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Piryaei F, Mehta P, Mozdarani H, Hamzehlooy F, Barati M, Piryaei Z, Gilani MAS, Alemi M, Singh R. Testicular piRNA Analysis Identified Dysregulated piRNAs in Non-obstructive Azoospermia. Reprod Sci 2024; 31:1246-1255. [PMID: 38133767 DOI: 10.1007/s43032-023-01433-3] [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: 08/18/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
Male infertility has remained idiopathic in a remarkable proportion of all cases. Gonadal expression of PIWI-interacting RNAs (piRNAs) has been shown to be vital to normal spermatogenesis, as they are expressed in almost all types of testicular germ cells. These molecules and their related Piwi proteins strictly regulate transposable elements' activity and gene expression. We aimed to identify dysregulated piRNAs in idiopathic non-obstructive azoospermic (NOA) testis by global expression analysis. Testis tissue samples from 18 azoospermic patients (ten NOA and eight OA) were studied by small RNA sequencing. To validate high-throughput sequencing data, quantitative real-time polymerase chain reactions for two differentially altered piRNAs were performed. Bioinformatics analyses were undertaken to identify pathways affected by piRNA dysregulation. In the NOA group, 1328 piRNAs were identified to be differentially expressed, of which 1322 were downregulated and 6 were upregulated. Bioinformatics analysis corroborated the involvement of dysregulated piRNA in spermatogenesis. We also identified 64 clusters of differentially expressed piRNAs, of which 42 clusters had a minimum of ten absolute piRNA hits. Our study suggests that piRNAs show significant dysregulation in infertility. Their target genes play a role in their self-biogenesis, probably by regulating their own production through a feedback mechanism. The downregulated piRNAs may find value as biomarkers for the presence of spermatozoa in the testis of azoospermic individuals, while the upregulated piRNAs are great candidates for further investigation of their precise functions in spermatogenesis.
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Affiliation(s)
- Fahimeh Piryaei
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Poonam Mehta
- Male Reproductive Biology Laboratory, Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
| | - Hossein Mozdarani
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fatemeh Hamzehlooy
- Department of Medical Biotechnology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mahmoud Barati
- Department of Medical Biotechnology, Faculty of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zeynab Piryaei
- Department of Bioinformatics, Kish International Campus, University of Tehran, Kish, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohsen Alemi
- Urology and Nephrology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rajender Singh
- Male Reproductive Biology Laboratory, Central Drug Research Institute, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, India
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Rambhatla A, Shah R, Ziouziou I, Kothari P, Salvio G, Gul M, Hamoda T, Kavoussi P, Atmoko W, Toprak T, Birowo P, Ko E, Arafa M, Ghayda RA, Karthikeyan VS, Russo GI, Pinggera GM, Chung E, Harraz AM, Martinez M, Phuoc NHV, Tadros N, Saleh R, Savira M, Colpi GM, Zohdy W, Pescatori E, Park HJ, Fukuhara S, Tsujimura A, Rojas-Cruz C, Marino A, Mak SK, Amar E, Ibrahim W, Sindhwani P, Alhathal N, Busetto GM, Al Hashimi M, El-Sakka A, Ramazan A, Dimitriadis F, Timpano M, Jezek D, Altay B, Zylbersztejn DS, Wong MY, Moon DG, Wyns C, Gamidov S, Akhavizadegan H, Franceschelli A, Aydos K, Quang N, Ashour S, Al Dayel A, Al-Marhoon MS, Micic S, Binsaleh S, Hussein A, Elbardisi H, Mostafa T, Ramsay J, Zachariou A, Abdelrahman IFS, Rajmil O, Kalkanli A, Molina JMC, Bocu K, Duarsa GWK, Çeker G, Serefoglu EC, Bahar F, Gherabi N, Kuroda S, Bouzouita A, Gudeloglu A, Ceyhan E, Hasan MSM, Musa MU, Motawi A, Cho CL, Taniguchi H, Ho CCK, Vazquez JFS, Mutambirwa S, Gungor ND, Bendayan M, Giulioni C, Baser A, Falcone M, Boeri L, Blecher G, Kheradmand A, Sethupathy T, Adriansjah R, Narimani N, Konstantinidis C, Nguyen TT, Japari A, Dolati P, Singh K, Ozer C, Sarikaya S, Sheibak N, Bosco NJ, Özkent MS, Le ST, Sokolakis I, Katz D, Smith R, Truong MN, Le TV, Huang Z, Deger MD, Arslan U, Calik G, Franco G, Rashed A, Kahraman O, Andreadakis S, Putra R, Balercia G, Khalafalla K, Cannarella R, Tuân AÐ, El Meliegy A, Zilaitiene B, Ramirez MLZ, Giacone F, Calogero AE, Makarounis K, Jindal S, Hoai BN, Banthia R, Peña MR, Moorthy D, Adamyan A, Kulaksiz D, Kandil H, Sofikitis N, Salzano C, Jungwirth A, Banka SR, Mierzwa TC, Turunç T, Jain D, Avoyan A, Salacone P, Kadıoğlu A, Gupta C, Lin H, Shamohammadi I, Mogharabian N, Barrett T, Danacıoğlu YO, Crafa A, Daoud S, Malhotra V, Almardawi A, Selim OM, Moussa M, Haghdani S, Duran MB, Kunz Y, Preto M, Eugeni E, Nguyen T, Elshahid AR, Suyono SS, Parikesit D, Nada E, Orozco EG, Boitrelle F, Trang NTM, Jamali M, Nair R, Ruzaev M, Gadda F, Thomas C, Ferreira RH, Gul U, Maruccia S, Kanbur A, Kinzikeeva E, Abumelha SM, Kosgi R, Gokalp F, Soebadi MA, Paul GM, Sajadi H, Gupte D, Ambar RF, Sogutdelen E, Singla K, Basukarno A, Kim SHK, Gilani MAS, Nagao K, Brodjonegoro SR, Rezano A, Elkhouly M, Mazzilli R, Farsi HMA, Ba HN, Alali H, Kafetzis D, Long TQT, Alsaid S, Cuong HBN, Oleksandr K, Mustafa A, Acosta H, Pai H, Şahin B, Arianto E, Teo C, Jayaprakash SP, Rachman RI, Yenice MG, Sefrioui O, Priyadarshi S, Tanic M, Alfatlaw NK, Rizaldi F, Vishwakarma RB, Kanakis G, Cherian DT, Lee J, Galstyan R, Keskin H, Wurzacher J, Seno DH, Noegroho BS, Margiana R, Javed Q, Castiglioni F, Tanwar R, Puigvert A, Kaya C, Purnomo M, Yazbeck C, Amir A, Borges E, Bellavia M, Deswanto IA, Kv V, Liguori G, Minh DH, Siddiqi K, Colombo F, Zini A, Patel N, Çayan S, Al-Kawaz U, Ragab M, Hebrard GH, de la Rosette J, Efesoy O, Hoffmann I, Teixeira TA, Saylam B, Delgadillo D, Agarwal A. Global Practice Patterns and Variations in the Medical and Surgical Management of Non-Obstructive Azoospermia: Results of a World-Wide Survey, Guidelines and Expert Recommendations. World J Mens Health 2024; 42:42.e42. [PMID: 38606867 DOI: 10.5534/wjmh.230339] [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: 11/22/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. MATERIALS AND METHODS A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. RESULTS Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in <10% of men with Klinefelter syndrome and 41.3% routinely recommended preimplantation genetic testing. Varicocele repair prior to SSR is recommended by 57.7%. Half of the respondents (57.4%) reported using ultrasound to identify the most vascularized areas in the testis for SSR. One-third proceed directly to microdissection testicular sperm extraction (mTESE) in every case of NOA while others use a staged approach. After a failed conventional TESE, 23.8% wait for 3 months, while 33.1% wait for 6 months before proceeding to mTESE. The cut-off of follicle-stimulating hormone for positive SSR was reported to be 12-19 IU/mL by 22.5% of participants and 20-40 IU/mL by 27.8%, while 31.8% reported no upper limit. CONCLUSIONS This is the largest survey to date on the real-world medical and surgical management of NOA by reproductive experts. It demonstrates a diverse practice pattern and highlights the need for evidence-based international consensus guidelines.
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Affiliation(s)
- Amarnath Rambhatla
- Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA
| | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Imad Ziouziou
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Priyank Kothari
- Department of Urology, Topiwala National Medical College, B.Y.L Nair Charitable Hospital, Mumbai, India
| | - Gianmaria Salvio
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Murat Gul
- Department of Urology, Selçuk University School of Medicine, Konya, Turkey
| | - Taha Hamoda
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Parviz Kavoussi
- Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Widi Atmoko
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ponco Birowo
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Ramy Abou Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | | | - Giorgio Ivan Russo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
| | - 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
| | - Marlon Martinez
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | | | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Missy Savira
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Giovanni M Colpi
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | - Wael Zohdy
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Edoardo Pescatori
- Andrology and Reproductive Medicine Unit, Next Fertility GynePro, Bologna, Italy
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Shinichiro Fukuhara
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Cesar Rojas-Cruz
- Department of Urology, University Hospital of Rostock, Rostock, Germany
| | - Angelo Marino
- Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | - Siu King Mak
- Department of Surgery, Union Hospital Reproductive Medicine Centre (Tsim Sha Tsui), Kowloon, China
| | - Edouard Amar
- Department of Urology, American Hospital of Paris, Paris, France
| | - Wael Ibrahim
- Department of Obstetrics Gynecology and Reproductive Medicine, Fertility Care Center in Cairo, Cairo, Egypt
| | - Puneet Sindhwani
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Naif Alhathal
- Department of Urology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Manaf Al Hashimi
- Department of Urology, Burjeel Hospital, Abu Dhabi, UAE
- Department of Urology, Khalifa University College of Medicine and Health Science, Abu Dhabi, UAE
| | - Ahmed El-Sakka
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Asci Ramazan
- 45Department of Urology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Fotios Dimitriadis
- 1st Urology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Massimiliano Timpano
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Davor Jezek
- Department for Transfusion Medicine and Transplantation Biology, Reproductive Tissue Bank, University Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Baris Altay
- Department of Urology, Ege University Medical School, Bornova, Turkey
| | - Daniel Suslik Zylbersztejn
- Department of Surgery, Discipline of Urology, Fleury Group and Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Michael Yc Wong
- Department of Andrology, International Urology, Fertility and Gynecology Centre, Mount Elizabeth Hospital, Singapore
| | - Du Geon Moon
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Christine Wyns
- Department of Gynaecology-Andrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Safar Gamidov
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia
| | - Hamed Akhavizadegan
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Kaan Aydos
- Department of Urology, Ankara University, Ankara, Turkey
| | - Nguyen Quang
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Shedeed Ashour
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Saleh Binsaleh
- Division of Urology, Deparment of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alayman Hussein
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Taymour Mostafa
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | - Islam Fathy Soliman Abdelrahman
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Andrology, Armed Forces College of Medicine, Cairo, Egypt
| | - Osvaldo Rajmil
- Department of Andrology, Fundació Puigvert, Barcelona, Spain
| | - Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | | | - Kadir Bocu
- Urology Department, Niğde Omer Halis Demir University, Faculty of Medicine, Sirnak, Turkey
| | | | - Gökhan Çeker
- Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Fahmi Bahar
- Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia
| | - Nazim Gherabi
- Department of Medicine, University of Algiers 1, Algiers, Algeria
| | - Shinnosuke Kuroda
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Ahmet Gudeloglu
- Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erman Ceyhan
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Mohamed Saeed Mohamed Hasan
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Muhammad Ujudud Musa
- Urology Unit, Department of Surgery, Federal Medical Center, Katsina State, Nigeria
| | - Ahmad Motawi
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Chak-Lam Cho
- Department of Surgery, S. H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | | | | | - Shingai Mutambirwa
- Department of Urology, Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Science University, Medunsa, South Africa
| | - Nur Dokuzeylul Gungor
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Marion Bendayan
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Carlo Giulioni
- Department of Urology, Polytechnic University of Marche, Ancona, Italy
| | - Aykut Baser
- Department of Urology, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Marco Falcone
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Luca Boeri
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gideon Blecher
- Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Urology, The Alfred Hospital, Melbourne, Australia
| | - Alireza Kheradmand
- Department of Urology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Ricky Adriansjah
- Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia
| | - Nima Narimani
- Department of Urology, School of Medicine, Hasheminejad Kidney Center, Iran University of Medical Science, Tehran, Iran
| | | | - Tuan Thanh Nguyen
- Department of Urology, University of California, Irvine, CA, USA
- Department of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Urology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Andrian Japari
- Department of Urology, Fertility Clinic, Telogorejo Hospital, Central Java, Indonesia
| | - Parisa Dolati
- Department of Animal Science, Faculty of Agriculture, University of Shiraz, Shiraz, Iran
| | - Keerti Singh
- Department of Preclinical and Health Sciences, Faculty of Medical Sciences, The University of West Indies, Bridgetown, Barbados
- Windsor Medical Centre, Bridgetown, Barbados
| | - Cevahir Ozer
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Selcuk Sarikaya
- Department of Urology, Gulhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Nadia Sheibak
- Department of Anatomical Sciences, Reproductive Sciences and Technology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Ndagijimana Jean Bosco
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | | | - Sang Thanh Le
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
- Department of Urology, Fertility Clinic, Telogorejo Hospital, Central Java, Indonesia
| | - Ioannis Sokolakis
- Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany
| | - Darren Katz
- Men's Health Melbourne, Victoria, Australia
- Department of Surgery, Western Precinct, University of Melbourne, Victoria, Australia
- Department of Urology, Western Health, Victoria, Australia
| | - Ryan Smith
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Manh Nguyen Truong
- Department of Animal Science, Faculty of Agriculture, University of Shiraz, Shiraz, Iran
- Fertility Centre, Hanh Phuc International Hospital, Binh Duong, Vietnam
| | - Tan V Le
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Zhongwei Huang
- Department of Obstetrics and Gynaecology, National University Health Systems, Singapore
| | - Muslim Dogan Deger
- Department of Urology, Edirne Sultan 1st Murat State Hospital, Edirne, Turkey
| | - Umut Arslan
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gokhan Calik
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Giorgio Franco
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ayman Rashed
- 123Department of Urology, Faculty of Medicine, 6th of October University, Giza, Egypt
| | - Oguzhan Kahraman
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | | | - Rosadi Putra
- Department of Urology, RSUD Ciawi Regional General Hospital, West Java, Indonesia
| | - Giancarlo Balercia
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Kareim Khalafalla
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
- Department of Urology, University of Illinois, Chicago, IL, USA
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Anh Ðăng Tuân
- Tam Anh IVF Center, Tam Anh General Hospital, Hanoi, Vietnam
| | - Amr El Meliegy
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Birute Zilaitiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Filippo Giacone
- HERA Center, Unit of Reproductive Medicine, Sant'Agata Li Battiati, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Sunil Jindal
- Department of Andrology & Reproductive Medicine, Jindal Hospital & Fertility Center, Meerut, India
| | - Bac Nguyen Hoai
- Department of Andrology and Sexual Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Ravi Banthia
- Department of Urology, Western General Hospital, Edinburgh, UK
| | - Marcelo Rodriguez Peña
- Institute of Gynecology and Fertility (IFER), University of Buenos Aires, Buenos Aires, Argentina
| | - Dharani Moorthy
- IVF Department, Swarupa Fertility & IVF Centre, Vijayawada, India
| | - Aram Adamyan
- Department of Urology, Astghik Medical Center, Yerevan, Armenia
| | - Deniz Kulaksiz
- Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | | | - Nikolaos Sofikitis
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
| | - Ciro Salzano
- PO San Giovanni Bosco, ASL Napoli 1 Centro, Napoli, Italy
| | | | - Surendra Reddy Banka
- Department of Andrology, Androcare Institute of Andrology and Men's Health, Hyderabad, India
| | - Tiago Cesar Mierzwa
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
| | - Tahsin Turunç
- Urology Clinic, Iskenderun Gelisim Hospital, Iskenderun, Turkey
| | - Divyanu Jain
- Department of Obstetrics and Gynecology, Jaipur Golden Hospital, New Delhi, India
| | - Armen Avoyan
- Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Pietro Salacone
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Ateş Kadıoğlu
- Section of Andrology, Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Chirag Gupta
- Department of Urology, Jaipur National University, Jaipur, India
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Peking University, Beijing, China
| | - Iman Shamohammadi
- Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasser Mogharabian
- Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Yavuz Onur Danacıoğlu
- Department of Urology, University of Health Science, Istanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Salima Daoud
- Laboratory of Histo-Embryology and Reproductive Biology, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Vineet Malhotra
- Department of Urology and Andrology, VNA Hospital, New Delhi, India
| | - Abdulmalik Almardawi
- Department of Urology, Prince Sultan Millitary Medical City, Riyadh, Saudi Arabia
| | - Osama Mohamed Selim
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamad Moussa
- Department of Urology, Lebanese University, Beirut, Lebanon
- Department of Urology, Al Zahraa Hospital, UMC, Beirut, Lebanon
| | - Saeid Haghdani
- Andrology Research Center, Yazd Reproductive Science Institute, Isfahan Fertility and Infertility Center, Isfahan, Iran
| | - Mesut Berkan Duran
- Department of Urology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Yannic Kunz
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Mirko Preto
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Elena Eugeni
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Department of Medicine and Medical Specialties, Division of Medical Andrology and Endocrinology of Reproduction, University of Terni, Terni, Italy
| | - Thang Nguyen
- Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Ahmed Rashad Elshahid
- 123Department of Urology, Faculty of Medicine, 6th of October University, Giza, Egypt
| | | | - Dyandra Parikesit
- Department of Urology, Faculty of Medicine, Universitas Indonesia Hospital, Depok, Indonesia
| | - Essam Nada
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | | | - Florence Boitrelle
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | | | - Mounir Jamali
- Department of Urology, Military Teaching Hospital, Rabat, Morocco
| | - Raju Nair
- Department of Reproductive Medicine, Mitera Hospital, Kottayam, India
| | | | - Franco Gadda
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Charalampos Thomas
- Urology and Neuro-Urology Unit, National Rehabilitation Center, Athens, Greece
| | | | - Umit Gul
- Private EPC Hospital, Adana, Turkey
| | - Serena Maruccia
- Department of Urology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milano, Italy
| | - Ajay Kanbur
- Department of Andrology, Kanbur Clinic, Thane, India
- Department of Urosurgery, Jupiter Hospital, Thane, India
| | | | | | - Raghavender Kosgi
- Department of Andrology and Men's Health, Apollo Hospitals, Hyderabad, India
| | - Fatih Gokalp
- Department of Urology, Faculty of Medicine, Hatay Mustafa Kemal University, Antakya, Turkey
| | | | - Gustavo Marquesine Paul
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hesamoddin Sajadi
- Department of Urology, Bombay Hospital and Medical Research Center, Mumbai, India
| | - Deepak Gupte
- Department of Urology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Rafael F Ambar
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
| | | | - Karun Singla
- Department of Urology, Dr. Dradjat Hospital, Serang, Indonesia
| | | | - Shannon Hee Kyung Kim
- Department of Urology, Macquarie University Faculty of Medicine and Health Sciences, Sydney, Australia
| | | | - Koichi Nagao
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Sakti Ronggowardhana Brodjonegoro
- Division of Urology, Department of Surgery, Prof. Dr. Sardjito Hospital, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andri Rezano
- Andrology Study Program, Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia
| | | | - Rossella Mazzilli
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Hasan M A Farsi
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hung Nguyen Ba
- Andrology Unit, ART Center, Vinmec Times City International Hospital, Hanoi, Vietnam
| | - Hamed Alali
- Department of Urology, Macquarie University Faculty of Medicine and Health Sciences, Sydney, Australia
| | | | - Tran Quang Tien Long
- Department of Obstetrics and Gynecology, Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Sami Alsaid
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hoang Bao Ngoc Cuong
- Department of Surgery, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Knigavko Oleksandr
- Department of Urology, Nephrology and Andrology Kharkiv National Medical University, Kharkiv, Ukraine
| | - Akhmad Mustafa
- Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia
| | - Herik Acosta
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | | | - Bahadır Şahin
- Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Eko Arianto
- Department of Urology, Prof R.D. Kandou Hospital, Manado, Indonesia
| | - Colin Teo
- Department of Urology, Gleneagles Hospital, Singapore
| | | | - Rinaldo Indra Rachman
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Mustafa Gurkan Yenice
- Department of Urology, University of Health Science, Istanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | | | - Shivam Priyadarshi
- Department of Urology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - Marko Tanic
- Department of Urology, General Hospital, Cuprija, Serbia
| | - Noor Kareem Alfatlaw
- Fertility Center of Al-Najaf, Al-Sadr Medical City, Babylon Health Directorate, Iraqi Ministry of Health, Baghdad, Iraq
| | - Fikri Rizaldi
- Andrology Study Program, Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Ranjit B Vishwakarma
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - George Kanakis
- Department of Endocrinology, Diabetes and Metabolism, Athens Naval & VA Hospital, Athens, Greece
| | | | - Joe Lee
- Department of Urology, National University Hospital, Singapore
| | - Raisa Galstyan
- Department of Urology, Yerevan State Medical University, Yerevan, Armenia
| | - Hakan Keskin
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Janan Wurzacher
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Doddy Hami Seno
- Division of Urology, Department of Surgery, Persahabatan General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Bambang S Noegroho
- Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia
| | - Ria Margiana
- Department of Urology, Prof R.D. Kandou Hospital, Manado, Indonesia
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Urology Unit, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Qaisar Javed
- Department of Urology, Al-Ahlia Hospital, Abu Dhabi, UAE
| | | | | | - Ana Puigvert
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey
- Institute of Andrology and Sexual Medicine (IANDROMS), Barcelona, Spain
| | - Coşkun Kaya
- Department of Urology, Health Science University Eskisehir City HPRH, Eskisehir, Turkey
| | | | - Chadi Yazbeck
- Department of Obstetrics Gynecology and Reproductive Medicine, Reprogynes Medical Institute, Paris, France
| | - Azwar Amir
- Department of Urology, Dr Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Edson Borges
- IVF Department, Fertility Assisted Fertilization Center, São Paulo, Brazil
| | - Marina Bellavia
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | - Isaac Ardianson Deswanto
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Vinod Kv
- Department of Urology, Cure & SK Hospital, Trivandrum, India
| | | | - Dang Hoang Minh
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | | | - Fulvio Colombo
- Andrology and Reproductive Medicine Unit, Next Fertility GynePro, Bologna, Italy
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Niket Patel
- Akanksha Hospital and Research Institute, Anand, Gujarat, India
| | - Selahittin Çayan
- Department of Urology, University of Mersin School of Medicine, Mersin, Turkey
| | - Ula Al-Kawaz
- High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq
| | - Maged Ragab
- Department of Andrology, Tanta University, Tanta, Egypt
| | | | | | - Ozan Efesoy
- Department of Andrology, Tanta University, Tanta, Egypt
| | - Ivan Hoffmann
- Department of Reproductive Medicine and Andrology, University Clinic Halle (Saale), Halle, Germany
- Reproductive Center Dr. Hoffmann, Berlin, Germany
| | - Thiago Afonso Teixeira
- Division of Urology, University Hospital, Federal University of Amapa, Macapá, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo, Brazil
- Androscience-Science and Innovation Center and High Complexity Clinical and Research Andrology Laboratory, São Paulo, Brazil
| | - Barış Saylam
- Department of Urology, University of Mersin School of Medicine, Mersin, Turkey
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Shah R, Rambhatla A, Atmoko W, Martinez M, Ziouziou I, Kothari P, Tadros N, Phuoc NHV, Kavoussi P, Harraz A, Salvio G, Gul M, Hamoda T, Toprak T, Birowo P, Ko E, Arafa M, Ghayda RA, Karthikeyan VS, Saleh R, Russo GI, Pinggera GM, Chung E, Savira M, Colpi GM, Zohdy W, Pescatori E, Park HJ, Fukuhara S, Tsujimura A, Rojas-Cruz C, Marino A, Mak SK, Amar E, Ibrahim W, Sindhwani P, Alhathal N, Busetto GM, Al Hashimi M, El-Sakka A, Ramazan A, Dimitriadis F, Timpano M, Jezek D, Altay B, Zylbersztejn DS, Wong MY, Moon DG, Wyns C, Gamidov S, Akhavizadegan H, Franceschelli A, Aydos K, Quang VN, Ashour S, Al Dayel A, Al-Marhoon MS, Micic S, Binsaleh S, Hussein A, Elbardisi H, Mostafa T, Taha E, Ramsay J, Zachariou A, Abdelrahman IFS, Rajmil O, Kalkanli A, Molina JMC, Bocu K, Duarsa GWK, Ceker G, Serefoglu EC, Bahar F, Gherabi N, Kuroda S, Bouzouita A, Gudeloglu A, Ceyhan E, Hasan MSM, Musa MU, Motawi A, Chak-Lam C, Taniguchi H, Ho CCK, Vazquez JFS, Mutambirwa S, Gungor ND, Bendayan M, Giulioni C, Baser A, Falcone M, Boeri L, Blecher G, Kheradmand A, Sethupathy T, Adriansjah R, Narimani N, Konstantinidis C, Nguyen TT, Japari A, Dolati P, Singh K, Ozer C, Sarikaya S, Sheibak N, Bosco NJ, Özkent MS, Le ST, Sokolakis I, Katz D, Smith R, Truong MN, Le TV, Huang Z, Deger MD, Arslan U, Calik G, Franco G, Rashed A, Kahraman O, Andreadakis S, Putra R, Balercia G, Khalafalla K, Cannarella R, Tuân AÐ, El Meliegy A, Zilaitiene B, Ramirez MLZ, Giacone F, Calogero AE, Makarounis K, Jindal S, Hoai BN, Banthia R, Peña MR, Moorthy D, Adamyan A, Kulaksiz D, Kandil H, Sofikitis N, Salzano C, Jungwirth A, Banka SR, Mierzwa TC, Turunç T, Jain D, Avoyan A, Salacone P, Kadıoğlu A, Gupta C, Lin H, Shamohammadi I, Mogharabian N, Barrett T, Danacıoğlu YO, Crafa A, Daoud S, Malhotra V, Almardawi A, Selim OM, Moussa M, Haghdani S, Duran MB, Kunz Y, Preto M, Eugeni E, Nguyen T, Elshahid AR, Suyono SS, Parikesit D, Nada E, Orozco EG, Boitrelle F, Trang NTM, Jamali M, Nair R, Ruzaev M, Gadda F, Thomas C, Ferreira RH, Gul U, Maruccia S, Kanbur A, Kinzikeeva E, Abumelha S, Quang N, Kosgi R, Gokalp F, Soebadi MA, Paul GM, Sajadi H, Gupte D, Ambar RF, Sogutdelen E, Singla K, Basurkano A, Kim SHK, Gilani MAS, Nagao K, Brodjonegoro SR, Rezano A, Elkhouly M, Mazzilli R, Farsi HMA, Ba HN, Alali H, Kafetzis D, Long TQT, Alsaid S, Cuong HBN, Oleksandr K, Mustafa A, Acosta H, Pai H, Şahin B, Arianto E, Teo C, Jayaprakash SP, Rachman RI, Yenice MG, Sefrioui O, Paghdar S, Priyadarshi S, Tanic M, Alfatlawy NK, Rizaldi F, Vishwakarma RB, Kanakis G, Cherian DT, Lee J, Galstyan R, Keskin H, Wurzacher J, Seno DH, Noegroho BS, Margiana R, Javed Q, Castiglioni F, Tanwar R, Puigvert A, Kaya C, Purnomo M, Yazbeck C, Amir A, Borges E, Bellavia M, Deswanto IA, V VK, Liguori G, Minh DH, Siddiqi K, Colombo F, Zini A, Patel N, Çayan S, Al-Kawaz U, Ragab M, Hebrard GH, Hoffmann I, Efesoy O, Saylam B, Agarwal A. Global Practice Patterns in the Evaluation of Non-Obstructive Azoospermia: Results of a World-Wide Survey and Expert Recommendations. World J Mens Health 2024; 42:42.e40. [PMID: 38606865 DOI: 10.5534/wjmh.230333] [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: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. MATERIALS AND METHODS A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 countries were analyzed descriptively, with a Delphi process used for expert recommendations. RESULTS Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoospermia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differentiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. CONCLUSIONS This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.
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Affiliation(s)
- Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Amarnath Rambhatla
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA
| | - Widi Atmoko
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Marlon Martinez
- Global Andrology Forum, Moreland Hills, OH, USA
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Imad Ziouziou
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Priyank Kothari
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, B.Y.L Nair Ch Hospital, Topiwala National Medical College, Mumbai, India
| | - Nicholas Tadros
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Nguyen Ho Vinh Phuoc
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Parviz Kavoussi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Ahmed Harraz
- Global Andrology Forum, Moreland Hills, OH, USA
- 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
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Murat Gul
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Selçuk University School of Medicine, Konya, Turkey
| | - Taha Hamoda
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Andrology, Faculty of Medicine, Assiut University, Asyut, Egypt
| | - Tuncay Toprak
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ponco Birowo
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Edmund Ko
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Mohamed Arafa
- Global Andrology Forum, Moreland Hills, OH, USA
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Ramy Abou Ghayda
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | | | - Ramadan Saleh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Giorgio Ivan Russo
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Section, University of Catania, Catania, Italy
| | - Germar-Michael Pinggera
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Eric Chung
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
| | - Missy Savira
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Giovanni M Colpi
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | - Wael Zohdy
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Edoardo Pescatori
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | - Hyun Jun Park
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Shinichiro Fukuhara
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Akira Tsujimura
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Cesar Rojas-Cruz
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University Hospital of Rostock, Rostock, Germany
| | - Angelo Marino
- Global Andrology Forum, Moreland Hills, OH, USA
- Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | - Siu King Mak
- Global Andrology Forum, Moreland Hills, OH, USA
- Union Hospital, Hong Kong SAR, China
| | - Edouard Amar
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, American Hospital of Paris, Paris, France
| | - Wael Ibrahim
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics Gynaecology and Reproductive Medicine, Fertility Care Center in Cairo, Cairo, Egypt
| | - Puneet Sindhwani
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Naif Alhathal
- Global Andrology Forum, Moreland Hills, OH, USA
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Gian Maria Busetto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Manaf Al Hashimi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Burjeel Hospital, Abu Dhabi, UAE
- Department of Urology, Khalifa University College of Medicine and Health Science, Abu Dhabi, UAE
| | - Ahmed El-Sakka
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Asci Ramazan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Fotios Dimitriadis
- Global Andrology Forum, Moreland Hills, OH, USA
- 1st Urology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Massimiliano Timpano
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Davor Jezek
- Global Andrology Forum, Moreland Hills, OH, USA
- Department for Transfusion Medicine and Transplantation Biology, Reproductive Tissue Bank, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Baris Altay
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ege University Medical School, Bornova, Izmir, Turkey
| | - Daniel Suslik Zylbersztejn
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Fleury Group and Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Michael Yc Wong
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, International Urology, Fertility and Gynecology Centre, Mount Elizabeth Hospital, Singapore
| | - Du Geon Moon
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Christine Wyns
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Gynaecology-Andrology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Safar Gamidov
- Global Andrology Forum, Moreland Hills, OH, USA
- V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, Moscow, Russia
| | - Hamed Akhavizadegan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, School of Medicine, Hasheminejad Kidney Center, Iran University of Medical Science, Tehran, Iran
| | - Alessandro Franceschelli
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Unit, University Hospital S. Orsola, Bologna, Italy
| | - Kaan Aydos
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ankara University, Ankara, Turkey
| | - Vinh Nguyen Quang
- Global Andrology Forum, Moreland Hills, OH, USA
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Shedeed Ashour
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Adel Al Dayel
- Global Andrology Forum, Moreland Hills, OH, USA
- Men's Health Clinic Dammam, Dammam, Saudi Arabia
| | - Mohamed S Al-Marhoon
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Oman
| | - Sava Micic
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Saleh Binsaleh
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Department of Surgery, Faculty of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Alayman Hussein
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Faculty of Medicine, Assiut University, Asyut, Egypt
| | - Haitham Elbardisi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Taymour Mostafa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Emad Taha
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Andrology, Faculty of Medicine, Assiut University, Asyut, Egypt
| | - Jonathan Ramsay
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Hammersmith Hospital, London, UK
| | - Athanasios Zachariou
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
| | - Islam Fathy Soliman Abdelrahman
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
- Department of Andrology, Armed Forces College of Medicine, Cairo, Egypt
| | - Osvaldo Rajmil
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Arif Kalkanli
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Juan Manuel Corral Molina
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hospital Clínico de Barcelona, Barcelona, Spain
| | - Kadir Bocu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Niğde Omer Halis Demir University Faculty of Medicine, Nigde, Turkey
| | - Gede Wirya Kusuma Duarsa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Udayana University, Denpasar, Indonesia
| | - Gokhan Ceker
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Ege Can Serefoglu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Fahmi Bahar
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia
| | - Nazim Gherabi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Medicine, University of Algiers 1, Algiers, Algeria
| | - Shinnosuke Kuroda
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Abderrazak Bouzouita
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Anatomy, Faculty of Medicine, Faculty Tunis Manar, Tunis, Tunisia
| | - Ahmet Gudeloglu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erman Ceyhan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Mohamed Saeed Mohamed Hasan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Muhammad Ujudud Musa
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Unit, Department of Surgery, Federal Medical Center, Katsina State, Nigeria
| | - Ahmad Motawi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Cho Chak-Lam
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, S. H. Ho Urology Centre, The Chinese University of Hong Kong, Hong Kong
| | - Hisanori Taniguchi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Andrology, Kansai Medical University, Osaka, Japan
| | - Christopher Chee Kong Ho
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, School of Medicine, Taylor's University, Selangor, Malaysia
| | | | - Shingai Mutambirwa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. George Mukhari Academic Hospital, Sefako Makgatho Health Science University, Medunsa, South Africa
| | - Nur Dokuzeylul Gungor
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Marion Bendayan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Carlo Giulioni
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Polytechnic University of Marche, Ancona, Italy
| | - Aykut Baser
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Marco Falcone
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Luca Boeri
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Gideon Blecher
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Urology, The Alfred Hospital, Melbourne, Australia
| | - Alireza Kheradmand
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Tamilselvi Sethupathy
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynaecology, CK Medical Centre Hospital, Erode, India
| | - Ricky Adriansjah
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia
| | - Nima Narimani
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, School of Medicine, Hasheminejad Kidney Center, Iran University of Medical Science, Tehran, Iran
| | - Charalampos Konstantinidis
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Department, General Hospital of Corinth, Corinth, Greece
| | - Tuan Thanh Nguyen
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University of California, Irvine, CA, USA
- Department of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Urology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Andrian Japari
- Global Andrology Forum, Moreland Hills, OH, USA
- Deparment of IVF, Fertility Clinic, Telogorejo Hospital, Semarang, Indonesia
| | - Parisa Dolati
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Animal Science, Faculty of Agriculture, University of Shiraz, Shiraz, Iran
| | - Keerti Singh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Preclinical and Health Sciences, Faculty of Medical Sciences, The University of West Indies, Cave Hill Campus, Bridgetown, Barbados
- Windsor Medical Centre, Bridgetown, Barbados
| | - Cevahir Ozer
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Selcuk Sarikaya
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Gulhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Nadia Sheibak
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Anatomical Sciences, Reproductive Sciences and Technology Research Center, Iran University of Medical Sciences, Tehran, Iran
- Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences, Tehran, Iran
| | - Ndagijimana Jean Bosco
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, University of Alexandria, Alexandria, Egypt
| | - Mehmet Serkan Özkent
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Konya City Hospital, Konya, Turkey
| | - Sang Thanh Le
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Deparment of IVF, Fertility Clinic, Telogorejo Hospital, Semarang, Indonesia
| | - Ioannis Sokolakis
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany
| | - Darren Katz
- Global Andrology Forum, Moreland Hills, OH, USA
- Men's Health Melbourne, Victoria, Australia
- Department of Surgery, Western Precinct, University of Melbourne, Victoria, Australia
- Department of Urology, Western Health, Victoria, Australia
| | - Ryan Smith
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Manh Nguyen Truong
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| | - Tan V Le
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Zhongwei Huang
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynaecology, National University Health Systems, Singapore
| | - Muslim Dogan Deger
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Edirne Sultan 1st Murat State Hospital, Edirne, Turkey
| | - Umut Arslan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Gokhan Calik
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Giorgio Franco
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Ayman Rashed
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, 6th of October University, Giza, Egypt
| | - Oguzhan Kahraman
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ankara University, Ankara, Turkey
| | - Sotiris Andreadakis
- Global Andrology Forum, Moreland Hills, OH, USA
- Private Practice, Thessaloniki, Greece
| | - Rosadi Putra
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, RSUD Ciawi Regional General Hospital, West Java, Indonesia
| | - Giancarlo Balercia
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Kareim Khalafalla
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, University of Illinois, Chicago, IL, USA
| | - Rossella Cannarella
- Global Andrology Forum, Moreland Hills, OH, USA
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Anh Ðăng Tuân
- Global Andrology Forum, Moreland Hills, OH, USA
- Tam Anh IVF Center, Tam Anh General Hospital, Hanoi, Vietnam
| | - Amr El Meliegy
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Birute Zilaitiene
- Global Andrology Forum, Moreland Hills, OH, USA
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Filippo Giacone
- Global Andrology Forum, Moreland Hills, OH, USA
- HERA Center, Unit of Reproductive Medicine, Sant'Agata Li Battiati, Catania, Italy
| | - Aldo E Calogero
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Section, University of Catania, Catania, Italy
| | - Konstantinos Makarounis
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Andrology, Locus Medicus, Athens, Greece
| | - Sunil Jindal
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology & Reproductive Medicine, Jindal Hospital & Fertility Center, Meerut, India
| | - Bac Nguyen Hoai
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology and Sexual Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Ravi Banthia
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Western General Hospital, Edinburgh, UK
| | - Marcelo Rodriguez Peña
- Global Andrology Forum, Moreland Hills, OH, USA
- Instituto de Ginecología y Fertilidad (IFER), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Dharani Moorthy
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Department, Swarupa fertility & IVF Centre, Vijayawada, India
| | - Aram Adamyan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Astghik Medical Center, Yerevan, Armenia
| | - Deniz Kulaksiz
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Kanuni Training and Research Hospital, University of Health Sciences, Trabzon, Turkey
| | - Hussein Kandil
- Global Andrology Forum, Moreland Hills, OH, USA
- Fakih IVF Fertility Center, Abu Dhabi, UAE
| | - Nikolaos Sofikitis
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
| | - Ciro Salzano
- Global Andrology Forum, Moreland Hills, OH, USA
- PO San Giovanni Bosco, ASL Napoli 1 Centro, Napoli, Italy
| | - Andreas Jungwirth
- Global Andrology Forum, Moreland Hills, OH, USA
- St. Barabara Private Clinic, Bad Vigaun, Austria
| | - Surendra Reddy Banka
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Androcare Institute of Andrology and Men's Health, Hyderabad, India
| | - Tiago Cesar Mierzwa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
| | - Tahsin Turunç
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Clinic, Iskenderun Gelisim Hospital, Iskenderun, Turkey
| | - Divyanu Jain
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Jaipur Golden Hospital, New Delhi, India
| | - Armen Avoyan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Astghik Medical Center, Yerevan, Armenia
| | - Pietro Salacone
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - Ateş Kadıoğlu
- Global Andrology Forum, Moreland Hills, OH, USA
- Section of Andrology, Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Chirag Gupta
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Jaipur National University, Jaipur, India
| | - Haocheng Lin
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Peking University Third Hospital, Peking University, Beijing, China
| | - Iman Shamohammadi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasser Mogharabian
- Global Andrology Forum, Moreland Hills, OH, USA
- Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Trenton Barrett
- Global Andrology Forum, Moreland Hills, OH, USA
- Perth Urology Clinic, Perth, WA, Australia
| | - Yavuz Onur Danacıoğlu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Science Istanbul, Istanbul, Turkey
| | - Andrea Crafa
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Section, University of Catania, Catania, Italy
| | - Salima Daoud
- Global Andrology Forum, Moreland Hills, OH, USA
- Laboratory of Histo-Embryology and Reproductive Biology, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Vineet Malhotra
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Andrology, VNA Hospital, New Delhi, India
| | - Abdulmalik Almardawi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Osama Mohamed Selim
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Mohamad Moussa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Lebanese University, Beirut, Lebanon
- Department of Urology, Al Zahraa Hospital, UMC, Beirut, Lebanon
| | - Saeid Haghdani
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Research Center, Yazd Reproductive Science Institute, Isfahan Fertility and Isfahan, Yazd, Iran
| | - Mesut Berkan Duran
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Pamukkale University School of Medicine, Denizli, Turkey
| | - Yannic Kunz
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Mirko Preto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Elena Eugeni
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Medicine and Surgery, University of Perugia, Perugia, Italy
- Department of Medicine and Medical Specialties, Division of Medical Andrology and Endocrinology of Reproduction, University of Terni, Terni, Italy
| | - Thang Nguyen
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology and Sexual Medicine, Hanoi Medical University Hospital, Hanoi, Vietnam
| | - Ahmed Rashad Elshahid
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Seso Sulijaya Suyono
- Global Andrology Forum, Moreland Hills, OH, USA
- Gladiool IVF, Magelang, Indonesia
| | - Dyandra Parikesit
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Universitas Indonesia Hospital, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia
| | - Essam Nada
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Eduardo Gutiérrez Orozco
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Department, CITMER Reproductive Medicine, Nuevo Leon, Mexico
| | - Florence Boitrelle
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Nguyen Thi Minh Trang
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Mounir Jamali
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Military Teaching Hospital, Rabat, Morocco
| | - Raju Nair
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Reproductive Medicine, Mitera Hospital, Kottayam, India
| | - Mikhail Ruzaev
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Clinic, Moscow, Russia
| | - Franco Gadda
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Charalampos Thomas
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Department, General Hospital of Corinth, Corinth, Greece
| | - Raphael Henrique Ferreira
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Santa Casa de Ribeirão Preto, São Paulo, Brazil
| | - Umit Gul
- Global Andrology Forum, Moreland Hills, OH, USA
- Private EPC Hospital, Adana, Turkey
| | - Serena Maruccia
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, ASST Santi Paolo e Carlo, San Paolo Hospital, Milano, Italy
| | - Ajay Kanbur
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Kanbur Clinic, Thane, India
- Department of Urosurgery, Jupiter Hospital, Thane, India
| | - Ella Kinzikeeva
- Global Andrology Forum, Moreland Hills, OH, USA
- Zucchi Clinical Institutes, Monza, Italy
| | - Saad Abumelha
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nguyen Quang
- Global Andrology Forum, Moreland Hills, OH, USA
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Raghavender Kosgi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Andrology, AIG Hospitals, Hyderabad, India
| | - Fatih Gokalp
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Hatay Mu Stafa Kemal University, Antakya, Turkey
| | - Mohammad Ayodhia Soebadi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Soetomo Hospital, Surabaya, Indonesia
| | - Gustavo Marquesine Paul
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hospital de Clínicas of the Federal University of Paraná, Curitiba, Brazil
| | - Hesamoddin Sajadi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Deepak Gupte
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Bombay Hospital and Medical Research Center, Mumbai, India
| | - Rafael F Ambar
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Fleury Group and Hospital Israelita Albert Einstein, São Paulo, Brazil
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
| | - Emrullah Sogutdelen
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Clarity Health, Chandigarh, India
| | - Karun Singla
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. Dradjat Hospital, Serang, Indonesia
| | - Ari Basurkano
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Australia, Sydney, Australia
| | - Shannon Hee Kyung Kim
- Global Andrology Forum, Moreland Hills, OH, USA
- Macquarie School of Medicine, Macquaire University, Sydney, Australia
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Mohammad Ali Sadighi Gilani
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Koichi Nagao
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Sakti Ronggowardhana Brodjonegoro
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Department of Surgery, Prof. Dr. Sardjito Hospital, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Andri Rezano
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Study Program, Department of Biomedical Sciences, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia
| | - Mohamed Elkhouly
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Department, Bourn Hall Fertility Center, Dubai, UAE
| | - Rossella Mazzilli
- Global Andrology Forum, Moreland Hills, OH, USA
- Unit of Endocrinology, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Hasan M A Farsi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hung Nguyen Ba
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Unit, ART Center, Vinmec Times City International Hospital, Hanoi, Vietnam
| | - Hamed Alali
- Global Andrology Forum, Moreland Hills, OH, USA
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Dimitrios Kafetzis
- Global Andrology Forum, Moreland Hills, OH, USA
- Orchid IVF Clinic, Dubai, UAE
| | - Tran Quang Tien Long
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Hanoi Obstetric and Gynecology Hospital, Hanoi, Vietnam
| | - Sami Alsaid
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Hoang Bao Ngoc Cuong
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - Knigavko Oleksandr
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Nephrology and Andrology, Kharkiv National Medical University, Kharkiv, Ukraine
| | - Akhmad Mustafa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia
| | - Herik Acosta
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
| | - Hrishikesh Pai
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Department, Bloom IVF Group, Mombai, India
| | - Bahadır Şahin
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, School of Medicine, Marmara University, İstanbul, Turkey
| | - Eko Arianto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Prof R.D. Kandou Hospital, Manado, Indonesia
| | - Colin Teo
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Gleneagles Hospital, Singapore
| | - Sanjay Prakash Jayaprakash
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Unit, Department of Urology, Apollo Hospitals, Greams Road, Chennai, India
| | - Rinaldo Indra Rachman
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Mustafa Gurkan Yenice
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, University of Health Science Istanbul, Istanbul, Turkey
| | - Omar Sefrioui
- Global Andrology Forum, Moreland Hills, OH, USA
- African Fertility Center, Casablanca, Morocco
| | - Smit Paghdar
- Global Andrology Forum, Moreland Hills, OH, USA
- UVA Urology Clinic in Charlottesville, UVA Specialty Care Clinic in Culpeper, Culpeper, VA, USA
| | - Shivam Priyadarshi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - Marko Tanic
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, General Hospital, Cuprija, Serbia
| | - Noor Kareem Alfatlawy
- Global Andrology Forum, Moreland Hills, OH, USA
- Fertility Center of Al-Najaf/Al-Sadr Medical City, Babylon Health Directorate, Iraqi Ministry of Health, Baghdad, Iraq
| | - Fikri Rizaldi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Soetomo Hospital, Surabaya, Indonesia
| | - Ranjit B Vishwakarma
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
- Global Andrology Forum, Moreland Hills, OH, USA
| | - George Kanakis
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Diabetes and Metabolism, Athens Naval & VA Hospital, Athens, Greece
| | - Dinesh Thomas Cherian
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Deparment, Aster Medcity, Kochi, India
| | - Joe Lee
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, National University Hospital, Singapore
| | - Raisa Galstyan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Yerevan State Medical University, Yerevan, Armenia
| | - Hakan Keskin
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Jana Wurzacher
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Doddy Hami Seno
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Department of Surgery, Persahabatan General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Bambang S Noegroho
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hasan Sadikin General Hospital, Faculty of Medicine of Padjadjaran University, Bandung, Indonesia
| | - Ria Margiana
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Anatomy, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Master's Programme Biomedical Sciences, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
- Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Qaisar Javed
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Al-Ahlia Hospital, Abu Dhabi, UAE
| | - Fabrizio Castiglioni
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Unit, ART Center - San Carlo Clinic, Milan, Italy
| | - Raman Tanwar
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Center, Jyoti Hospital, Gurugram, India
| | - Ana Puigvert
- Global Andrology Forum, Moreland Hills, OH, USA
- Institute of Andrology and Sexual Medicine (IANDROMS), Barcelona, Spain
| | - Coşkun Kaya
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Health Science University Eskisehir City HPRH, Eskisehir, Turkey
| | - Medianto Purnomo
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Brawijaya University, Malang, Indonesia
| | - Chadi Yazbeck
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics Gynecology and Reproductive Medicine, Reprogynes Medical Institute, Paris, France
| | - Azwar Amir
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr Wahidin Sudirohusodo Hospital, Makassar, Indonesia
| | - Edson Borges
- Global Andrology Forum, Moreland Hills, OH, USA
- Fertility Assisted Fertilization Center, São Paulo, Brazil
| | - Marina Bellavia
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | - Isaac Ardianson Deswanto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Vinod K V
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Cure & SK Hospital, Trivandrum, India
| | - Giovanni Liguori
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University of Trieste, Trieste, Italy
| | - Dang Hoang Minh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Can Tho University of Medicine and Pharmacy Hospital, Can Tho, Vietnam
| | - Kashif Siddiqi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Cleveland Clinic, Abu Dhabi, UAE
| | - Fulvio Colombo
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | - Armand Zini
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Niket Patel
- Global Andrology Forum, Moreland Hills, OH, USA
- Akanksha Hospital and Research Institute, Anand, Gujarat, India
| | - Selahittin Çayan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University of Mersin School of Medicine, Mersin, Turkey
| | - Ula Al-Kawaz
- Global Andrology Forum, Moreland Hills, OH, USA
- High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, Baghdad, Iraq
| | - Maged Ragab
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Tanta University, Tanta, Egypt
| | | | - Ivan Hoffmann
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Reproductive Medicine and Andrology, University Clinic Halle (Saale), Halle, Germany
- Reproductive Center Dr. Hoffmann, Berlin, Germany
| | - Ozan Efesoy
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Mersin City Training and Research Hospital, University of Health Sciences, Mersin, Turkey
| | - Barış Saylam
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Mersin City Training and Research Hospital, University of Health Sciences, Mersin, Turkey
| | - Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
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4
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Arasteh H, Gilani MAS, Ramezani-Binabaj M, Babaei M. Microdissection testicular sperm extraction outcomes in azoospermic patients with bilateral orchidopexy. Andrology 2024; 12:157-163. [PMID: 37210678 DOI: 10.1111/andr.13463] [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] [Received: 06/28/2022] [Revised: 04/28/2023] [Accepted: 05/18/2023] [Indexed: 05/22/2023]
Abstract
BACKGROUND Cryptorchidism is considered to be one of the most common causes of non-obstructive azoospermia. There are several surgical techniques to retrieve sperm in these patients. Microdissection testicular sperm extraction (m-TESE) is a recent sperm retrieval technique which is considered to be a safe, non-blind, and feasible method. OBJECTIVES This study aimed to investigate sperm retrieval rate (SRR) by the mTESE method in patients who have undergone orchidopexy due to bilateral cryptorchidism. MATERIALS AND METHODS In this retrospective study, 56 ex-cryptorchid patients, who underwent mTESE due to post orchidopexy azoospermia, were included. Patients with hypogonadotropic hypogonadism, Klinefelter syndrome, azoospermia factors (AZF) microdeletion, or chromosomal translocation were excluded from the study. Data were obtained from medical files. RESULTS SRR in this study was 46%. Patients were divided into two groups of negative (n = 30) and positive (n = 26) based on the sperm extraction outcomes. There was no statistically significant difference between two groups regarding the mean age at mTESE, mean age at orchidopexy, testicular size, and serum testosterone concentration. However, testicular location, histological patterns, FSH, and LH level showed to have statistically significant relation with sperm retrieval results. But, according to our logistic regression, none of the included variable in the model including FSH, LH, histopathology, and testis location have a significant effect on the presence of the sperm. DISCUSSION In the present study, SRR was significantly higher in patients with scrotal testis and low level of FSH and LH. CONCLUSIONS Performing mTESE could be recommended in ex-cryptorchid patients with post orchidopexy NOA. Preoperative testicular biopsy seems to be unnecessary while clinical criteria can perfectly define NOA.
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Affiliation(s)
- Hamid Arasteh
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Tehran, Iran
- Department of Urology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Tehran, Iran
- Department of Urology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Ramezani-Binabaj
- Department of Urology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Babaei
- Department of Urology, Shariati Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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5
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Agarwal A, Farkouh A, Saleh R, Hamoda TAAAM, Salvio G, Boitrelle F, Harraz AM, Ghayda RA, Kavoussi P, Gül M, Toprak T, Russo GI, Durairajanayagam D, Rambhatla A, Birowo P, Cannarella R, Phuoc NHV, Zini A, Arafa M, Wyns C, Tremellen K, Sarıkaya S, Lewis S, Evenson DP, Ko E, Calogero AE, Bahar F, Martínez M, Ambar RF, Colpi GM, Bakircioglu ME, Henkel R, Kandil H, Serefoglu EC, Alfakhri A, Tsujimura A, Kheradmand A, Marino A, Adamyan A, Zilaitiene B, Ozer C, Pescatori E, Vogiatzi P, Busetto GM, Balercia G, Elbardisi H, Akhavizadegan H, Sajadi H, Taniguchi H, Park HJ, Maldonado Rosas I, Al-Marhoon M, Sadighi Gilani MA, Alhathal N, Quang N, Pinggera GM, Kothari P, Micic S, Homa S, Long TQT, Zohdy W, Atmoko W, Ibrahim W, Sabbaghian M, Abumelha SM, Chung E, Ugur MR, Ozkent MS, Selim O, Darbandi M, Fukuhara S, Jamali M, de la Rosette J, Kuroda S, Smith RP, Baser A, Kalkanli A, Tadros NN, Aydos K, Mierzwa TC, Khalafalla K, Malhotra V, Moussa M, Finocchi F, Rachman RI, Giulioni C, Avidor-Reiss T, Kahraman O, Çeker G, Zenoaga-Barbăroșie C, Barrett TL, Yilmaz M, Kadioglu A, Jindal S, Omran H, Bocu K, Karthikeyan VS, Franco G, Solorzano JF, Vishwakarma RB, Arianto E, Garrido N, Jain D, Gherabi N, Sokolakis I, Palani A, Calik G, Kulaksiz D, Simanaviciene V, Simopoulou M, Güngör ND, Blecher G, Falcone M, Jezek D, Preto M, Amar E, Le TV, Ahn ST, Rezano A, Singh K, Rocco L, Savira M, Rajmil O, Darbandi S, Sogutdelen E, Boeri L, Hernández G, Hakim L, Morimoto Y, Japari A, Sofikitis N, Altay B, Metin Mahmutoglu A, Al Hashimi M, Ziouziou I, Anagnostopoulou C, Lin H, Shah R. Technical Aspects and Clinical Limitations of Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations. World J Mens Health 2024; 42:202-215. [PMID: 37635341 PMCID: PMC10782128 DOI: 10.5534/wjmh.230076] [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: 03/27/2023] [Accepted: 04/10/2023] [Indexed: 08/29/2023] Open
Abstract
PURPOSE Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial.
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Affiliation(s)
- Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- Cleveland Clinic, Cleveland, OH, USA.
| | | | - Ramadan Saleh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Taha Abo-Almagd Abdel-Meguid Hamoda
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Gianmaria Salvio
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Florence Boitrelle
- Global Andrology Forum, Moreland Hills, OH, USA
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment, and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Ahmed M Harraz
- Global Andrology Forum, Moreland Hills, OH, USA
- 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
| | - Ramy Abou Ghayda
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Parviz Kavoussi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Murat Gül
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Selçuk University School of Medicine, Konya, Turkey
| | - Tuncay Toprak
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Giorgio Ivan Russo
- Global Andrology Forum, Moreland Hills, OH, USA
- Urology Section, University of Catania, Catania, Italy
| | - Damayanthi Durairajanayagam
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Amarnath Rambhatla
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA
| | - Ponco Birowo
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Rossella Cannarella
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Nguyen Ho Vinh Phuoc
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Armand Zini
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Mohamed Arafa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
- Department of Andrology and STDs, Cairo University, Cairo, Egypt
| | - Christine Wyns
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Gynaecology-Andrology, Cliniques Universitaires Saint-Luc, Universitat Catholique de Louvain, Brussels, Belgium
| | - Kelton Tremellen
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia
| | - Selçuk Sarıkaya
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Galhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Sheena Lewis
- Global Andrology Forum, Moreland Hills, OH, USA
- Examen Lab Ltd., Northern Ireland, UK
| | - Donald P Evenson
- Global Andrology Forum, Moreland Hills, OH, USA
- SCSA Diagnostics, Brookings, SD, USA
| | - Edmund Ko
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Aldo E Calogero
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
| | - Fahmi Bahar
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia
| | - Marlon Martínez
- Global Andrology Forum, Moreland Hills, OH, USA
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Rafael F Ambar
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Centro Universitario em Saude do ABC, Santo Andre, Brazil
- Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo Andre, Brazil
| | - Giovanni M Colpi
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | | | - Ralf Henkel
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Hussein Kandil
- Global Andrology Forum, Moreland Hills, OH, USA
- Fakih IVF Fertility Center, Abu Dhabi, UAE
| | - Ege Can Serefoglu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Abdullah Alfakhri
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Akira Tsujimura
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Alireza Kheradmand
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Angelo Marino
- Global Andrology Forum, Moreland Hills, OH, USA
- Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Aram Adamyan
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Department, Astghik Medical Center, Yerevan, Armenia
| | - Birute Zilaitiene
- Global Andrology Forum, Moreland Hills, OH, USA
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Cevahir Ozer
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Edoardo Pescatori
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | - Paraskevi Vogiatzi
- Global Andrology Forum, Moreland Hills, OH, USA
- Andromed Health & Reproduction, Fertility & Reproductive Health Diagnostic Center, Athens, Greece
| | - Gian Maria Busetto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy
| | - Giancarlo Balercia
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Haitham Elbardisi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
- Department of Urology, College of Medicine, Qatar University, Doha, Qatar
| | - Hamed Akhavizadegan
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hesamoddin Sajadi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hisanori Taniguchi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Hyun Jun Park
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Israel Maldonado Rosas
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico
| | - Mohamed Al-Marhoon
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammad Ali Sadighi Gilani
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Naif Alhathal
- Global Andrology Forum, Moreland Hills, OH, USA
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nguyen Quang
- Global Andrology Forum, Moreland Hills, OH, USA
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Germar-Michael Pinggera
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Innsbruck Medical University, Innsbruck, Austria
| | - Priyank Kothari
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Topiwala National Medical College, B.Y.L Nair Ch Hospital, Mumbai, India
| | - Sava Micic
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Sheryl Homa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Biosciences, University of Kent, Canterbury, UK
| | - Tran Quang Tien Long
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Hanoi Obstetric and Gynecology Hospital, Hanoi, Vietnam
| | - Wael Zohdy
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology and STDs, Cairo University, Cairo, Egypt
| | - Widi Atmoko
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Wael Ibrahim
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, School of Medicine, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Marjan Sabbaghian
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Saad Mohammed Abumelha
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Eric Chung
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University of Queensland, Princess Alexandra Hospital, Brisbane QLD, Australia
| | - Muhammet Rasit Ugur
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Michigan, Bloomfield Hills, MI, USA
| | - Mehmet Serkan Ozkent
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Konya City Hospital, Konya, Turkey
| | - Osama Selim
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology and STDs, Cairo University, Cairo, Egypt
| | - Mahsa Darbandi
- Global Andrology Forum, Moreland Hills, OH, USA
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran
- Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | - Shinichiro Fukuhara
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Mounir Jamali
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Mohammed V Military Hospital, Rabat, Morocco
| | - Jean de la Rosette
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Shinnosuke Kuroda
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Ryan P Smith
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Aykut Baser
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Bandirma Onyedi Eylül University, Balikesir, Turkey
| | - Arif Kalkanli
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Nicholas N Tadros
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Urology, Southern Illinois University, Springfield, IL, USA
| | - Kaan Aydos
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ankara University, Ankara, Turkey
| | - Tiago Cesar Mierzwa
- Global Andrology Forum, Moreland Hills, OH, USA
- Androlab, Fertility Clinic, Curitiba, PR, Brazil
| | - Kareim Khalafalla
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, University of Texas McGovern Medical School, Houston, TX, USA
- Department of Urology, MD Anderson Cancer Center, Houston, TX, USA
| | - Vineet Malhotra
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, SCM Clinic and Hospital, New Delhi, India
| | - Mohamad Moussa
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Lebanese University, Beirut, Lebanon
- Department of Urology, Al Zahraa Hospital, UMC, Lebanon
| | - Federica Finocchi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Rinaldo Indra Rachman
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Carlo Giulioni
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Tomer Avidor-Reiss
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Biological Sciences, University of Toledo, Toledo, OH, USA
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Oguzhan Kahraman
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | - Gökhan Çeker
- Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Cătălina Zenoaga-Barbăroșie
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Trenton L Barrett
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Perth Urology Clinic, Murdoch, WA, Australia
| | - Mehmet Yilmaz
- Global Andrology Forum, Moreland Hills, OH, USA
- Asklepios Klinik Triberg, Urology, Triberg, Germany
| | - Ates Kadioglu
- Global Andrology Forum, Moreland Hills, OH, USA
- Section of Andrology, Department of Urology, Istanbul University, Istanbul, Turkey
| | - Sunil Jindal
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Huda Omran
- Global Andrology Forum, Moreland Hills, OH, USA
- Molecular Genetics Department, Pulse Health Training Center, Manama, Bahrain
| | - Kadir Bocu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | | | - Giorgio Franco
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Jesús Fernando Solorzano
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico
| | - Ranjit B Vishwakarma
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Eko Arianto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, Prof. Dr. R.D. Kandou Central General Hospital, Manado, Indonesia
| | - Nicolas Garrido
- Global Andrology Forum, Moreland Hills, OH, USA
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Divyanu Jain
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Jaipur Golden Hospital, New Delhi, India
| | - Nazim Gherabi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Medicine, University of Algiers 1, Algiers, Algeria
| | - Ioannis Sokolakis
- Global Andrology Forum, Moreland Hills, OH, USA
- 2nd Department of Urology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ayad Palani
- Global Andrology Forum, Moreland Hills, OH, USA
- Research Centre, University of Garmian, Kalar, Iraq
| | - Gokhan Calik
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Deniz Kulaksiz
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, University of Health Sciences Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Vaida Simanaviciene
- Global Andrology Forum, Moreland Hills, OH, USA
- Fertility Centre, Northway Medical Centre, Vilnius, Lithuania
| | - Mara Simopoulou
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nur Dokuzeylül Güngör
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Gideon Blecher
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Marco Falcone
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
| | - Davor Jezek
- Global Andrology Forum, Moreland Hills, OH, USA
- Reproductive Tissue Bank, Department for Transfusion Medicine and Transplantation Biology, University Hospital Zagreb, Zagreb, Croatia
| | - Mirko Preto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
| | - Edouard Amar
- Global Andrology Forum, Moreland Hills, OH, USA
- American Hospital of Paris, Paris, France
| | - Tan V Le
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Sun Tae Ahn
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Andri Rezano
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Biomedical Sciences, Division of Cell Biology, Faculty of Medicine, Universitas Padjadjaran, Sumedang, West Java, Indonesia
| | - Keerti Singh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Preclinical and Health Sciences, Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, St Michael, Barbados, Italy
| | - Lucia Rocco
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Missy Savira
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Dr. Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Osvaldo Rajmil
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Sara Darbandi
- Global Andrology Forum, Moreland Hills, OH, USA
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran
- Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | - Emrullah Sogutdelen
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Luca Boeri
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Guadalupe Hernández
- Global Andrology Forum, Moreland Hills, OH, USA
- IVF Department, CITMER Reproductive Medicine, Puebla, Mexico
| | - Lukman Hakim
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Faculty of Medicine, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Yoshiharu Morimoto
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, HORAC Grand Front Osaka Clinic, Osaka, Japan
| | - Andrian Japari
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Fertility Clinic, Telogorejo Hospital, Central Java, Indonesia
| | - Nikolaos Sofikitis
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
| | - Baris Altay
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Ege University, Izmir, Turkey
| | - Asli Metin Mahmutoglu
- Global Andrology Forum, Moreland Hills, OH, USA
- Departmant of Medical Biology, Faculty of Medical, Yozgat Bozok University, Yozgat, Turkey
| | - Manaf Al Hashimi
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Burjeel Hospital, Abu Dhabi, UAE
| | - Imad Ziouziou
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, University Hospital of Souss Massa, Massa, Morocco
| | - Christina Anagnostopoulou
- Global Andrology Forum, Moreland Hills, OH, USA
- Unit of Reproductive Medicine, EmbryoART, Leto Maternity Hospital, Athens, Greece
| | - Haocheng Lin
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Rupin Shah
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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Jahangiri AR, Ziarati N, Dadkhah E, Bucak MN, Rahimizadeh P, Shahverdi A, Sadighi Gilani MA, Topraggaleh TR. Microfluidics: The future of sperm selection in assisted reproduction. Andrology 2023. [PMID: 38148634 DOI: 10.1111/andr.13578] [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: 11/16/2022] [Revised: 11/03/2023] [Accepted: 12/10/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Obtaining functional sperm cells is the first step to treat infertility. With the ever-increasing trend in male infertility, clinicians require access to effective solutions that are able to single out the most viable spermatozoa, which would max out the chance for a successful pregnancy. The new generation techniques for sperm selection involve microfluidics, which offers laminar flow and low Reynolds number within the platforms can provide unprecedented opportunities for sperm selection. Previous studies showed that microfluidic platforms can provide a novel approach to this challenge and since then researchers across the globe have attacked this problem from multiple angles. OBJECTIVE In this review, we seek to provide a much-needed bridge between the technical and medical aspects of microfluidic sperm selection. Here, we provide an up-to-date list on microfluidic sperm selection procedures and its application in assisted reproductive technology laboratories. SEARCH METHOD A literature search was performed in Web of Science, PubMed, and Scopus to select papers reporting microfluidic sperm selection using the keywords: microfluidic sperm selection, self-motility, non-motile sperm selection, boundary following, rheotaxis, chemotaxis, and thermotaxis. Papers published before March 31, 2023 were selected. OUTCOMES Our results show that most studies have used motility-based properties for sperm selection. However, microfluidic platforms are ripe for making use of other properties such as chemotaxis and especially rheotaxis. We have identified that low throughput is one of the major hurdles to current microfluidic sperm selection chips, which can be solved via parallelization. CONCLUSION Future work needs to be performed on numerical simulation of the microfluidics chip prior to fabrication as well as relevant clinical assessment after the selection procedure. This would require a close collaboration and understanding among engineers, biologists, and medical professionals. It is interesting that in spite of two decades of microfluidics sperm selection, numerical simulation and clinical studies are lagging behind. It is expected that microfluidic sperm selection platforms will play a major role in the development of fully integrated start-to-finish assisted reproductive technology systems.
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Affiliation(s)
- Ali Reza Jahangiri
- NanoLund, Lund University, Lund, Sweden
- Materials Science and Applied Mathematics, Malmö University, Malmö, Sweden
| | - Niloofar Ziarati
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ehsan Dadkhah
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mustafa Numan Bucak
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Medicine, Selcuk University, Konya, Turkey
| | - Pegah Rahimizadeh
- Division of Experimental Surgery, McGill University, Montreal, Quebec, Canada
- Cancer Research Program, The Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Tohid Rezaei Topraggaleh
- Reproductive Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
- Department of Anatomical Sciences, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
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Ghanami Gashti N, Sadighi Gilani MA, Kabodmehri R, Nikmahzar A, Salem M, Abbasi M. Evaluation of PGK2 and ACR proteins in seminal plasma: suggestion of potential new biomarkers for prediction of sperm retrieval in non-obstructive azoospermia patients. HUM FERTIL 2023; 26:1073-1079. [PMID: 35930251 DOI: 10.1080/14647273.2022.2104136] [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: 10/05/2020] [Accepted: 01/21/2022] [Indexed: 11/04/2022]
Abstract
This study aimed to assess the role of testis-specific proteins, PGK2 and ACR, in the prediction of sperm retrieval results by microdissection testicular sperm extraction (micro-TESE) in men with non-obstructive azoospermia (NOA). This was a case-control study including 48 semen samples of NOA patients undergoing the micro-TESE procedure, 15 semen samples from normozoospermic men as the positive control, and 12 semen samples from obstructive azoospermia/post-vasectomy (OA/PV) as negative controls. We investigated the levels of PGK2 and ACR proteins by ELISA tests in seminal plasma samples. The ELISA results revealed a significantly higher concentration of PGK2 and ACR in the NOA patients with successful sperm retrieval (NOA+) in comparison to NOA patients with failed sperm retrieval (NOA-) group (p = 0.0001 in both cases). For the first time, the data from this study suggests that a seminal PGK2 concentration of 136.3 pg/ml and ACR concentration of 21.75 mIU/ml can be used as cut-off values for the prediction of micro-TESE outcomes in NOA patients. These findings may be useful to avoid unnecessary micro-TESE operations. Overall, the seminal levels of the PGK2 and ACR proteins may be useful in predicting sperm retrieval success by micro-TESE in NOA patients.
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Affiliation(s)
- Nasrin Ghanami Gashti
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Kabodmehri
- Reproductive Health Research Center, Department of Obstetrics & Gynecology, Al-Zahra Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Aghbibi Nikmahzar
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Salem
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Yazdanpanah Ghadikolaei P, Ghaleno LR, Vesali S, Janzamin E, Gilani MAS, Sajadi H, Dizaj AVT, Shahverdi A, Drevet JR, Moghadam Masouleh AA. Epidemiology of sperm DNA fragmentation in a retrospective cohort of 1191 men. Andrology 2023; 11:1663-1672. [PMID: 37280171 DOI: 10.1111/andr.13472] [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: 11/29/2022] [Revised: 05/11/2023] [Accepted: 06/01/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND The scientific and clinical communities now recognize that sperm DNA integrity is crucial for successful fertilization, good embryo development, and offspring quality of life. Despite the apparent unanimity, this criterion is rarely evaluated in clinical practice. We evaluated the sperm DNA fragmentation index of nearly 1200 sperm samples and its connections based on the patient's age, body mass index, the season of sperm collection, geographical location, medical history, and addictive behaviors. METHODS A cohort of 1503 patients who were referred to the Royan Institute between July 2018 and March 2020 was examined. Only 1191 patient records with demographic data, complete semen analysis, and DNA fragmentation index measurements were included in the final cohort. Documents were classified, incorporated into statistical models, and analyzed. RESULTS The results confirmed previous findings that the sperm DNA fragmentation index was significantly higher in aging men. The sperm DNA fragmentation index and high DNA stainability levels were significantly higher in spring and summer samples than in those of other seasons. No correlation was found between semen DNA fragmentation index and patient body mass index, although the study cohort was significantly overweight. Contrary to what might be expected, we observed that the sperm DNA fragmentation index was higher in rural than in urban patients. Intriguingly, epileptic patients exhibited significantly higher sperm DNA fragmentation index levels. DISCUSSION AND CONCLUSION Age is the factor that is most strongly associated with sperm DNA fragmentation index levels. Our analysis of 1191 samples indicates that between the ages of 19 and 59, the sperm DNA fragmentation index increases by an average of 2% each year. Intriguingly, from an epidemiological perspective, the warm season (spring/summer) is associated with a higher sperm DNA fragmentation index in the study population, possibly due to the deleterious effect of temperature on sperm quality. Some neurological diseases, such as epilepsy, are associated with decreased sperm DNA integrity. This observation could be related to the iatrogenic effects of associated therapies. In the study cohort, body mass index did not appear to be correlated with the DNA fragmentation index.
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Affiliation(s)
- Parisa Yazdanpanah Ghadikolaei
- Department of Molecular and Cellular Biology, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Leila Rashki Ghaleno
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Samira Vesali
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ehsan Janzamin
- SABA Biomedical Science -Based Company, Tehran, Iran
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hesamoddin Sajadi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ahmad Vosough Taghi Dizaj
- Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Joël R Drevet
- Faculty of Medicine, GReD Institute, Clermont-Ferrand, France
| | - AliReza Alizadeh Moghadam Masouleh
- Department of Molecular and Cellular Biology, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Gyn-medicum, Center for Reproductive Medicine, Göttingen, Germany
- Institute of Pharmacology and Toxicology, University Medical Center Göttingen, Göttingen, Germany
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Farkouh A, Agarwal A, Hamoda TAAAM, Kavoussi P, Saleh R, Zini A, Arafa M, Harraz AM, Gul M, Karthikeyan VS, Durairajanayagam D, Rambhatla A, Boitrelle F, Chung E, Birowo P, Toprak T, Ghayda RA, Cannarella R, Phuoc NHV, Dimitriadis F, Russo GI, Sokolakis I, Mostafa T, Makarounis K, Ziouziou I, Kuroda S, Bendayan M, Kaiyal RS, Japari A, Simopoulou M, Rocco L, Garrido N, Gherabi N, Bocu K, Kahraman O, Le TV, Wyns C, Tremellen K, Sarikaya S, Lewis S, Evenson DP, Ko E, Calogero AE, Bahar F, Martinez M, Crafa A, Nguyen Q, Ambar RF, Colpi G, Bakircioglu ME, Henkel R, Kandil H, Serefoglu EC, Alarbid A, Tsujimura A, Kheradmand A, Anagnostopoulou C, Marino A, Adamyan A, Zilaitiene B, Ozer C, Pescatori E, Vogiatzi P, Busetto GM, Balercia G, Elbardisi H, Akhavizadegan H, Sajadi H, Taniguchi H, Park HJ, Maldonado Rosas I, Al-Marhoon M, Sadighi Gilani MA, Alhathal N, Pinggera GM, Kothari P, Mogharabian N, Micic S, Homa S, Darbandi S, Long TQT, Zohdy W, Atmoko W, Sabbaghian M, Ibrahim W, Smith RP, Ho CCK, de la Rosette J, El-Sakka AI, Preto M, Zenoaga-Barbăroșie C, Abumelha SM, Baser A, Aydos K, Ramirez-Dominguez L, Kumar V, Ong TA, Mierzwa TC, Adriansjah R, Banihani SA, Bowa K, Fukuhara S, Rodriguez Peña M, Moussa M, Ari UÇ, Cho CL, Tadros NN, Ugur MR, Amar E, Falcone M, Santer FR, Kalkanli A, Karna KK, Khalafalla K, Vishwakarma RB, Finocchi F, Giulioni C, Ceyhan E, Çeker G, Yazbeck C, Rajmil O, Yilmaz M, Altay B, Barrett TL, Ngoo KS, Roychoudhury S, Salvio G, Lin H, Kadioglu A, Timpano M, Avidor-Reiss T, Hakim L, Sindhwani P, Franco G, Singh R, Giacone F, Ruzaev M, Kosgi R, Sofikitis N, Palani A, Calik G, Kulaksız D, Jezek D, Al Hashmi M, Drakopoulos P, Omran H, Leonardi S, Celik-Ozenci C, Güngör ND, Ramsay J, Amano T, Sogutdelen E, Duarsa GWK, Chiba K, Jindal S, Savira M, Boeri L, Borges E, Gupte D, Gokalp F, Hebrard GH, Minhas S, Shah R. Controversy and Consensus on the Management of Elevated Sperm DNA Fragmentation in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations. World J Mens Health 2023; 41:809-847. [PMID: 37118965 PMCID: PMC10523126 DOI: 10.5534/wjmh.230008] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 01/12/2023] [Revised: 01/18/2023] [Accepted: 01/27/2023] [Indexed: 04/30/2023] Open
Abstract
PURPOSE Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. MATERIALS AND METHODS An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. RESULTS A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4-6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. CONCLUSIONS This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians.
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Affiliation(s)
- Ala’a Farkouh
- Global Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USA
| | - Ashok Agarwal
- Global Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USA
- Cleveland Clinic Foundation, Cleveland, OH, 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
| | - Parviz Kavoussi
- Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- Ajyal IVF Center, Ajyal Hospital, Sohag, Egypt
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Andrology, Sexology & STIs, Cairo University, Cairo, Egypt
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Ahmed M. Harraz
- Urology Department, Urology and Nephrology Center, Mansoura University, Mansura, Egypt
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
- Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
| | - Murat Gul
- Department of Urology, Selçuk University School of Medicine, Konya, Turkey
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Amarnath Rambhatla
- Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
| | - Ponco Birowo
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ramy Abou Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Nguyen Ho Vinh Phuoc
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Fotios Dimitriadis
- Department of Urology, Aristotle University, School of Medicine, Thessaloniki,
| | | | - Ioannis Sokolakis
- Department of Urology, Aristotle University, School of Medicine, Thessaloniki,
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Cairo University, Cairo, Egypt
| | | | - Imad Ziouziou
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Shinnosuke Kuroda
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Marion Bendayan
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
| | - Raneen Sawaid Kaiyal
- Department of Urology, Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Andrian Japari
- Fertility Clinic, Telogorejo Hospital, Semarang, Indonesia
| | - Mara Simopoulou
- Department of Physiology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Nazim Gherabi
- Department of Urology, University of Algiers, Algiers, Algeria
| | - Kadir Bocu
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | - Oguzhan Kahraman
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Tan V. Le
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Christine Wyns
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, South Australia, Australia
| | - Selcuk Sarikaya
- Department of Urology, Gülhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Fahmi Bahar
- Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia
| | - Marlon Martinez
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Quang Nguyen
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - 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
| | - Giovanni Colpi
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | | | - Ralf Henkel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | | | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Abdullah Alarbid
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
| | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Alireza Kheradmand
- Urology Department, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Angelo Marino
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Aram Adamyan
- IVF Department, Astghik Medical Center, Yerevan, Armenia
| | - Birute Zilaitiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Cevahir Ozer
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Edoardo Pescatori
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility & Reproductive Health Diagnostic Center, Athens, Greece
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy
| | - Giancarlo Balercia
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Andrology, Sexology & STIs, Cairo University, Cairo, Egypt
| | - Hamed Akhavizadegan
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hesamoddin Sajadi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Teheran, Iran
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | - Mohamed Al-Marhoon
- Division of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Teheran, Iran
| | - Naif Alhathal
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | | | - Priyank Kothari
- Department of Urology, Topiwala National Medical College, B.Y.L Nair Ch Hospital, Mumbai, India
| | - Nasser Mogharabian
- Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Sheryl Homa
- Department of Biosciences, University of Kent, Canterbury, UK
| | - Sara Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran
- Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | - Tran Quang Tien Long
- Department of Obstetrics and Gynecology, Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Wael Zohdy
- Department of Andrology, Sexology & STIs, Cairo University, Cairo, Egypt
| | - Widi Atmoko
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Teheran, Iran
| | - Wael Ibrahim
- Department of Obstetrics Gynaecology and Reproductive Medicine, Fertility Care Center in Cairo, Cairo, Egypt
| | - Ryan P. Smith
- Department of Urology, University of Virginia School of Medicine, Virginia, USA
| | | | | | | | - Mirko Preto
- Department of Urology, University of Turin, Turin, Italy
| | | | - Saad Mohammed Abumelha
- Division of Urology, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Aykut Baser
- Department of Urology, Bandirma Onyedi Eylül University, Balikesir, Turkey
| | - Kaan Aydos
- Department of Urology, Ankara University, Ankara, Turkey
| | | | - Vijay Kumar
- Department of Microbiology, Kurukshetra University, Kurukshetra, India
| | - Teng Aik Ong
- Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Ricky Adriansjah
- Department of Urology, Faculty of Medicine of Padjadjaran University, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Saleem A. Banihani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Kasonde Bowa
- Department of Urology, University of Lusaka, Lusaka, Zambia
| | - Shinichiro Fukuhara
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | | | - Mohamad Moussa
- Department of Urology, Lebanese University, Beirut, Lebanon
- Department of Urology, Al Zahraa Hospital, UMC, Lebanon
| | - Umut Çağın Ari
- Department of Reproduction, Kafkas University, Kars, Turkey
| | - Chak-Lam Cho
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | | | | | | | - Marco Falcone
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | | | - Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Keshab Kumar Karna
- Department of Molecular Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Kareim Khalafalla
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Urology Department, University of Texas McGovern Medical School, Houston, TX, USA
- Urology Department, MD Anderson Cancer Center, Houston, TX, USA
| | - Ranjit B. Vishwakarma
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Federica Finocchi
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Carlo Giulioni
- Department of Urology, Polytechnic University of Marche Region, Ancona, Italy
| | - Erman Ceyhan
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Gökhan Çeker
- Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
| | - Chadi Yazbeck
- Obstetrics Gynecology and Reproductive Medicine, Reprogynes Medical Institute, Paris, France
| | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Mehmet Yilmaz
- Asklepios Clinic Triberg, Urology, Freiburg, Germany
| | - Baris Altay
- Department of Urology, Ege University, Izmir, Turkey
| | | | - Kay Seong Ngoo
- Hospital Angkatan Tentera Tuanku Mizan, Kuala Lumpur, Malaysia
| | | | - Gianmaria Salvio
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Ates Kadioglu
- Section of Andrology, Department of Urology, Istanbul University, Istanbul, Turkey
| | - Massimiliano Timpano
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Tomer Avidor-Reiss
- Department of Biological Sciences, University of Toledo, Toledo, OH, USA
- Department of Urology and Transplantation, University of Toledo, Toledo, OH, USA
| | - Lukman Hakim
- Department of Urology, Universitas Airlangga, Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Puneet Sindhwani
- Department of Urology, Universitas Airlangga, Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Giorgio Franco
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Rajender Singh
- Division of Endocrinology, Central Drug Research Institute, Lucknow, India
| | - Filippo Giacone
- Centro HERA, Unità di Medicina della Riproduzione, Sant’Agata Li Battiati, Catania, Italy
| | | | - Raghavender Kosgi
- Department of Urology, Andrology and Renal Transplant, AIG Hospitals, Hyderabad, India
| | - Nikolaos Sofikitis
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
| | - Ayad Palani
- Research Centre, University of Garmian, Kalar, Iraq
| | - Gokhan Calik
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Deniz Kulaksız
- Department of Obstetrics and Gynecology, University of Health Sciences Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Davor Jezek
- Department for Transfusion Medicine and Transplantation Biology, Reproductive Tissue Bank, University Hospital Zagreb, Zagreb, Croatia
| | - Manaf Al Hashmi
- Department of Urology, Burjeel Hospital, Abu Dhabi, UAE
- Department of Urology, College of Medicine and Health Science, Khalifa University, Abu Dhabi, UAE
| | - Panagiotis Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- IVF Athens, Athens, Greece
| | - Huda Omran
- Al Aljenan Medical Center, Pulse Health Training Center, Manama, Kingdom of Bahrain
| | - Sofia Leonardi
- Central Laboratory, Hospital Público Materno Infantil de Salta, Salta, Argentina
| | - Ciler Celik-Ozenci
- Department of Histology and Embryology, Faculty of Medicine, Koç University, Istanbul, Turkey
| | - Nur Dokuzeylül Güngör
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | | | - Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan
| | | | | | - Koji Chiba
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Missy Savira
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Luca Boeri
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Edson Borges
- Fertility Assisted Fertilization Center, São Paulo, Brazil
| | - Deepak Gupte
- Department of Urology, Bombay Hospital and Medical Research Center, Mumbai, India
| | - Fatih Gokalp
- Department of Urology, Hatay Mustafa Kemal University, Antakya, Turkey
| | | | - Suks Minhas
- Division of Surgery, Department of Surgery and Cancer, Imperial College, London, UK
| | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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Aliakbari F, Taghizabet N, Rezaei-Tazangi F, Kalantari H, Vosough Dizaj A, Mohammadi M, Sajadi H, Sadighi Gilani MA. Evaluation of Predicting Factors Affecting Sperm Retrieval in Patients with Klinefelter Syndrome: A Prospective Study. Int J Fertil Steril 2023; 17:276-280. [PMID: 37577912 PMCID: PMC10439984 DOI: 10.22074/ijfs.2023.562534.1371] [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] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/05/2023] [Accepted: 05/25/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND This study aimed to evaluate the predicting factors affecting sperm retrieval. We prospectively assessed the relationship between sonographic and microdissection testicular sperm extraction (mTESE) findings in Klinefelter syndrome (KS). MATERIALS AND METHODS In this prospective study, 44 azoospermic men with 47, XXY karyotypes participated in this study. In order to evaluate the amount of blood supply in different parts of testicular tissue, a doppler ultra-sonographic was performed. Also, for the detection of sperm in this group mTESE technique was performed. RESULTS The age average of positive mTESE and negative mTESE groups was 29.4 and 33.6 years, respectively. By comparing the testicle volume (based on the data obtained from the clinical examinations conducted by the urologist) it was determined that there is no significant difference between mTESE positive and negative groups. Folliclestimulating hormone (FSH) levels in men with negative mTESE (P=0.03) and testosterone levels in men with positive mTESE significantly increased (P=0.017). The overall rate of testis vascularity was significantly higher in the positive mTESE group than in the negative mTESE group. The clinical pregnancy rate in positive mTESE men was 9% per cycle, 16.6% per embryos were transferred (ET), and 12.5% per cycle. CONCLUSION Totally, our observation indicated that there is not a significant relationship between sonographic and mTESE results in KS patients. However, more investigations with bigger sample Size can be useful to validate our results.
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Affiliation(s)
- Fereshteh Aliakbari
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Taghizabet
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Rezaei-Tazangi
- Department of Anatomy, School of Medicine, Fasa University of Medical Sciences, Fasa, Iran
| | - Hamid Kalantari
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Urology, Shariati Hosital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Vosough Dizaj
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Maryam Mohammadi
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hesamoddin Sajadi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
- Department of Urology, Shariati Hosital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Urology, Shariati Hosital, Tehran University of Medical Sciences, Tehran, Iran
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11
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Agarwal A, Farkouh A, Saleh R, Abdel-Meguid Hamoda TAA, Harraz AM, Kavoussi P, Arafa M, Salvio G, Rambhatla A, Toprak T, Gül M, Phuoc NHV, Boitrelle F, Birowo P, Ghayda RA, Cannarella R, Kuroda S, Durairajanayagam D, Zini A, Wyns C, Sarikaya S, Tremellen K, Mostafa T, Sokolakis I, Evenson DP, Henkel R, Zohdy W, Chung E, Ziouziou I, Falcone M, Russo GI, Al-Hashimi M, Calogero AE, Ko E, Colpi G, Lewis S, Serefoglu EC, Bahar F, Martinez M, Nguyen Q, Ambar RF, Bakircioglu ME, Kandil H, Mogharabian N, Sabbaghian M, Taniguchi H, Tsujimura A, Sajadi H, Ibrahim W, Atmoko W, Vogiatzi P, Gunes S, Gilani MAS, Roychoudhury S, Güngör ND, Hakim L, Adriansjah R, Kothari P, Jindal S, Amar E, Park HJ, Long TQT, Homa S, Karthikeyan VS, Zilaitiene B, Rosas IM, Marino A, Pescatori E, Ozer C, Akhavizadegan H, Garrido N, Busetto GM, Adamyan A, Al-Marhoon M, Elbardisi H, Dolati P, Darbandi M, Darbandi S, Balercia G, Pinggera GM, Micic S, Ho CCK, Moussa M, Preto M, Zenoaga-Barbăroşie C, Smith RP, Kosgi R, de la Rosette J, El-Sakka AI, Abumelha SM, Mierzwa TC, Ong TA, Banihani SA, Bowa K, Fukuhara S, Boeri L, Danacıoğlu YO, Gokalp F, Selim OM, Cho CL, Tadros NN, Ugur MR, Ozkent MS, Chiu P, Kalkanli A, Khalafalla K, Vishwakarma RB, Finocchi F, Andreadakis S, Giulioni C, Çeker G, Ceyhan E, Malhotra V, Yilmaz M, Timpano M, Barrett TL, Kim SHK, Ahn ST, Giacone F, Palani A, Duarsa GWK, Kadioglu A, Gadda F, Zylbersztejn DS, Aydos K, Kulaksız D, Gupte D, Calik G, Karna KK, Drakopoulos P, Baser A, Kumar V, Molina JMC, Rajmil O, Ferreira RH, Leonardi S, Avoyan A, Sogutdelen E, Franco G, Ramsay J, Ramirez L, Shah R. Controversy and Consensus on Indications for Sperm DNA Fragmentation Testing in Male Infertility: A Global Survey, Current Guidelines, and Expert Recommendations. World J Mens Health 2023; 41:575-602. [PMID: 37118960 PMCID: PMC10307662 DOI: 10.5534/wjmh.220282] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 12/23/2022] [Accepted: 01/02/2023] [Indexed: 04/30/2023] Open
Abstract
PURPOSE Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. MATERIALS AND METHODS Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. RESULTS The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. CONCLUSIONS This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.
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Affiliation(s)
- Ashok Agarwal
- Global Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USA
- Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Ala’a Farkouh
- Global Andrology Forum, American Center for Reproductive Medicine, Moreland Hills, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - 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
| | - Ahmed M. Harraz
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
- Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
| | - Parviz Kavoussi
- Department of Reproductive Urology, Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Gianmaria Salvio
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Amarnath Rambhatla
- Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Murat Gül
- Department of Urology, Selçuk University School of Medicine, Konya, Turkey
| | - Nguyen Ho Vinh Phuoc
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Ponco Birowo
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Ramy Abou Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Christine Wyns
- Department of Gynaecology-Andrology, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Selcuk Sarikaya
- Department of Urology, Gülhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia
| | - Taymour Mostafa
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ioannis Sokolakis
- Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany
| | | | - Ralf Henkel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
- LogixX Pharma, Theale, Berkshire, UK
| | - Wael Zohdy
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
| | - Imad Ziouziou
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Marco Falcone
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | | | - Manaf Al-Hashimi
- Department of Urology, Burjeel Hospital, Abu Dhabi, UAE
- Department of Urology, Clinical Urology, Khalifa University, College of Medicine and Health Sciences, Abu Dhabi, UAE
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Giovanni Colpi
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | | | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Fahmi Bahar
- Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia
| | - Marlon Martinez
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Quang Nguyen
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - 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
| | | | | | - Nasser Mogharabian
- Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Hesamoddin Sajadi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Wael Ibrahim
- Department of Obstetrics Gynaecology and Reproductive Medicine, Fertility Care Center in Cairo, Cairo, Egypt
| | - Widi Atmoko
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility & Reproductive Health Diagnostic Center, Athens, Greece
| | - Sezgin Gunes
- Department of Medical Biology, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Nur Dokuzeylül Güngör
- Department of Obstetrics and Gynecology, Reproductive Endocrinology and IVF Unit, School of Medicine, Bahcesehir University, Istanbul, Turkey
| | - Lukman Hakim
- Department of Urology, Faculty of Medicine Universitas Airlangga, Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Ricky Adriansjah
- Department of Urology, Faculty of Medicine Universitas Padjajaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Priyank Kothari
- Department of Urology, Topiwala National Medical College, B.Y.L Nair Ch Hospital, Mumbai, India
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Edouard Amar
- Department of Urology, American Hospital of Paris, Paris, France
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Tran Quang Tien Long
- Department of Obstetrics and Gynecology, Hanoi Obstetric and Gynecology Hospital, Hanoi, Vietnam
| | - Sheryl Homa
- Department of Biosciences, University of Kent, Canterbury, UK
| | | | - Birute Zilaitiene
- Institute of Endocrinology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | | | - Angelo Marino
- Reproductive Medicine Unit, ANDROS Day Surgery Clinic, Palermo, Italy
| | - Edoardo Pescatori
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | - Cevahir Ozer
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Hamed Akhavizadegan
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia, Policlinico Riuniti, Foggia, Italy
| | - Aram Adamyan
- IVF Department, Astghik Medical Center, Yerevan, Armenia
| | - Mohamed Al-Marhoon
- Division of Urology, Department of Surgery, Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Parisa Dolati
- Department of Animal Science, Faculty of Agriculture, University of Shiraz, Iran
| | - Mahsa Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran
- Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | - Sara Darbandi
- Fetal Health Research Center, Hope Generation Foundation, Tehran, Iran
- Gene Therapy and Regenerative Medicine Research Center, Hope Generation Foundation, Tehran, Iran
| | - Giancarlo Balercia
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | | | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | | | - Mohamad Moussa
- Department of Urology, Lebanese University, Beirut, Lebanon
- Department of Urology, Al Zahraa Hospital, UMC, Lebanon
| | - Mirko Preto
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | | | - Ryan P. Smith
- Department of Urology, University of Virginia School of Medicine, Virginia, USA
| | - Raghavender Kosgi
- Department of Urology, Andrology and Renal Transplant, AIG Hospitals, Hyderabad, India
| | - Jean de la Rosette
- Department of Urology, Istanbul Medipol Mega University Hospital, Istanbul, Turkey
| | | | - Saad Mohammed Abumelha
- Division of Urology, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | | | - Teng Aik Ong
- Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia
| | - Saleem A. Banihani
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Kasonde Bowa
- Department of Urology, University of Lusaka, Lusaka, Zambia
| | - Shinichiro Fukuhara
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Luca Boeri
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Yavuz Onur Danacıoğlu
- Department of Urology, University of Health Science Istanbul Bakırköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Fatih Gokalp
- Department of Urology, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Osama Mohamed Selim
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Chak-Lam Cho
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | | | | | | | - Peter Chiu
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Kareim Khalafalla
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, University of Illinois, Chicago, IL, USA
| | | | - Federica Finocchi
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
- Unit of Andrology and Reproductive Medicine, University of Padua, Padua, Italy
| | | | - Carlo Giulioni
- Department of Urology, Polytechnic University of Marche Region, Ancona, Italy
| | - Gökhan Çeker
- Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
- Department of Embryology and Histology, Zonguldak Bülent Ecevit University Institute of Health Sciences, Zonguldak, Turkey
| | - Erman Ceyhan
- Department of Urology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Vineet Malhotra
- Department of Urology, SCM Clinic and Hospital, New Delhi, India
| | - Mehmet Yilmaz
- Department of Urology, Faculty of Medicine, University of Freiburg-Medical Centre, Freiburg, Germany
| | - Massimiliano Timpano
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | | | - Shannon Hee Kyung Kim
- IVF Australia, Sydney, Australia
- Macquarie School of Medicine, Macquaire University, Sydney, Australia
| | - Sun-Tae Ahn
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Filippo Giacone
- Centro HERA, Unità di Medicina della Riproduzione, Sant'Agata Li Battiati, Catania, Italy
| | - Ayad Palani
- Research Centre, University of Garmian, Kalar, Iraq
| | | | - Ates Kadioglu
- Section of Andrology, Department of Urology, Istanbul University, Istanbul, Turkey
| | - Franco Gadda
- Department of Urology, IRCCS Fondazione Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Kaan Aydos
- Department of Urology, Ankara University, Ankara, Turkey
| | - Deniz Kulaksız
- Department of Obstetrics and Gynecology, University of Health Sciences Kanuni Training and Research Hospital, Trabzon, Turkey
| | - Deepak Gupte
- Department of Urology, Bombay Hospital and Medical Research Center, Mumbai, India
| | - Gokhan Calik
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Keshab Kumar Karna
- Department of Molecular Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA, USA
| | - Panagiotis Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- IVF Athens, Athens, Greece
| | - Aykut Baser
- Department of Urology, Bandirma Onyedi Eylül University, Balikesir, Turkey
| | - Vijay Kumar
- Department of Microbiology, Kurukshetra University, Kurukshetra, India
| | | | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | | | - Sofia Leonardi
- Central Laboratory, Hospital Publico Materno Infantil de Salta, Salta, Argentina
| | - Armen Avoyan
- Urology Department, Astghik Medical Center, Yerevan, Armenia
| | | | - Giorgio Franco
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - Liliana Ramirez
- IVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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12
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Jabari A, Gholami K, Khadivi F, Koruji M, Amidi F, Gilani MAS, Mahabadi VP, Nikmahzar A, Salem M, Movassagh SA, Feizollahi N, Abbasi M. In vitro complete differentiation of human spermatogonial stem cells to morphologic spermatozoa using a hybrid hydrogel of agarose and laminin. Int J Biol Macromol 2023; 235:123801. [PMID: 36842740 DOI: 10.1016/j.ijbiomac.2023.123801] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 10/18/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 02/28/2023]
Abstract
Spermatogenesis refers to the differentiation of the spermatogonial stem cells (SSCs) located in the base seminiferous tubules into haploid spermatozoa. Prerequisites for in vitro spermatogenesis include an extracellular matrix (ECM), paracrine factors, and testicular somatic cells which play a supporting role for SSCs. Thus, the present study evaluated the potential of co-culturing Sertoli cells and SSCs embedded in a hybrid hydrogel of agarose and laminin, the main components of the ECM. Following the three-week conventional culture of human testicular cells, the cells were cultured in agarose hydrogel or agarose/laminin one (hybrid) for 74 days. Then, immunocytochemistry, real-time PCR, electron microscopy, and morphological staining methods were applied to analyze the presence of SSCs, as well as the other cells of the different stages of spermatogenesis. Based on the results, the colonies with positive spermatogenesis markers were observed in both culture systems. The existence of the cells of all three phases of spermatogenesis (spermatogonia, meiosis, and spermiogenesis) was confirmed in the two groups, while morphological spermatozoa were detected only in the hybrid hydrogel group. Finally, a biologically improved 3D matrix can support all the physiological activities of SSCs such as survival, proliferation, and differentiation.
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Affiliation(s)
- Ayob Jabari
- Department of Obstetrics and Gynecology, Molud Infertility Center, Zahedan University of Medical Sciences, Zahedan, Iran; Cellular and Molecular Research Center, Research Institute of Cellular and Molecular Science in Infectious Diseases, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Keykavos Gholami
- Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Khadivi
- Department of Anatomy, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Morteza Koruji
- Cellular and Molecular Research Center & Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Aghbibi Nikmahzar
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Salem
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Narjes Feizollahi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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13
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Kalantari H, Sabbaghian M, Vogiatzi P, Rambhatla A, Agarwal A, Colpi GM, Sadighi Gilani MA. Bridging the Gap between AZF Microdeletions and Karyotype: Twelve Years' Experience of an Infertility Center. World J Mens Health 2023:41.e7. [PMID: 36593709 DOI: 10.5534/wjmh.220089] [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: 05/15/2022] [Revised: 08/13/2022] [Accepted: 08/31/2022] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Despite all past efforts, the current guidelines are not explicit enough regarding the indications for performing azoospermia factor (AZF) screening and karyotype, burdening clinicians with the decision to assess whether such tests are meaningful for the infertile male patient. These assessments can be costly and it is up to the healthcare practitioner to decide which are necessary and to weigh the benefits against economic/psychological harm. The aim of this study is to address such gaps and provide update on current management options for this group of patients. MATERIALS AND METHODS To address such gaps in male infertility management and to elucidate whether AZF screening is indicated in individuals who concomitantly harbor chromosomal abnormalities we conducted a retrospective cohort analysis of 10,388 consecutive patients with non-obstructive azoospermia (NOA) and severe oligozoospermia. RESULTS Previously, it has been suggested that all NOA cases with chromosomal defects, except males with 46,XY/45,X karyotype, have no indication for AZF screening. Our findings revealed that cases carrying the following chromosomal abnormalities inv(Y)(p11.2q12); idic(Y)(q11.2); 46,XY,r(Y); idic(Y)(p11.2) and der(Y;Autosome) (76/169; 44.9%; 95% CI, 37.7-52.5) should also be referred for AZF deletion screening. Here, we also report the correlation between sperm count and AZF deletions as a secondary outcome. In accordance with previously reported data from North America and Europe, our data revealed that only 1% of cases with >1×106 sperm/mL had Y chromosome microdeletions (YCMs). CONCLUSIONS In the era of assisted reproduction, finding cost-minimization strategies in infertility clinics without affecting the quality of diagnosis is becoming one of the top prioritized topics for future research. From a diagnostic viewpoint, the results reflect a need to reconsider the different karyotype presentations and the sperm count thresholds in male infertility guidelines as indicators for YCM screening during an infertility evaluation.
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Affiliation(s)
- Hamid Kalantari
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Reproductive Health Diagnostic Center, Athens, Greece
| | - Amarnath Rambhatla
- Vattikuti Urology Institute, Department of Urology, Henry Ford Hospital, Detroit, MI, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Global Andrology Forum, Moreland Hills, OH, USA
| | - Giovanni M Colpi
- Andrology and IVF Unit, Next Fertility Procrea, Lugano, Switzerland
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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14
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Shah R, Agarwal A, Kavoussi P, Rambhatla A, Saleh R, Cannarella R, Harraz AM, Boitrelle F, Kuroda S, Hamoda TAAAM, Zini A, Ko E, Calik G, Toprak T, Kandil H, Gül M, Bakırcıoğlu ME, Parekh N, Russo GI, Tadros N, Kadioglu A, Arafa M, Chung E, Rajmil O, Dimitriadis F, Malhotra V, Salvio G, Henkel R, Le TV, Sogutdelen E, Vij S, Alarbid A, Gudeloglu A, Tsujimura A, Calogero AE, El Meliegy A, Crafa A, Kalkanli A, Baser A, Hazir B, Giulioni C, Cho CL, Ho CCK, Salzano C, Zylbersztejn DS, Tien DMB, Pescatori E, Borges E, Serefoglu EC, Saïs-Hamza E, Huyghe E, Ceyhan E, Caroppo E, Castiglioni F, Bahar F, Gokalp F, Lombardo F, Gadda F, Duarsa GWK, Pinggera GM, Busetto GM, Balercia G, Cito G, Blecher G, Franco G, Liguori G, Elbardisi H, Keskin H, Lin H, Taniguchi H, Park HJ, Ziouziou I, de la Rosette J, Hotaling J, Ramsay J, Molina JMC, Lo KL, Bocu K, Khalafalla K, Bowa K, Okada K, Nagao K, Chiba K, Hakim L, Makarounis K, Hehemann M, Rodriguez Peña M, Falcone M, Bendayan M, Martinez M, Timpano M, Altan M, Fode M, Al-Marhoon MS, Sadighi Gilani MA, Soebadi MA, Gherabi N, Sofikitis N, Kahraman O, Birowo P, Kothari P, Sindhwani P, Javed Q, Ambar RF, Kosgi R, Ghayda RA, Adriansjah R, Condorelli RA, La Vignera S, Micic S, Kim SHK, Fukuhara S, Ahn ST, Mostafa T, Ong TA, Takeshima T, Amano T, Barrett T, Arslan U, Karthikeyan VS, Atmoko W, Yumura Y, Yuan Y, Kato Y, Jezek D, Cheng BKC, Hatzichristodoulou G, Dy J, Castañé ER, El-Sakka AI, Nguyen Q, Sarikaya S, Boeri L, Tan R, Moussa MA, El-Assmy A, Alali H, Alhathal N, Osman Y, Perovic D, Sajadi H, Akhavizadegan H, Vučinić M, Kattan S, Kattan MS, Mogharabian N, Phuoc NHV, Ngoo KS, Alkandari MH, Alsuhaibani S, Sokolakis I, Babaei M, King MS, Diemer T, Gava MM, Henrique R, Silva RSE, Paul GM, Mierzwa TC, Glina S, Siddiqi K, Wu H, Wurzacher J, Farkouh A, Son H, Minhas S, Lee J, Magsanoc N, Capogrosso P, Albano GJ, Lewis SEM, Jayasena CN, Alvarez JG, Teo C, Smith RP, Chua JBM, Jensen CFS, Parekattil S, Finelli R, Durairajanayagam D, Karna KK, Ahmed A, Evenson D, Umemoto Y, Puigvert A, Çeker G, Colpi GM. Consensus and Diversity in the Management of Varicocele for Male Infertility: Results of a Global Practice Survey and Comparison with Guidelines and Recommendations. World J Mens Health 2023; 41:164-197. [PMID: 35791302 PMCID: PMC9826919 DOI: 10.5534/wjmh.220048] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [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: 03/08/2022] [Revised: 03/15/2022] [Accepted: 03/20/2022] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Varicocele is a common problem among infertile men. Varicocele repair (VR) is frequently performed to improve semen parameters and the chances of pregnancy. However, there is a lack of consensus about the diagnosis, indications for VR and its outcomes. The aim of this study was to explore global practice patterns on the management of varicocele in the context of male infertility. MATERIALS AND METHODS Sixty practicing urologists/andrologists from 23 countries contributed 382 multiple-choice-questions pertaining to varicocele management. These were condensed into an online questionnaire that was forwarded to clinicians involved in male infertility management through direct invitation. The results were analyzed for disagreement and agreement in practice patterns and, compared with the latest guidelines of international professional societies (American Urological Association [AUA], American Society for Reproductive Medicine [ASRM], and European Association of Urology [EAU]), and with evidence emerging from recent systematic reviews and meta-analyses. Additionally, an expert opinion on each topic was provided based on the consensus of 16 experts in the field. RESULTS The questionnaire was answered by 574 clinicians from 59 countries. The majority of respondents were urologists/uro-andrologists. A wide diversity of opinion was seen in every aspect of varicocele diagnosis, indications for repair, choice of technique, management of sub-clinical varicocele and the role of VR in azoospermia. A significant proportion of the responses were at odds with the recommendations of AUA, ASRM, and EAU. A large number of clinical situations were identified where no guidelines are available. CONCLUSIONS This study is the largest global survey performed to date on the clinical management of varicocele for male infertility. It demonstrates: 1) a wide disagreement in the approach to varicocele management, 2) large gaps in the clinical practice guidelines from professional societies, and 3) the need for further studies on several aspects of varicocele management in infertile men.
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Affiliation(s)
- Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, TX, USA
| | - Amarnath Rambhatla
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ahmed M Harraz
- 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
| | - Florence Boitrelle
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Shinnosuke Kuroda
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, 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
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - 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
| | | | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | | | - Neel Parekh
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ates Kadioglu
- Section of Andrology, Department of Urology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
| | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Fotios Dimitriadis
- Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gianmaria Salvio
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Ralf Henkel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Tan V Le
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | | | - Sarah Vij
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Abdullah Alarbid
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
| | - Ahmet Gudeloglu
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Akira Tsujimura
- Department of Urology, Juntendo University Urayasu Hospital, Chiba, Japan
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Amr El Meliegy
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Arif Kalkanli
- Department of Urology, Taksim Education and Research Hospital, Istanbul, Turkey
| | - Aykut Baser
- Department of Urology, Faculty of Medicine, Bandırma Onyedi Eylül University, Balıkesir, Turkey
| | - Berk Hazir
- Reproductive medicine, Clinical Research Centre, Lund University, Malmö, Sweden
| | - Carlo Giulioni
- Department of Urology, Polytechnic University of Marche Region, Ancona, Italy
| | - Chak-Lam Cho
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Christopher C K Ho
- Department of Urology, Universiti Teknologi Mara (UiTM) Specialist Centre, Selangor, Malaysia
| | - Ciro Salzano
- PO San Giovanni Bosco, ASL Napoli 1 Centro, Napoli, Italy
| | | | - Dung Mai Ba Tien
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Edoardo Pescatori
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | | | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Emine Saïs-Hamza
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Eric Huyghe
- Department of Urology and Andrology, University Hospital of Toulouse, France
| | - Erman Ceyhan
- Department of Urology, School of Medicine, Baskent University, Konya, Turkey
| | - Ettore Caroppo
- Asl Bari, PTA "F Jaia", Reproductive and IVF unit, Andrology Outpatients Clinic, Asl Bari, Conversano (Ba), Italy
| | | | - Fahmi Bahar
- Andrology Section, Siloam Sriwijaya Hospital, Palembang, Indonesia
| | - Fatih Gokalp
- Department of Urology, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Francesco Lombardo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, University of Rome "Sapienza", Rome, Italy
| | - Franco Gadda
- Department of Urology, IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy
| | - Giancarlo Balercia
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Gianmartin Cito
- Department of Urology, University of Florence, Florence, Italy
| | - Gideon Blecher
- Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia
- Department of Urology, The Alfred Hospital, Melbourne, Australia
| | - Giorgio Franco
- Department of Urology, Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | | | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Hakan Keskin
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Peking University, Beijing, China
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Imad Ziouziou
- Department of Urology, College of medicine and pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Jean de la Rosette
- Department of urology, Faculty of Medicine, Istanbul Medipol Mega University Hospital, Istanbul, Turkey
| | - Jim Hotaling
- Department of Surgery (Urology), University of Utah, Salt Lake City, UT, USA
| | - Jonathan Ramsay
- Department of Andrology, Hammersmith Hospital, Imperial, London, UK
| | | | - Ka Lun Lo
- Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Kadir Bocu
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | - Kareim Khalafalla
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, University of Illinois, Chicago, IL, USA
| | - Kasonde Bowa
- Department of Urology, School of Medicine and Health Sciences, University of Lusaka, Lusaka, Zambia
| | - Keisuke Okada
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koichi Nagao
- Department of Urology, Toho University Faculty of Medicine, Tokyo, Japan
| | - Koji Chiba
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Lukman Hakim
- Department of Urology, Universitas Airlangga/Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | | | - Marah Hehemann
- Department of Urology, University of Washington, Seattle, WA, USA
| | - Marcelo Rodriguez Peña
- Instituto de Ginecología y Fertilidad (IFER), Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Marco Falcone
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Marion Bendayan
- Department of Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment and Development, Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Marlon Martinez
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Massimiliano Timpano
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Mesut Altan
- Department of Urology, Haceppete University, Ankara, Turkey
| | - Mikkel Fode
- Department of Urology, Herlev and Gentofte University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Nazim Gherabi
- Andrology Committee of the Algerian Association of Urology, Algiers, Algeria
| | - Nikolaos Sofikitis
- Department of Urology, Ioannina University School of Medicine, Ioannina, Greece
| | - Oğuzhan Kahraman
- Department of Urology, School of Medicine, Baskent University, Konya, Turkey
| | - Ponco Birowo
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | | | - Puneet Sindhwani
- Department of Urology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Qaisar Javed
- Department of Urology, Al - Ahlia Hospital Abu Dhabi UAE, Abu Dhabi, UAE
| | - 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
| | - Raghavender Kosgi
- Department of Urology and Andrology, AIG Hospitals, Hyderabad, Telangana, India
| | - Ramy Abou Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Ricky Adriansjah
- Department of Urology, Faculty of Medicine Universitas Padjadjaran, Hasan Sadikin General Hospital, Banding, Indonesia
| | | | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Shannon Hee Kyung Kim
- IVF Australia, Sydney, New South Wales, Australia
- Macquarie School of Medicine, Macquaire University, Sydney, New South Wales, Australia
| | - Shinichiro Fukuhara
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Sun Tae Ahn
- Department of Urology, Korea University College of Medicine, Seoul, Korea
| | - Taymour Mostafa
- Department of Andrology, Sexology and STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Teng Aik Ong
- Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Teppei Takeshima
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan
| | | | - Umut Arslan
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Widi Atmoko
- Department of Urology and Andrology, AIG Hospitals, Hyderabad, Telangana, India
| | - Yasushi Yumura
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yiming Yuan
- Andrology Center & Urology Department, Peking University First Hospital, Peking University, Beijing, China
| | - Yuki Kato
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Davor Jezek
- Department for Transfusion Medicine and Transplantation Biology, Reproductive Tissue Bank, University of Zagreb, School of Medicine, University Hospital Zagreb, Zagreb, Croatia
| | | | | | - Jun Dy
- Stone and Prostate Treatment Services/Pelvic Floor Center and Anorectal Diseases, St. Luke's Medical Center, Quezon City, Metro Manila, Philippines
| | - Eduard Ruiz Castañé
- Department of Andrology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ahmed I El-Sakka
- Department of Urology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Quang Nguyen
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Selcuk Sarikaya
- Department of Urology, Gülhane Research and Training Hospital, University of Health Sciences, Ankara, Turkey
| | - Luca Boeri
- Department of Urology, IRCCS Fondazione Ca Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Ronny Tan
- Advanced Urology Associates, Singapore
- Mount Elizabeth Hospital, Singapore
| | - Mohamad A Moussa
- Department of Urology, Lebanese University, Beirut, Lebanon
- Department of Urology, Al Zahraa Hospital, UMC, Lebanon
| | - Ahmed El-Assmy
- Mansoura University Urology and Nephrology Center, Mansoura, Egypt
| | - Hamed Alali
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Naif Alhathal
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Yasser Osman
- Mansoura University Urology and Nephrology Center, Mansoura, Egypt
| | - Dragoljub Perovic
- Urology and Andrology Center, CODRA Hospital, University of Montenegro, Podgorica, Montenegro
| | | | - Hamed Akhavizadegan
- Department of Urology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Said Kattan
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohamed S Kattan
- King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Nasser Mogharabian
- Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | | | - Kay Seong Ngoo
- Urology Unit, Department of Surgery, Hospital Angkatan Tentera Tuanku Mizan, Kuala Lumpur, Malaysia
| | - Mohammad H Alkandari
- Department of Urology, Mubarak Al-Kabeer Teaching Hospital, Kuwait University, Jabriya, Kuwait
| | - Shaheed Alsuhaibani
- Department of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ioannis Sokolakis
- Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany
| | - Mehdi Babaei
- Department of Andrology, Shariati Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mak Siu King
- Division of Urology, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China
| | - Thorsten Diemer
- Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University Giessen (GER), University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany
| | - Marcelo M Gava
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
- Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | | | - Rodrigo Spinola E Silva
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
- Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Gustavo Marquesine Paul
- Department of Urology, Hospital de Clínicas of the Federal University of Paraná, Curitiba, Brazil
| | | | - Sidney Glina
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
| | | | - Han Wu
- Department of Andrology, PKU 3rd Hospital Reproductive Medicine Center, Beijing, China
| | - Jana Wurzacher
- Department of Urology, University Hospital Innsbruck, Innsbruck, Austria
| | - Ala'a Farkouh
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Hwancheol Son
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Suks Minhas
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Joe Lee
- Department of Urology, National University Hospital, Singapore
| | - Nikko Magsanoc
- Department of Surgery, University of the Philippines College of Medicine, Manila, Philippines
| | | | - German Jose Albano
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | | | - Channa N Jayasena
- Department of Reproductive Endocrinology and Andrology, Imperial College London, London, UK
- Department of Andrology, Hammersmith & St. Mary's Hospitals, London, UK
| | - Juan G Alvarez
- Department of Andrology, Centro ANDROGEN, La Coruña, Spain
| | - Colin Teo
- Department of Urology, Gleneagles Hospital, Singapore
| | - Ryan P Smith
- Department of Urology, University of Virginia School of Medicine, Virginia, USA
| | - Jo Ben M Chua
- Department of Urology, East Avenue Medical Center, Quezon City, Philippines
| | | | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Keshab Kumar Karna
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Abdelkareem Ahmed
- Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
| | | | - Yukihiro Umemoto
- Department of Nephro-Urology, Nagoya City West Medical Center, Nagoya, Japan
| | - Ana Puigvert
- Urological and Human Reproduction Unit, Quiron Hospital, Barcelona, Spain
| | - Gökhan Çeker
- Department of Urology, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey
- Department of Embryology and Histology, Zonguldak Bülent Ecevit University Institute of Health Sciences, Zonguldak, Turkey
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15
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Abbasihormozi S, Kouhkan A, Shahverdi A, Sadighi Gilani MA, Babapour V, Niasari Naslji A, Akbarinehad V, Alizadeh A. Nuclear Factor Kappa-B Protein Levels in Sperm of Obese Men with and without Diabetes; Cellular Approach in Male Infertility. Cell J 2023; 25:17-24. [PMID: 36680480 PMCID: PMC9868436 DOI: 10.22074/cellj.2022.557547.1065] [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] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Although the role of obesity and diabetes mellitus (DM) in male infertility is well established, little information about the underlying cellular mechanisms in infertility is available. In this sense, nuclear factor kappa-B (NF-kB) has been recognized as an important regulator in obesity and DM; However, its function in the pathogenesis of male infertility has never been studied in obese or men who suffer from diabetes. Therefore, the main goal of current research is assessing NF-kB existence and activity in ejaculated human spermatozoa considering the obesity and diabetics condition of males. MATERIALS AND METHODS In an experimental study, the ELISA technique was applied to analyze NF-kB levels in sperm of four experimental groups: non-obese none-diabetic men (body mass index (BMI) <25 kg/m2; control group; n=30), obese non-diabetic men (BMI >30 kg/m2; OB group; n=30), non-obese diabetic men (BMI <25 kg/m2; DM group; n=30), and obese diabetic men (BMI >30 kg/m2; OB-DM group; n=30) who were presented to Royan Institute Infertility Center. In addition, protein localization was shown by Immunocytofluorescent assay. Sperm features were also evaluated using CASA. RESULTS The diabetic men were older than non-diabetic men regardless of obesity status (P=0.0002). Sperm progressive motility was affected by obesity (P=0.035) and type A sperm progressive motility was affected by DM (P=0.034). The concentration of sperm (P=0.013), motility (P=0.025) and morphology (P<0.0001) were altered by obesity × diabetes interaction effects. The NF-kB activity was negatively influenced by the main impact of diabetics (P=0.019). Obesity did not affect (P=0.248) NF-kB activity. Uniquely, NF-kB localized to the midpiece of sperm and post-acrosomal areas. CONCLUSION The current study indicated a lower concentration of NF-kB in diabetic men, no effect of obesity on NF-kB was observed yet. Additionally, we revealed the main obesity and diabetes effects, and their interaction effect adversely influenced sperm characteristics.
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Affiliation(s)
- Shima Abbasihormozi
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine,
ACECR, Tehran, Iran
| | - Azam Kouhkan
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Abdolhossein Shahverdi
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine,
ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Vahab Babapour
- Department of Basic Science, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Amir Niasari Naslji
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Vahid Akbarinehad
- Department of Theriogenology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - AliReza Alizadeh
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine,
ACECR, Tehran, Iran ,P.O.Box: 16635-148Department of EmbryologyReproductive Biomedicine Research CenterRoyan
Institute for Reproductive BiomedicineACECRTehranIran
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16
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Habibi M, Fakhari Zavareh Z, Abbasi B, Esmaeili V, Shahverdi A, Sadighi Gilani MA, Tavalaee M, Nasr-Esfahani MH. Alpha-Lipoic Acid Supplementation for Male Partner of Couples with Recurrent Pregnancy Loss: A Post hoc analysis in Clinical Trial. Int J Fertil Steril 2023; 17:67-74. [PMID: 36617206 PMCID: PMC9807888 DOI: 10.22074/ijfs.2022.543027.1222] [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] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Increased sperm DNA damage is known as one of the causes of recurrent pregnancy loss (RPL) which can be due to increased levels of oxidative stress. Therefore, the aim of this study was to assess the effect of alpha-lipoic acid (ALA) on sperm parameters and sperm functions in couples with a history of RPL. MATERIALS AND METHODS In this post hoc analysis in clinical trial study, a total of 37 couples with RPL (n=12 and n=25 for placebo and ALA groups, respectively) were considered. Men were treated with ALA (600 mg/day) or placebo for 80 days. Semen samples were acquired from the participants before initiation and after completion of the medication course and assessed regarding conventional sperm parameters, chromatin damage/integrity, intracellular oxidative stress, lipid peroxidation, and seminal antioxidant characteristics. Individuals were further followed up for twelve months for pregnancy occurrence and outcomes. Finally, after excluding patients with no history of RPL, the data was analyzed. RESULTS No significant differences were observed between the baseline measures of the aforementioned parameters except for seminal volume. After the intervention, the mean sperm DNA damage, protamine deficiency, and persisted histones were significantly lower in the ALA group than in placebo receivers (P<0.05). A decrease in the mean of seminal total antioxidant capacity (P=0.03), malondialdehyde (P=0.02), and sperm DNA damage (P=0.004) as well as an increase in sperm total motility (P=0.04) after treatment with ALA was noticed. In addition, the mean of protamine deficiency and persisted histones were declined post-ALA therapy (P=0.003 and 0.002, respectively). The percentage of spontaneous pregnancy in the ALA group (4 of 25 cases; 16%) was higher than in the placebo group (1 of 12, 8.3%). CONCLUSION ALA-therapy attenuates sperm DNA damage and lipid peroxidation while enhancing sperm total motility and chromatin compaction in the male partner of couples with PRL (registration number: IRCT20190406043177N1).
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Affiliation(s)
- Masoud Habibi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive
Biomedicine, ACECR, Tehran, Iran
| | - Zohreh Fakhari Zavareh
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive
Biomedicine, ACECR, Tehran, Iran
| | - Behzad Abbasi
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology,
ACECR, Isfahan, Iran,Isfahan Fertility and Infertility Center, Isfahan, Iran
| | - Vahid Esmaeili
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive
Biomedicine, ACECR, Tehran, Iran
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive
Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine,
ACECR, Tehran, Iran
| | - Marziyeh Tavalaee
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology,
ACECR, Isfahan, Iran,P.O.Box: 8165131378Department of Animal BiotechnologyReproductive Biomedicine Research CenterRoyan Institute for BiotechnologyACECRIsfahanIran
Emails:,
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology,
ACECR, Isfahan, Iran,Isfahan Fertility and Infertility Center, Isfahan, Iran,P.O.Box: 8165131378Department of Animal BiotechnologyReproductive Biomedicine Research CenterRoyan Institute for BiotechnologyACECRIsfahanIran
Emails:,
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17
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Habibi M, Abbasi B, Fakhari Zavareh Z, Esmaeili V, Shaverdi A, Sadighi Gilani MA, Tavalaee M, Nasr Esfahani MH. Alpha-Lipoic Acid Ameliorates Sperm DNA Damage and Chromatin Integrity in Men with High DNA Damage: A Triple Blind Randomized Clinical Trial. Cell J 2022; 24:603-611. [PMID: 36259478 PMCID: PMC9617023 DOI: 10.22074/cellj.2022.8273] [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] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 03/06/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Evidence suggests the contributory role of oxidative stress (OS) to sperm DNA damage and eventually, male infertility. Antioxidant supplementation has exhibited favorable results regarding seminal OS, sperm DNA damage, and chromatin integrity. We aimed to evaluate the effect of alpha-lipoic acid (ALA) supplementation on semen analysis, sperm DNA damage, chromatin integrity, and seminal/intracellular OS in infertile men with high sperm DNA damage. MATERIALS AND METHODS In this randomized triple-blind placebo-controlled clinical trial study, we opted for a triple-blind controlled clinical trial design. Considering the study's inclusion criteria for the level of sperm DNA fragmentation (higher than the threshold of 30 and 15%), 70% of participants were selected for this clinical research study. Subjects were divided into case and control groups receiving oral ALA (600 mg/day) and placebo for eighty days, respectively. Sperm parameters and functional tests were examined and compared before and after treatment. The final sample size was 34 and 29 for ALA and placebo receivers, respectively. RESULTS No significant differences were observed about anthropometrics and baseline measures of semen analysis, DNA damage, OS, and chromatin integrity between the two groups. Conventional semen parameters were enhanced insignificantly in both groups (P>0.05). DNA damage decreased significantly in the ALA group, as per sperm chromatin structure assay (SCSA, P<0.001). Moreover, chromomycin A3 (CMA3) staining results indicated a decrease in nuclear protamine deficiency post-ALA therapy (P=0.004). Lipid peroxidation decreased significantly after treatment with ALA (P=0.003). Further, seminal antioxidant capacity/activity did not differ significantly in either of the groups (registration number: IRCT20190406043177N1). CONCLUSION An 80-day course of oral ALA supplementation (600 mg/day) alleviates sperm OS, DNA damage, and chromatin integrity in men with high sperm DNA damage.
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Affiliation(s)
- Masoud Habibi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Behzad Abbasi
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
- Isfahan Fertility and Infertility Center, Isfahan, Iran
| | - Zohreh Fakhari Zavareh
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Vahid Esmaeili
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Abdolhossein Shaverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marziyeh Tavalaee
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mohammad Hossein Nasr Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
- Isfahan Fertility and Infertility Center, Isfahan, Iran
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18
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Sabbaghian M, Hosseinifar H, Rafaee A, Gilani MAS. Assessment of the Impact Induced by Different Incubation Time, Storage Time, Storage Medium and Thawing Methods on Sperm DNA Fragmentation Assay: A Before-After Study. J Hum Reprod Sci 2022; 15:377-381. [PMID: 37033135 PMCID: PMC10077746 DOI: 10.4103/jhrs.jhrs_145_22] [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: 09/30/2022] [Revised: 11/09/2022] [Accepted: 12/05/2022] [Indexed: 04/11/2023] Open
Abstract
Background The sperm DNA fragmentation has been considered an important index in the field of male infertility. Aims Our study aims to evaluate the impact of different factors, including incubation time, storage time, storage medium and method of thawing, on DNA fragmentation of semen samples. Settings and Design This study was designed as a before-after study in five experiments. Materials and Methods Experiment 1 was conducted to assess the effect of storage time in liquid nitrogen on 15 semen samples. In experiment 2, DNA fragmentation was performed on 10 semen samples with different incubation times before freezing. In experiments 3, 4, two different storage media and thawing methods were applied respectively in two separate groups, each containing 30 samples and the DNA fragmentation index (DFI) was measured using the sperm chromatin structure assay method. Statistical Analysis Data were analysed using Stata version 11. Results There was a significant increase in sperm DNA fragmentation of samples stored in liquid nitrogen for 1 month. This increase occurred in the first 2 weeks. Furthermore, our results showed a significant increase in the DFI after 120 min of incubation at room temperature (RT) and also thawing in RT separately. Conclusion It is better to use fresh samples to measure DNA fragmentation up to 2 h after ejaculation to achieve more accurate results. Furthermore, if sperm freezing is inevitable, the use of a water bath (37°C) to thaw will be the most appropriate option, as it can lead to less DNA damage.
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Affiliation(s)
- Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Hani Hosseinifar
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Alemeh Rafaee
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sadeghiani G, Khanehzad M, Sadighi Gilani MA, Amidi F, Malekzadeh M, Rastegar T. Evaluation of Nrf2/ARE Signaling Pathway in the Presence of Pentoxifylline as a Cryoprotectant in Mouse Spermatogonial Stem Cells. Biopreserv Biobank 2022. [PMID: 36006661 DOI: 10.1089/bio.2021.0167] [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: 11/12/2022] Open
Abstract
The process of spermatogonial stem cell cryopreservation (SSCs) in young male cancer survivors is associated with increased reactive oxygen species (ROS), DNA fragmentation, apoptosis, decreased cell activity, and finally reduced fertility of SSCs. Therefore, it is necessary to add cryoprotectants to the freezing medium to minimize the injuries associated with cryopreservation. In addition, the Nrf2/ARE pathway is a main cellular pathway that regulates the antioxidant defense system. The purpose of this study was to evaluate the cryoprotective effect of pentoxifylline (PTX) on SSCs after freezing-thawing through the Nrf2/ARE pathway. SSCs extracted from neonatal mice testes were isolated and their purity was measured by flow cytometry with GDNF family receptor alpha-1 (GFRα1) and inhibitor of differentiation 4 (ID4). After culturing, the cells were frozen in different groups for 1 month. After freezing-thawing, cell viability, colonization rate, and intracellular ROS, malondialdehyde (MDA), superoxide dismutase (SOD), and catalase (CAT) were evaluated. Quantitative real-time polymerase chain reaction and western blotting were done to assess the expression levels of Nrf2, Keap-1, PI3K, and AKT genes and proteins. The survival and colonization rates of SSCs, SOD, and CAT levels, and Nrf2, PI3K, and AKT expression levels were significantly higher in the PTX group compared with the other cryopreservation groups. The Keap-1 expression level and the ROS and MDA production levels also decreased significantly in the PTX group (p-value <0.05). According to our findings, PTX can activate the antioxidant defense through the Nrf2/ARE signaling pathway; therefore, it could be a suitable cryoprotectant candidate for freezing and long-term storage of SSCs in the clinical setting.
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Affiliation(s)
- Ghazaleh Sadeghiani
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Khanehzad
- Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for reproductive Biomedicine, ACECR, Tehran, Iran
| | - Fardin Amidi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnoush Malekzadeh
- Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tayebeh Rastegar
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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20
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Zarei S, Dehghan SF, Vaziri MH, Gilani MAS, Ardakani SK. Assessment of semen quality of taxi drivers exposed to whole body vibration. J Occup Med Toxicol 2022; 17:16. [PMID: 35922802 PMCID: PMC9347065 DOI: 10.1186/s12995-022-00357-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
Whole body vibration (WBV) is a recognized occupational hazard for many workers such as drivers and operators of heavy and light machinery and exposure to it is accompanied by physical and mental repercussions. Only the limited studies have been done on the effects of vibration exposure on reproductive indices, however vibration exposure has been indicated as being a hazardous agents with the potential of being able to directly affect the reproductive system. Considering the importance of infertility, the present study was conducted with the aim of investigating semen quality among taxi drivers in Tehran and determine the effect of exposure to WBV on sperm parameters. The study population consisted of 70 taxi drivers and 70 office employee who attended infertility clinics for diagnostic purposes in the past year. The participants had to meet the entry criteria of the study while also being willing to recruit. Data was collected in the form of demographic questionnaires and general health questionnaires as well as sperm analysis conducted in an infertility clinic according to standard laboratory guidelines. The 8-hour time-weighted average (TWA) exposure to of WBV in automobile was measured as per ISO 2631-1. The TWA exposure to WBV among the taxi drivers and office employees were 0.697 ± 0.13 m/s2 and 0.068 ± 0.09 m/s2 respectively (P < 0.05). A statistically significant difference in total sperm count, progressive motility, non-progressive motility and total motility was observed between the taxi drivers and the office employees (P < 0.05). According to the univariate analysis of variance, exposure to WBV had negative effect on sperm concentration, progressive motility and normal morphology (P > 0.05); moreover exposure to WBV resulted in the larger effect size (B) on sperm parameters than the demographic variables (P > 0.05). Being taxi drivers increase the chance of the decreased semen quality (P > 0.05). It is difficult to draw definitive conclusions regarding the effects of WBV while intervening factors exist, such as psychological stressors, quality of sleep, background issues as well as environmental factors such as chemical pollutants (heavy metals) or ergonomic factors (body posture and working while sitting down).
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Affiliation(s)
- Sirvan Zarei
- Workplace Health Promotion Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Farhang Dehghan
- Workplace Health Promotion Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohammad Hossein Vaziri
- Workplace Health Promotion Research Center, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Urology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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21
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Akhavizadegan H, Sadighi Gilani MA, Jannati NA, Heidari M. Sperm Retrieval in Non-azoospermic Patients with Persistent Ejaculation Dysfunction. J Reprod Infertil 2022; 23:141-147. [DOI: 10.18502/jri.v23i3.10004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Infertility is a common disease that affects 15 to 20% of couples at some point in their lives. Among infertile couples, male factor accounts for 50% of infertile cases. Assisted reproductive techniques are the gold standard approach in case of failure in medical or surgical treatments. Moreover, the role of the urologist in these approaches is to provide appropriate sperm on the day of oocyte pick-up. However, sperm retrieval procedure is quite different in azoospermic and non-azoospermic men. Although most cases of infertile patients are not azoospermic, their ejaculation disorder prevents obtaining sperm for assisted reproductive techniques. This review article explains common problems of sperm retrieval in non-azoospermic patients with persistent ejaculatory dysfunction and introduces some management strategies. In fact, it is possible to design a classic approach for managing such patients, which definitely reduces the problems faced by clinicians as well.
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22
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Agarwal A, Gupta S, Sharma RK, Finelli R, Kuroda S, Vij SC, Boitrelle F, Kavoussi P, Rambhatla A, Saleh R, Chung E, Mostafa T, Zini A, Ko E, Parekh N, Martinez M, Arafa M, Tadros N, de la Rosette J, Le TV, Rajmil O, Kandil H, Blecher G, Liguori G, Caroppo E, Ho CCK, Altman A, Bajic P, Goldfarb D, Gill B, Zylbersztejn DS, Molina JMC, Gava MM, Cardoso JPG, Kosgi R, Çeker G, Zilaitiene B, Pescatori E, Borges E, Duarsa GWK, Pinggera GM, Busetto GM, Balercia G, Franco G, Çalik G, Sallam HN, Park HJ, Ramsay J, Alvarez J, Khalafalla K, Bowa K, Hakim L, Simopoulou M, Rodriguez MG, Sabbaghian M, Elbardisi H, Timpano M, Altan M, Elkhouly M, Al-Marhoon MS, Sadighi Gilani MA, Soebadi MA, Nasr-Esfahani MH, Garrido N, Vogiatzi P, Birowo P, Patel P, Javed Q, Ambar RF, Adriansjah R, AlSaid S, Micic S, Lewis SE, Mutambirwa S, Fukuhara S, Parekattil S, Ahn ST, Jindal S, Takeshima T, Puigvert A, Amano T, Barrett T, Toprak T, Malhotra V, Atmoko W, Yumura Y, Morimoto Y, Lima TFN, Kunz Y, Kato Y, Umemoto Y, Colpi GM, Durairajanayagam D, Shah R. Post-Vasectomy Semen Analysis: Optimizing Laboratory Procedures and Test Interpretation through a Clinical Audit and Global Survey of Practices. World J Mens Health 2022; 40:425-441. [PMID: 35021311 PMCID: PMC9253792 DOI: 10.5534/wjmh.210191] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The success of vasectomy is determined by the outcome of a post-vasectomy semen analysis (PVSA). This article describes a step-by-step procedure to perform PVSA accurately, report data from patients who underwent post vasectomy semen analysis between 2015 and 2021 experience, along with results from an international online survey on clinical practice. MATERIALS AND METHODS We present a detailed step-by-step protocol for performing and interpretating PVSA testing, along with recommendations for proficiency testing, competency assessment for performing PVSA, and clinical and laboratory scenarios. Moreover, we conducted an analysis of 1,114 PVSA performed at the Cleveland Clinic's Andrology Laboratory and an online survey to understand clinician responses to the PVSA results in various countries. RESULTS Results from our clinical experience showed that 92.1% of patients passed PVSA, with 7.9% being further tested. A total of 78 experts from 19 countries participated in the survey, and the majority reported to use time from vasectomy rather than the number of ejaculations as criterion to request PVSA. A high percentage of responders reported permitting unprotected intercourse only if PVSA samples show azoospermia while, in the presence of few non-motile sperm, the majority of responders suggested using alternative contraception, followed by another PVSA. In the presence of motile sperm, the majority of participants asked for further PVSA testing. Repeat vasectomy was mainly recommended if motile sperm were observed after multiple PVSA's. A large percentage reported to recommend a second PVSA due to the possibility of legal actions. CONCLUSIONS Our results highlighted varying clinical practices around the globe, with controversy over the significance of non-motile sperm in the PVSA sample. Our data suggest that less stringent AUA guidelines would help improve test compliance. A large longitudinal multi-center study would clarify various doubts related to timing and interpretation of PVSA and would also help us to understand, and perhaps predict, recanalization and the potential for future failure of a vasectomy.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland, OH, USA.
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Rakesh K Sharma
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland, OH, USA
| | | | - Sarah C Vij
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, Australia
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicina, Cairo University, Cairo, Egypt
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Neel Parekh
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Jean de la Rosette
- Department of Urology, Medipol Mega University Hospital, Istanbul, Turkey
| | - Tan V Le
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | | | - Gideon Blecher
- Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Australia
| | | | | | - Christopher C K Ho
- Department of Surgery, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Andrew Altman
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Petar Bajic
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - David Goldfarb
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Bradley Gill
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA
| | | | | | - Marcello M Gava
- Sexual and Reproductive Medicine, Department of Urology, Faculdade de Medicina do ABC, Santo André, Brazil
- Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Joao Paulo Greco Cardoso
- Divisao de Urologia, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | - Raghavender Kosgi
- Department of Urology and Andrology, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Gökhan Çeker
- Department of Urology, Samsun Vezirköprü State Hospital, Samsun, Turkey
| | - Birute Zilaitiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Edoardo Pescatori
- Andrology and Reproductive Medicine Unit, Gynepro Medical, Bologna, Italy
| | | | - Gede Wirya Kusuma Duarsa
- Department of Urology, Faculty of Medicine, Sanglah General Academic Hospital, Udayana University, Denpasar, Indonesia
| | | | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Ospedali Riuniti of Foggia, Foggia, Italy
| | - Giancarlo Balercia
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | - Giorgio Franco
- UOC Urologia, Department Materno-Infantile e Scienze Urologiche, AOU Policlinico Umberto I, Sapienza University of Rome, Rome, Italy
| | - Gökhan Çalik
- Department of Urology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | | | | | - Kasonde Bowa
- Department of Urology, School of Medicine and Health Sciences, University of Lusaka, Lusaka, Zambia
| | - Lukman Hakim
- Department of Urology, Universitas Airlangga/Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Mara Simopoulou
- Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Marcelo Gabriel Rodriguez
- Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | | | - Mesut Altan
- Department of Urology, Hacettepe University, Ankara, Turkey
| | | | | | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ayodhia Soebadi
- Department of Urology, Universitas Airlangga/Rumah Sakit Universitas Airlangga Teaching Hospital, Surabaya, Indonesia
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
| | - Ponco Birowo
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Premal Patel
- Section of Urology, University of Manitoba, Winnipeg, MB, Canada
| | - Qaisar Javed
- Department of Urology, Ahalia Hospital, Hamdan Street Branch, Abu Dhabi, UAE
| | - Rafael F Ambar
- Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
- Department of Urology, Centro Universitario em Saude do ABC, Santo André, Brazil
| | - Ricky Adriansjah
- Department of Urology, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, Indonesia
| | - Sami AlSaid
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Sheena E Lewis
- Examenlab Ltd., Weavers Court Business Park, Linfield Road, Belfast, Northern Ireland, UK
| | - Shingai Mutambirwa
- Division of Urology, Safeko Makgatho Health Scienses University and Dr George Mukhari Academic Hospital, Pretoria, South Africa
| | - Shinichiro Fukuhara
- Department of Urology, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Sun Tae Ahn
- Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Teppei Takeshima
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Ana Puigvert
- Fundació Puigvert, Hospital de la Santa Cruz y San Pablo, Universidad Autonoma de Barcelona, Barcelona, Spain
| | - Toshiyasu Amano
- Department of Urology, Nagano Red Cross Hospital, Nagano, Japan
| | | | - Tuncay Toprak
- Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
| | - Vineet Malhotra
- Department of Andrology and Urology, Diyos Hospital, New Delhi, India
| | - Widi Atmoko
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Yasushi Yumura
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Japan
| | | | | | - Yannic Kunz
- Department of Urology, Innsbruck Medical University, Innsbruck, Austria
| | - Yuki Kato
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Yukihiro Umemoto
- Department of Nephro-Urology, Nagoya City West Medical Center, Nagoya, Japan
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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23
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Mahdavinezhad F, Gilani MAS, Gharaei R, Ashrafnezhad Z, Valipour J, Nashtai MS, Amidi F. Protective roles of seminal plasma exosomes and microvesicles during human sperm cryopreservation. Reprod Biomed Online 2022; 45:341-353. [DOI: 10.1016/j.rbmo.2022.03.033] [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: 01/06/2022] [Revised: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
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24
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Gupta S, Sharma R, Agarwal A, Parekh N, Finelli R, Shah R, Kandil H, Saleh R, Arafa M, Ko E, Simopoulou M, Zini A, Rajmil O, Kavoussi P, Singh K, Ambar RF, Elbardisi H, Sengupta P, Martinez M, Boitrelle F, Alves MG, Khalafalla K, Roychoudhury S, Busetto GM, Gosalvez J, Tadros N, Palani A, Rodriguez MG, Anagnostopoulou C, Micic S, Rocco L, Mostafa T, Alvarez JG, Jindal S, Sallam H, Maldonado Rosas I, Lewis SEM, AlSaid S, Altan M, Park HJ, Ramsay J, Parekattil S, Sabbaghian M, Tremellen K, Vogiatzi P, Sadighi Gilani MA, Evenson DP, Colpi GM. A Comprehensive Guide to Sperm Recovery in Infertile Men with Retrograde Ejaculation. World J Mens Health 2022; 40:208-216. [PMID: 34169680 PMCID: PMC8987146 DOI: 10.5534/wjmh.210069] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/23/2021] [Accepted: 04/30/2021] [Indexed: 02/05/2023] Open
Abstract
Retrograde ejaculation (RE) is a condition defined as the backward flow of the semen during ejaculation, and when present can result in male infertility. RE may be partial or complete, resulting in either low seminal volume or complete absence of the ejaculate (dry ejaculate). RE can result from anatomic, neurological or pharmacological conditions. The treatment approaches outlined are determined by the cause. Alkalinizing urinary pH with oral medications or by adding sperm wash media into the bladder prior to ejaculation may preserve the viability of the sperm. This article provides a step-by-step guide to diagnose RE and the optimal techniques to retrieve sperm.
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Affiliation(s)
- Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | | | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Mara Simopoulou
- Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Rafael F Ambar
- Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouyen-Josas, France
| | - Marco G Alves
- Department of Anatomy & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | | | | | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
| | - Jaime Gosalvez
- Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Marcelo Gabriel Rodriguez
- Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
| | | | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Hassan Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Israel Maldonado Rosas
- Center of Technological Innovation, and Reproductive Medicine (CITMER), Mexico City, Mexico
| | | | - Sami AlSaid
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Mesut Altan
- Department of Urology, Haceppete University, Ankara, 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
| | | | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Athens, Greece
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Kohandani F, Jazireian P, Favaedi R, Sadighi Gilani MA, Moshtaghioun SM, Shahhoseini M. Epigenetic Dysregulation of BRDT Gene in Testis Tissues of Infertile Men: Case-Control Study. Cell J 2022; 24:99-102. [PMID: 35279966 PMCID: PMC8918272 DOI: 10.22074/cellj.2022.7724] [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] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Accepted: 11/28/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Bromodomain testis associated (BRDT), a testis-specific member of the Bromo- and Extra-Terrminal domain (BET) protein family, is involved in spermatogenesis and, more specifically, chromatin remodeling. In the post-meiotic spermatogenic cells, BRDT protein binds to the hyperacetylated histones and facilitates their replacement with transition proteins (TPs), particularly protamines, which are essential for chromatin condensation. The current research was conducted to assess the expression and epigenetic profile of BRDT in the testis tissues of infertile men. MATERIALS AND METHODS In this case-control study, three groups were included: positive control group: obstructive azoospermia (OA, n=10), round spermatid maturation arrest group (SMA, n=10) and negative control group: sertoli cellonly syndrome (SCOS, n=10). Using quantitative real-time polymerase chain reaction (PCR), the expression profile of BRDT was generated. Also, ChIP-real time PCR was used to measure the following histone marks: H3K9ac, H3K9me3, H3K4me3, H3K27me3 on the promoter region of BRDT. RESULTS Our data indicated that BRDT expression decreased in the SMA group in comparison with the positive control group and this finding is in line with the ChIP results obtained in this group. CONCLUSION Based on these data, we postulate that BRDT gene has a vital role in the spermatogenesis and its decreased expression due to an aberrant epigenetic signaling might be associated with male infertility.
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Affiliation(s)
- Fereshteh Kohandani
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran,Biology Department, Faculty of Science, Yazd University, Yazd, Iran
| | - Parham Jazireian
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Raha Favaedi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran,Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Moshtaghioun
- Biology Department, Faculty of Science, Yazd University, Yazd, Iran,P.O.Box: 81195-741Biology DepartmentFaculty of ScienceYazd UniversityYazdIranP.O.Box: 16635-144Royan Institute for Reproductive BiomedicineACECRTehranIran
Emails:,,
| | - Maryam Shahhoseini
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR,
Tehran, Iran,Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,Department of Cell and Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran,P.O.Box: 81195-741Biology DepartmentFaculty of ScienceYazd UniversityYazdIranP.O.Box: 16635-144Royan Institute for Reproductive BiomedicineACECRTehranIran
Emails:,,
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Shamohammadi I, Sadighi Gilani MA, Kazemeyni SM, Hasanzadeh T, Taqi Dizaj AV, Dizavi A. Evaluation of Azoospermic Patients to Distinguish Obstructive from Non-Obstructive Azoospermia, and Necessity of Diagnostic Testis Biopsy: A Retrospective Study. Int J Fertil Steril 2022; 16:156-161. [PMID: 36029050 PMCID: PMC9421263 DOI: 10.22074/ijfs.2021.532258.1140] [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] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Indexed: 12/01/2022]
Abstract
Accurate etiology of azoospermia is required for optimal management of patients. The aim of this<br />study was the determination of serum hormonal levels and testicular long axis cut off points to distinguish obstructive<br />azoospermia (OA) from non-OA (NOA) in Iranian patients as well as the evaluation of the necessity of diagnostic<br />testis biopsy in azoospermic patients.<br />Materials and Methods: In this retrospective study, data of 471 azoospermic patients such as history and physical<br />examination, serum hormonal level, semen fluid parameter, and testicular long axis based on ultrasound were<br />evaluated from 2016 to 2020. All patients were examined by a single urologist and underwent a diagnostic testis<br />biopsy for a definite diagnosis. The diagnostic parameters were analyzed using Statistical Package for the Social<br />Sciences (SPSS) version 16 with t test and chi-square test and receiver operating characteristic (ROC) curves to<br />distinguish NOA from OA.<br />Results: A total of 127 patients with OA and 284 with NOA were included in this study. The mean serum testosterone<br />level was significantly higher in OA than NOA (4.2 vs. 3.4 ng/ml), whereas the mean serum follicular stimulating hormone<br />(FSH, 5.3 vs. 19.1 mIU/ml) and luteinizing hormone (LH, 5.3 vs. 11 mIU/ml) were lower in OA. ROC curve analysis<br />showed that FSH and testicular long axis were the best diagnostic predictors. Using a combination of serum FSH (8.9<br />mIU/ml) and testicular long axis (39 mm), the positive predictive value for NOA was 97.02% and for OA was 78.8%.<br />Conclusion: Combination of serum FSH higher than 8.9 mIU/ml and testicular long axis lower than 39 mm were<br />strong predictors to distinguish NOA from OA in Iranian participants in this study. In addition, diagnostic testicular<br />biopsy seems to be necessary for patients with OA and NOA characteristics.
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Affiliation(s)
- Iman Shamohammadi
- Department of Urology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran,Department of Urology, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Urology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran,Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi-
cine, ACECR, Tehran, Iran,P.O.Box: 1411713135Department of UrologyShariati HospitalTehran University of Medical ScienceTehranIran
| | | | - Tara Hasanzadeh
- Department of Urology, Nemazee Hospital, Shiraz University of Medical Science, Shiraz, Iran
| | - Ahmad Vosough Taqi Dizaj
- Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi-
cine, ACECR, Tehran, Iran
| | - Alireza Dizavi
- Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedi-
cine, ACECR, Tehran, Iran
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Jazayeri M, Alizadeh A, Sadighi Gilani MA, Eftekhari-Yazdi P, Sharafi M, Shahverdi A. Underestimated Aspects in Male Infertility: Epigenetics is A New Approach in Men with Obesity or Diabetes: A Review. Int J Fertil Steril 2022; 16:132-139. [PMID: 36029047 PMCID: PMC9396004 DOI: 10.22074/ijfs.2021.534003.1158] [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] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Indexed: 11/25/2022]
Abstract
Infertility is a complex multifactorial problem that affects about 7% of men and 15% of couples worldwide. Many molecular mechanisms involved in male infertility. Destructive effects of infertility on the next generations are not well understood. Approximately 60-75% of male infertility cases have idiopathic causes, and there is a need for additional investigations other than routine examinations. Molecular factors that surround DNA, which are mitotically stable and independently regulate genome activity of DNA sequences, are known as epigenetics. The known epigenetic mechanisms are DNA methylation, histone modifications and non-coding RNAs. Prevalence of metabolic diseases has been increased dramatically because of changes in lifestyle and the current levels of inactivity. Metabolic disorders, such<br />as obesity and diabetes, are prevalent reasons for male infertility; despite the association between metabolic diseases and male infertility, few studies have been conducted on the effects of epigenetic alterations associated with these diseases and sperm abnormalities. Diabetes can affect the reproductive system and testicular function at multiple levels;<br />however, there are very few molecular and epigenetic studies related to sperm from males with diabetes. On the other hand, obesity has similar conditions, while male obesity is linked to notable alterations in the sperm molecular architecture affecting both function and embryo quality. Therefore, in this review article, we presented new and developed technologies to study different patterns of epigenetic changes, and explained the exact mechanisms of epigenetic changes linked to metabolic diseases and their relationship with male infertility.
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Affiliation(s)
- Maryam Jazayeri
- Department of Reproductive Biology, Faculty of Basic Sciences and Advanced Medical Technologies, Royan Institute, ACECR, Tehran, Iran,Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - AliReza Alizadeh
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Poopak Eftekhari-Yazdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohsen Sharafi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,Department of Poultry Sciences, Faculty of Agriculture, Tarbiat Modares University, Tehran, Iran
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,P.O. Box: 16635-148Department of EmbryologyReproductive Biomedicine Research CenterRoyan Institute for Reproductive BiomedicineACECRTehranIran
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Jazireian P, Favaedi R, Sadighi Gilani MA, Shahhoseini M. Dynamic Expression and Chromatin Incorporation of ACT and CREM Transcription Factors in Testis Tissues of Infertile Men. Cell J 2021; 23:736-741. [PMID: 34979062 PMCID: PMC8753101 DOI: 10.22074/cellj.2021.7634] [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] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 08/17/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Activator of CREM in the testis (ACT) is a tissue specific transcription factor which activates cAMP responsive element modulator (CREM), a key transcription factor in differentiation of round spermatids into mature spermatozoa. They bind to CRE region in the promoters of transition protein genes (TNP1, TNP2) and protamine genes (PRM1 and PRM2), which are essential for sperm chromatin compaction, and regulates their transcription. This study was conducted to consider the expression of ACT and CREM and their regulatory roles on the expression of PRM1, PRM2, TNP1 and TNP2 genes in testis tissues of infertile men. MATERIALS AND METHODS In this case-control study, testicular biopsies were collected from 40 infertile men and classified into three groups: obstructive azoospermia (OA, n=10, positive control), round spermatid maturation arrest (SMA, n=20), Sertoli cell-only syndrome (SCOS, n=10, negative control group). Using quantitative real-time polymerase chain reaction (PCR), the expression profile of ACT, CREM, TNP1, TNP2, PRM1 and PRM2 genes were assessed in testicular samples and incorporation of ACT and CREM proteins on the promoters of PRM1, PRM2, TNP1 and TNP2 genes were also evaluated by ChIP-real time PCR. RESULTS Our results demonstrated significant decrease in the expression levels of ACT, CREM and in their incorporations on their target genes in SMA group in comparison to control groups (P≤0.05). CONCLUSION These data confirm that there is low expression and incorporation of ACT and CREM and of their target genes in infertilities which are associated with post-meiotic arrest.
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Affiliation(s)
- Parham Jazireian
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran,
Iran
| | - Raha Favaedi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran,
Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran,
Iran,Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shahhoseini
- Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran,Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran,
Iran,Department of Cell and Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran, *Corresponding Address: P.O.Box: 16635-148Department of GeneticsReproductive Biomedicine Research CenterRoyan Institute for Reproductive BiomedicineACECRTehranIran
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Olia Bagheri F, Alizadeh A, Sadighi Gilani MA, Shahhoseini M. Role of peroxisome proliferator-activated receptor gamma (PPARγ) in the regulation of fatty acid metabolism related gene expressions in testis of men with impaired spermatogenesis. Reprod Biol 2021; 21:100543. [PMID: 34492575 DOI: 10.1016/j.repbio.2021.100543] [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: 04/01/2021] [Revised: 07/13/2021] [Accepted: 08/06/2021] [Indexed: 12/26/2022]
Abstract
Although male infertility is a multifactorial syndrome in which genetic factors are responsible for up to 15 % of cases, there are few studies of genes involved in lipid metabolism and male infertility. Peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand-activated transcription factor in testis tissue. PPARγ binds to DNA and regulates the genes for fatty acid (FA) metabolism. Thus, it has a key role in male reproduction. The current study assessed the expressions of fatty acid desaturase 2 (FADS2), elongation of very-long-chain fatty acids-like 2 (ELOVL2), stearoyl-CoA desaturase-1 (SCD), and lipoprotein lipase (LPL) and incorporation of PPARγ in the promoter regions of these genes in testicular tissue biopsies from 30 infertile males who underwent testicular sperm extraction. The samples were classified into three groups: obstructive azoospermia (OA), which was the positive control (n = 10); round spermatid maturation arrest (SMA, n = 10); and Sertoli cell-only syndrome (SCOS, n = 10). There were significantly lower relative mRNA expression levels of the FADS2, ELOVL2, SCD, and LPL genes in the SCOS (P < 0.01) and SMA (P < 0.01) groups compared to the OA control group. We observed a significant decrease in chromatin incorporation of PPARγ on the promoter regions of the candidate FA metabolism genes (P < 0.05). For the first time, the present study results show that PPARγ is a strong mediator for regulation of FA metabolism in human testis tissue and we confirmed its critical role in normal spermatogenesis.
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Affiliation(s)
- Fateme Olia Bagheri
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Genetics, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - AliReza Alizadeh
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Urology, Shariati Hospital, Tehran University of Medical Science, Tehran, Iran
| | - Maryam Shahhoseini
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran; Department of Cell and Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran.
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30
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Yahyazadeh SR, Sadighi Gilani MA, Karimi A. Vasectomy reversal: Unilateral versus bilateral vasovasostomy. Andrologia 2021; 53:e14178. [PMID: 34268801 DOI: 10.1111/and.14178] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/22/2021] [Accepted: 06/10/2021] [Indexed: 11/27/2022] Open
Abstract
The aim of this study was to evaluate and compare the efficiencies of unilateral and bilateral vasovasostomies as the vasectomy reversal procedures. A total of 95 patients with a history of bilateral vasectomy were evaluated. 42 of them had undergone unilateral surgery, and bilateral surgery had been done for the other 53 patients. Their information including the age, the time interval between the initial vasectomy to the reversal surgery and other underlying illnesses or medications was gathered. Patency rates in the unilateral and bilateral groups were 88.1% (38 patients) and 88.7% (48 patients), respectively, the difference of which was not statistically significant (p = .907). Successful pregnancies occurred in 22 (52.4%) and 29 (54.7%) patients, respectively, which did not show any statistically significant difference too (p = .713). Based on the multivariate logistic regression model, only the time interval between vasectomy and the reversal (duration of obstruction) was predictive of patency (OR = 1.112, p = .037). The outcomes of the unilateral and bilateral vasovasostomies in terms of patency and pregnancy rates were not significantly different. We suggest that performing unilateral, instead of bilateral, vasovasostomy can reduce the time of anaesthesia and surgery and save costs and consumables without having a significant negative impact on the surgical outcomes.
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Affiliation(s)
- Seyed Reza Yahyazadeh
- Department of Urology, Faculty of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Urology, Faculty of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Ali Karimi
- Department of Surgery, Valiasr Hospital, Arak University of Medical Sciences, Arak, Iran
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Hezavehei M, Sharafi M, Fathi R, Shahverdi A, Gilani MAS. Membrane lipid replacement with nano-micelles in human sperm cryopreservation improves post-thaw function and acrosome protein integrity. Reprod Biomed Online 2021; 43:257-268. [PMID: 34256996 DOI: 10.1016/j.rbmo.2021.05.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 01/06/2021] [Revised: 04/27/2021] [Accepted: 05/01/2021] [Indexed: 12/27/2022]
Abstract
RESEARCH QUESTION Membrane lipid replacement (MLR) of oxidized membrane lipids can restore sperm cellular membrane functionality and help improve surface protein stability during cryopreservation. What are the effects of MLR with nano-micelles made from a glycerophospholipid (GPL) mixture and cholesterol-loaded cyclodextrin (CLC), on the cryosurvival and expression of acrosome-related proteins in thawed human spermatozoa? DESIGN Twenty samples were used to determine the optimum level of nano-micelles by incubation of semen with different concentrations of GPL (0.1 and 1%) and CLC (1 and 2 mg/ml) (including GPL-0.1, GPL-1, CLC-1, CLC-2, CLC-1/GPL-0.1, CLC-2/GPL-0.1, CLC-1/GPL-1 and CLC-2/GPL-1) before cryopreservation. Then, 30 semen samples were collected, and each sample was divided into the following three aliquots: fresh, frozen control and frozen incubated with optimum level of nano-micelles (0.1% GPL and 1 mg/ml CLC). RESULTS CLC-1/GPL-0.1 and GPL-0.1 significantly increased motility parameters. CLC-1, GPL-0.1 and CLC-1/GPL-0.1 significantly improved viability rate compared with frozen control group. Significantly higher mitochondrial activity and acrosome integrity, and a lower rate of apoptosis, were observed in the CLC-1/GPL-0.1 compared with the frozen control group. The expression ratios of arylsulfatase A (ARSA), serine protease 37 (PRSS37), serine protease inhibitor Kazal-type 2 (SPINK2) and equatorin (EQTN) significantly increased compared with the frozen control group. CONCLUSIONS Modification of membrane cholesterol and GPL mixtures in spermatozoa enhances their acrosome protein integrity by inhibiting early apoptotic changes and spontaneous acrosome reactions.
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Affiliation(s)
- Maryam Hezavehei
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Banihashem St Tehran 16635-148, Iran
| | - Mohsen Sharafi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Banihashem St Tehran 16635-148, Iran; Department of Animal Science, College of Agriculture, Tarbiat Modarres University
| | - Rohoullah Fathi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Banihashem St Tehran 16635-148, Iran
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Banihashem St Tehran 16635-148, Iran.
| | - Mohammad Ali Sadighi Gilani
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Banihashem St Tehran 16635-148, Iran.
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Agarwal A, Finelli R, Selvam MKP, Leisegang K, Majzoub A, Tadros N, Ko E, Parekh N, Henkel R, Durairajanayagam D, Colpi GM, Cho CL, Sallam HN, Park HJ, Saleh R, Micic S, Ambar RF, Zini A, Tremellen K, Alvarez JG, Palani A, Arafa M, Gava MM, Jindal S, Amar E, Kopa Z, Moein MR, Busetto GM, Sengupta P, Kavoussi P, Maldonado I, Fikri J, Borges E, Martinez M, Bojovic D, Rajmil O, Aydos K, Parekattil S, Marmar JL, Sefrioui O, Jungwirth A, Peña MGR, Cordts EB, Elbardisi H, Mostafa T, Sabbaghian M, Sadighi Gilani MA, Morimoto Y, Alves MG, Spasic A, Kenic U, Ramsay J, Akande EO, Oumeziane A, Dozortsev D, Chung E, Bell EG, Allegra A, Tanos V, Fiadjoe M, Gurgan T, Abou-Abdallah M, Al-Rumaih H, Oborna I, Arab H, Esteves S, Amer M, Kadioglu A, Yuzko O, Korsak V, Shah R. A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility. World J Mens Health 2021; 39:470-488. [PMID: 33831977 PMCID: PMC8255391 DOI: 10.5534/wjmh.210025] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 02/27/2021] [Revised: 03/10/2021] [Accepted: 03/17/2021] [Indexed: 02/05/2023] Open
Abstract
Purpose The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. Materials and Methods Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility. Results Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3–6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility. Conclusions This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA.
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA
| | - Manesh Kumar Panner Selvam
- American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA.,Department of Urology, Tulane University Health Sciences Center, New Orleans, LA, USA
| | - Kristian Leisegang
- School of Natural Medicine, University of the Western Cape, South Africa
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar.,Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | | | | | - Chak Lam Cho
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Hassan N Sallam
- Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea.,Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Sava Micic
- Uromedica Polyclinic, Andrology Department, Belgrade, Serbia
| | - Rafael F Ambar
- Sexual and Reproductive Medicine, Department of Urology, Faculdade de Medicina do ABC, Santo André, Brazil.,Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo Andre, Brazil
| | - Armand Zini
- Department of Surgery, McGill University, St. Mary's Hospital, Montreal, QC, Canada
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, South Australia
| | | | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Ohio, USA.,Hamad Medical Corporation, Doha, Qatar.,Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marcello M Gava
- Sexual and Reproductive Medicine, Department of Urology, Faculdade de Medicina do ABC, Santo André, Brazil.,Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo Andre, Brazil
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Edouard Amar
- Cabinet D'Andrologie Victor Hugo, American Hospital of Paris Reproductive Center, Paris, France
| | - Zsolt Kopa
- Andrology Centre, Department of Urology, Semmelweis University, Budapest, Hungary
| | | | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Kuala Lumpur, Malaysia
| | - Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | | | - Jamal Fikri
- IVF Unit, Al Boustane Clinic, Rabat, Morocco
| | - Edson Borges
- Fertility Medical Group, Sapientiae Institute, São Paulo, Brazil
| | - Marlon Martinez
- Department of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | | | - Osvaldo Rajmil
- Deparment of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Kaan Aydos
- Department of Urology, University of Ankara, Ankara, Turkey
| | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Joel L Marmar
- Honorary Staff of Cooper University Hospital, Camden, NJ, USA
| | | | | | | | - Emerson B Cordts
- Instituto Ideia Fertil-Human Reproduction Centre-Faculdade de Medicina do ABC, Sao Paulo, Brazil
| | | | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Marco G Alves
- Department of Anatomy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | | | | | | | | | | | | | - Eric Chung
- Department of Urology, University of Queensland, Brisbane, Australia
| | | | - Adolfo Allegra
- ANDROS Day Surgery Clinic, Reproductive Medicine Unit, Palermo, Italy
| | - Vasilios Tanos
- Department of Obstetrics and Gynecology, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Timur Gurgan
- Department of Obstetrics and Gynecology, Bahcesehir University, Istanbul, Turkey
| | - Michel Abou-Abdallah
- Middle East Fertility Society, Canadian Foundation for Reproductive Medicine, Lebanon
| | - Hazem Al-Rumaih
- Reproductive Medicine Unit, New Jahra Hospital, Ministry of Health, Al Jahra, Kuwait
| | | | - Hesham Arab
- RMU Dr. Arab Medical Center, Jeddah, Saudi Arabia
| | - Sandro Esteves
- ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, Brazil.,Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil
| | - Medhat Amer
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ates Kadioglu
- Section of Andrology, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Oleksandr Yuzko
- Department of Obstetrics and Gynecology, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Vladislav Korsak
- International Centre for Reproductive Medicine, Saint-Petersburg, Russia
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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Hosseini SH, Sabbaghian M, Mohseni Meybodi A, Maroufizadeh S, Sadighi Gilani MA. Observational retrospective study of Intracytoplasmic sperm injection outcomes of 117 infertile men with severe short tail sperm defect. Andrologia 2021; 53:e13935. [PMID: 33774863 DOI: 10.1111/and.13935] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 10/31/2020] [Accepted: 11/10/2020] [Indexed: 11/26/2022] Open
Abstract
Intracytoplasmic sperm injection (ICSI) is increasingly used to treat male-factor infertility when sperm parameters are not proper for intrauterine insemination (IUI) or in vitro fertilization (IVF). Among sperm abnormalities, short tail sperm defect is a rare kind of teratozoospermia, which is a severe cause of male infertility. In this study, we evaluated the ICSI outcomes of infertile men with severely short tail sperm defect. 117 infertile men with primary infertility were included in this study. We evaluated the impact of short tail sperm defect on large ICSI series (228 cycles) outcomes. The fertilisation rate (FR) was 49.0%, the clinical pregnancy rate (PR) was 21.7%, and the delivery rate (DR) was 17.5%. The results of statistical analysis show that there is no relationship between short tail sperm defect and clinical pregnancy. According to the present study, there were patients with successful ICSI outcomes despite the severe defect in their spermatozoa flagella. Our results can be considered in two main aspects: (a) it seems that ICSI could be a proper therapy for infertile men with short-tailed sperm defect and (b) the abnormal sperm morphology (especially in sperm flagellum) is not a reliable predictor for the ICSI outcomes. In conclusion, our study suggests that ICSI should be considered as a proper treatment way for infertile men with severe short tail sperm defect and probably other sperm flagella abnormalities.
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Affiliation(s)
- Seyedeh-Hanieh Hosseini
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Anahita Mohseni Meybodi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Pathology and Laboratory Medicine, Western University, London, Ontario, Canada.,Molecular Genetics Laboratory, Molecular Diagnostics Division, London Health Sciences Centre, London, Ontario, Canada
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Akbari A, Padidar K, Salehi N, Mashayekhi M, Almadani N, Sadighi Gilani MA, Bashambou A, McElreavey K, Totonchi M. Rare missense variant in MSH4 associated with primary gonadal failure in both 46, XX and 46, XY individuals. Hum Reprod 2021; 36:1134-1145. [PMID: 33448284 DOI: 10.1093/humrep/deaa362] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 10/13/2020] [Revised: 11/21/2020] [Indexed: 12/13/2022] Open
Abstract
STUDY QUESTION Can whole-exome sequencing (WES) reveal a shared pathogenic variant responsible for primary gonadal failure in both male and female patients from a consanguineous family? SUMMARY ANSWER Patients with primary ovarian insufficiency (POI) and non-obstructive azoospermia (NOA) were homozygous for the rare missense variant p. S754L located in the highly conserved MSH4 MutS signature motif of the ATPase domain. An oligozoospermic patient was heterozygous for the variant. WHAT IS KNOWN ALREADY MSH4 is a meiosis-specific protein expressed at a certain level in the testes and ovaries. Along with its heterodimer partner MSH5, it is responsible for double-strand Holliday junction recognition and stabilization, to ensure accurate chromosome segregation during meiosis. Knockout male and female mice for Msh4 and Msh5 are reportedly infertile due to meiotic arrest. In humans, MSH4 is associated with male and female gonadal failure, with distinct variations in the MutS domain V. STUDY DESIGN, SIZE, DURATION This was a retrospective genetics study of a consanguineous family with multiple cases of gonadal failure in both genders. The subject family was recruited in Iran, in 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS The proband who is affected by POI, an NOA brother, a fertile sister and their parents were subjected to WES. The discovered variant was validated in these individuals, and the rest of the family was also genotyped by Sanger sequencing. The variant was not detected in 800 healthy Iranian individuals from the Iranome database nor in 30 sporadic NOA and 30 sporadic POI patients. Suggested effect in aberrant splicing was studied by RT-PCR. Moreover, protein homology modeling was used to further investigate the amino acid substitution in silico. MAIN RESULTS AND THE ROLE OF CHANCE The discovered variant is very rare and has never been reported in the homozygous state. It occurs in the ATPase domain at Serine 754, the first residue within the highly conserved MutS signature motif, substituting it with a Leucine. All variant effect prediction tools indicated this variant as deleterious. Since the substitution occurs immediately before the Walker B motif at position 755, further investigations based on protein homology were conducted. Considering the modeling results, the nature of the substituted amino acid residue and the distances between p. S754L variation and the residues of the Walker B motif suggested the possibility of conformational changes affecting the ATPase activity of the protein. LARGE SCALE DATA We have submitted dbSNP entry rs377712900 to ClinVar under SCV001169709, SCV001169708 and SCV001142647 for oligozoospermia, NOA and POI, respectively. LIMITATIONS, REASONS FOR CAUTION Studies in model organisms can shed more light on the role of this variant as our results were obtained by variant effect prediction tools and protein homology modeling. WIDER IMPLICATIONS OF THE FINDINGS Identification of variants in meiotic genes should improve genetic counseling for both male and female infertility. Also, as two of our NOA patients underwent testicular sperm extraction (TESE) with no success, ruling out the existence of pathogenic variants in meiotic genes in such patients prior to TESE could prove useful. STUDY FUNDING/COMPETING INTEREST(S) This study was financially supported by Royan Institute in Tehran, Iran, and Institut Pasteur in Paris, France. The authors declare no competing interests. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Arvand Akbari
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kimiya Padidar
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Molecular Genetics, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - Najmeh Salehi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Bioinformatics, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran
| | - Mehri Mashayekhi
- Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Navid Almadani
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Anu Bashambou
- Human Developmental Genetics Unit, Institut Pasteur, Paris, France
| | - Ken McElreavey
- Human Developmental Genetics Unit, Institut Pasteur, Paris, France
| | - Mehdi Totonchi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
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Ghanami Gashti N, Sadighi Gilani MA, Abbasi M. Sertoli cell-only syndrome: etiology and clinical management. J Assist Reprod Genet 2021; 38:559-572. [PMID: 33428073 PMCID: PMC7910341 DOI: 10.1007/s10815-021-02063-x] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 01/02/2021] [Indexed: 12/28/2022] Open
Abstract
Almost 50% of infertility cases are due to male factors, and spermatogenesis failure is one of the most severe forms of male infertility. Sertoli cell-only syndrome (SCOS) also known as germ cell aplasia is characterized by azoospermia in which the seminiferous tubules of testicular biopsy are lined only with Sertoli cells. The definitive diagnosis of SCOS is by diagnostic testicular biopsy. Although SCOS may be a result of Klinefelter syndrome, most of the SCOS men have a normal karyotype. Along with genetic aberrations, signaling pathways and endocrine processes might be major factors in the development of SCOS. Sperm retrieval and intracytoplasmic sperm injection (ICSI) are available treatments for SCOS. However, some SCOS patients do not have therapeutic options to help them having a biological child. This review aims to summarize our present knowledge about SCOS and to highlight the importance of future researches in the diagnosis and treatment of this disorder.
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Affiliation(s)
- Nasrin Ghanami Gashti
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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36
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Alimohammadi F, Ebrahimi Nasab M, Rafaee A, Hashemi M, Totonchi M, Mohseni Meybodi A, Sadighi Gilani MA, Sabbaghian M. Corrigendum to: Deletion of dpy-19 like 2 (DPY19L2) gene is associated with total but not partial globozoospermia. Reprod Fertil Dev 2021; 32:805. [PMID: 32389181 DOI: 10.1071/rd19025_co] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The dpy-19 like 2 (DPY19L2) gene is the most common genetic cause of globozoospermia characterised by the production of round-headed spermatozoa without an acrosome. The present study was performed on 63 men with globozoospermia and 41 normozoospermic individuals to evaluate the frequency of the DPY19L2 gene and exons; deletion and genetic changes in exons 1, 5, 7-11, 19, 21 and interval introns; and some epidemiological factors (e.g. varicocele, smoking, drug use, alcohol consumption and a family history of infertility). Homozygous deletion of DPY19L2 was identified in 35% of men with globozoospermia. Exon 7 was deleted in 4.8% of men with globozoospermia in which DPY19L2 was not deleted. No genetic variations were observed within the DPY19L2 exons examined, but five intronic polymorphisms were detected: 1054-77T>C in intron 9, 1131+65T>C and 1131+53A>G in intron 10 and 1218+22T>C and 1218+73T>C in intron 11. There were significant differences in the frequency of 1054-77T>C and 1218+22T>C polymorphisms between the globozoospermic and normozoospermic groups. In addition, there were significant differences between the two groups in sperm count, sperm motility, a history of infertility in the family and varicocele. Based on these findings, DPY19L2 deletion is the major cause of total globozoospermia and there is no association between exons 1, 5, 8-11, 19 and 21 polymorphisms of the DPY19L2 gene in the occurrence of this defect.
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37
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Ghanami Gashti N, Sadighi Gilani MA, Jabari A, Qasemi M, Feizollahi N, Abbasi M. The Germ Cell-Specific Markers ZPBP2 and PGK2 in Testicular Biopsies Can Predict the Presence as well as the Quality of Sperm in Non-obstructive Azoospermia Patients. Reprod Sci 2021; 28:1466-1475. [PMID: 33507524 DOI: 10.1007/s43032-020-00427-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/10/2020] [Indexed: 11/25/2022]
Abstract
To assess the role of three testis-specific genes including ZPBP2, PGK2, and ACRV1 in the prediction of sperm retrieval result and quality of retrieved sperm by microdissection testicular sperm extraction (micro-TESE) in non-obstructive azoospermia (NOA) patients. This was a case-control study including 57 testicular samples of NOA patients including 32 patients with successful sperm retrieval (NOA+) and 25 patients with failed sperm retrieval (NOA-), and 9 samples of men with normal spermatogenesis in the testes as the positive control (OA). We investigated the expression of candidate genes by RT-qPCR and germ cell population patterns by DNA flow cytometry in testicular biopsy samples. The association between PGK2 expressions with the quality of retrieved spermatozoa was also evaluated. The RT-qPCR data revealed a significantly higher expression of ZPBP2 and PGK2 in the NOA+ in comparison to NOA- group (P = 0.002, and P = 0.002, respectively). Flow cytometry results revealed that the haploid cell percentage was significantly higher in NOA+ vs. NOA- group (P = 0.0001). In samples with a higher percentage of haploid cells, expression levels of ZPBP2 and PGK2 were higher (P = 0.001). The PGK2 expression was significantly associated with retrieved sperm quality (P = 0.01). Our results contribute to the search for the biomarkers for predicting the presence of testicular sperm and would be useful to avoid unnecessary multiple micro-TESE. Overall, the expression pattern of the ZPBP2 and PGK2 may be useful in predicting sperm recovery success and quality of retrieved sperm in NOA patients.
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Affiliation(s)
- Nasrin Ghanami Gashti
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
- Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ayob Jabari
- Department of Obstetrics and Gynecology, Moluod Infertility Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Maryam Qasemi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Narjes Feizollahi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Jabari A, Sadighi Gilani MA, Koruji M, Gholami K, Mohsenzadeh M, Rastegar T, Khadivi F, Ghanami Gashti N, Nikmahzar A, Mojaverrostami S, Talebi A, Ashouri Movassagh S, Rezaie MJ, Abbasi M. Three-dimensional co-culture of human spermatogonial stem cells with Sertoli cells in soft agar culture system supplemented by growth factors and Laminin. Acta Histochem 2020; 122:151572. [PMID: 32622422 DOI: 10.1016/j.acthis.2020.151572] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 03/24/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 12/20/2022]
Abstract
Application of a three-dimensional (3D) culture system for in vitro proliferation and differentiation of human spermatogonial stem cells (SSCs) is a useful tool for the investigation of the spermatogenesis process and the management of male infertility particularly in prepubertal cancer patients. The main purpose of this study was to investigate the proliferation of human SSCs co-cultured with Sertoli cells in soft agar culture system (SACS) supplemented by Laminin and growth factors. Testicular cells were isolated from testes of brain-dead patients and cultured in two-dimensional (2D) culture system for 3 weeks. After 3 weeks, functional SSCs were evaluated by xenotransplantation and also identification of cells was assessed by immunocytochemistry, flow cytometry, and RT-PCR. Then, SSCs and Sertoli cells were transferred to the upper layer of SACS for 3 weeks. After 3 weeks, the number of colonies and the expression of specific SSCs and Sertoli cell markers, as well as apoptotic genes were evaluated. Our results showed that transplanted SSCs, migrated into the basement membrane of seminiferous tubules of recipient mice. The expression of PLZF, α6-Integrin, and Vimentin proteins in SSCs and Sertoli cells were observed in 2D and 3D culture systems. The expression rate of PLZF, α6-Integrin, Bcl2, and colony number in SACS supplemented by Laminin and growth factors group were significantly higher than non-supplemented groups (P ≤ 0.01), but the expression rate of c-kit and Bax in supplemented group were significantly lower than non-supplemented groups (P ≤ 0.05). This 3D co-culture system decreased apoptosis and increased propagation of human SSCs. Therefore, this designed system can be utilized to increase the proliferation of human SSCs in prepubertal male cancer and azoospermic men to obtain an adequate SSCs number to outotransplant success and in vitro spermatogenesis.
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Affiliation(s)
- Ayob Jabari
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Morteza Koruji
- Cellular and Molecular Research Center & Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Keykavos Gholami
- Gametogenesis Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Mojtaba Mohsenzadeh
- Iranian Tissue Bank and Research Center of Tehran University of Medical Sciences, Tehran, Iran
| | - Tayebeh Rastegar
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Khadivi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Ghanami Gashti
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Aghbibi Nikmahzar
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Mojaverrostami
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Talebi
- School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran; Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Sepideh Ashouri Movassagh
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Human and Animal Cell Bank, Iranian Biological Resource Center (IBRC), ACECR, Tehran, Iran
| | - Mohammad Jafar Rezaie
- Department of Embryology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Piryaei F, Mozdarani H, Sadighi Gilani MA, Ebrahimi M. Homo Sapiens (Human) microRNA 187 Expression Is Dysregulated in Testis of Non-obstructive Azoospermic Men. Int J Basic Sci Med 2020. [DOI: 10.34172/ijbsm.2020.08] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: MiRNA expression alterations are closely related to growth, proliferation, and cell development. In addition, miR-187 has been found to regulate cellular proliferation. Further, spermatogenesis is a highly complicated process which is regulated through several genes targeted by miRNAs. However, no study has completely addressed the etiology of spermatogenic impairments. Accordingly, the present study examined the expression pattern of Homo sapiens (human) microRNA (hsa-mir-187) in the testicular biopsies of infertile men with non-obstructive azoospermia (NOA) and Sertoli cell-only syndrome (SCOS) subtype in comparison with those with obstructive azoospermia (OA). Methods: Quantitative reverse‐transcription polymerase chain reaction analysis was performed to assess the expression level of hsa-mir-187 using the ΔΔCt method. Results: Our data indicated that hsa-mir-187 was significantly up-regulated in the testis of the SCOS group (P˂ 0.05) in comparison with the OA group. Conclusion: In general, the findings suggest that the differential expression of hsa-mir-187 is linked with male infertility and shed more light on molecular defects that underlie spermatogenic impairments.
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Affiliation(s)
- Fahimeh Piryaei
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Mozdarani
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mansour Ebrahimi
- Department of Biology, School of Basic Sciences, Qom University, Qom, Iran
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40
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Ashrafzade AM, Sadighi Gilani MA, Topraggaleh TR, Khojasteh M, Sepidarkish M, Borjian Boroujeni P, Zamanian MR. Oxidative stress-related miRNAs in spermatozoa may reveal the severity of damage in grade III varicocele. Andrologia 2020; 52:e13598. [PMID: 32478945 DOI: 10.1111/and.13598] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/31/2020] [Revised: 03/14/2020] [Accepted: 03/18/2020] [Indexed: 12/21/2022] Open
Abstract
Varicocele is associated with excessive production of reactive oxygen species (ROS). Although the harmful effects of ROS on sperm DNA, proteins and lipids are well documented, its impact on the expression of miRNAs in spermatozoa has not been fully understood. In this study, the expression patterns of microRNAs (miRNAs), miR-21, miR-34a and miR-122a as well as the level of ROS in the fertile control (FC; proven fertility without varicocele, n = 15) and grade III varicocele patients with normal (VN; n = 15) and abnormal (VA; n = 15) spermogram were investigated. The real-time PCR was performed to analyse the expression of the miRNAs, while oxidative stress was evaluated by measuring the concentrations of MDA. Our results showed that the expression levels of miR-21 (p = .001), miR-34a, (p = .007) and miR-122a (p < .001) were significantly decreased in spermatozoa of VN and VA patients in comparison with the fertile group. Also, increased levels of oxidative stress were detected in semen samples of varicocele patients compared with the fertile control (p < .0001). Overall, these findings demonstrate oxidative stress changes the expression pattern of some miRNAs, and these alterations could be a valuable diagnostic marker for the diagnosis and prognosis of varicocele-induced oxidative stress to retain the male fertility during the spermatogenesis process.
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Affiliation(s)
- Amir Mehdi Ashrafzade
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Genetics, University of Science and Culture, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Tohid Rezaei Topraggaleh
- Department of Reproductive Biology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Khojasteh
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Genetics, University of Science and Culture, ACECR, Tehran, Iran
| | - Mehdi Sepidarkish
- Department of Biostatistics and Epidemiology, Babol University of Medical Sciences, Babol, Iran
| | - Parinaz Borjian Boroujeni
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Reza Zamanian
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Alimohammadi F, Ebrahimi Nasab M, Rafaee A, Hashemi M, Totonchi M, Mohseni Meybodi A, Sadighi Gilani MA, Sabbaghian M. Deletion of dpy-19 like 2 (DPY19L2) gene is associated with total but not partial globozoospermia. Reprod Fertil Dev 2020; 32:727-737. [DOI: 10.1071/rd19025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 11/21/2019] [Indexed: 11/23/2022] Open
Abstract
The dpy-19 like 2 (DPY19L2) gene is the most common genetic cause of globozoospermia characterised by the production of round-headed spermatozoa without an acrosome. The present study was performed on 63 men with globozoospermia and 41 normozoospermic individuals to evaluate the frequency of the DPY19L2 gene and exons; deletion and genetic changes in exons 1, 5, 7–11, 19, 21 and interval introns; and some epidemiological factors (e.g. varicocele, smoking, drug use, alcohol consumption and a family history of infertility). Homozygous deletion of DPY19L2 was identified in 35% of men with globozoospermia. Exon 7 was deleted in 4.8% of men with globozoospermia in which DPY19L2 was not deleted. No genetic variations were observed within the DPY19L2 exons examined, but five intronic polymorphisms were detected: 1054–77T>C in intron 9, 1131+65T>C and 1131+53A>G in intron 10 and 1218+22T>C and 1218+73T>C in intron 11. There were significant differences in the frequency of 1054–77T>C and 1218+22T>C polymorphisms between the globozoospermic and normozoospermic groups. In addition, there were significant differences between the two groups in sperm count, sperm motility, a history of infertility in the family and varicocele. Based on these findings, DPY19L2 deletion is the major cause of total globozoospermia and there is no association between exons 1, 5, 8–11, 19 and 21 polymorphisms of the DPY19L2 gene in the occurrence of this defect.
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Atshan M, Kakavand K, Hosseini SH, Sadighi Gilani MA, Mohseni Meybodi A, Sabbaghian M. Evaluation of sperm DNA fragmentation and chromatin structure in infertile men with immotile short-tail sperm defect. Andrologia 2019; 52:e13445. [PMID: 31657071 DOI: 10.1111/and.13445] [Citation(s) in RCA: 5] [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: 12/04/2017] [Revised: 08/26/2019] [Accepted: 09/09/2019] [Indexed: 11/26/2022] Open
Abstract
Teratozoospermia is characterised by the presence of spermatozoa with abnormal morphology. One of the morphological disorders that lead to male infertility is immotile short-tail sperm (ISTS) defect. In this study, we evaluated the levels of chromatin packing and DNA fragmentation in patients with immotile short-tail sperm defect. Semen samples were obtained from 31 infertile men with ISTS as case group and 31 normozoospermic men as a control group. Protamine status was evaluated using chromomycin A3 (CMA3) staining and sperm DNA fragmentation assessed by sperm chromatin structure assay (SCSA) and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick-end labelling (TUNEL). The percentage of positive CMA3 spermatozoa was significantly higher in patients' samples (22.6 ± 6.9) compared with controls (16.3 ± 4.2) (p < .05) and also mean (±SD) of sperm DNA fragmentation was significantly higher in patients compared with controls, as measured by TUNEL assay (10.45 ± 4.60 vs. 7.03 ± 2.86, p < .05) and SCSA (24.80 ± 13.1 vs. 15.2 ± 7.2, p < .05). According to our study, sperm DNA fragmentation and chromatin packing abnormality are significantly higher in the ISTS samples compared with normal samples. A possible explanation for this relationship is that sperm chromatin condensation and sperm flagellum formation occur during the same phase of spermatogenesis.
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Affiliation(s)
- Marzieh Atshan
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kianoosh Kakavand
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Seyedeh Hanieh Hosseini
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Anahita Mohseni Meybodi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Hasani N, Mohseni Meybodi A, Rafaee A, Sadighi Gilani MA, Mohammadzadeh R, Sabbaghian M. Spermatogenesis disorder is associated with mutations in the ligand-binding domain of an androgen receptor. Andrologia 2019; 51:e13376. [PMID: 31373714 DOI: 10.1111/and.13376] [Citation(s) in RCA: 5] [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: 02/06/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 12/26/2022] Open
Abstract
Androgens play a key role in spermatogenesis, and their functions are mediated by the androgen receptor (AR). Some mutations in the AR gene have the potential to alter the primary structure and function of the protein. The aim of this study was to investigate the AR gene mutations in a cohort of males with idiopathic azoospermia referred to Royan Institute. Fifty-one biopsy samples were obtained for routine clinical purposes from 15 men with hypospermatogenesis (HS), 17 patients with maturation arrest (MA) and 19 patients with Sertoli cell-only syndrome (SCOS). The AR cDNAs were prepared from tissue mRNAs and were sequenced. One synonymous variant and three nonsynonymous protein coding single nucleotide polymorphisms (nsSNPs) were detected. Protein structure prediction demonstrated that the S815I and M746T nonsynonymous variants would affect protein structure and its normal function. Our study suggests that mutations in the AR gene would change or disturb the receptor's normal activity. Although these variations may influence spermatogenesis, it is difficult to say that they lead to a lack of spermatogenesis.
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Affiliation(s)
- Nafiseh Hasani
- Department of Cell and Molecular Biology, Faculty of Basic Science, University of Maragheh, Maragheh, Iran
| | - Anahita Mohseni Meybodi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Alemeh Rafaee
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Mohammadzadeh
- Department of Cell and Molecular Biology, Faculty of Basic Science, University of Maragheh, Maragheh, Iran
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
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Askari M, Karamzadeh R, Ansari-Pour N, Karimi-Jafari MH, Almadani N, Sadighi Gilani MA, Gourabi H, Vosough Taghi Dizaj A, Mohseni Meybodi A, Sadeghi M, Bashamboo A, McElreavey K, Totonchi M. Identification of a missense variant in CLDN2 in obstructive azoospermia. J Hum Genet 2019; 64:1023-1032. [DOI: 10.1038/s10038-019-0642-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/30/2019] [Accepted: 07/03/2019] [Indexed: 11/09/2022]
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Talebi A, Sadighi Gilani MA, Koruji M, Ai J, Rezaie MJ, Navid S, Salehi M, Abbasi M. Colonization of Mouse Spermatogonial Cells in Modified Soft Agar Culture System Utilizing Nanofibrous Scaffold: A New Approach. Galen Med J 2019; 8:e1319. [PMID: 34466493 PMCID: PMC8343708 DOI: 10.31661/gmj.v8i0.1319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 08/09/2018] [Revised: 09/07/2018] [Accepted: 09/16/2018] [Indexed: 01/23/2023] Open
Abstract
Background: Spermatogonial stem cells (SSCs) are considered in fertility management approaches of prepubertal boys facing cancer therapies. However, in vitro propagation has become an important issue due to a small number of SSCs in testicular tissue. The present study aimed to investigate a modified soft agar culture system by using a nanofibrous scaffold as a new approach to mimic in vivo conditions of SSCs development. Materials and Methods: The SSCs were isolated from neonate mouse testes, cultured on polycaprolactone scaffold, and covered by a layer of soft agar for 2 weeks. Then, the number and diameter of colonies formed in experimental groups were measured and spermatogonial markers (i.e., Plzf, Gfrα1, Id4, and c-Kit) in SSCs colonies were evaluated by a real-time polymerase chain reaction and immunostaining. Results: Our results indicated that the colonization rate of SSCs was significantly higher in the present modified soft agar culture system (P<0.05). Only Plzf indicated a significant increased at the levels (P<0.05), the gene expression levels of Id4, Plzf, and Gfrα1 were higher in the present culture system. In addition, the expression of the c-Kit gene as a differentiating spermatogonia marker was higher in presence of scaffold and soft agar compared with the amount of other experimental groups (P<0.05). Conclusion: The culture system by using nanofibrous scaffold and soft agar as a new culture method suggests the potential of this approach in SSCs enrichment and differentiation strategies for male infertility treatments, as well as in vitro spermatogenesis.
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Affiliation(s)
- Ali Talebi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Morteza Koruji
- Cellular and Molecular Research Center & Department of Anatomical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Ai
- Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Jafar Rezaie
- Department of Embryology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Shadan Navid
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Salehi
- Department of Tissue Engineering, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mehdi Abbasi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Correspondence to: Mehdi Abbasi, Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Telephone Number: +989125139314 Email Address:
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Firouzi V, Borjian Boroujeni P, Rokhsat Talab Z, Mohammadi M, Sadighi Gilani MA, Sabbaghian M, Mohseni Meybodi A. Possible role of androgen receptor gene in therapeutic response of infertile men with hypogonadotropic hypogonadism. Syst Biol Reprod Med 2019; 65:326-332. [PMID: 31030566 DOI: 10.1080/19396368.2019.1590478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/26/2022]
Abstract
Hypogonadotropic hypogonadism (HH) is defined as a dysfunction of hypothalamic-pituitary-gonadal axis, which causes impairments in gametogenesis, pubertal maturation, and/or secretion of the gonadal sex hormones. Human chronic gonadotropin (hCG) stimulates the Leydig cells of the testis to secrete testosterone, which is essential for spermatogenesis. Testosterone replacement therapy is one of the possible options to manage HH treatment. Given the fact that testosterone functions are mediated via androgen receptor (AR), the aim of the present study was to evaluate whether the CAG/GGN triple repeat expansion in AR gene can modulate the response to hCG and testosterone treatment in HH men. Sixty-two men who diagnosed with HH and treated with testosterone and hCG were assessed after treatment. They were classified into two groups, 31 subjects with a positive and 31 subjects with a negative response to replacement therapy within 12-18 months. Androgen receptor CAG and GGN repeat numbers were measured in both groups by hot start polymerase chain reaction (PCR)-sequencing technique. Subjects who reached complete spermatogenesis showed the 20 and 23 as the median numbers of AR CAG/GGN repeats, respectively. In individuals who did not respond to treatment the median length for both CAG/GGN repeats were 23. The average of CAG repeats was statistically lower in patients who had the positive response in comparison to patients who did not respond to hormone therapy (p < 0.05), but the length of GGN repeats were not statistically different between these groups of patients (p > 0.05). The number of CAG repeats are negatively and significantly associated with better hormone therapy response. Our results suggest that the length of CAG repeat polymorphism in AR gene might affect the response to treatment in men suffering from HH, whereas no relationship was found between AR gene GGN repeat polymorphism and testosterone and hCG replacement therapy response. Abbreviations: AR: androgen receptor; FSH: follicle stimulating hormone; Gn: gonadotropins; GnRH: gonadotropin-releasing hormone; hCG: human chronic gonadotropin; HH: hypogonadotropic hypogonadism; LH: luteinizing hormone; PCR: polymerase chain reaction.
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Affiliation(s)
- Vida Firouzi
- a Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Parnaz Borjian Boroujeni
- a Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Zeinab Rokhsat Talab
- a Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Maryam Mohammadi
- b Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center , Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Mohammad Ali Sadighi Gilani
- c Department of Andrology , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Marjan Sabbaghian
- c Department of Andrology , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
| | - Anahita Mohseni Meybodi
- a Department of Genetics , Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR , Tehran , Iran
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Sajadi H, Hosseini J, Farrahi F, Dadkhah F, Sepidarkish M, Sabbaghian M, Eftekhari-Yazdi P, Sadighi Gilani MA. Varicocelectomy May Improve Results for Sperm Retrieval and Pregnancy Rate in Non-Obstructive Azoospermic Men. Int J Fertil Steril 2018; 12:303-305. [PMID: 30291690 PMCID: PMC6186284 DOI: 10.22074/ijfs.2019.5344] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 07/10/2018] [Indexed: 11/10/2022]
Abstract
Background Assessing the net-results of microsurgical varicocelectomy in infertile men with non-obstructive azoosper-
mic (NOA) and clinical varicocele in five years at Royan Institute. Materials and Methods This is a descriptive retrospective cohort study. A backward-looking review of patients
treated for NOA and varicocele from march 2011 to march 2016 was performed. In addition, MDTESE results of 57
patients with NOA and clinical varicocele, with 537 NOA patients without varicocele were compared. Results Of 57 patients who underwent varicocelectomy, eight patients (14%) had sperm on sperm analysis post-opera-
tively. One of the eight patients was single, and one of them had spontaneous pregnancy (1/7) 14%, and one had a child
by microinjection (1/7) 14%. Out of these 8 patients, 6 had hypospermatogenesis pathology. Of 38 patients who under-
went MDTESE, 14 patients (36%) had sperm on their testis tissues, but one of them had no egg fertilization. Therefore,
the fertilization rate was (92%). Of the remaining 13 patients, 3 had live child birth (3/13) 23%. Sperm retrieval rate
(SRR) in NOA men without clinical varicocele was lower from those who had varicocele and NOA (22 vs. 36%). Also
live birth rate in NOA men with varicocelectomy was higher than NOA men without varicocele (23 vs. 11%). Conclusion Microsurgical varicocelectomy in NOA men may have positive effects on post-operative sperm in ejacu-
late and natural or assisted pregnancies, but it seems that the effect is more significant on MDTESE results and follow-
ing successful microinjection. Meanwhile, SRR and live birth rate was higher in our patients compare to NOA men
without clinical varicocele.
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Affiliation(s)
- Hesamoddin Sajadi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Jalil Hosseini
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Faramarz Farrahi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Farid Dadkhah
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahdi Sepidarkish
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Poopak Eftekhari-Yazdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Urology, Shariati Hosital, Tehran University of Medical Sciences, Tehran, Iran. Electronic Address:
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Miraghazadeh A, Sadighi Gilani MA, Reihani-Sabet F, Ghaheri A, Borjian Boroujeni P, Zamanian M. Detection of Partial AZFc Microdeletions in Azoospermic Infertile Men Is Not Informative of MicroTESE Outcome. Int J Fertil Steril 2018; 12:298-302. [PMID: 30291689 PMCID: PMC6186279 DOI: 10.22074/ijfs.2019.5397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 04/22/2018] [Indexed: 11/10/2022]
Abstract
Background Microdeletions of the Yq chromosome are among the most frequent genetic etiological factor of male
infertility which spans the azoospermia factor regions (AZFa, AZFb and AZFc). Microdeletions are mostly seen in
the AZFc region and usually cover genes actively involved in spermatogenesis. Partial AZFc microdeletions may
also occur with various spans, namely gr/gr, b2/b3 and b1/b3. It is known that the outcome of microtesticular sperm
extraction (TESE), the surgical process for sperm retrieval from the testis in infertile azoospermic men, may be pre-
dicted based on the type of AZF microdeletion. We therefore aimed to evaluate the correlation between partial AZFc
microdeletions and microTESE results. Materials and Methods In this cross-sectional study, 200 infertile azoospermic men referred to the Royan Institute
were examined for the presence of partial AZFc microdeletions before undergoing microTESE. Partial AZFc micro-
deletions were detected by multiplex polymerase chain reaction (PCR) of seven different sequence-tagged site (STS)
markers. The data were analyzed with the Chi-square test. Results Among the 90 patients (45%) with a positive microTESE outcome, 9 (10%) showed a partial microdeletion
in AZFc region. Of the 110 (55%) patients with a negative microTESE outcome, 7 (6.3%) had an AZFc partial micro-
deletion. With respect to the span of the microdeletions, among the 200 patients, 11 (5.5%) were gr/gr and 5 (2.5%)
were b2/b3. Statistical analysis showed no significant difference between the patients with and without partial AZFc
microdeletions with respect to microTESE outcome. Conclusion Partial AZFc microdeletions is not a predictor of microTESE outcome in azoospermic men.
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Affiliation(s)
- Azam Miraghazadeh
- Department of Molecular and Cellular Sciences, Faculty of Advanced Sciences and Technology, Science and Research Branch, Islamic Azad University, Tehran, Iran.,Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Fakhredin Reihani-Sabet
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Azadeh Ghaheri
- Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Parnaz Borjian Boroujeni
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammadreza Zamanian
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. Electronic Address:
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Zangeneh M, Sedaghat Jou M, Sadighi Gilani MA, Jamshidi Makiani M, Sadeghinia S, Salman Yazdi R. The prevalence of HBV, HCV and HIV infections among Iranian infertile couples referring to Royan institute infertility clinic: A cross-sectional study. Int J Reprod Biomed 2018; 16:595-600. [PMID: 30643867 PMCID: PMC6312715] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/30/2022] Open
Abstract
BACKGROUND The role of the screening protocol for viral hepatitis and human immuunodeficiency virus (HIV) infections among infertile couples were seldom investigated. OBJECTIVE The present study was performed to assess the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV) and HIV infections among infertile couples referring to infertility clinic of Royan Institute. MATERIALS AND METHODS This analytical cross-sectional study was performed on 21673 infertile couples referring to infertility clinic of Royan Institute between 2009 and 2014. Serological findings for viral hepatitis B, C and HIV infection were gathered herewith demographic data of the study participants through the study checklist. Ultimately, 302 couples who had at least one positive result in their serological tests were included in the statistical analysis. RESULTS The HBV and HCV infections prevalence among study participants were 0.57% and 0.148% respectively; only two cases had HIV infection. HBV and HCV infections prevalence had significant association with the gender of participants, but there was no significant relationship between these infections and infertility types. CONCLUSION Viral hepatitis infections screening among infertile couples undergoing assisted reproductive techniques needs more attention.
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Affiliation(s)
- Mehrangiz Zangeneh
- Department of Infectious Diseases, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.,Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Maryam Sedaghat Jou
- General Physician, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | | | - Shaghayegh Sadeghinia
- Department of Biomolecular & Biomedical Science, School of Health Life & Science, Glasgow Caledonian University, Glasgow, UK.
| | - Reza Salman Yazdi
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
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50
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Sabbaghian M, Mohseni Meybodi A, Rafaee A, Saba S, Zamanian M, Sadighi Gilani MA. Sperm retrieval rate and reproductive outcome of infertile men with azoospermia factor c deletion. Andrologia 2018; 50:e13052. [PMID: 29920741 DOI: 10.1111/and.13052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/05/2018] [Accepted: 03/08/2018] [Indexed: 11/29/2022] Open
Abstract
To evaluate the success rate in sperm retrieval (SR) through microdissection testicular sperm extraction (micro-TESE) in infertile azoospermia factor c (AZFc)-deleted men and determining their reproductive outcomes following ICSI, medical records of couples with AZFc-deleted male partners were reviewed on patient's age, serum hormone levels, karyotype, testicular pathology and pregnancy outcomes. A comparison on age and serum hormone level was conducted between groups with positive and negative sperm retrieval in both azoospermic and oligozoospermic AZFc-deleted men. Of 225 who had AZFc deletion, 195 cases followed clinical treatments. From 195 cases, 116 were azoospermic, 79 were oligozoospermic. Pathology profile was available in 103 of 195 subjects which the predominant trait was SCOS and was seen in 66.9% of cases (69 of 103). Success rate of sperm retrieval in azoospermic patients who underwent micro-TESE was 36.3% (28/77). Forty-three oligozoospermic and 17 azoospermic patients started ART cycle. Pregnancy rate in oligozoospermic group was 35.4% (17 cases), whilst there was no clinical pregnancy in azoospermic group. In conclusion, the pregnancy and delivery in oligozoospermic patients with AZFc deletion are comparable with other studies, but despite of sperm retrieval in azoospermic patients with AZFc deletion, the chance of pregnancy or delivery in these patients was very low.
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Affiliation(s)
- Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Anahita Mohseni Meybodi
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Alemeh Rafaee
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Sadaf Saba
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammadreza Zamanian
- Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mohammad Ali Sadighi Gilani
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.,Department of Urology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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