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Sciorio R, Tramontano L, Adel M, Fleming S. Decrease in Sperm Parameters in the 21st Century: Obesity, Lifestyle, or Environmental Factors? An Updated Narrative Review. J Pers Med 2024; 14:198. [PMID: 38392631 PMCID: PMC10890002 DOI: 10.3390/jpm14020198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/24/2024] Open
Abstract
Semen quality represents a compelling factor for fertility, and delineating the normal values has proven difficult. In the last four decades, several authors have reported a noticeable decline in sperm parameters. Also, studies investigating 'time to pregnancy' have shown that fecundity begins to be reduced when sperm numbers decrease below 30 million, even though according to the 6th edition of the WHO manual, the normal value is currently 16 million/mL or 39 million per ejaculate. There exists sufficient data to suggest a decline in sperm counts over time, even though the clear reason for this adverse trend is not well established, but some associations have been hypothesised, such as maternal smoking during pregnancy. Additional potential factors have yet to be fully illustrated but involve poor diet, increased obesity, and exposure to environmental toxins. Moreover, the change in environmental conditions and more common exposure to endocrine-disrupting chemicals (EDCs), such as pesticides and herbicides, as well as bisphenol A, phthalates, polychlorinated biphenyls, and heavy metals, starting from prenatal life and continuing into adulthood, may exhibit probable features explaining the reduction in sperm parameters. Therefore, the main goal of this narrative review is to furnish an overview of the possible effects of exposure to EDCs on testicular function and spermatogenesis and, also, to summarise the evidence regarding a decrease in sperm quality and examine its potential consequences.
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Affiliation(s)
- Romualdo Sciorio
- Fertility Medicine and Gynaecological Endocrinology Unit, Department Woman-Mother-Child, Lausanne University Hospital, 1011 Lausanne, Switzerland
| | - Luca Tramontano
- Department of Women, Infants and Adolescents, Division of Obstetrics, Geneva University Hospitals, 1211 Geneve, Switzerland
| | - Mohammed Adel
- Zoology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11651, Egypt
| | - Steven Fleming
- Discipline of Anatomy & Histology, School of Medical Sciences, University of Sydney, Sydney, NSW 2006, Australia
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Xiao X, Han Y, Li Q, Zheng D, Cheng CY, Ni Y. Exploring the evolving function of soluble intercellular adhesion molecule-1 in junction dynamics during spermatogenesis. Front Endocrinol (Lausanne) 2024; 14:1281812. [PMID: 38260159 PMCID: PMC10801026 DOI: 10.3389/fendo.2023.1281812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/15/2023] [Indexed: 01/24/2024] Open
Abstract
Intercellular adhesion molecule-1 (ICAM-1) is a transmembrane glycoprotein expressed on immune, endothelial, and epithelial cells. Its ectodomain can be proteolytically cleaved to release a circulating soluble form called sICAM-1. Clinical studies demonstrate sICAM-1 is upregulated in various diseases and associated with disease severity. Research has identified sICAM-1 as a regulator of the blood-testis barrier (BTB) and spermatogenesis. Overexpression of sICAM-1 weakened the BTB in vitro and in vivo, downregulated junction proteins including N-cadherin, γ-catenin, and connexin 43, and caused germ cell loss. This contrasts with barrier-strengthening effects of membrane-bound ICAM-1. sICAM-1 may act as a molecular switch enabling germ cells to open BTB and Sertoli-germ cell adhesion for transport across the seminiferous epithelium. While the mechanism remains unclear, reduced SRC family kinase (SFK) signaling was observed following sICAM-1 overexpression. SRC promotes BTB protein endocytosis and degradation, influences cytoskeletal dynamics, and affects cell polarity. As sICAM-1 overexpression phenocopies SRC inhibition, SRC may operate downstream of sICAM-1 in regulating BTB dynamics and spermatogenesis. Investigating sICAM-1's structure-function regions and downstream targets will elucidate the molecular mechanisms of junction disruption. This knowledge could enable strategies targeting sICAM-1/SRC to modulate BTB permeability and treat male infertility or diseases involving endothelial/epithelial barrier dysfunction.
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Affiliation(s)
- Xiang Xiao
- Center for Reproductive Health, School of Pharmaceutical Sciences, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China
- Engineering Research Center of Novel Vaccine of Zhejiang Province, Hangzhou Medical College, Hangzhou, China
| | - Yating Han
- Center for Reproductive Health, School of Pharmaceutical Sciences, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China
- School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, China
| | - Qin Li
- School of Pharmaceutical Sciences, Hangzhou Medical College, Hangzhou, China
| | - Dongwang Zheng
- Center for Reproductive Health, School of Pharmaceutical Sciences, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China
| | - C. Yan Cheng
- Department of Urology and Andrology, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ya Ni
- Center for Reproductive Health, School of Pharmaceutical Sciences, Hangzhou Medical College (Zhejiang Academy of Medical Sciences), Hangzhou, China
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Huang B, Wang Z, Kong Y, Jin M, Ma L. Global, regional and national burden of male infertility in 204 countries and territories between 1990 and 2019: an analysis of global burden of disease study. BMC Public Health 2023; 23:2195. [PMID: 37940907 PMCID: PMC10631182 DOI: 10.1186/s12889-023-16793-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/19/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Many countries and regions have experienced male fertility problems due to various influencing factors, especially in less developed countries. Unlike female infertility, male infertility receives insufficient attention. Understanding the changing patterns of male infertility in the world, different regions and different countries is crucial for assessing the global male fertility and reproductive health. METHODS We obtained data on prevalence, years of life lived with disability (YLD), age-standardized rates of prevalence (ASPR) and age-standardized YLD rate (ASYR) from the Global Burden of Disease Study 2019. We analyzed the burden of male infertility at all levels, including global, regional, national, age stratification and Socio-demographic Index (SDI). RESULTS In 2019, the global prevalence of male infertility was estimated to be 56,530.4 thousand (95% UI: 31,861.5-90,211.7), reflecting a substantial 76.9% increase since 1990. Furthermore, the global ASPR stood at 1,402.98 (95% UI: 792.24-2,242.45) per 100,000 population in 2019, representing a 19% increase compared to 1990. The regions with the highest ASPR and ASYR for male infertility in 2019 were Western Sub-Saharan Africa, Eastern Europe, and East Asia. Notably, the prevalence and YLD related to male infertility peaked in the 30-34 year age group worldwide. Additionally, the burden of male infertility in the High-middle SDI and Middle SDI regions exceeded the global average in terms of both ASPR and ASYR. CONCLUSION The global burden of male infertility has exhibited a steady increase from 1990 to 2019, as evidenced by the rising trends in ASPR and ASYR, particularly in the High-middle and Middle SDI regions. Notably, the burden of male infertility in these regions far exceeds the global average. Additionally, since 2010, there has been a notable upward trend in the burden of male infertility in Low and Middle-low SDI regions. Given these findings, it is imperative to prioritize efforts aimed at improving male fertility and reproductive health.
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Affiliation(s)
- Baoyi Huang
- The Reproductive Medical Center, The Seventh Affiliated Hospital, Sun Yat-sen University, No.628, Zhenyuan Rd, Shenzhen, 518107, China
| | - Zhaojun Wang
- Department of Thoracic Surgery, The Seventh Affiliated Hospital, Sun Yat-sen University, No.628, Zhenyuan Rd, Shenzhen, 518107, China
| | - Yanxiang Kong
- The Reproductive Medical Center, The Seventh Affiliated Hospital, Sun Yat-sen University, No.628, Zhenyuan Rd, Shenzhen, 518107, China
| | - Mengqi Jin
- The Reproductive Medical Center, The Seventh Affiliated Hospital, Sun Yat-sen University, No.628, Zhenyuan Rd, Shenzhen, 518107, China
| | - Lin Ma
- The Reproductive Medical Center, The Seventh Affiliated Hospital, Sun Yat-sen University, No.628, Zhenyuan Rd, Shenzhen, 518107, China.
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Lien HT, Tsai NC, Lin YJ, Lan KC. The effect of various air pollution and participants' age on semen quality in southern Taiwan. Taiwan J Obstet Gynecol 2023; 62:838-844. [PMID: 38008502 DOI: 10.1016/j.tjog.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2023] [Indexed: 11/28/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the association between semen quality and air pollution in southern Taiwan. MATERIALS AND METHODS In this retrospective study, 4338 males aged 21-70 years were recruited between 2001 and 2018 from a reproductive medical center. Semen quality was assessed according to standardized methods outlined in the World Health Organization (WHO) Laboratory Manual 1999 and 2010, including total sperm count, progressive sperm motility (%), rapid progressive sperm motility (%), and sperm with normal morphology (%). All designated national air quality automatic continuous monitoring stations measured the levels of air pollution [particulate matter (PM10 and PM2.5), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), ozone (O3)], and was documented by Environmental Protection Administration in Taiwan. We collected data on the levels of air pollution based on the participants' residential addresses. RESULTS In our study, we found that progressive and rapid progressive sperm motility significantly decreased annually (p < 0.05). In addition, increasing age influenced total sperm count, progressive sperm motility, rapid progressive sperm motility, and sperm with normal morphology (p < 0.05). Among different air pollution, we observed SO2 was associated with lower rapid progressive sperm motility and lower sperm with normal morphology (β = -0.103, p = 0.043; β = 0.118, p = 0.001, respectively). However, NO2 was associated with higher rapid progressive sperm motility and a high number of sperm with normal morphology (β = 0.129, p = 0.002; β = 0.127, p < 0.001, respectively). CONCLUSIONS The semen quality in southern Taiwan appears to have declined in recent years. The participant's age for semen analysis was most strongly associated with semen parameters, Moreover, a significant association between SO2 and NO2 levels and semen motility was observed, even after adjusting for multiple comparisons. Further study is required to analyze the dose-dependent effect of SO2 and NO2 on semen parameters.
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Affiliation(s)
- Hao-Ting Lien
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ni-Chin Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Ju Lin
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuo-Chung Lan
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Center for Menopause and Reproductive Medicine Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Obstetrics and Gynecology, Jen-Ai Hospital, Taichung, Taiwan.
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Liu N, Chen HG, Li Y, Zhang G, Zhang J, Qu G, He B, Meng TQ, Xiong CL, Pan A, Yin Y, Liang Y, Shi J, Wang YX, Hu L, Jiang G. Exogenous Metals Atlas in Spermatozoa at Single-Cell Resolution in Relation to Human Semen Quality. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:7358-7369. [PMID: 37144275 DOI: 10.1021/acs.est.2c08838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
While exogenous metal/metalloid (metal) exposure has been associated with reduced human semen quality, no study has assessed the associations of exogenous metals in human spermatozoa with semen quality. Here, we developed a strategy to explore the associations between exogenous metals in spermatozoa at single-cell resolution and human semen quality among 84 men screened as sperm donors, who provided 266 semen samples within 90 days. A cellular atlas of exogenous metals at the single-cell level was created with mass cytometry (CyTOF) technology, which concurrently displayed 18 metals in more than 50 000 single sperm. Exogenous metals in spermatozoa at single-cell resolution were extremely heterogeneous and diverse. Further analysis using multivariable linear regression and linear mixed-effects models revealed that the heterogeneity and prevalence of the exogenous metals at single-cell resolution were associated with semen quality. The heterogeneity of lead (Pb), tin (Sn), yttrium (Y), and zirconium (Zr) was negatively associated with sperm concentration and count, while their prevalence showed positive associations. These findings revealed that the heterogeneous properties of exogenous metals in spermatozoa were associated with human semen quality, highlighting the importance of assessing exogenous metals in spermatozoa at single-cell resolution to evaluate male reproductive health risk precisely.
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Affiliation(s)
- Nian Liu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
| | - Heng-Gui Chen
- Clinical Research and Translation Center, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, China
| | - Yu Li
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
| | - Guohuan Zhang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
| | - Jie Zhang
- School of Public Health, Xiamen University, Xiamen 361102, China
| | - Guangbo Qu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
| | - Bin He
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
| | - Tian-Qing Meng
- Center of Reproductive Medicine, Wuhan Tongji Reproductive Medicine Hospital, Wuhan 430030, China
- Hubei Province Human Sperm Bank, Wuhan 430030, China
| | - Cheng-Liang Xiong
- Center of Reproductive Medicine, Wuhan Tongji Reproductive Medicine Hospital, Wuhan 430030, China
- Hubei Province Human Sperm Bank, Wuhan 430030, China
| | - An Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yongguang Yin
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
| | - Yong Liang
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China
| | - Jianbo Shi
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
| | - Yi-Xin Wang
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts 02115, United States
| | - Ligang Hu
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China
| | - Guibin Jiang
- State Key Laboratory of Environmental Chemistry and Ecotoxicology, Research Center for Eco-Environmental Science, Chinese Academy of Sciences, Beijing 100085, China
- School of Environment, Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou 310042, China
- Institute of Environment and Health, Jianghan University, Wuhan 430056, China
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Auger J, Eustache F, Chevrier C, Jégou B. Spatiotemporal trends in human semen quality. Nat Rev Urol 2022; 19:597-626. [PMID: 35978007 PMCID: PMC9383660 DOI: 10.1038/s41585-022-00626-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 11/09/2022]
Abstract
Over the past four decades, studies of various designs have reported spatial and temporal trends in human semen quality. Several standardized-methodology studies in homogeneous populations that compare specific cities within a country or a continent provide clear evidence of geographical differences in sperm production, even over short distances within the same country. Human sperm production is widely believed to be declining over time, but evidence from the scientific literature is less clear. Studies based on repeated cross-sectional data from a single centre have shown mixed results. Among the numerous retrospective studies conducted in a single centre, only some included homogeneous groups of men and appropriate methods, and most of them suggest a temporal decrease in human sperm production in the geographical areas considered. Conclusions reporting temporal trends in sperm production that came from existing retrospective multicentre studies based on individual semen data and those using means, medians or estimates of sperm production are questionable, owing to intrinsic limitations in the studies performed. Regardless of study design, studies on the percentage of motile or morphologically normal spermatozoa are still limited by the inherent variability in assessment. Overall, available data do not enable us to conclude that human semen quality is deteriorating worldwide or in the Western world, but that a trend is observed in some specific areas. To understand these trends and contrasts in sperm and semen quality, prospective studies should be encouraged and combined with assessment of the male exposome. Several studies over the past few decades have suggested that sperm quality varies by geographical region and might be subject to a temporal decline worldwide. However, the data supporting these conclusions have come from studies of various methodologies and heterogeneous populations, making them unreliable. In this in-depth Review, Chevrier and colleagues discuss the data surrounding discussion of spatiotemporal trends in semen parameters and consider how these trends and the factors promoting them interact. The vast literature on human semen quality trends is extremely heterogeneous in terms of the populations studied and study designs, and so these studies have been unable to draw firm conclusions. Understanding the data around spatiotemporal semen trends requires a focus on the methodological choices and application of criteria to filter findings from the studies with optimal design. Numerous appropriately designed studies suggest unambiguous geographical contrasts in human sperm production; however, evidence of a decline in sperm production is reliable only in specific populations and cities in which studies with a complete set of quality criteria have been conducted. By contrast, suggestions of a worldwide drop in human semen quality on the basis of retrospective multicentre studies cannot be substantiated, owing to intrinsic limitations in the studies performed. Many and varied factors of variation, in particular the diverse modalities of assessment, do not enable us to conclude that clear temporal trends of sperm motility and normal morphology are present. Progress in our understanding of the highlighted trends and their causal factors requires prospective studies that minimize all known biases combined with the assessment of men’s exposome.
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Affiliation(s)
- Jacques Auger
- INSERM U1016-Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes-Paris, Paris, France
| | - Florence Eustache
- INSERM U1016-Equipe "Génomique, Epigénétique et Physiologie de la Reproduction", Institut Cochin, Université Paris Descartes-Paris, Paris, France.,CECOS, Hôpitaux Universitaires Paris Seine-Saint-Denis, Hôpital Jean Verdier and Service de Biologie de la Reproduction, Hôpitaux Universitaires Paris Nord Val de Seine, Hôpital Bichat, Paris, France
| | - Cécile Chevrier
- Université Rennes, INSERM, EHESP, IRSET-UMR_S 1085, Rennes, France.
| | - Bernard Jégou
- Université Rennes, INSERM, EHESP, IRSET-UMR_S 1085, Rennes, France
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Tvrdá E, Ďuračka M, Benko F, Lukáč N. Bacteriospermia - A formidable player in male subfertility. Open Life Sci 2022; 17:1001-1029. [PMID: 36060647 PMCID: PMC9386612 DOI: 10.1515/biol-2022-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/29/2022] [Accepted: 05/18/2022] [Indexed: 11/24/2022] Open
Abstract
Bacterial colonization of male reproductive tissues, cells, and fluids, and the subsequent impact of bacteria on the sperm architecture, activity, and fertilizing potential, has recently gained increased attention from the medical and scientific community. Current evidence strongly emphasizes the fact that the presence of bacteria in semen may have dire consequences on the resulting male fertility. Nevertheless, the molecular basis underlying bacteriospermia-associated suboptimal semen quality is sophisticated, multifactorial, and still needs further understanding. Bacterial adhesion and subsequent sperm agglutination and immobilization represent the most direct pathway of sperm-bacterial interactions. Furthermore, the release of bacterial toxins and leukocytic infiltration, associated with a massive outburst of reactive oxygen species, have been repeatedly associated with sperm dysfunction in bacteria-infested semen. This review serves as a summary of the present knowledge on bacteriospermia-associated male subfertility. Furthermore, we strived to outline the currently available methods for assessing bacterial profiles in semen and to outline the most promising strategies for the prevention and/or management of bacteriospermia in practice.
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Affiliation(s)
- Eva Tvrdá
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Michal Ďuračka
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Filip Benko
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
| | - Norbert Lukáč
- Department of Animal Physiology, Institute of Applied Biology, Faculty of Biotechnology and Food Sciences, Slovak University of Agriculture in Nitra, Tr. A. Hlinku 2, Nitra-Chrenová, 949 76, Slovakia
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Kortenkamp A, Scholze M, Ermler S, Priskorn L, Jørgensen N, Andersson AM, Frederiksen H. Combined exposures to bisphenols, polychlorinated dioxins, paracetamol, and phthalates as drivers of deteriorating semen quality. ENVIRONMENT INTERNATIONAL 2022; 165:107322. [PMID: 35691715 DOI: 10.1016/j.envint.2022.107322] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/20/2022] [Accepted: 05/23/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Semen quality in men continues to decline in Western countries, but the contours of the issue remain obscure, in relation to contributing chemicals. OBJECTIVES To obtain more clarity about the chemicals that drive the deterioration of semen quality, we conducted a mixture risk assessment based on European exposures. METHODS We included chemicals capable of affecting semen quality after prenatal exposures, among them androgen receptor antagonists, substances that disrupt prostaglandin signalling, suppress testosterone synthesis, inhibit steroidogenic enzymes or activate the aryl hydrocarbon receptor. We employed the Hazard Index approach (HI), based on risk quotients of exposures in Europe and reference doses for reductions in semen quality. By summing up the risk quotients of the 29 chemicals included in the assessment we examined fold-exceedances of "acceptable" mixture exposures relative to an index value of 1. For bisphenols A, F, S, phthalates DEHP, DnBP, BBzP, DiNP, n-butyl paraben and paracetamol we relied on biomonitoring studies in which these 9 chemicals were measured together in the same subjects. This allowed us to construct personalised Hazard Indices. RESULTS Highly exposed subjects experienced combined exposures to the 9 chemicals that exceeded the index value of 1 by more than 100-fold; the median was a 17-fold exceedance. Accounting for median background exposures to the remaining 20 chemicals added a Hazard Index of 1.39. Bisphenol A made the largest contribution to the HI, followed by polychlorinated dioxins, bisphenols S and F and DEHP. Eliminating bisphenol A alone would still leave unacceptably high mixture risks. Paracetamol is also a driver of mixture risks among subjects using the drug. CONCLUSIONS Tolerable exposures to substances associated with deteriorations of semen quality are exceeded by a large margin. Bisphenols, polychlorinated dioxins, phthalates and analgesics drive these risks. Dedicated efforts towards lowering exposures to these substances are necessary to mitigate risks.
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Affiliation(s)
- Andreas Kortenkamp
- Brunel University London, Centre for Pollution Research and Policy, College of Health, Medicine and Life Sciences, Kingston Lane, Uxbridge UB8 3PH, United Kingdom.
| | - Martin Scholze
- Brunel University London, Centre for Pollution Research and Policy, College of Health, Medicine and Life Sciences, Kingston Lane, Uxbridge UB8 3PH, United Kingdom
| | - Sibylle Ermler
- Brunel University London, Centre for Pollution Research and Policy, College of Health, Medicine and Life Sciences, Kingston Lane, Uxbridge UB8 3PH, United Kingdom
| | - Lærke Priskorn
- Copenhagen University Hospital - Rigshospitalet, Department of Growth and Reproduction, Blegdamsvej, Copenhagen, Denmark; International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
| | - Niels Jørgensen
- Copenhagen University Hospital - Rigshospitalet, Department of Growth and Reproduction, Blegdamsvej, Copenhagen, Denmark; International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Copenhagen University Hospital - Rigshospitalet, Department of Growth and Reproduction, Blegdamsvej, Copenhagen, Denmark; International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
| | - Hanne Frederiksen
- Copenhagen University Hospital - Rigshospitalet, Department of Growth and Reproduction, Blegdamsvej, Copenhagen, Denmark; International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Blegdamsvej, Copenhagen, Denmark
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Li Y, Sun C, Ma H, Zhu H, Zhang F, Jiang F. Basic Phenotyping of Male Fertility from 2019 to 2020 at the Human Sperm Bank of Fudan University. PHENOMICS (CHAM, SWITZERLAND) 2022; 2:211-218. [PMID: 36939761 PMCID: PMC9590568 DOI: 10.1007/s43657-022-00047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 11/25/2022]
Abstract
The aim of this cross-sectional survey was to analyze the semen parameters of volunteers from the Human Sperm Bank of Fudan University, as well as the related factors influencing these parameters. From January 2019 to December 2020, semen parameters from a total of 5214 men were included in this survey. The Kruskal-Wallis test was used to detect differences associated with several independent variables. A total of 5214 volunteers were included. The volunteers were registered in 33 provinces, autonomous regions, municipalities (including Macau and Taiwan) and 294 prefecture-level cities. The average age of volunteers was 27.40 years. Overall, 76.50% of the volunteers had a college education or higher. Volunteers with BMI values of 18.5-23.9 kg/m2 accounted for 60.70% of participants. Semen parameters were significantly different according to season, education level, duration of abstinence, age group and BMI. The basic male fertility phenotypes (semen parameters) showed new trends in the study period, and accurate long-term tracking of male semen parameters will help researchers to better understand the changes in male fertility phenotypes (semen).
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Affiliation(s)
- Yadong Li
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Can Sun
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Haitao Ma
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Hong Zhu
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Feng Zhang
- Obstetrics and Gynecology Hospital of Fudan University, NHC Key Laboratory of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011 China
| | - Feng Jiang
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai, 200011 China
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10
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Skakkebæk NE, Lindahl-Jacobsen R, Levine H, Andersson AM, Jørgensen N, Main KM, Lidegaard Ø, Priskorn L, Holmboe SA, Bräuner EV, Almstrup K, Franca LR, Znaor A, Kortenkamp A, Hart RJ, Juul A. Environmental factors in declining human fertility. Nat Rev Endocrinol 2022; 18:139-157. [PMID: 34912078 DOI: 10.1038/s41574-021-00598-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 12/14/2022]
Abstract
A severe decline in child births has occurred over the past half century, which will lead to considerable population declines, particularly in industrialized regions. A crucial question is whether this decline can be explained by economic and behavioural factors alone, as suggested by demographic reports, or to what degree biological factors are also involved. Here, we discuss data suggesting that human reproductive health is deteriorating in industrialized regions. Widespread infertility and the need for assisted reproduction due to poor semen quality and/or oocyte failure are now major health issues. Other indicators of declining reproductive health include a worldwide increasing incidence in testicular cancer among young men and alterations in twinning frequency. There is also evidence of a parallel decline in rates of legal abortions, revealing a deterioration in total conception rates. Subtle alterations in fertility rates were already visible around 1900, and most industrialized regions now have rates below levels required to sustain their populations. We hypothesize that these reproductive health problems are partially linked to increasing human exposures to chemicals originating directly or indirectly from fossil fuels. If the current infertility epidemic is indeed linked to such exposures, decisive regulatory action underpinned by unconventional, interdisciplinary research collaborations will be needed to reverse the trends.
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Affiliation(s)
- Niels E Skakkebæk
- 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | | | - Hagai Levine
- School of Public Health, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - 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), Rigshospitalet, 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Katharina M Main
- 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Øjvind Lidegaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lærke Priskorn
- 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stine A Holmboe
- 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Elvira V Bräuner
- 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Almstrup
- 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Luiz R Franca
- Department of Morphology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ariana Znaor
- Cancer Surveillance Branch, International Agency for Research on Cancer, Lyon, France
| | - Andreas Kortenkamp
- Division of Environmental Sciences, Brunel University London, Uxbridge, UK
| | - Roger J Hart
- Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Western Australia, Australia
- Fertility Specialists of Western Australia, Bethesda Hospital, Claremont, Western Australia, Australia
| | - 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), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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11
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Montano L, Donato F, Bianco PM, Lettieri G, Guglielmino A, Motta O, Bonapace IM, Piscopo M. Air Pollution and COVID-19: A Possible Dangerous Synergy for Male Fertility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18136846. [PMID: 34202243 PMCID: PMC8297116 DOI: 10.3390/ijerph18136846] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022]
Abstract
Several studies indicate that semen quality has strongly declined in the last decades worldwide. Air pollution represents a significant co-factor with the COVID-19 impact and has negative effects on the male reproductive system, through pro-oxidant, inflammatory and immune-dysregulating mechanisms. It has recently been reported that chronic exposure to PM2.5 causes overexpression of the alveolar ACE2 receptor, the entry route of SARS-CoV-2 into the organism shared by the lungs and testis where expression is highest in the body. In the testis, the ACE2/Ang-(1-7)/MasR pathway plays an important role in the regulation of spermatogenesis and an indirect mechanism of testicular damage could be due to the blockade of the ACE2 receptor by SARS-CoV-2. This prevents the conversion of specific angiotensins, and their excess causes inflammation with the overproduction of cytokines. PM2.5-induced overexpression of the alveolar ACE2 receptor, in turn, could increase local viral load in patients exposed to pollutants, producing ACE2 receptor depletion and compromising host defenses. By presenting an overall view of epidemiological data and molecular mechanisms, this manuscript aims to interpret the possible synergistic effects of both air pollution and COVID-19 on male reproductive function, warning that the spread of SARS-CoV-2 in the fertile years may represent a significant threat to global reproductive health. All of this should be of great concern, especially for men of the age of maximum reproductive capacity, and an important topic of debate for policy makers. Altered environmental conditions, together with the direct and indirect short- and long-term effects of viral infection could cause a worsening of semen quality with important consequences for male fertility, especially in those areas with higher environmental impact.
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Affiliation(s)
- Luigi Montano
- Andrology Unit and Service of Lifestyle Medicine in UroAndrology, Local Health Authority (ASL) Salerno, Coordination Unit of the Network for Environmental and Reproductive Health (EcoFoodFertility Project), “Oliveto Citra Hospital”, 84020 Oliveto Citra, Italy
- PhD Program in Evolutionary Biology and Ecology, Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
| | - Francesco Donato
- Unit of Hygiene, Epidemiology, and Public Health, Department of Medical and Surgical Specialties Radiological Sciences and Public Health, University of Brescia, 21100 Brescia, Italy;
| | - Pietro Massimiliano Bianco
- ISPRA, Italian Institute for Environmental Protection and Research, Via Vitaliano Brancati 60, 00144 Roma, Italy;
| | - Gennaro Lettieri
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
| | | | - Oriana Motta
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Salerno, Italy;
| | - Ian Marc Bonapace
- Department of Biotechnology and Life Sciences, University of Insubria, 21100 Varese, Italy
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
| | - Marina Piscopo
- Department of Biology, University of Naples Federico II, 80126 Napoli, Italy;
- Correspondence: (L.M.); (I.M.B.); (M.P.); Tel.: +39-0331-339452 (I.M.B.); +39-0816-79081 (M.P.)
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12
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Cannarella R, Crafa A, Condorelli RA, Mongioì LM, La Vignera S, Calogero AE. Relevance of sperm imprinted gene methylation on assisted reproductive technique outcomes and pregnancy loss: a systematic review. Syst Biol Reprod Med 2021; 67:251-259. [PMID: 34080930 DOI: 10.1080/19396368.2021.1909667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Recent evidence suggests that gamete-imprinted genes play a role in embryo and placenta development and growth. This systematic review aimed to evaluate whether altered methylation of sperm-imprinted genes associates with sperm DNA fragmentation (SDF), pregnancy loss rate and assisted reproductive technique (ART) outcome. To accomplish this, Pubmed, MEDLINE, Cochrane, Academic One Files, Google Scholar, and Scopus databases were used for search strategy from each database inception until December 2020. Specific keywords were used. Studies satisfying the PECOS (Population, Exposure, Comparison/Comparator, Outcomes, Study design) model were retrieved. Ten studies could be included in the qualitative analysis. A significant association was reported between increased SDF rate and aberrant methylation of H19/IGF2 and KCNQ1 genes by two studies. A significantly lower H19 methylation was found in patients with idiopathic recurrent pregnancy loss (RPL) and in infertile patients compared to fertile men. Methylation of GLT2, PEG1/MEST, and ZAC/PLACL1 were similar in patients with RPL and controls. The ART outcome was similar in patients with aberrant and normal methylation of H19, SNRPN, KCNQ1OT1, PEG1/MEST, LIT1, PEG3, NESPAS, and GLT2. By contrast, a study showed an association between altered GLT2 methylation and more inferior ART results. If further confirmed by well-sized studies, these data might be helpful to identify possible epigenetic predictors of ART outcome. Particularly, aberrant methylation of H19/IGF2 and KCNQ1 genes might represent interesting targets that deserve further investigation.
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Affiliation(s)
- Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Laura M Mongioì
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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13
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Liu J, Dai Y, Li Y, Yuan E, Wang Q, Wang X, Guan Y. A longitudinal study of semen quality among Chinese sperm donor candidates during the past 11 years. Sci Rep 2020; 10:10771. [PMID: 32612270 PMCID: PMC7329839 DOI: 10.1038/s41598-020-67707-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/11/2020] [Indexed: 11/09/2022] Open
Abstract
Studies suggest that semen quality is declining globally, however, the debate remains open due to the possible effects of ethnic and geographical differences. This study aimed to explore whether semen quality of sperm donor candidates has changed in Henan Province, China from 2009 to 2019. In this retrospective study, we included 23,936 sperm donor candidates who were recruited by the Henan Human Sperm Bank of China between 2009 and 2019. To minimize intra-individual bias, we included only the first ejaculate provided by each sperm donor candidate. The following parameters were measured: volume, sperm concentration, total sperm count, progressive motility, and total motility. After adjustment for age, body mass index (BMI), and sexual abstinence duration, we evaluated changes in main semen parameters over time using multiple linear regression analyses. The sperm concentration decreased from 62.0 million/mL in 2009 to 32.0 million/mL in 2019 (P < 0.001), with an average annual rate of 3.9%. The total sperm count decreased from 160.0 million in 2009 to 80.0 million in 2019 (P < 0.001), with an average annual rate of 4.2%. The progressive motility decreased from 54.0% in 2009 to 40.0% in 2019 (P < 0.001), with an average annual rate of 2.5%. The total motility decreased from 60.0% in 2009 to 46.0% in 2019 (P < 0.001), with an average annual rate of 1.9%. Our results indicated that semen quality among sperm donor candidates had decreased during the study period in Henan Province, China.
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Affiliation(s)
- Junjie Liu
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, No. 7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China
| | - Yanpeng Dai
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, No.7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China
| | - Yushan Li
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, No. 7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China.
| | - Enwu Yuan
- Department of Clinical Laboratory, The Third Affiliated Hospital of Zhengzhou University, No.7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China.
| | - Quanxian Wang
- Henan Human Sperm Bank, The Third Affiliated Hospital of Zhengzhou University, No. 7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China
| | - Xingling Wang
- Center for Reproductive Medicine, The Third Affiliated Hospital of Zhengzhou University, No.7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China
| | - Yichun Guan
- Center for Reproductive Medicine, The Third Affiliated Hospital of Zhengzhou University, No.7 Front Kangfu Street, Er'qi District, Zhengzhou, 450052, China
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14
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Abstract
PURPOSE OF REVIEW To review the evidence regarding a decrease in worldwide sperm parameters and discuss potential causative factors. RECENT FINDINGS The topic of worldwide decline in sperm parameters is contentious; however, recent high-quality studies have demonstrated that there is indeed a decline in sperm parameters. Several retrospective and basic science studies have shown possible links for this decline in sperm parameters such as obesity, diet, and environmental toxins. SUMMARY There exist substantial data to suggest a decline in sperm counts over time. Although causative factors have yet to be fully elucidated, potential causes include, increased rates of obesity, poor diet, and exposure to environmental toxins. How this decline in sperm counts reflects fertility has yet to be determined. As such, further studies are necessary to evaluate whether this decline in sperm count correlates with decreased fecundity and how to identify and mitigate potential causative factors.
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Affiliation(s)
- Uday Mann
- Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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15
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Li WN, Jia MM, Peng YQ, Ding R, Fan LQ, Liu G. Semen quality pattern and age threshold: a retrospective cross-sectional study of 71,623 infertile men in China, between 2011 and 2017. Reprod Biol Endocrinol 2019; 17:107. [PMID: 31815629 PMCID: PMC6902580 DOI: 10.1186/s12958-019-0551-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this study was to provide information on the semen quality pattern of infertile men and age thresholds for semen parameters in China. METHODS This was a retrospective cross-sectional study investigating 71,623 infertile men from the Reproductive and Genetic Hospital of CITIC Xiangya in Hunan, China, from 2011 to 2017. The Kruskal-Wallis test, Mann-Kendall test, linear regression model and joinpoint regression were used. RESULTS Although erratic changes were observed in the median semen parameters (sperm concentration 40.1-52.1 × 106/ml, total sperm count 117.8-153.1 × 106, sperm progressive motility 33.4-38.1%) during the 7 years of observation, no significant decrease in semen quality was found, and 47.88% of infertile men showed normal semen parameters according to the World Health Organization (WHO) criteria. According to the joinpoint regression analysis, sperm progressive motility appeared to decrease earlier than the sperm concentration and total sperm count (at 28, 58, and 42 years of age, respectively). CONCLUSIONS There is no evidence of a deterioration in semen quality among infertile men in Hunan, China. Semen parameters decreased with increasing age, with turning points noted at different ages. Semen parameters are not absolute evidence for the assessment of male fertility potential. Therefore, we believe that, among semen parameters, the sperm concentration is the best predictor of fertility for ART, followed by motility. Decreased sperm motility may affect natural pregnancy, but it is not necessary for successful IVF.
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Affiliation(s)
- W N Li
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Xiangya Road 84, Kaifu District, Changsha, 410008, Hunan, China
| | - M M Jia
- Northwest Women's and Children's Hospital, Houzaimen Street, Xincheng District, Xi'an, 710000, Shanxi Province, China
| | - Y Q Peng
- Reproductive and Genetic Hospital of CITIC-Xiangya, Xiangya Road 84, Kaifu District, Changsha, 410008, Hunan, China
| | - R Ding
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China
| | - L Q Fan
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Xiangya Road 84, Kaifu District, Changsha, 410008, Hunan, China
| | - G Liu
- The Institute of Reproduction and Stem Cell Engineering, Central South University, Luyun Road 8, Changsha, 410008, Hunan, China.
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16
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The current status and future of andrology: A consensus report from the Cairo workshop group. Andrology 2019; 8:27-52. [PMID: 31692249 DOI: 10.1111/andr.12720] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND In attempting to formulate potential WHO guidelines for the diagnosis of male infertility, the Evidence Synthesis Group noted a paucity of high-quality data on which to base key recommendations. As a result, a number of authors suggested that key areas of research/evidence gaps should be identified, so that appropriate funding and policy actions could be undertaken to help address key questions. OBJECTIVES The overall objective of this Consensus workshop was to clarify current knowledge and deficits in clinical laboratory andrology, so that clear paths for future development could be navigated. MATERIALS AND METHODS Following a detailed literature review, each author, prior to the face-to-face meeting, prepared a summary of their topic and submitted a PowerPoint presentation. The topics covered were (a) Diagnostic testing in male fertility and infertility, (b) Male fertility/infertility in the modern world, (c) Clinical management of male infertility, and (d) The overuse of ICSI. At the meeting in Cairo on February 18, 2019, the evidence was presented and discussed and a series of consensus points agreed. RESULTS The paper presents a background and summary of the evidence relating to these four topics and addresses key points of significance. Following discussion of the evidence, a total of 36 consensus points were agreed. DISCUSSION The Discussion section presents areas where there was further debate and key areas that were highlighted during the day. CONCLUSION The consensus points provide clear statements of evidence gaps and/or potential future research areas/topics. Appropriate funding streams addressing these can be prioritized and consequently, in the short and medium term, answers provided. By using this strategic approach, andrology can make the rapid progress necessary to address key scientific, clinical, and societal challenges that face our discipline now and in the near future.
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