyvitamin D (25OHD) levels and semen parameters, as well as ART outcomes for men from infertile couples. MATERIALS AND METHODS This study recruited 1308 men from infertile couples who attended the Reproductive Medicine Center of Peking University Third Hospital for first time from February to August 2019 (NCT03804294). Reproductive hormones levels, semen parameters, and clinical outcomes of ART were compared between vitamin D-deficient group (serum 25OHD ≤ 10 ng/mL), insufficient group (serum 25OHD 10-20 ng/mL), and sufficient group (serum 25OHD ≥ 20 ng/mL). RESULTS We found 27.7% of participants were vitamin D sufficient, suggesting high prevalence of vitamin D insufficiency/deficiency in China. Reproductive hormone levels were similar between the three groups. The total number of morphologically normal spermatozoa was significantly different between the three groups in all participants, impaired semen quality subgroup, and normozoospermia subgroup (P < .05) with the adjustment of confounders (age, BMI, alcohol consumption, cigarette smoking, and physical exercise). The percentage of normal sperm morphology significantly increased with elevated serum 25OHD levels in all participants and the participants with impaired semen quality (P < .05), and the total sperm count showed significant difference in participants with impaired semen quality (P = .026). For routine in vitro fertilization and intracytoplasmic sperm injection cycles, there were no differences in fertilization rate, top-quality embryo rate, biochemical pregnancy rate, and clinical pregnancy rate between serum 25OHD < 20 ng/mL and serum 25OHD ≥ 20 ng/mL groups. CONCLUSIONS Males of infertile couples with higher serum 25OHD levels exhibit better results in sperm morphology, and serum 25OHD levels may contribute to total sperm number in participants with impaired semen quality, but show no effects on the ART outcomes.
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Affiliation(s)
- Yilu Chen
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
| | - Defeng Liu
- Department of Urology, Peking University Third Hospital, Beijing, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China.,Department of Andrology, Peking University Third Hospital, Beijing, China.,Department of Human Sperm Bank, Peking University Third Hospital, Beijing, China
| | - Lin Zeng
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Huiyu Xu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China.,Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China.,Department of Andrology, Peking University Third Hospital, Beijing, China.,Department of Human Sperm Bank, Peking University Third Hospital, Beijing, China
| | - Rui Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
| | - Haining Wang
- Department of Endocrinology and Metabolism, Peking University Third Hospital, Beijing, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
| | - Rong Li
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
| | - Xu Zhi
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.,National Clinical Research Center for Obstetrics and Gynecology, Beijing, China.,Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
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Dias TR, Martin-Hidalgo D, Silva BM, Oliveira PF, Alves MG. Endogenous and Exogenous Antioxidants As a Tool to Ameliorate Male Infertility Induced by Reactive Oxygen Species. Antioxid Redox Signal 2020; 33:767-785. [PMID: 32368933 DOI: 10.1089/ars.2019.7977] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Significance: Antioxidants are essential for the maintenance of cellular redox homeodynamics in the male reproductive tract, playing a key role in fertilizing potential. Reactive oxygen species (ROS), at physiological levels, are essential for sperm function and fertilization. Under pathological conditions, abnormal production of ROS may occur. Redox control is primarily regulated by the inner antioxidant system. However, these endogenous antioxidants may be present at abnormal amounts or may be insufficient. Exogenous antioxidants obtained through the diet may have an important role, particularly in specific pathological conditions. This review addresses the regulation of redox homeodynamics in the male reproductive tract by endogenous and exogenous antioxidants and the importance of their cooperation for the maintenance of fertility. Recent Advances: Many studies have shown the importance of antioxidants for the preservation of male fertility, mostly under pathological conditions. Excessive antioxidants can inhibit ROS-induced signaling pathways that are essential for the reproductive system. The challenge is to keep the balance between oxidants and antioxidants to maintain ROS-amount at physiological concentration. Critical Issues: Although antioxidant therapies are gaining popularity and showing promising results in the improvement of male fertility, there is a lack of knowledge regarding the type of exogenous antioxidant, the doses and time to be administered. Future Directions: It would be of great importance to find a way to restore redox homeostasis under stress conditions. Understanding the poorly studied mechanisms by which exogenous antioxidants cooperate with the inner cellular antioxidant system to counteract free radicals may help in the development of new fertility therapies.
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Affiliation(s)
- Tânia R Dias
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar and Unit for Multidisciplinary Research in Biomedicine, University of Porto, Porto, Portugal
- Department of Medical Sciences, Universidade da Beira Interior, Covilhã, Portugal
- LAQV/REQUIMTE-Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, Porto, Portugal
| | - David Martin-Hidalgo
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar and Unit for Multidisciplinary Research in Biomedicine, University of Porto, Porto, Portugal
- Research Group of Intracellular Signaling and Technology of Reproduction (SINTREP), Institute of Biotechnology in Agriculture and Livestock (INBIO G+C), University of Extremadura, Cáceres, Spain
| | - Branca M Silva
- Department of Medical Sciences, Universidade da Beira Interior, Covilhã, Portugal
| | - Pedro F Oliveira
- Department of Chemistry, QOPNA and LAQV, University of Aveiro, Aveiro, Portugal
| | - Marco G Alves
- Laboratory of Cell Biology, Department of Microscopy, Institute of Biomedical Sciences Abel Salazar and Unit for Multidisciplinary Research in Biomedicine, University of Porto, Porto, Portugal
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Krzywański J, Pokrywka A, Młyńczak M, Mikulski T. Is vitamin D status reflected by testosterone concentration in elite athletes? Biol Sport 2020; 37:229-37. [PMID: 32879544 DOI: 10.5114/biolsport.2020.95633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 04/04/2020] [Accepted: 04/28/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D is a nutrient whose active form affects tissues as a hormone and possibly enhances performance. One plausible mechanism is by increasing testosterone concentration, which is established as an important factor for athletic performance. Therefore the aim of the study was to examine the relationship between plasma concentration of 25(OH)D and testosterone in Polish elite track and field athletes depending on vitamin D status, season, training period, body composition, sex, type of training, sun exposure and vitamin D supplementation. Plasma concentrations of 25(OH)D and testosterone were measured in all seasons within two years in athletes (70 females, 79 males) who represent strength (n = 103) and endurance (n = 46) kinds of sports, in the preparatorycompetitive season and transition period. There were no differences in 25(OH)D concentration between male and female athletes, insufficiency [25(OH)D < 30 ng/ml] was observed in 32.9%, whereas deficiency [25(OH)D < 20 ng/ ml] in 3.2%. Circannual rhythm was noted for vitamin D but not for testosterone concentration; no correlations between them were found either in strength or endurance athletes or between 25(OH)D and body composition. Testosterone concentration was higher in the transition period than in the preparatory-competition period only in male athletes. Higher 25(OH)D was observed in athletes who trained during winter in Africa (higher sun exposure) or used oral supplementation, whereas the respective testosterone levels were unchanged. In athletes, testosterone concentration did not reflect vitamin D status. The widespread of inadequate vitamin D status among athletes, makes it vital to recommend them the regular monitoring of 25(OH)D concentration and use of reasonable supplementation.
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Holt R, Juel Mortensen L, Harpelunde Poulsen K, Nielsen JE, Frederiksen H, Jørgensen N, Jørgensen A, Juul A, Blomberg Jensen M. Vitamin D and sex steroid production in men with normal or impaired Leydig cell function. J Steroid Biochem Mol Biol 2020; 199:105589. [PMID: 31953167 DOI: 10.1016/j.jsbmb.2020.105589] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 12/23/2019] [Accepted: 01/13/2020] [Indexed: 12/14/2022]
Abstract
Production of testosterone is under tight control by human chorion gonadotropin (hCG) during fetal life and luteinizing hormone (LH) in adulthood. Several animal and human studies have linked vitamin D status with sex steroid production although it is not clear whether there exist a direct or indirect involvement in androgen production. Few studies have investigated this crosslink in young healthy men and putative direct or synergistic effect of activated vitamin D (1,25(OH)2D3) and LH/hCG on sex steroid production in vitro. Here, we present cross-sectional data from 300 young men and 41 hCG-stimulated men with impaired Leydig cell function combined with data from an ex vivo culture of human testicular tissue exposed to 1,25(OH)2D3 alone or in combination with hCG. Serum 25-OHD was positively associated with SHBG (β:0.002; p = 0.023) and testosterone/estradiol-ratio (β:0.001; p = 0.039), and inversely associated with free testosterone (%) (free testosterone/total testosterone) (β:-0.002; p = 0.016) in young men. Vitamin D deficient men had higher total and free estradiol concentrations than men with higher vitamin D status (19% and 18%, respectively; p < 0.01). Interestingly, men with impaired Leydig cell function and vitamin D deficiency had a significantly lower hCG-mediated increase in total and free testosterone compared with vitamin D sufficient men (p < 0.05). Accordingly, testicular tissue exposed to 100 nM 1,25(OH)2D3 had a 15% higher testosterone release into the media compared with vehicle treated specimens (p = 0.030). In conclusion, vitamin D deficiency is associated with lower testosterone/estradiol ratio in young men and lower Leydig cell sensitivity after hCG-stimulation in men with impaired gonadal function. The significant effect of 1,25(OH)2D3 on testosterone production in a human testis model supports that the stimulatory effect at least in part may be direct. Larger placebo-controlled studies are needed to determine whether vitamin D supplementation can influence testosterone production.
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Affiliation(s)
- Rune Holt
- Group of skeletal, mineral and gonadal endocrinology, Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Li Juel Mortensen
- Group of skeletal, mineral and gonadal endocrinology, Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark
| | - Katrine Harpelunde Poulsen
- Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - John Erik Nielsen
- Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Hanne Frederiksen
- Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Niels Jørgensen
- Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Anne Jørgensen
- Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Anders Juul
- Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark and International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, Denmark
| | - Martin Blomberg Jensen
- Group of skeletal, mineral and gonadal endocrinology, Dept. of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark; Division of Bone Health and Mineral Research, HSDM, Harvard University, Boston, USA.
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