Empowering tomorrow's leaders: the impact of the 15th Network of Young Researchers in Andrology (NYRA) meeting on male reproductive health and interdisciplinary collaboration

The 15th Network of Young Researchers in Andrology (NYRA) meeting, held at the Palace de Caux, Switzerland, served as a valuable platform to disseminate cutting-edge research and facilitate interactions among early-career researchers and trainees in andrology from around the world. Preceding the 22nd European Testis Workshop, the 2-day event brought together participants from a variety of countries to discuss a range of topics pertaining to men's reproductive health and biology. Specific focuses included piRNAs in mammalian reproduction, biomolecules enhancing sperm physiology, advances in in vitro spermatogenesis, reproductive strategies across species, and career development. A dedicated 'scientific speed-dating' social event also stood out, encouraging cross-disciplinary collaborations and strengthening ties within the scientific community. The high participation rate of the meeting highlighted its value in connecting the andrology community. Finally, the announcement of NYRA's merger with the European Academy of Andrology (EAA) marked a pivotal moment, enabling NYRA to support young researchers while collaborating with the EAA to advance andrology research. The 15th NYRA meeting played a crucial role in enhancing knowledge dissemination and andrology research, empowering young researchers, and addressing key challenges in male infertility.

University students' opinion on gamete donor identification regimes

PURPOSE

This study aims to evaluate the opinion of university students about the identification or nonidentification of gamete donation and the probability of donation according to the different regimes.

METHODS

This was a cross-sectional observational study based on an online anonymous survey including questions about sociodemographic data, reasons for considering donations, information about the donation process and legislation, and their opinions about the different regimes and how they would influence donations.

RESULTS

In total, 1393 valid responses were obtained, with a mean age of 24.0 years (SD = 4.8), most of the respondents being female (68.5%), living in a relationship (56.7%), and without children (88.4%). The main reasons for considering donation would be altruism and monetary compensation. Overall, it was found that participants were poorly informed about the donation procedure and legislation. Students revealed preference for nonidentified donation, and they were less likely to donate in an open identity regime.

CONCLUSION

Most university students consider themselves poorly informed about gamete donation, express a preference for nonidentified gamete donation, and would less likely donate on an open identity basis. Thus, an identified regime may be less attractive to potential donors and lead to a decrease in the availability of gamete donors.

Effects of Covid-19 vaccination on different semen parameters

Background

The possible effects of COVID-19 vaccines on reproductive health and male fertility in particular have been discussed intensely by the scientific community and the public since their introduction during the pandemic. On news outlets and social media platforms, many claims have been raised regarding the deleterious effects of COVID-19 vaccines on sperm quality without scientific evidence. In response to this emerging conflict, we designed this study to evaluate and assess the effect of the Pfizer-BioNTech mRNA COVID-19 vaccine on male fertility represented by the semen analysis parameters.

Results

Comparing the semen parameters of the participants before and after vaccination, no statistically significant effects on semen volume, pH or normal sperm concentration and morphology were shown. However, there were statistically significant differences on total sperm motility (P = 0.05) and progressive motility (P = 0.02). These differences are clinically insignificant given the fact that both readings before and after vaccination were within the normal ranges, according to the WHO manual guidelines for the examination and processing of human semen.

Conclusion

Our data suggest that the Pfizer-BioNTech mRNA COVID-19 vaccine has no deleterious effects on semen parameters.

P-058 Risk factors associated with sperm DNA fragmentation in Tunisian subfertile men

Study question

The aim of the study was to investigate risk factors for sperm DNA fragmentation to determine which factors influence significantly the sperm DNA fragmentation.

Summary answer

Obesity seems to lead to higher risk of sperm DNA damage in Tunisian subfertile men.

What is known already

A positive association between lifestyle conditions, varicocele, advanced age and exposure to toxicants and DNA fragmentation has been documented.

Study design, size, duration

It’s a retrospective case control study. 61 Patients registered from October 2018 to December 2021 were divided into two groups: group “C” with good quality sperm DNA (n = 20) and group “F” with fragmented sperm DNA (n = 41).

Participants/materials, setting, methods

DNA fragmentation was measured using terminal deoxynucleotidyltransferase dUTP nick and labeling assay. The Odds Ratio (OR) and their 95% CI were calculated using univariate logistic regression in order to quantify the association between the variable of interest “Sperm DNA fragmentation” and the various risk factors: lifestyle conditions (e.g. tobacco smoking, alcohol consumption, and obesity), age, professional exposure to high temperature and toxic products and urological history (e.g. varicocele, testicular hypotrophy or hypertrophy).

Main results and the role of chance

Our results showed that tobacco, professional exposure to high temperature and toxic products and urological history are risk factors that may alter sperm DNA with an odds ratio (OR) of 2.1, 1.9 and 1.5, respectively. Interestingly, we demonstrated that obesity seems to be the most significant risk factor of DNA fragmentation with an OR of 4.2 (p = 0.002).

Limitations, reasons for caution

Further studies are needed to investigate the mechanism by which obesity occur sperm DNA damage.

Wider implications of the findings

Our finding are in accordance with several retrospective studies demonstrating that obesity is liable to sperm DNA damage

Trial registration number

not applicable

P-741 The COVID-19 pandemic: is there any impact on male fertility?

Study question

Is there any impact of the pandemic period on semen parameters?

Summary answer

Both total and progressive sperm motility as well as sperm morphology were impaired during COVID-19 pandemic.

What is known already

Male fertility could be affected by many environmental conditions. The COVID-19 pandemic has led to many dramatic consequences on human lives (psychological, financial level…). However, little information is available on the impact of the emergent COVID-19 on male fertility.

Study design, size, duration

This was a cohort study comparing semen parameters before and during the two first COVID-19 waves in infertile Tunisian patients.

Participants/materials, setting, methods

Were included in the current study 90 patients followed in the consultation of the department of Cytogenetics and Reproductive Biology (Monastir, Tunisia) for hypofertility. Each of the included patients has already a spermogram before the COVID-19 pandemic and a spermogram during the COVID-19 pandemic allowing the comparison of semen parameters for each patient so that he was considered as his own control. Patients who received medication (antibiotics, antioxidants…) were excluded from the current study.

Main results and the role of chance

Among standard semen parameters, we have shown a significant decrease in both total and progressive sperm motility during COVID-19 pandemic (p < 0.0001 and p = 0.001 respectively). The observed decrease 30 min after ejaculation was maintained 2 hours and 4 hours after ejaculation. Furthermore, we observed an impairment in sperm morphology. Indeed, the percentage of morphologically abnormal spermatozoa raises from 90.99±7.37% to 93.67±4.54% (p < 0.0001). The remaining semen parameters was similar between the two compared timepoints except a slight decrease in sperm count during the pandemic (p = 0.079).

Multivariate analysis didn’t show among clinical and epidemiological characteristics any associated factor with the observed decrease in semen quality.

Limitations, reasons for caution

The included patients didn’t have any COVID-19 symptoms on the day of sperm collection. However, as we have no proof of negative PCR test, the observed impairment in semen quality could be not only the consequence of psychological stress but may be also induced by a latent infection.

Wider implications of the findings

Even in patients with no proof of COVID-19 infection, the pandemic seems to have a real impact on hypofertile men as sperm motility and morphology were significantly impaired. It would be preffered to control semen parameters away from such period before referring patients to assisted reproduction.

Trial registration number

Not Applicable

P-068 Oxidative stress and DNA fragmentation of spermatozoa in patients with cancer

Study question

Does cancer increase sperm DNA fragmentation (sDF) level by increasing oxidative stress in human spermatozoa?

Summary answer

Cancer increases both sDF and oxidative stress, but further studies are necessary to understand whether higher levels of ROS are responsible for sperm DNA damage.

What is known already

In recent years, it has been emerging that not only oncological therapies but also cancer itself can induce abnormal spermatogenesis. In addition, several Authors reported that occurrence of malignancy provokes also increases of sperm DNA damage, although such finding was not confirmed by others and the possible mechanisms responsible for such damage are presently unknown

Study design, size, duration

This was a prospective observational study conducted from 2018 to today, conducted in 102 patients affected by cancer and in 66 control subjects.

Participants/materials, setting, methods

We recruited 102 patients affected by cancer and 66 male partners of infertile couples as control subjects, in the Andrology Clinic of University of Florence. Control subjects were normozoospermic with absence of leukocytospermia, semen viscosity, smoking habit and recent antibiotic therapies. In the recruited men, we evaluated standard semen parameters, sperm DNA Fragmentation with SCD (Sperm Chromatin Dispersion) Test and oxidative stress as percentage of viable spermatozoa with MitoSOX™ Red labeling on total viable spermatozoa.

Main results and the role of chance

We found poorer standard semen parameters (sperm motility, concentration and number) in cancer patients (both testicular and hematological ones) with respect to control group, whereas no differences were observed between the two types of cancer. Testicular, but not hematological patients, were younger than control subjects. No difference was seen in the other tested characteristics (sperm morphology, abstinence, semen volume and pH, BMI). Regarding sDF, we found higher median values [IQR] in cancer patients (total: 22.25[17.00-25.95], n = 68; hematological: 23.00[20.13-26.38], n = 28; testicular: 21.13[16.13-25.73], n = 40) vs control subjects (12.50[8.25-14.75], n = 53); p &lt; 0.05, test U di Mann-Whitney. In addition, the amount of sperm oxidative stress was dramatically higher in patients with cancer (total:38.92[24.90-58.87], n = 79; hematological: 38.85[24.98-50.77], n = 34; testicular: 38.92[20.59-63.59], n = 45) vs control subjects (11.50[8.38-17.20], n = 62); p &lt; 0.05, test U di Mann-Whitney. We also studied the occurrence of a correlation between levels of sDF and oxidative stress. We found a sharp correlation when both cancer patients and control subjects were analysed (Spearman coefficient = 0.62, p &lt; 0.001, n = 103), but such correlation was completely lost when only cancer patients were considered (Spearman coefficient = 0.10, p &gt; 0.05, n = 50). This finding suggests that mechanisms different from ROS attack to DNA could explain the increase of sDF levels in cancer patients.

Limitations, reasons for caution

The study did not investigate, because of scarce availability of semen samples from cancer patients, other possible mechanisms (i.e apoptosis, defects in sperm chromatin maturation, failure in DNA system repair) which could cause the observed increase of sperm DNA damage in such patients.

Wider implications of the findings

Cancer patients show high levels of both sDF and oxidative stress. This finding rises concern, as cancer patients cryopreserve semen for using it with Assisted Reproductive Tecnhologies and both parameters represent a threat for natural and assisted reproduction. In addition, emerging evidence suggest that oxidative stress may alter sperm epigenome.

Trial registration number

not applicable

P–086 High level of sperm DNA breaks in infertile men with varicocele: its association with sperm cells death, seminal oxidative stress, and spermatic parameters

Study question

Our objectives were to determine the extent of nuclear sperm injury in varicocele patients with and without altered spermatic parameters and to investigate its relationship with apoptosis and oxidative stress.

Summary answer

Oxidative stress (OS) in the varicocele patients may play a role in the etiology of nuclear sperm DNA damage associated with apoptosis.

What is known already

Varicocele is associated with high level of DNA Breaks.

Study design, size, duration

Ejaculated sperm samples from 51 patients diagnosed with varicocele and 29 fertile men were examined. According to the guidelines, the patient’s sperm samples were classified into varicocele with normal semen parameters (n = 11) and varicocele with abnormal semen parameters (n = 40).

Participants/materials, setting, methods

Sperm DNA breaks was assessed using terminal deoxynucleotidyl transferase dUTP nick end labeling assay. The proportion of both viable and dead spermatozoa with externalized phosphatidylserine was detected by the bivariate annexin V cy3/6-CFDA staining method. Seminal malondialdehyde (MDA) amounts and antioxidant enzymes activities of superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) were measured spectrophotometrically.

Main results and the role of chance

Sperm DNA Breaks, viable spermatozoa with externalized PS, and MDA levels were significantly higher in studied subgroups of patients with varicocele, either with normal or with abnormal semen parameters than controls. The seminal antioxidant enzymes activities were significantly reduced in both subgroups of patients with varicocele compared to the controls. The percentage of spermatozoa with fragmented DNA was positively correlated to the MDA level as well as the proportion of viable spermatozoa with externalized PS. However, the decreased seminal antioxidant status was negatively correlated with the increased proportion of sperm DNA fragmentation and apoptotic spermatozoa.

Limitations, reasons for caution

We suggest further comparative studies connecting the varicocele patients with and without altered spermatic parameters representing high level of DNA fragmentation with more apoptotic and oxidative stress markers.

Wider implications of the findings: This study reveals that impaired seminal antioxidant profile and increased seminal level of lipid peroxidation may be involved in the pathophysiological mechanisms of cell death-mediated DNA breaks in patients with varicocele.

Trial registration number

Not applicable

Evaluation of teamwork in operating rooms in a Tunisian university hospital

Background

Teamwork is fundamental to ensuring the quality of care and patient safety in operating rooms. It has been shown that the occurrence of adverse events is closely linked to a poor quality of teamwork in these settings. Thus, this study aimed to assess teamwork in different operating rooms of the university hospital of Sahloul Sousse (Tunisia).

Methods

It is a descriptive cross-sectional study with convenience sampling, conducted in operating rooms of the university hospital of Sahloul Sousse (Tunisia) between February and April 2018. The measuring instrument was the validated observation grid 'Communication and Teamwork Skills Assessment Tool (CATS) '. Teamwork is assessed through 4 domains (Situation awareness, Coordination, Communication, Cooperation). Behaviors are marked in rows each time they occur and are rated for quality in columns labeled “Observed and Good,” “Variation in Quality” (meaning incomplete or of variable quality), and “Expected but not Observed.”

Results

A total of 51 interventions were observed. Good coordination between the team members was noted, as well as good cooperation within the teams. A variation of quality level of communication with the patient was noted in 31.4% of cases, also communication about the context, the situation and recommendation among caregivers is not quite good with a percentage of 39.2%. Moreover, the work environment was rated as good in 84.3% of cases.

Conclusions

Some failures in teamwork were noted, hence it is important to take corrective measures for better practice and better patient management in such a complex environment, the operating rooms, where there is a strong need for team coordination.

Key messages

There is a direct relationship between the quality of care and the effectiveness of teamwork. It is necessary to eliminate the barriers to communication, in order to prevent adverse events.