Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies

Correlation of mediterranean diet pattern and lifestyle factors with semen quality of men attending fertility clinics: A cross-sectional study

BACKGROUND

While numerous studies have examined the impact of individual or combined nutrients on semen quality, research on the correlation between overall dietary patterns and semen quality remains limited. This cross-sectional study investigates the relationship between adherence to the alternative Mediterranean diet (aMED) and semen quality.

METHODS

A total of 274 men, presenting with both normal and abnormal semen parameters, participated in this study. Dietary data were collected using a 147-item semi-quantitative food frequency questionnaire (FFQ). Participants were divided into three groups based on their adherence to the Mediterranean diet (T1, T2, and T3). Statistical analyses, including ANOVA for numerical data and Chi-square tests for categorical data, were conducted. Multivariable logistic regression models were employed to estimate the association between aMED scores and abnormal semen parameters.

RESULTS

Participants in the highest adherence group (T3) were younger and had lower BMI compared to those in the other tertiles. Significant differences in sperm parameters were observed across the tertiles. T3 recorded the highest levels of sperm concentration, total sperm count, motility, progressive motility, and normal morphology (57.53 ± 36.16, 213.8 ± 158.9, 73.4 ± 25.9, 61.2 ± 24.6, and 6.42 ± 1.51, respectively), whereas T1 had the lowest values (11.92 ± 22.29, 43.3 ± 73.8, 36.7 ± 33.8, 4.6 ± 5.7, respectively). No significant differences were found in semen volume and viscosity. The regression analysis revealed a significant positive correlation between aMED scores and sperm concentration (B = 1.32, P = 0.001), total sperm count (B = 1.12, P = 0.001), and total motility (B = 0.71, P = 0.001).

CONCLUSION

Adherence to a high-quality Mediterranean diet is positively associated with improved semen quality and increased male fertility potential. Promoting healthy dietary patterns may be an effective strategy to enhance sperm motility and overall male reproductive health.

Association Between Dietary Habits and the Semen Quality of South Asian Men Attending Fertility Clinic: A Cross-sectional Study

The purpose of the study is to explore the impact of dietary habits, including daily intake of nutrients and dietary patterns, on the semen characteristics of South-Asian men. This cross-sectional study included 162 South-Asian men aged 21-40 years who were undergoing infertility evaluation. Based on semen analysis, men were grouped into categories of normal and abnormal semen characteristics. The participants' dietary habits were captured using '24-hour dietary recall' and 'Food Frequency Questionnaire (FFQ)'. Daily dietary intake of various nutrients and adherence to prevalent dietary patterns were compared between men with normal and abnormal semen characteristics. Six dietary patterns were identified following factor analysis of FFQ data. Men with normal semen characteristics showed significantly higher consumption of "coastal diet" rich in seafood, fish, cereals, beans, and coconut oil than those with abnormal semen characteristics. Further, the multivariable-adjusted model, adjusted for clinically relevant confounders, like age, body mass index (BMI), physical activity, smoking and sexual abstinence, also showed a lower risk of abnormal semen characteristics among men consuming "coastal diet" (odds ratio [OR] = 0.56, 95% confidence interval [CI] 0.37-0.82). In terms of daily nutrient intake, men with normal semen characteristics showed significantly lower consumption of monounsaturated fatty acids (MUFA) compared to men with abnormal semen characteristics (p = 0.008). Our findings suggest that higher consumption of "coastal pattern diet" lowers the risk of abnormal semen characteristics. Additionally, a negative association of MUFA consumption with semen quality was also identified, which needs cautious interpretation until replicated in future studies with biochemical validations.

Healthy and unhealthy dietary patterns and sperm quality from the Led-Fertyl study

BACKGROUND

Dietary patterns may affect sperm quality, but the scientific evidence is limited.

OBJECTIVE

To evaluate the association between adherence to different a-priori dietary patterns and sperm quality parameters in healthy reproductive-age men.

MATERIALS AND METHODS

A cross-sectional analysis was conducted using data from 200 young men enrolled in the Led-Fertyl study. Tertiles of six a-priori dietary patterns were estimated: four healthy dietary patterns [Mediterranean Diet Adherence Screener (MEDAS), Dietary Approaches to Stop Hypertension (DASH), Healthful Plant-Based Diet Index (hPDI) and EAT-Lancet Score], and two unhealthy dietary patterns [Western Diet and Unhealthful Plant-Based Diet Index (uPDI)]. Sperm quality parameters (count, concentration, vitality, total and progressive motility, and normal morphology) were considered the main outcomes.

RESULTS

Compared with the lowest tertile, participants in the highest MEDAS tertile had higher total sperm count (β = 3.2;95%CI: 1.0, 5.5) and concentration (β = 1.8;95%CI: 0.6, 3.0), and total (β = 8.2;95%CI: 1.3, 15.1) and progressive motility (β = 7.1;95%CI: 0.2, 14.0). Similarly, participants in the highest hPDI tertile had higher total sperm count (β = 3.4;95%CI: 1.4, 5.5) and concentration (β = 1.2;95%CI: 0.0, 2.3) compared with those in the lowest tertile. When these dietary patterns were modelled as continuous variables (for each 1-point increment in the specific score), an inverse association was found between the uPDI and Western and total sperm count [(β = -2.7;95%CI: -4.8, -0.7) and (β = -3.8;95%CI: -5.8, -1.7), respectively] and sperm concentration [(β = -1.2;95%CI: -2.4, -0.1) and (β = -1.7;95%CI: -2.8, -0.5), respectively]. Compared with participants in the lowest tertile, those in the highest uPDI tertile presented higher odds of abnormal sperm concentration (OR: 4.6;95%CI: 1.0, 19.9) and one or more seminogram abnormalities (OR: 2.3;95%CI: 1.1, 5.0).

CONCLUSIONS

Our findings suggest that higher adherence to healthy dietary patterns (Mediterranean and healthful plant-based diet) was positively associated with better sperm quality parameters, in contrast, greater adherence to unhealthy dietary patterns was inversely associated.

Association between the composite dietary antioxidant index and risk of infertility: Evidence from NHANES 2013-2020 and a Mendelian randomization study

OBJECTIVE

The Composite Dietary Antioxidant Index (CDAI) measures the antioxidant capacity of the diet, which is believed to provide protection against various diseases, including depression, osteoporosis, and papillomavirus infection, by neutralizing harmful oxidative stress. However, the relationship between CDAI and infertility is not well understood. This research aims to explore the potential correlations between CDAI and the risk of infertility.

METHODS

This research harnessed data from the National Health and Nutrition Examination Survey (NHANES) to execute a cross-sectional analysis involving 8263 US women aged 20-45. Each participant was subjected to two distinct 24-h dietary recall interviews. We calculated the CDAI using average daily antioxidant intake. Infertility was assessed using a standardized questionnaire. The association between CDAI and infertility was examined using weighted multiple logistic regression models, while nonlinear correlations were explored through restricted cubic splines. To affirm the robustness of our findings, sensitivity and subgroup analyses were performed using unweighted logistic regression. Additionally, to ascertain the causal influence of circulating antioxidant levels on infertility, a two-sample univariable Mendelian randomization (MR) analysis was conducted, using the inverse variance weighted (IVW) method as the primary analytic approach.

RESULTS

Participants who were infertile exhibited lower CDAI levels compared to their fertile counterparts. When confounding variables were accounted for in the multivariate weighted logistic regression model, an inverse relationship was observed between CDAI and infertility, with the odds ratio for the highest versus lowest quartile being 0.55 (0.33-0.90, P = 0.02). However, the IVW method indicated that genetically predicted elevated levels of CDAI did not significantly correlate with infertility.

CONCLUSION

Cross-sectional observational studies indicate that antioxidants from diets might diminish infertility risks. However, findings from MR studies do not confirm a causal connection. Additional prospective research is required to elucidate this association further.

Association between body mass index and semen quality: a systematic review and meta-analysis

The continuous decline of human semen quality during the past decades has drawn much concern globally. Previous studies have suggested a link between abnormal BMI and semen quality decline, but the results remain inconsistent. This systematic review and meta-analysis aimed to evaluate the association between body mass index (BMI) and semen quality. We searched PubMed, Embase, and Web of Science for eligible studies from inception to April 17, 2022. We considered men with BMI < 25.0 kg/m2 as the reference and calculated the pooled weighted mean difference of men with overweight (BMI 25.0-29.9 kg/m2), obesity (BMI ≥ 30.0 kg/m2), class I obesity (BMI 30.0-34.9 kg/m2), and class II/III obesity (BMI ≥ 35.0 kg/m2). A total of 5070 articles were identified, of which 50 studies were included (71,337 subjects). Compared with men with BMI < 25.0 kg/m2, men with obesity had an average reduction of 0.24 ml in semen volume, 19.56 × 106 in total sperm number, 2.21% in total motility, 5.95% in progressive motility, and 1.08% in normal forms, respectively, while men with overweight had an average reduction of 0.08 ml in semen volume and 2.91% in progressive motility, respectively. The reduction of semen quality was more pronounced among men with obesity than that among men with overweight. Moreover, significant reductions in semen quality were identified in men with different classes of obesity, which were more pronounced in men with class II/III obesity than that in men with class I obesity. Across men from the general population, infertile or subfertile men, and suspiciously subfertile men, we identified significant semen quality reductions in men with obesity/overweight. In conclusion, obesity and overweight were significantly associated with semen quality reductions, suggesting that maintaining normal weight may help prevent semen quality decline.

Mitochondrial DNA content and methylation in sperm of patients with asthenozoospermia

PURPOSE

The aim of the current study was to investigate the mtDNA methylation levels and mtDNA copy numbers in the sperm of patients with asthenozoospermia and compare them to those observed in controls with normozoospermia.

METHODS

Pyrosequencing analysis of the methylation levels of the mitochondrial D-loop and MT-CO1/chr1:631,907-632083/chrX:26,471,887-126,472,063 (hereinafter referred to as "MT-CO1-AVG") region and quantitative PCR analysis of the mtDNA copy number were performed on sperm from 30 patients with asthenozoospermia and 30 controls with normozoospermia.

RESULTS

Compared with those of controls with normozoospermia, the methylation levels of D-loop and MT-CO1-AVG regions and mtDNA copy number were significantly higher in patients with asthenozoospermia. The methylation level of the D-loop region in patients with asthenozoospermia and controls with normozoospermia and that of MT-CO1-AVG region in patients with asthenozoospermia showed a decreasing tendency with increasing total sperm motility. A significant inverse correlation between the mtDNA copy number and total sperm motility was observed in patients with asthenozoospermia but not in controls with normozoospermia. In patients with asthenozoospermia, but not in controls with normozoospermia, we observed a significant inverse correlation between D-loop methylation levels and mtDNA copy number, while no significant correlation was observed between MT-CO1-AVG methylation levels and mtDNA copy number.

CONCLUSION

These results reveal the occurrence of mtDNA methylation in human sperm and altered D-loop and MT-CO1-AVG methylation levels in patients with asthenozoospermia. Additional research is needed to determine the function of these features in the etiology and course of asthenozoospermia.

Dietary Glycemic Index and Load and Semen Quality: A Cross-Sectional and Prospective Analysis within the FERTINUTS Trial

PURPOSE

Infertility is a global health issue and nutrition plays a significant role in fertility outcomes. We aimed to investigate the cross-sectional and prospective associations of glycemic index (GI) and glycemic load (GL) with semen quality parameters in a cohort of healthy young men.

MATERIALS AND METHODS

The study included 106 men aged 18-35 years from the FERTINUTS trial. Dietary intake was estimated through 3-day dietary records and several semen parameters were assessed. Multivariable linear regression analysis with the Least Absolute Shrinkage and Selection Operator (LASSO) approach was employed.

RESULTS

The cross-sectional analysis revealed positive associations between GI and GL and total sperm count, sperm concentration, and total motility. In the prospective analysis, baseline GI was associated with increases in pH, vitality, immotile sperm or abnormal midpiece and decreases in total sperm count and motility. Conversely, GL was positively associated with changes in vitality and total sperm count.

CONCLUSIONS

While these findings suggest that GI may have adverse effects on several sperm quality parameters, the results were not consistently observed in the cross-sectional analysis. However, GL was consistently associated with better sperm quality in both analyses. The impact of carbohydrate quality and quantity on fertility remains uncertain and larger prospective studies are needed.

Exploring the association between urinary bisphenol A, S, and F levels and semen quality parameters: Findings from Led-Fertyl cross-sectional study

Infertility is recognized as a multifaceted condition affecting approximately 15% of couples globally, influenced by various factors including genetic predisposition and environmental exposures. Among these environmental factors, bisphenol A (BPA) emerges as a prominent Endocrine-disrupting chemical (EDCs) widely distributed, leading to chronic human exposure in daily life. As regulations on BPA became more stringent, alternative substances such as bisphenol S (BPS) and bisphenol F (BPF) have emerged. Animal studies have demonstrated a dose-dependent decline in fertility and embryotoxicity following chronic exposure to BPA. However, literature data on human studies are limited and heterogeneous. Additionally, even less is known about the relationship between exposure to the BPA analogues (BPS and BPF) and sperm quality. Therefore, the present study aimed to examine the association between urinary concentrations of BPA, BPF, and BPS and semen quality parameters among 195 adult Spanish men from the Led-Fertyl study cohort using multiple linear regression models adjusted by potential confounding variables. Our results revealed an inverse association between log-transformed creatinine-adjusted concentration (ng/mg) of BPA and BPF levels and the percentage of sperm vitality (β: 3.56 %; 95%CI: 6.48 to -0.63 and β: 4.14 %; 95%CI: 6.97 to -1.31; respectively). Furthermore, participants in the highest quartile of BPA and BPF urinary concentration exhibited lower sperm vitality compared to those in the lowest quartile (β: 6.90 %; 95%CI: 11.60 to -2.15 and β: 9.68 %; 95%CI: 14.43 to -4.94; respectively). These results supply epidemiological evidence establishing a relationship between bisphenols urine exposure and sperm quality, suggesting that a re-evaluation of the overall safety of BPA alternatives is warranted.

Male Fertility as a Proxy for Health

Male fertility is affected by a wide range of medical conditions that directly and indirectly affect spermatogenesis. As such, it can be useful as both an indicator of current health and a predictive factor for future health outcomes. Herein, we discuss the current literature regarding the association between male fertility and systemic health conditions and exposures. We review the connection between male fertility and genetics, medications, diet, and environmental pollutants, as well as its effects on future oncologic, cardiovascular, and autoimmune conditions. Understanding this interplay will allow more health care providers to engage in health counseling that will not only improve men's reproductive outcomes but also their overall health.

A Study of Factors Contributing to the Nutritional Status of Elderly People Receiving Home Care

(1) Background: Nutrition is a critical aspect of health and well-being in the elderly population, as physiological changes associated with aging can impact nutrient utilization and dietary needs. The aim of this study was the assessment of nutritional screening and associated factors among community-dwelling elderly people. (2) Methods: This study is the first phase of an intervention trial of people aged 65 years and over who received primary health services and resided in the municipality of Archanes Asterousia in Crete, Greece. Nutritional risk was assessed using the Mini Nutritional Assessment. Diet-related factors were analyzed, including health status (oral hygiene, depression, cognitive decline, impaired functioning, quality of life), social factors (educational attainment, marital status, type of work before 60 years), and lifestyle factors (smoking, drinking, diet). (3) Results: A total of 730 elderly people were evaluated (males, 31.5%), with an average age (±SD) of 76.83 (±6.68) years. MNA was found to have a statistically significant connection with assessment of oral hygiene, mental state, Charlson comorbidity, functional independence (assessed with the Barthel scale), and quality of life. The exception was geriatric depression (GDS), with which no statistically significant association was found (p > 0.05). Nutritional risk analysis revealed 379 participants (51.9%) to be adequately nourished, 205 (28.1%) to be at risk of malnutrition, and 146 (20.0%) to be malnourished. (4) Conclusions: These results clearly demonstrated the key factors that contribute to the nutritional screening of elderly people and need to be addressed by health authorities and social services.

Association between spectrum of mycotoxins and semen quality: A cross-sectional study in Beijing, China

Exposure to mycotoxins is unavoidable in daily life through ingestion, dermal, and inhalation routes. Toxicological studies found that exposure to mycotoxins might affect male reproductive function. However, there is still a lack of population evidence. We aimed to assess the association of individual and joint exposure to spectrum of mycotoxins with semen quality. The present study included 192 participants in Beijing, China. We measured conventional semen parameters and assessed semen quality. Sixty-seven traditional or emerging mycotoxins were determined to describe the spectrum of mycotoxins. The participants were widely exposed to multiple mycotoxins, and nearly half were simultaneously exposed to more than six mycotoxins. After adjusting potential confounders, logistic regression indicated that the number and concentration of plasma mycotoxin were correlated to the risk of low semen quality. Plasma beauvericin and citrinin concentrations were associated with lower semen quality. The least absolute shrinkage and selection operator regression showed similar results to logistic regression. Quantile-based g-computation and Bayesian kernel machine regression models found that the mixture of mycotoxins was harmful to semen quality, especially in sperm motility. In conclusion, both individual and mixture of mycotoxin exposure were correlated with lower semen quality. More regulations and measures should be taken to reduce mycotoxin contamination.

Mercury, natural fertility and outcomes of assisted reproduction: A systematic review

The primary route of mercury exposure for the general population is through consumption of contaminated seafood. There is a biological basis for an adverse effect of mercury exposure on human fertility. The goal of this review was to evaluate the existing literature on the association between mercury and pregnancy, among men and women attempting to conceive with and without assisted reproductive technology (ART). Systematic searches were performed in PubMed, EMBASE, Scopus and Web of Science for papers published up to March 2023 with no early date restriction, only including studies with a biomarker measurement of mercury exposure. We identified 11 studies examining mercury and natural fertility and 12 studies examining mercury and outcomes of assisted reproduction (implantation or clinical pregnancy). The accumulated evidence provides some support for a null association between bodily mercury concentrations and natural fertility among women, however, a large proportion of studies did not report adjusted estimates or were extremely imprecise. The majority of studies of natural fertility were also cross-sectional in nature. There was no evidence for an inverse or null association between mercury and natural fertility among men, or mercury and ART outcomes among men or women. In spite of biological plausibility, the existing evidence includes studies that are imprecise and often conflicting and does not allow us to make definitive conclusions on the associations of mercury exposure with successful pregnancy. Additional, larger studies are warranted, especially among individuals with high concentrations of mercury exposure as these individuals may be underrepresented in the current literature.

The Role of the Mediterranean Diet in Assisted Reproduction: A Literature Review

The Mediterranean Diet, characterized by high consumption of plant-based foods, olive oil, moderate intake of fish and poultry, and low consumption of red meat and processed foods, has been suggested to improve assisted reproductive technology (ART) outcomes. This narrative review aimed to summarize and synthesize the evidence from observational studies on the associations between preconception adherence to the Mediterranean Diet and ART outcomes. PubMed/MEDLINE, Embase, ScienceDirect, Google Scholar, and Web of Science databases were searched to identify relevant studies. Seven observational studies (n = 2321 women undergoing ART) were included. Adherence to the Mediterranean Diet was assessed using food frequency questionnaires with 6-195 items. Three studies found that higher Mediterranean Diet scores were associated with improved clinical pregnancy rates (OR 1.4, 95% CI 1.0-1.9; RR 1.98, 95% CI 1.05-3.78) or live birth rates (RR 2.64, 95% CI 1.37-5.07). Two studies showed a positive effect on embryo yield (p = 0.028) and ovarian response. However, two studies reported no significant associations with ultimate ART success, and four studies found no effects on oocyte and embryo number or quality. The heterogeneity in study designs, Mediterranean Diet assessment methods, and ART protocols limited the strength of conclusions. Evidence for the effects of greater adherence to the Mediterranean Diet on ART outcomes is limited but promising. Future research should focus on conducting randomized controlled trials with standardized Mediterranean Diet assessment methods to establish causal relationships between Mediterranean Diet adherence and ART outcomes, and to elucidate potential mechanisms of action.

Weight Loss as Therapeutic Option to Restore Fertility in Obese Men: A Meta-Analytic Study

PURPOSE

Weight loss has been shown to significantly elevate testosterone serum levels, though the impact on semen analysis parameters and fertility remains incompletely understood. The objective of this study was to examine the influence of body weight loss on semen parameters in obese men.

MATERIALS AND METHODS

A meta-analysis was performed that included clinical trials in which a semen analysis before and after weight loss was evaluated. All strategies potentially available for weight loss were considered eligible. The primary outcome was the comparison of conventional semen analysis parameters before and after weight loss.

RESULTS

Twelve studies were considered including 345 subjects (mean age 37.6±7.9 years; mean baseline body mass index 45.4±6.0 kg/m²). Weight loss resulted in a significant increase of sperm concentration (effect size 0.495, standard error 0.251 [0.003, 0.986], p=0.049) and progressive motility (effect size 0.567, standard error 0.372 [0.370, 0.764], p<0.001). Moreover, a significant decrease of sperm DNA fragmentation index after weight loss (effect size -0.689, standard error 0.278 [-1.123, -0.255], p=0.002) was observed.

CONCLUSIONS

This meta-analytic analysis confirmed that body weight loss may improve qualitative and quantitative sperm characteristics providing evidence for suggesting weight loss to male partners with obesity and semen analysis alteration in couples attempting conception.

A comprehensive review on potential role of selenium, selenoproteins and selenium nanoparticles in male fertility

Selenium (Se), a component of selenoproteins and selenocompounds in the human body, is crucial for the development of male reproductive organs, DNA synthesis, thyroid hormone, metabolism, and defence against infections and oxidative damage. In the testis, it must exceed a desirable level since either a shortage or an overabundance causes aberrant growth. The antioxidant properties of selenium are essential for preserving human reproductive health. Selenoproteins, which have important structural and enzymatic properties, control the biological activities of Se primarily. These proteins specifically have a role in metabolism and a variety of cellular processes, such as the control of selenium transport, thyroid hormone metabolism, immunity, and redox balance. Selenium nanoparticles (SeNPs) are less hazardous than selenium-based inorganic and organic materials. Upon being functionalized with active targeting ligands, they are both biocompatible and capable of efficiently delivering combinations of payloads to particular cells. In this review, we discuss briefly the chemistry, structure and functions of selenium and milestones of selenium and selenoproteins. Next we discuss the various factors influences male infertility, biological functions of selenium and selenoproteins, and role of selenium and selenoproteins in spermatogenesis and male fertility. Furthermore, we discuss the molecular mechanism of selenium transport and protective effects of selenium on oxidative stress, apoptosis and inflammation. We also highlight critical contribution of selenium nanoparticles on male fertility and spermatogenesis. Finally ends with conclusion and future perspectives.

Impact of Coffee Consumption on Subjective Perception and Inflammatory Markers in Patients with Inflammatory Bowel Diseases

Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic conditions marked by persistent inflammation, impacting patients' quality of life. This study assessed differences in coffee consumption between CD and UC patients and its potential effects on the subjective perception and objective changes in inflammation markers in these two categories of patients. Using questionnaires, coffee consumption patterns, and perceived symptom effects were evaluated. Biological samples were collected to measure the following inflammatory markers: leukocytes, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and fecal calprotectin (FC). Among 148 patients, 60% reported regular coffee consumption, with no significant difference between CD and UC patients. While 45.93% perceived no impact on symptoms, 48% of those reporting exacerbation continued their regular coffee consumption. FC values were significantly lower in coffee consumers than in non-consumers (p < 0.05), particularly in those consuming natural coffee (p < 0.001), and the case was observed for UC patients (p < 0.05). No significant differences were observed in other inflammatory markers, regardless of coffee type, frequency, or milk addition. This study highlights the commonality of coffee consumption among IBD patients and the association of lower FC levels with coffee consumption, especially in UC patients, suggesting that coffee may influence intestinal inflammatory responses.

Hirsutella sinensis intensifies testicular function and spermatogenesis in male mice with high-fat diet-induced obesity

BACKGROUND

Hirsutella sinensis (HS) is a mycelium isolated from the fruiting body of the medicinal mushroom Cordyceps sinensis . This study explored whether HS treatment affects reproductive dysfunction in a high-fat diet (HFD)-induced mouse model and regulates various mechanisms, focusing on oxidative stress, apoptosis, inflammation, and autophagy.

METHODS

Twenty-four C57BL/6J (B6) mice were randomly divided into a standard chow diet (NCD)- or HFD-fed group for 24 weeks. During the final 8 weeks, half of the HFD-fed mice were orally administered HS (HFD + HS). Biochemical markers, including glucose, insulin, triglycerides, and total cholesterol, were assessed, and hormones, including testosterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), were analyzed. Liver and testicular histology, as well as sperm quality markers such as sperm motility, sperm count, and percentage of sperm with normal morphology, were observed. The activities of the testicular antioxidants superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPx) and the products of lipid peroxidation, such as malondialdehyde (MDA), were measured. The protein expression levels of apoptosis-, autophagy- and inflammation-related markers were measured.

RESULTS

The HFD-fed mice had abnormal sex hormone levels, poor sperm quality, and a destroyed testicular structure, with increased oxidative stress and apoptosis in the testis. HS supplementation in HFD-fed mice attenuated testicular apoptosis by suppressing the Bax/Bcl-xl ratio and cleaved caspase 3 protein expression. The HS-treated mice exhibited improved reproductive function, possibly due to reduced oxidative stress and apoptosis, suggesting that HS has a protective effect against HFD-induced testicular damage.

CONCLUSION

Male mice supplemented with HS exhibited attenuated poor semen quality and reduced testosterone levels brought about by HFD-induced obesity by reducing oxidative stress.

Association of urinary metal element with semen quality: a cross-sectional study from Eastern China

The effect of metallic elements on semen quality remains controversial, with limited evidence on the effects of metal mixtures. We conducted a study involving 338 participants from multiple centers in Eastern China, measuring 17 urinary metals and semen quality parameters. Our analysis used various statistical models, including multivariate logistic and linear regression, Bayesian Kernel Machine Regression, and weighted quantile sum models, to examine the associations between metal levels and semen quality. Logistic regression showed that higher urinary lead was associated with increased risk of abnormal sperm concentration (OR = 1.86, p = 0.021), arsenic to higher abnormal progressive motility risk (OR = 1.49, p = 0.027), and antimony to greater abnormal total motility risk (OR = 1.37, p = 0.018). Conversely, tin was negatively correlated with the risk of abnormal progressive motility (OR = 0.76, p = 0.012) and total motility (OR = 0.74, p = 0.003), respectively. Moreover, the linear models showed an inverse association between barium and sperm count, even after adjusting for other metals (β = - 0.32, p < 0.001). Additionally, the WQS models showed that the metal mixture may increase the risk of abnormal total motility (βWQS = 0.55, p = 0.046). In conclusion, semen quality may be adversely affected by exposure to metals such as arsenic, barium, lead, and antimony. The combined effect of the metal mixture appears to be particularly impaired total motility.

Paternal Preconceptional Alcohol Use Disorder With the Offspring's Mortality Risk

INTRODUCTION

Paternal preconceptional alcohol use may contribute to early pregnancy loss. However, the link between paternal preconceptional alcohol use disorder and long-term offspring's mortality risk remains unclear. This study examined the association of paternal preconceptional alcohol use disorder and recency of diagnosis with offspring's mortality and further stratified the mortality after the first year of birth by age.

METHODS

This is a nationwide cohort study with 1,973,174 Danish births (1980-2012), with follow-up from birth until death; emigration; or December 31, 2016. Paternal conceptional alcohol use disorder was identified from Danish National Patient Register and Prescription Registry, categorizing recency of diagnosis into <1 year, 1 to <4 years, 4 to <8 years, and ≥8 years. Logistic regression estimated the ORs and 95% CIs for offspring mortality risk. All data were analyzed in 2023.

RESULTS

Paternal preconceptional alcohol use disorder was associated with a 28% increased mortality after 1 year of birth (95% CI=1.09, 1.51), 23% increased infant mortality (95% CI=1.07, 1.42), and 23% increased odds of stillbirth (95% CI=1.06, 1.43). Paternal alcohol use disorder diagnosed <1 year before conception was associated with an 85%-111% increased risk of mortality in offspring aged 15-40 years. More recent alcohol use disorder diagnosis (i.e., 1 year before conception) had a higher risks of death from infectious and circulatory diseases in offsprings.

CONCLUSIONS

Offspring of fathers with alcohol use disorder before conception had higher mortality risk from birth to early adulthood, especially when alcohol use disorder diagnosis is close to conception. Current awareness regarding paternal preconceptional alcohol dependence use is insufficient. Promoting alcohol dependence avoidance, including educating men on the impact of alcohol on child health during prepregnancy examination, may help reduce or prevent long-term offspring mortality.

Impact of bariatric surgery, lifestyle change, and pharmacotherapy on fertility in men with obesity: a systematic review protocol

OBJECTIVE

This review will determine whether various health interventions designed to reduce weight (lifestyle change, bariatric surgery, pharmacotherapy) in men with obesity are associated with improved fertility markers. The review will also establish whether the degree of weight loss achieved through these methods is associated with improvement.

INTRODUCTION

Current preconception guidelines provide limited information for men with obesity. Small studies implementing lifestyle changes in men are associated with improvement in sperm quality, whereas bariatric surgery has not been associated with improvements in sperm quality. Determining the benefit of different interventions and the relationship to weight lost is necessary to optimize male fertility.

INCLUSION CRITERIA

The population will be men younger than 50 years with overweight (BMI >25 kg/m 2 ) or obesity (BMI >30 kg/m 2 ). The exposure of interest will be an intervention undertaken to improve health or reduce weight, categorized as lifestyle change, bariatric surgery, or pharmacotherapy. Outcomes will include time to conception, fecundity rate, assisted reproduction outcomes, and semen quality measures. Secondary analysis will determine whether degree of weight loss achieved is associated with degree of improvement.

METHODS

This review will follow the JBI methodology for systematic reviews of etiology and risk. Databases to be searched will include PubMed, Embase (Ovid), Cochrane Central Register of Controlled Trials, Web of Science Core Collection, and Scopus. Articles not published or translated into English will be excluded. Methodological quality will be assessed using the JBI critical appraisal tools. Data will be extracted using a tool developed by the reviewers. Statistical meta-analysis will be performed where possible to synthesize outcomes of similar methods.

REVIEW REGISTRATION

PROSPERO CRD42022349665.

Effects of environmental temperature extremes exposure on sperm quality - evidence from a prospective cohort study in Anhui Province, China

Extreme weather is becoming more frequent due to drastic changes in the climate. Despite this, the body of research focused on the association between temperature extreme events and sperm quality remains sparse. In this study, we elucidate the impact of exposure to environmental temperature extremes on sperm quality. Data for this investigation were derived from the Anhui Prospective Assisted Reproduction Cohort, encompassing the period from 2015 to 2020. Parameters such as sperm concentration, total sperm count, total motility, progressive motility, total motile sperm count, and progressive motile sperm count were quantified from semen samples. We assessed the exposure of participants to temperature extremes during the 0-90 days prior to sampling. This investigation encompassed 15,112 participants, yielding 28,267 semen samples. Our research findings indicate that exposure to low temperature extreme for three consecutive days (at the first percentile threshold) has a detrimental correlation with sperm count parameters and concentration. Similar trends were observed with the second percentile threshold, where significant adverse effects typically manifested after a four-day exposure sequence. Analysis of high temperature extreme showed that exposure at the 98th percentile had adverse effects on all six sperm quality parameters, and the sperm count parameter was particularly sensitive to high temperature, showing significant results immediately after three days of exposure. When considering even more temperature extreme (99th percentile), the negative consequences were more pronounced on the sperm count parameter. Additionally, progressive motility showed a stronger negative response. In summary, parameters associated with sperm count are particularly vulnerable to temperature extremes exposure. Exposure to high temperature extremes environments may also be associated with a decrease in sperm concentration and vitality. The findings of this study suggest that male population should pay attention to avoid exposure to temperature extreme environment, which has important significance for improving the quality of human fertility.

Nutritional aphrodisiacs: Biochemistry and Pharmacology

In 2022, the global prevalence of erectile dysfunction (ED) was estimated to be at least 150 million cases. This number is greatly suspected to be underestimate as most men withhold information about ED. Also, about 15% of world population have infertility troubles, and male factors are responsible for almost half of these cases. Studies have shown that the quality of semen has decreased in the past several decades owing to various health factors and environmental toxicants. The current medical interventions involve the inhibition of phosphodiesterase 5 which suffer from serious side effects and costly. One of the popular and most sought interventions are the natural and nutritional remedies as they are foods in essence and potentially with no harm to the body. Therefore, the goal of this paper is to provide a review of the most common nutritional aphrodisiacs with increasing libido and fertility highlighting the potential active constituents as well as the underlying mechanisms.

Do Popular Diets Impact Fertility?

Infertility affects 15% of the population in developed countries, and its prevalence is increasing. Fertility can be influenced by different factors. Although key factors like maternal age cannot be changed, there is growing evidence that other modifiable factors, such as diet, can have an impact on fertility. Diet has become increasingly important in recent years for a number of reasons: the new trend toward a healthy lifestyle, the higher prevalence of certain digestive disorders, a lack of time that leads people to consume more prepared and processed food, and personal choice to not eat meat, among others. To meet these needs, several diets have recently become popular, such as the Mediterranean diet, known as the gold standard of health; the DASH diet, known for preventing hypertension; the Western diet, characterized by processed food; the ketogenic diet, characterized by low carbohydrate intake; and the vegetarian diet, which is the choice for people who do not eat meat or animal by-products. Diets present a unique composition characterized by the presence or absence of specific nutrients, which have also been associated with male and female fertility individually. This review assesses the impact of these diets and of macro- and micronutrients on both female and male fertility.

The Influence of Lifestyle on Male Fertility in the Context of Insulin Resistance-Identification of Factors That Influence Semen Quality

Background: Male fertility is known to have been negatively influenced by the progress of civilization. Another condition whose incidence has been on the increase for the same reason is insulin resistance (IR). In addition, men increasingly often resign from the pursuit of active forms of leisure, preferring more sedentary ones. Considering these trends, this aim of this study was to investigate the relationships between lifestyle factors, insulin resistance, and male fertility in men with and without the condition. A further aim was to select those lifestyle factors that would make it possible to predict the level of male fertility, especially when IR is concerned. Methods: This study was performed in a group of 73 participants, divided into groups based on their insulin resistance status. Their physical activity, diet, perceived stress, sleep quality, libido level, and duration of sexual abstinence were assessed on the basis of a number of parameters, including indices proposed by the authors. In addition, relevant anthropometric measurements were taken and tests related to glucose metabolism and semen quality were carried out. On the basis of these data, statistical tests were performed to establish or disprove relationships between lifestyle choices and semen quality, as measured my sperm motility. Results: The results of this study highlighted the associations between a number of parameters, i.e., micronutrient and vitamin intake, diet quality, body composition, insulin resistance, and the duration of sexual abstinence, and semen quality, as measured by sperm motility. Significantly, the presence or absence of IR was linked to male fertility. A multivariate model was developed, incorporating parameters such as the Matsuda index, vitamin intake, and sexual abstinence duration, to predict motility scores. Conclusions: This study underscores the negative impact of modern civilization's lifestyle choices on male fertility. Notably, vitamin and mineral consumption, especially from antioxidant-rich diets like the Mediterranean diet, emerged as key modifiable factors affecting fertility. Routine diagnostics for insulin resistance in fertility-related interventions is recommended. This study also highlights the importance of considering sexual abstinence duration during semen collection for accurate diagnostic results. Future research should focus on validating the proposed multivariate model and exploring the effects of lifestyle modifications, particularly vitamin supplementation, on fertility outcomes in men, especially in the context of IR.

High Dietary Inflammatory Index increases the risk of female infertility: An analysis of NHANES 2013-2018

Diet-related inflammation, which can be evaluated using the dietary inflammatory index (DII), is increasingly related to female infertility. However, studies on the association between DII and infertility are limited. In this study, we aim to explore the association between DII and infertility and its dose-effect relationship among women aged 20 to 45 years through a cross-sectional analysis of the National Health and Nutrition Examination Survey 2013-2018. A total of 2613 women aged 20 to 45 years were included and analyzed. The DII was calculated using the first 24-hour dietary recall interview data and divided into quartiles. Weighted multivariable logistic regression and restricted cubic spline analysis were used to explore the relationship between DII and infertility. The odds ratio (OR) (95% confidence interval [CI]) for the association between DII and infertility was 1.06 (0.96-1.19) after multivariable adjustment. Compared with the first quartile (anti-inflammatory diet), the fourth quartile of DII (pro-inflammatory diet) was more strongly associated with an increased risk of infertility, with an OR of 1.61 (95% CI, 1.05-2.47). Restricted cubic splines showed a J-shaped nonlinear association between DII and infertility (P for nonlinear = .003), with a cutoff point of 2.45. When DII was higher than 2.45, the OR for infertility was 1.95 (95% CI, 1.49-2.54). Similar results were observed among the subgroup analyses. In conclusion, this study found high DII (pro-inflammatory diet) increases the risk of female infertility. DII had a J-shaped nonlinear relationship with female infertility, whose cut point is 2.45. Controlling the intake of pro-inflammatory food may be beneficial for female infertility.

A metabolomic perspective on the mechanisms by which environmental pollutants and lifestyle lead to male infertility

The incidence of male infertility (MI) is rising annually. According to epidemiological studies, environmental pollution (e.g., organic, inorganic, and air pollutants), occupational exposure (e.g., high temperature, organic solvents, and pesticides), and poor lifestyle (e.g., diet, sleep, smoking, alcohol consumption, and exercise) are important non-genetic causative factors of MI. Due to multiple and complex causative factors, the dose-effect relationship, and the uncertainty of pathogenicity, the pathogenesis of MI is far from fully clarified. Recent data show that the pathogenesis of MI can be monitored by the metabolites in serum, seminal plasma, urine, testicular tissue, sperm, and other biological samples. It is considered that these metabolites are closely related to MI phenotypes and can directly reflect the individual pathological and physiological conditions. Therefore, qualitative and quantitative analysis of the metabolome, the related metabolic pathways, and the identification of biomarkers will help to explore the MI-related metabolic problems and provide valuable insights into its pathogenic mechanisms. Here, we summarized new findings in MI metabolomics biomarkers research and their abnormal metabolic pathways triggered by the presented non-genetic risk factors, providing a metabolic landscape of semen and seminal plasma in general MI patients. Then, we compared the similarities and differences in semen and seminal plasma biomarkers between MI patients exposed to environmental and poor lifestyle factors and MI patients in general, and summarized some common biomarkers. We provide a better understanding of the biological underpinnings of MI pathogenesis, which might offer novel diagnostic, prognostic, and precise treatment approaches to MI.

[First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022]

OBJECTIVE

To update the 2010 CNGOF clinical practice guidelines for the first-line management of infertile couples.

MATERIALS AND METHODS

Five major themes (first-line assessment of the infertile woman, first-line assessment of the infertile man, prevention of exposure to environmental factors, initial management using ovulation induction regimens, first-line reproductive surgery) were identified, enabling 28 questions to be formulated using the Patients, Intervention, Comparison, Outcome (PICO) format. Each question was addressed by a working group that had carried out a systematic review of the literature since 2010, and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) methodology to assess the quality of the scientific data on which the recommendations were based. These recommendations were then validated during a national review by 40 national experts.

RESULTS

The fertility work-up is recommended to be prescribed according to the woman's age: after one year of infertility before the age of 35 and after 6months after the age of 35. A couple's initial infertility work-up includes a single 3D ultrasound scan with antral follicle count, assessment of tubal permeability by hysterography or HyFOSy, anti-Mullerian hormone assay prior to assisted reproduction, and vaginal swabbing for vaginosis. If the 3D ultrasound is normal, hysterosonography and diagnostic hysteroscopy are not recommended as first-line procedures. Chlamydia trachomatis serology does not have the necessary performance to predict tubal patency. Post-coital testing is no longer recommended. In men, spermogram, spermocytogram and spermoculture are recommended as first-line tests. If the spermogram is normal, it is not recommended to check the spermogram. If the spermogram is abnormal, an examination by an andrologist, an ultrasound scan of the testicles and hormonal test are recommended. Based on the data in the literature, we are unable to recommend a BMI threshold for women that would contraindicate medical management of infertility. A well-balanced Mediterranean-style diet, physical activity and the cessation of smoking and cannabis are recommended for infertile couples. For fertility concern, it is recommended to limit alcohol consumption to less than 5 glasses a week. If the infertility work-up reveals no abnormalities, ovulation induction is not recommended for normo-ovulatory women. If intrauterine insemination is indicated based on an abnormal infertility work-up, gonadotropin stimulation and ovulation monitoring are recommended to avoid multiple pregnancies. If the infertility work-up reveals no abnormality, laparoscopy is probably recommended before the age of 30 to increase natural pregnancy rates. In the case of hydrosalpinx, surgical management is recommended prior to ART, with either salpingotomy or salpingectomy depending on the tubal score. It is recommended to operate on polyps>10mm, myomas 0, 1, 2 and synechiae prior to ART. The data in the literature do not allow us to systematically recommend asymptomatic uterine septa and isthmoceles as first-line surgery.

CONCLUSION

Based on strong agreement between experts, we have been able to formulate updated recommendations in 28 areas concerning the initial management of infertile couples.

Validation and measurement properties of the Male and Female Fertility Knowledge Inventories (MFKI and FFKI) in Iranian couples

BACKGROUND

One of the most important population challenges during the last three decades has been the significant decrease in the fertility rate worldwide. Since the validity and reliability of the Male and Female Fertility Knowledge Inventories (MFKI and FFKI) have not been determined in Iran, we conducted this study to assess psychometric characteristics of the MFKI and FFKI in couples in Tabriz and Urmia, Iran.

METHODS

This was a cross-sectional study, as the first part (quantitative phase) of a sequential explanatory mixed-method study. The current study was done on 1200 participants (600 women with their husbands) living in the northwestern region of Iran, between January 2023 and September 2023. The psychometric properties of the Persian version of the tool (MFKI and FFKI) were performed in 5 stages, including translation process, content validity, face validity, construct validity and reliability assesment.

RESULTS

In this study, the CVI, CVR, and impact scores of the MFKI tool were equal to 0.90, 0.88, 3.26 and CVI, CVR, and Impact scores of the FFKI tool were respectively equal to 0.95, 0.91 and 3.59, that it indicated a satisfactory level of content and face validity. Then, to check the construct validity, the results of the exploratory factor analysis of the MFKI tool on 13 items led to the identification of 3 factors, including Environment and reproductive health (ERH), Lifestyle factors (LSF) and Sperm quality (SQ), which explained 66% of the cumulative variance. The results of the exploratory factor analysis of the FFKI tool on 15 items led to the identification of 4 factors, including Reproductive health (RH), Lifestyle factors (LSF), Chance of conception (CHC) and Ovarian reserve and preservation (ORP), which explained 68% of the cumulative variance.

CONCLUSIONS

The findings of this study indicated that the Persian version of MFKI and FFKI has acceptable psychometric properties to measure the awareness of Iranian couples regarding fertility, which can be used as a screening tool for fertility knowledge by health care professionals and also as a reliable tool in research.

A Gnotobiotic Mouse Model with Divergent Equol-Producing Phenotypes: Potential for Determining Microbial-Driven Health Impacts of Soy Isoflavone Daidzein

The implications of soy consumption on human health have been a subject of debate, largely due to the mixed evidence regarding its benefits and potential risks. The variability in responses to soy has been partly attributed to differences in the metabolism of soy isoflavones, compounds with structural similarities to estrogen. Approximately one-third of humans possess gut bacteria capable of converting soy isoflavone daidzein into equol, a metabolite produced exclusively by gut microbiota with significant estrogenic potency. In contrast, lab-raised rodents are efficient equol producers, except for those raised germ-free. This discrepancy raises concerns about the applicability of traditional rodent models to humans. Herein, we designed a gnotobiotic mouse model to differentiate between equol producers and non-producers by introducing synthetic bacterial communities with and without the equol-producing capacity into female and male germ-free mice. These gnotobiotic mice display equol-producing phenotypes consistent with the capacity of the gut microbiota received. Our findings confirm the model's efficacy in mimicking human equol production capacity, offering a promising tool for future studies to explore the relationship between endogenous equol production and health outcomes like cardiometabolic health and fertility. This approach aims to refine dietary guidelines by considering individual microbiome differences.

APHRODITE criteria: addressing male patients with hypogonadism and/or infertility owing to altered idiopathic testicular function

RESEARCH QUESTION

Can a novel classification system of the infertile male - 'APHRODITE' (Addressing male Patients with Hypogonadism and/or infeRtility Owing to altereD, Idiopathic TEsticular function) - stratify different subgroups of male infertility to help scientists to design clinical trials on the hormonal treatment of male infertility, and clinicians to counsel and treat the endocrinological imbalances in men and, ultimately, increase the chances of natural and assisted conception?

DESIGN

A collaboration between andrologists, reproductive urologists and gynaecologists, with specialization in reproductive medicine and expertise in male infertility, led to the development of the APHRODITE criteria through an iterative consensus process based on clinical patient descriptions and the results of routine laboratory tests, including semen analysis and hormonal testing.

RESULTS

Five patient groups were delineated according to the APHRODITE criteria; (1) Hypogonadotrophic hypogonadism (acquired and congenital); (2) Idiopathic male infertility with lowered semen analysis parameters, normal serum FSH and normal serum total testosterone concentrations; (3) A hypogonadal state with lowered semen analysis parameters, normal FSH and reduced total testosterone concentrations; (4) Lowered semen analysis parameters, elevated FSH concentrations and reduced or normal total testosterone concentrations; and (5) Unexplained male infertility in the context of unexplained couple infertility.

CONCLUSION

The APHRODITE criteria offer a novel and standardized patient stratification system for male infertility independent of aetiology and/or altered spermatogenesis, facilitating communication among clinicians, researchers and patients to improve reproductive outcomes following hormonal therapy. APHRODITE is proposed as a basis for future trials of the hormonal treatment of male infertility.

The influence of lifestyle and biological factors on semen variability

PURPOSE

Semen parameters are subjected to within-individual variability over time. The driving factors for this variability are likely multi-factorial, with healthier lifestyle associated with better semen quality. The extent in which variations in individual's lifestyle contributes to within-individual semen variability is unknown.

METHODS

A total of 116 repeat semen samples from 29 men aged 19-37 over 6 months were collected. Basic semen analysis as per 5th WHO manual and extended semen parameters (sperm DNA fragmentation, redox potential and lipid peroxidation, sperm binding to hyaluronan and hyperactive motility) were assessed. An additional 39 lifestyle/biological factors (weight, blood pressure, etc.) were collected at each sample including validated health questionnaires SF36 Health Status, Australian Recommend Food Score, and International Physical Activity Questionnaire.

RESULTS

Only 10 out of the 39 lifestyle factors varied within men across samples including age (P = 0.0024), systolic blood pressure (P = 0.0080), social functioning (P = 0.0340), energy (P = 0.0069), non-alcoholic caffeinated beverages (P = 0.0010), and nutrition (P < 0.0001). The only semen parameter that varied between collections was sperm morphology (coefficient of variation 23.8 (6.1-72.0), P < 0.05). We only observed weak (r < 0.3) to moderate (r > 0.3- < 0.6) correlations between lifestyle factors, including body mass index, waist circumference, nutrition, exercise, blood pressure and semen parameters including sperm count, progressive motility, and sperm DNA fragmentation (P < 0.05).

CONCLUSION

In healthy men from the general population, semen quality and associated lifestyle factors do not significantly vary over 6 months, indicating that one semen sample is likely sufficient for determining male fertility in this population.

A ripple effect? The impact of obesity on sperm quality and function

Infertility affects approximately 15% of couples trying to conceive. Male-related causes account for roughly 50% of cases, with obesity emerging as a possible significant factor. Obesity, defined as a body mass index of 30.0 or higher, has become a widespread epidemic associated with numerous health issues, including a decrease of fertility. This review discusses the relationship between obesity and male infertility, particularly focusing on sperm quality and function. An overview of the literature suggests that obesity may influence the male reproductive system via disruptions in hormonal profiles, oxidative stress, and inflammation, leading to changes in sperm parameters. Several studies have discussed if obesity causes a decrease in sperm concentration, motility, and normal morphology, so far without a consensus being reached. However, available evidence suggests an impairment of sperm function in obese men, due to an increase in DNA damage and oxidative stress, impaired mitochondrial function and acrosome reaction in response to progesterone. Finally, the relationship between obesity and assisted reproductive technologies outcomes remains debatable, with conflicting evidence regarding the influence on fertilisation, pregnancy, and live birth rates. Therefore, the actual impact of obesity on human spermatozoa still needs to be clarified, due to the multiple factors potentially in play.

Identification of testis development-related genes by combining Iso-Seq and RNA-Seq in Zeugodacus tau

Introduction: Zeugodacus tau (Walker) is an invasive pest. An effective method to control this pest is the sterile insect technique (SIT). To better apply this technique, it is necessary to understand testis development progression. Methods: Differentially expressed genes (DEGs) during testis development were analyzed by PacBio Iso-Seq and RNA-seq. Results: RNA-Seq library of Z. tau testes on day 1, 6, and 11 post eclosion were constructed. We identified 755 and 865 differentially expressed genes in the comparisons of T6 (testes on day 6) vs. T1 and T11 vs. T1, respectively. The KEGG pathway analysis showed that the DEGs were significantly enriched in retinol metabolism, vitamin B6 metabolism, and ascorbate and aldarate metabolism pathways. Knockdown of retinol dehydrogenase 12-like (rdh12-like), pyridoxal kinase (pdxk) and regucalcin (rgn), the representative gene in each of the above 3 pathways, reduced the hatching rate of Z. tau offspring. In addition, we identified 107 Drosophila spermatogenesis-related orthologous genes in Z. tau, of which innexin 2 (inx2) exhibited significantly up-regulated expression throughout testis development, and the knockdown of this gene reduced offspring hatching rate. Discussion: Our data indicated that rdh12-like, pdxk, rgn, and inx2 genes were related to testis development, and they were conserved in tephritid species. These results suggested that this gene might have the same function in tephritid. The findings provide an insight into testis development and spermatogenesis in tephritid species.

A preconception cohort study of sugar-sweetened beverage consumption and semen quality

BACKGROUND

Dietary factors, including high sugar intake, may have adverse effects on male reproduction. Studies of the association between sugar-sweetened beverage (SSB) intake and semen quality have reported inconsistent results.

OBJECTIVE

We estimated the effects of SSB consumption on semen quality in a North American preconception cohort study.

METHODS

We analyzed baseline data from 690 males (n = 1,247 samples) participating in Pregnancy Study Online (PRESTO) during 2015-2022. Participants aged ≥21 years completed a baseline questionnaire on which they reported information about intake of SSBs, including sodas, energy drinks, sports drinks, and fruit juices. After enrollment, we invited U.S. participants to a semen testing substudy, in which they collected and analyzed two samples using an at-home semen testing kit. We used linear regression models to estimate adjusted percent differences (%D) and 95% confidence intervals (CI) for associations of SSB intake with semen volume, sperm concentration, total sperm count (TSC), motility, and total motile sperm count (TMSC). We used modified Poisson regression models to estimate adjusted risk ratios (RRs) and 95% CIs for the association of SSB intake with World Health Organization semen parameter cut points.

RESULTS

Relative to non-consumers of SSBs, those who consumed ≥7 SSBs/week had lower semen volume (%D = -6, 95% CI: -13, 0), sperm concentration (%D = -22, 95% CI: -38, 0), TSC (%D = -22, 95% CI: -38, -2), motility (%D = -4, 95% CI: -10, 2), and TMSC (%D = -25, 95% CI: -43, -2). High SSB consumers also had greater risks of low sperm concentration (≤16 million/mL; RR = 1.89, 95% CI: 1.11, 3.21), low TSC (≤39 million; RR = 1.75, 95% CI: 0.92, 3.33), low motility (≤42%; RR = 1.23, 95% CI: 0.87, 1.75) and low TMSC (≤21 million; RR = 1.95, 95% CI: 1.12, 3.38). Associations were stronger among participants with body mass index ≥ 25 kg/m2 .

CONCLUSION

Greater SSB consumption was associated with reduced semen quality in a North American preconception cohort.

Effects of Korean Versus Western Diets on Reproductive Function in Young Korean Men: A 12-Week Randomized Parallel Clinical Trial

Background

Studies report that diet may have contributed to a 50-60% decrease in human sperm quality over the past few decades. Unhealthy lifestyles affect the structure of spermatozoa, affecting the male reproductive potential. This study aimed to compare the effects of Korean and Western diets on reproductive function in young male Koreans.

Methods

Study participants were provided either the Korean Diet (KD group) or the Western Diet (WD group) for 12 weeks. Semen quality parameters such as volume, motility, cell count, and sex hormone levels were evaluated. Sexual function was assessed using the International Index of Erectile Function and the Male Sexual Health Questionnaire. Efficacy and safety evaluations were conducted at baseline, 8 weeks, and 12 weeks.

Results

The KD group demonstrated a significantly increased sperm motility after 8 weeks relative to baseline but decreased after 12 weeks. In contrast, sperm motility in the WD group significantly decreased after 8 weeks compared with baseline and remained constant after 12 weeks. Statistically, a near-significant difference was observed between groups (p = 0.057). Similarly, free testosterone levels in the KD group increased after 12 weeks compared with baseline, whereas that in the WD group decreased. The free testosterone levels in the KD group were significantly higher than those in the WD group (p = 0.020). There were no statistically significant differences in other sex hormone and sexual function questionnaires between the groups. None of the participants reported any severe side effects, and no significant alterations in clinical diagnostic test values were detected.

Conclusion

The results of the study strongly reveal that KD positively affects sperm motility and male hormone levels in young men, indicating potential benefits for reproductive function.

Urinary concentrations of bisphenol A, parabens and benzophenone-type ultra violet light filters in relation to sperm DNA fragmentation in young men: A chemical mixtures approach

People are daily exposed to multiple endocrine disruptor compounds (EDCs) that may interfere with different molecular and cellular processes, promoting a potential estrogenic, androgenic, or anti-androgenic state. However, most epidemiological studies attempting to establish relationships between EDCs exposure and health effects are still considering individual compounds. A few studies have shown associations between exposure to individual non-persistent EDCs and sperm DNA fragmentation (SDF) in different male populations. Thus, the aim of this study was to investigate associations between combined exposure to non-persistent EDCs and SDF index in young men. A cross-sectional study was conducted with 158 healthy university students from Southeaster Spain. The participants provided spot urine and semen samples on the same day. The concentrations of urinary bisphenol A (BPA), benzophenones [2,4-dihydroxybenzophenone (BP-1); 2,2',4,4'-tetrahydroxybenzophenone (BP-2), 2-hydroxy-4-methoxybenzophenone (BP-3), 2,2'-dihydroxy-4-methoxybenzophenone (BP-8), 4-hydroxybenzophenone (4OHBP)], and parabens (methylparaben, ethylparaben, propylparaben, butylparaben) were measured by dispersive liquid-liquid microextraction and ultrahigh-performance liquid chromatography with tandem mass spectrometry detection. SDF was analysed using a Sperm Chromatin Dispersion test. Statistical analyses were carried out using Bayesian Kernel Machine Regression models to evaluate associations between combined exposure to these compounds and SDF index while adjusting by relevant covariates. The increase in urinary concentration of 4OHBP was found to be the most important contributor to the negative association between urinary EDCs concentrations and SDF index, being of -5.5 % [95 % CI: -10.7, -0.3] for those in percentile 50, and - 5.4 % [95 % CI: -10.8, -0.1] for those in percentile 75. No significant associations were observed between other EDCs and SDF index. Our findings show that urinary 4OHBP levels may be associated with a decrease in the SDF index. Nonetheless, the effects we observed were likely to be small and of uncertain clinical significance. Further research is needed to replicate our findings in other male populations.

Influence of the Mediterranean diet on seminal quality-a systematic review

Currently, there is a growing interest in the study of fertility because fertility-related problems affect up to 15% of the world's population. The aim of this study was to determine the influence of the Mediterranean diet on seminal quality in men of reproductive age. For this purpose, a systematic review of the literature was carried out following the PRISMA method. Electronic searches were carried out in the international databases PubMed, Scopus, the Cochrane Library, and Web of Science. In total, 10 articles with 2032 men were included. As inclusion criteria, articles published between 2012 and 2022 were selected, including those that included men aged between 18 and 55 years. Nutritional status was assessed through weight, height, and BMI. Dietary habits were evaluated through different indexes and food frequency questionnaires, and finally, semen quality was evaluated by measuring sperm concentration and motility (progressive and non-progressive). In six (60%) of the included articles, a positive relationship between adherence to the Mediterranean diet and semen quality was demonstrated; in two (20%) of the articles, no association was found; and finally, in two (20%) of the included articles, the relationship between dietary patterns typical of DM and semen quality was evaluated. Dietary habits influence semen quality. Adherence to the Mediterranean diet can improve male reproductive health, as it is a diet with antioxidant and anti-inflammatory effects. This is the first systematic review about the influence of the Mediterranean diet on semen quality, and the results are positive. These findings may allow us to provide better advice to our patients and to establish interventions with the aim of improving the results of assisted reproduction techniques.

Decrease in Sperm Parameters in the 21st Century: Obesity, Lifestyle, or Environmental Factors? An Updated Narrative Review

Semen quality represents a compelling factor for fertility, and delineating the normal values has proven difficult. In the last four decades, several authors have reported a noticeable decline in sperm parameters. Also, studies investigating 'time to pregnancy' have shown that fecundity begins to be reduced when sperm numbers decrease below 30 million, even though according to the 6th edition of the WHO manual, the normal value is currently 16 million/mL or 39 million per ejaculate. There exists sufficient data to suggest a decline in sperm counts over time, even though the clear reason for this adverse trend is not well established, but some associations have been hypothesised, such as maternal smoking during pregnancy. Additional potential factors have yet to be fully illustrated but involve poor diet, increased obesity, and exposure to environmental toxins. Moreover, the change in environmental conditions and more common exposure to endocrine-disrupting chemicals (EDCs), such as pesticides and herbicides, as well as bisphenol A, phthalates, polychlorinated biphenyls, and heavy metals, starting from prenatal life and continuing into adulthood, may exhibit probable features explaining the reduction in sperm parameters. Therefore, the main goal of this narrative review is to furnish an overview of the possible effects of exposure to EDCs on testicular function and spermatogenesis and, also, to summarise the evidence regarding a decrease in sperm quality and examine its potential consequences.

The impact of vegetarian diet on sperm quality, sex hormone levels and fertility: a systematic review and meta-analysis

BACKGROUND

An increasing number of people have adhered to a vegetarian diet for several years. Nowadays, the favourable effect of this dietary pattern on metabolic diseases is well established, but its impact on fertility and reproductive health as a serious health concern is not clear yet. Therefore, we aim to summarise existing evidence regarding the possible association between a vegetarian diet and fertility as measured by key indicators such as sperm quality and sex hormone levels.

METHODS

We systematically searched online databases, including PubMed, ISI, Scopus and Google Scholar, up to 1 December 2022 using relevant keywords. We included observational studies that compared semen quality, sex hormone levels and infertility in people who adhered to a vegetarian diet versus an omnivore diet. Heterogeneity between studies was assessed using I2 and Q tests. Standardised mean differences (SMD) using a random/fixed model were calculated to assess outcomes between vegetarians and omnivores in included articles.

RESULTS

Finally, out of 972 documents that were retrieved, 20 articles met our inclusion criteria, and 16 were eligible for quantitative synthesis. Results of meta-analyses showed that there were no significant differences between vegetarians and omnivores in terms of semen quality parameters, including total sperm count, total and progressive sperm motility, sperm morphology and sperm concentration. Seven studies on female sex hormone profiles were eligible for meta-analysis. The only significant difference was the lower level of plasma oestrone in vegetarians (pooled SMD: -0.56; 95% confidence interval [CI]: -1.08, -0.05; p-value = 0.03) compared to omnivores. Furthermore, our meta-analysis revealed significantly higher sex-hormone-binding globulin levels in vegetarian men than in omnivores (pooled SMD: 0.52; 95% CI: 0.18, 0.86; p-value = 0.002).

CONCLUSION

Despite the numerous health benefits of a vegetarian diet, our review suggested that there were no conclusive positive or negative associations between vegetarian diet and semen quality, sex hormone levels and infertility. Further studies are recommended to better understand vegetarian dietary pattern effect on infertility and reproductive health.

Food, nutrition, and fertility: from soil to fork

Food and nutrition-related factors, including foods and nutrients consumed, dietary patterns, use of dietary supplements, adiposity, and exposure to food-related environmental contaminants, have the potential to impact semen quality and male and female fertility; obstetric, fetal, and birth outcomes; and the health of future generations, but gaps in evidence remain. On 9 November 2022, Tufts University's Friedman School of Nutrition Science and Policy and the school's Food and Nutrition Innovation Institute hosted a 1-d meeting to explore the evidence and evidence gaps regarding the relationships between food, nutrition, and fertility. Topics addressed included male fertility, female fertility and gestation, and intergenerational effects. This meeting report summarizes the presentations and deliberations from the meeting. Regarding male fertility, a positive association exists with a healthy dietary pattern, with high-quality evidence for semen quality and lower quality evidence for clinical outcomes. Folic acid and zinc supplementation have been found to not impact male fertility. In females, body weight status and other nutrition-related factors are linked to nearly half of all ovulation disorders, a leading cause of female infertility. Females with obesity have worse fertility treatment, pregnancy-related, and birth outcomes. Environmental contaminants found in food, water, or its packaging, including lead, perfluorinated alkyl substances, phthalates, and phenols, adversely impact female reproductive outcomes. Epigenetic research has found that maternal and paternal dietary-related factors can impact outcomes for future generations. Priority evidence gaps identified by meeting participants relate to the effects of nutrition and dietary patterns on fertility, gaps in communication regarding fertility optimization through changes in nutritional and environmental exposures, and interventions impacting germ cell mechanisms through dietary effects. Participants developed research proposals to address the priority evidence gaps. The workshop findings serve as a foundation for future prioritization of scientific research to address evidence gaps related to food, nutrition, and fertility.

Bioactive compounds as potential alternative treatments to prevent cancer therapy-induced male infertility

About 8-12% of couples experience infertility, with male infertility being the cause in 50% of cases. Several congenital and acquired conditions, including chronic diseases and their treatments, can contribute to male infertility. Prostate cancer incidence increases annually by roughly 3%, leading to an increment in cancer treatments that have adverse effects on male fertility. To preserve male fertility post-cancer survival, conventional cancer treatments use sperm cryopreservation and hormone stimulation. However, these techniques are invasive, expensive, and unsuitable in prepubertal patients lacking mature sperm cells. Alternatively, nutritional therapies enriched with bioactive compounds are highlighted as non-invasive approaches to prevent male infertility that are easily implementable and cost-effective. In fact, curcumin and resveratrol are two examples of bioactive compounds with chemo-preventive effects at the testicular level. In this article, we summarize and discuss the literature regarding bioactive compounds and their mechanisms in preventing cancer treatment-induced male infertility. This information may lead to novel opportunities for future interventions.

Ultra-processed food consumption and semen quality parameters in the Led-Fertyl study

STUDY QUESTION

Is ultra-processed food (UPF) consumption associated with semen quality parameters?

SUMMARY ANSWER

Higher UPF consumption was inversely associated with total sperm count, sperm concentration, and total motility in men of reproductive age.

WHAT IS KNOWN ALREADY

The consumption of UPF, which has been rising during the last decades, has been demonstrated to be positively associated with several chronic diseases such as diabetes or cardiovascular diseases. However, the scientific evidence on its potential impact on semen quality remains notably limited.

STUDY DESIGN SIZE DURATION

A cross-sectional analysis was conducted using data from 200 healthy men (mean age 28.4 ± 5.5 years) enrolled in the Led-Fertyl (Lifestyle and Environmental Determinants of Seminogram and Other Male Fertility-Related Parameters) study between February 2021 and April 2023.

PARTICIPANTS/MATERIALS SETTING METHODS

UPF consumption (% of energy from UPF) was estimated according to the NOVA classification system using a validated 143-item semi-quantitative food frequency questionnaire. Total sperm count, sperm concentration, sperm vitality, total motility, progressive motility, and normal sperm forms were set as the main outcomes. Microscopic parameters were analyzed using a phase-contrast microscope and a computer-assisted sperm analysis (CASA) system. Semen samples were collected and tested according to World Health Organization 2010 standards. Multivariable linear regression models were fitted to estimate the associations between UPF tertile and semen quality parameters.

MAIN RESULTS AND THE ROLE OF CHANCE

Sperm concentration (β: -1.42 × 106 spz./ml; 95% CI: -2.72 to -0.12) and motility (β: -7.83%; 95% CI: -15.16 to -0.51) were lower in participants in the highest tertile of UPF compared to the lowest. A similar association was observed for sperm count when UPF was analyzed per 10% increment of energy from UPF consumption (β: -1.50 × 106 spz.; 95% CI: -2.83 to -0.17). Theoretically replacing 10% of energy from UPF consumption with 10% of energy from unprocessed or minimally processed food consumption was associated with a higher total sperm count, sperm concentration, total motility, progressive motility, and normal sperm forms.

LIMITATIONS REASONS FOR CAUTION

Cross-sectional studies do not permit the drawing of causal inferences. Measurement errors and reporting bias cannot be entirely ruled out.

WIDER IMPLICATIONS OF THE FINDINGS

This work suggests that consumption of UPF may have an impact on certain semen quality parameters. Furthermore, opting for unprocessed or minimally processed foods instead of UPFs could potentially benefit semen quality. If these results are replicated in future epidemiological studies with different long-term designs, these novel findings could provide valuable insights for updating or even designing preventive and interventional programs to address infertility among men of reproductive age.

STUDY FUNDING/COMPETING INTERESTS

This study was supported by the Spanish government's official funding agency for biomedical research, ISCIII, through the Fondo de Investigación para la Salud (FIS), the European Union ERDF/ESF, 'A way to make Europe'/'Investing in your future' [PI21/01447], and the Diputació de Tarragona (2021/11-No.Exp. 8004330008-2021-0022642). J.S.-S. gratefully acknowledges the financial support of ICREA under the ICREA Academia program. C.V.-H. received a predoctoral grant from the Generalitat de Catalunya (2022 FI_B100108). M.Á.M. was supported by the Sara Borrell postdoctoral fellowship (CD21/00045-Instituto de Salud Carlos III (ISCIII)). M.F.d.l.P. was supported by a predoctoral grant from the Rovira i Virgili University and Diputació de Tarragona (2020-PMF-PIPF-8). All authors have no conflict of interest to declare.

TRIAL REGISTRATION NUMBER

N/A.

Nut Consumption and Fertility: a Systematic Review and Meta-Analysis

The high concentration of omega-3 polyunsaturated fats, dietary fibers, vitamins, minerals, and polyphenols found in nuts suggest their regular consumption may be a simple strategy for improving reproductive health. This systematic review and meta-analysis aimed to present up-to-date evidence regarding the association between nut intake and fertility outcomes in males and females. Ovid MEDLINE, Embase, CINAHL, and Scopus were searched from inception to 30 June 2023. Eligible articles were interventional or observational studies in human subjects of reproductive age (18-49 y) that assessed the effects (or association) of dietary nut consumption (for a minimum of 3 mo) on fertility-related outcomes. Random-effects meta-analyses were completed to produce a pooled effect estimate of nut consumption on sperm total motility, vitality, morphology, and concentration in healthy males. Four studies involving 875 participants (646 males, 229 females) were included in this review. Meta-analysis of 2 RCTs involving 223 healthy males indicated consumption of ≥ 60g nuts/d increased sperm motility, vitality, and morphology in comparison to controls but had no effect on sperm concentration. Nonrandomized studies reported no association between dietary nut intake and conventional sperm parameters in males, embryo implantation, clinical pregnancy or live birth in males and females undergoing ART. Our meta-analysis shows that including at least 2 servings of nuts daily as part of a Western-style diet in healthy males improves sperm parameters, which are predictors of male fertility. Due to their nutritional profile, nuts were found to have potential to promote successful reproductive outcomes. This trial was registered at PROSPERO (CRD42020204586).

Role of Mediterranean diet in endocrine diseases: a joint overview by the endocrinologist and the nutritionist

PURPOSE

The purpose of this review is to examine the current evidence on the potential role of Mediterranean diet (MD) in the prevention and management of endocrine disorders and to highlight the importance of interdisciplinary collaboration between endocrinologists and nutritionists.

METHODS

A literature search was conducted using PubMed and Google Scholar databases to identify relevant studies published in English. Studies were selected based on their relevance to the role of MD in the prevention and management of endocrine disorders. The search terms included "Mediterranean diet," "endocrine disorders," "thyroid disorders," "gonadal disorders," and "neuroendocrine tumors".

RESULTS

The studies reviewed suggest that MD may have a beneficial effect in the prevention and management of various endocrine disorders, including thyroid disorders, gonadal disorders, and neuroendocrine tumors. MD has been associated with decreased risk of nodular thyroid disease and thyroid cancer, improved male and female reproductive health, and a potential role in the management of neuroendocrine tumors. MD's anti-inflammatory and antioxidant properties, as well as its high levels of phytochemicals, may play a role in its beneficial effects.

CONCLUSION

Interdisciplinary collaboration between endocrinologists and nutritionists is essential for the optimal management of endocrine disorders, including the potential role of MD in their prevention and management. While further research is needed, the current evidence suggests that MD may have a protective effect against endocrine disorders, and its incorporation into dietary recommendations may be beneficial.

Perspective: Potatoes, Quality Carbohydrates, and Dietary Patterns

Potatoes have long been a staple food in many cultures and cuisines, but they have gained a reputation as a low-quality carbohydrate source that should be avoided in the diet. Historically, this view has been justified by citing the glycemic index of potatoes as the main indicator of their quality. However, their nutrient composition should also be considered. The association of potatoes with energy-dense Western dietary patterns has also contributed to a perception that potatoes are inherently unhealthy. Although some studies have suggested an association between potato consumption and increased risk of health problems, such as type 2 diabetes, these associations may be confounded by fried potato intake and are strongest at intake levels higher than average consumption rates. Epidemiologic data suggest total potato intake is not a health risk in Eastern populations and can be consumed as part of a healthy diet. Furthermore, clinical trial data demonstrate that potatoes' health impact, irrespective of preparation, is similar to legumes and comparable with refined grains, with few deleterious effects found. These findings highlight the importance of moving beyond the glycemic index and adopting a more nuanced evaluation of the epidemiologic data to better understand the health impact of potato intake. Ultimately, the negative reputation of potatoes stems from an overinterpretation of their glycemic index and association with unhealthy Western dietary patterns, as well as oversimplification of the epidemiologic data. By considering carbohydrate quality, it becomes clear that potatoes can be part of a healthy diet given the proper consideration.

Holistic Assessment Based On Hepatocyte Mitochondria: Lycopene Repairs Oxidized mtDNA to Alleviate Mitochondrial Stress Induced by Atrazine

Atrazine (ATZ) is a highly persistent herbicide that harms organism health. Lycopene (LYC) is an antioxidant found in plants and fruits. The aim of this study is to investigate the mechanisms of atrazine-induced mitochondrial damage and lycopene antagonism in the liver. The mice were divided into seven groups by randomization: blank control (Con group), vehicle control (Vcon group), 5 mg/kg lycopene (LYC group), 50 mg/kg atrazine (ATZ1 group), ATZ1+LYC group, 200 mg/kg atrazine (ATZ2 group), and ATZ2+LYC group. The present study performed a holistic assessment based on mitochondria to show that ATZ causes the excessive fission of mitochondria and disrupts mitochondrial biogenesis. However, the LYC supplementation reverses these changes. ATZ causes increased mitophagy and exacerbates the production of oxidized mitochondrial DNA (Ox-mtDNA) and mitochondrial stress. This study reveals that LYC could act as an antioxidant to repair Ox-mtDNA and restore the disordered mitochondrial function caused by ATZ.

Effect of obstructive sleep apnea on semen quality

BACKGROUND

Obstructive sleep apnea (OSA) has several notable complications such as hypertension and diabetes. Studies have also shown that OSA is associated with erectile dysfunction and reduced androgen levels. However, the effect of OSA on semen quality remains poorly studied.

METHODS

Men attending a tertiary reproductive center for semen analysis were tested with a portable sleep breathing monitor. Patients were divided into four groups based on their apnea hypopnea index: none, mild, moderate, and severe obstructive sleep apnea. Differences between groups were assessed using χ2, and associations were tested with multiple regression analysis.

RESULTS

We included a total of 175 male subjects with a mean age of 32.2 ± 3.6 years. There were significant differences between groups in progressive sperm motility (%) (43 ± 16, 42 ± 17, 36 ± 18, 29 ± 18, respectively; p = 0.002), total motility (%) (59 ± 19, 59 ± 20, 49 ± 21, 42 ± 20, respectively; p = 0.010), and vitality (%) (80 ± 10, 81 ± 11, 79 ± 8, 72 ± 19, respectively; p = 0.039). Asthenospermia (progressive motility < 35%) was significantly more common in subjects with OSA (χ2 = 5.195, p = 0.023). In multiple regression models, after adjusting for age and body mass index, apnea hypopnea index remained negatively and significantly associated with progressive motility, total motility, and vitality.

CONCLUSIONS

OSA is an independent risk factor for sperm motility and vitality, and further investigation is now needed to determine if continuous positive pressure ventilation or other therapies can improve semen quality in these patients.

Diet and recreational drug use in relation to male reproductive health

Diet and lifestyle interventions present promising avenues for the improvement of male fertility. Our objective was to review and synthesize the existing observational and experimental studies among humans on the associations of diet and recreational drug use with semen quality and fertility outcomes. The available data on this topic are limited and, at times, conflicting. Nevertheless, on the basis of this review, dietary patterns that are composed of higher intakes of fruits, vegetables, whole grains, nuts, low-fat dairy, and seafood, as well as lower intakes of red and processed meats, sweets, and sugar-sweetened beverages were identified as having the strongest evidence for associations with better sperm quality. However, whether these dietary patterns translate into positive associations with clinical fertility endpoints such as assisted reproductive technology success rates or time-to-pregnancy among couples trying to conceive without medical assistance remains unclear. Male caffeine and alcohol intake, within low-to-moderate ranges of intake, do not appear to be detrimental to semen quality. Yet high-quality research on this topic, focused on clinical fertility endpoints, should continue given the conflicting evidence, particularly in populations undergoing infertility treatment with assisted reproductive technology. Recreational drug use, including marijuana, electronic cigarettes, and other illicit drugs, does not appear to be beneficial for male reproductive health and should be avoided or ceased. In conclusion, men should be encouraged to consume a healthy diet rich in fruits, vegetables, whole grains, nuts, low-fat dairy, and seafood, as well as lacking in red and processed meats, sweets, and sugar-sweetened beverages, and to avoid recreational drug use for improved male reproductive health.

The relationship between the intake of dietary fatty acids and minerals with sperm parameters in infertile men

BACKGROUND & AIMS

Infertility has been increasing among Iranian couples. Some epidemiological studies have reported a relationship between infertility and lifestyle patterns, including dietary habits. Our objective was to evaluate the relationship between sperm parameters and the intake of dietary fatty acids and minerals among Iranian infertile men.

METHODS

This cross-sectional was performed on 400 newly diagnosed infertile men at Yazd Reproductive Sciences Institute from July to December 2019. Men whose infertility was confirmed by an andrologist based on the World Health Organization (WHO) criteria were selected. They delivered a semen sample and answered a 168-item semi-quantitative food frequency questionnaire. All data were analyzed using SPSS and STATA software. A p-value of less than 0.5 was considered significant.

RESULTS

In the adjusted model, a significant negative association between sperm motility and the 3rd quartile (Q) of poly-unsaturated fatty acids compared to the 1st quartile) P = 0.02). Also, in the adjusted model, total mobility was significantly increased in the second, third and last quartiles of omega-3 fatty acids compared to the first quartile (P < 0.001, P = 0.02, P < 0.001, respectively). Furthermore, omega-6 fatty acid intake in the last quartile were positively associated with sperm motility (P = 0.01). Moreover, there was a significant association between omega-3 fatty acid intake in the second, third, and last quartiles and sperm normal morphology (P = 0.003, P = 0.018, and P = 0.005, respectively) compared with the first quartile. Further, we observed a significant association between omega-6 fatty acid intake and sperm normal morphology in the last quartile compared with the reference quartile (P = 0.04). Also, the findings showed a significant negative association between the second quartile of sodium and calcium intake and sperm volume compared with the first quartile (P = 0.04, for both) in the adjusted model.

CONCLUSIONS

We concluded that dietary polyunsaturated fatty acid, sodium, and calcium intake are related to sperm morphology, volume, and total motility in Iranian infertile men. However, more research is needed to confirm these relationships and provide evidence to exert these findings into clinical practice.

Deafening Silence of Male Infertility

Think about 6 loved ones of reproductive age in your life. Now imagine that 1 of these 6 individuals is suffering from infertility. Perhaps they feel alone and isolated, unable to discuss their heartbreak with their closest friends, family, and support network. Suffering in silence. In this editorial, we discuss the infertility journey through the lens of the patients, the providers, and the scientists who struggle with infertility each and every day. Our goal is to open a dialogue surrounding infertility, with an emphasis on dismantling the longstanding societal barriers to acknowledging male infertility as a disease. Through education, communication, compassion, and advocacy, together we can all begin to break the deafening silence of male infertility.