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Atli Eklioglu O, Ilgin S. Adverse effects of antiepileptic drugs on hormones of the hypothalamic-pituitary-gonadal axis in males: A review. Toxicology 2022; 465:153043. [PMID: 34800598 DOI: 10.1016/j.tox.2021.153043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/31/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022]
Abstract
The HPG axis is critical in the maintenance of spermatogenesis and sexual function in males. The GnRH-releasing neurons of the hypothalamus are the axis's main hierarchical element. These neurons make connections with different areas of the brain to regulate the release of GnRH. Neurotransmitters have a critical in the connections between these neurons. So, neurotransmitters can inhibit or stimulate the release of GnRH by affecting GnRH-releasing neurons. In neurological disorders, neurotransmitter's activities inevitably change; therefore, these changes can affect the HPG axis via affecting GnRH-releasing neurons, just like in epilepsy. Many investigations have attracted attention to be decreased fertility potential in males with epilepsy. It has been stated that changes in the HPG axis hormone levels have been found in these patients. Moreover, it has also been observed that sperm quality decreased in patients. It has been emphasized that a decrease in sperm quality may be related to both epilepsy and AEDs. It has been shown that AEDs caused decreased sperm quality by impairing the HPG axis, so they act like endocrine-disrupting chemicals. AEDs can affect fertility and cause additive adverse effects in terms of sperm quality together with epilepsy. Therefore, it is crucial to investigate the adverse reproductive effects of AEDs, which are frequently used during reproductive ages, and determine the role of the HPG axis on potential reproductive pathologies.
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Affiliation(s)
- Ozlem Atli Eklioglu
- Anadolu University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Eskisehir, Turkey
| | - Sinem Ilgin
- Anadolu University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Eskisehir, Turkey.
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52
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Talbi A, Khelili K, Remita F, Abdennour C. The benefit of Silybum marianum in ethanol-induced reprotoxicity of male Wistar rat. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e19264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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53
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Endocrinopathies and Male Infertility. LIFE (BASEL, SWITZERLAND) 2021; 12:life12010010. [PMID: 35054403 PMCID: PMC8779600 DOI: 10.3390/life12010010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/09/2021] [Accepted: 12/16/2021] [Indexed: 01/22/2023]
Abstract
Male infertility is approaching a concerning prevalence worldwide, and inflicts various impacts on the affected couple. The hormonal assessment is a vital component of male fertility evaluation as endocrine disorders are markedly reversible causatives of male infertility. Precise hormonal regulations are prerequisites to maintain normal male fertility parameters. The core male reproductive event, spermatogenesis, entails adequate testosterone concentration, which is produced via steroidogenesis in the Leydig cells. Physiological levels of both the gonadotropins are needed to achieve normal testicular functions. The hypothalamus-derived gonadotropin-releasing hormone (GnRH) is considered the supreme inducer of the gonadotropins and thereby the subsequent endocrine reproductive events. This hypothalamic–pituitary–gonadal (HPG) axis may be modulated by the thyroidal or adrenal axis and numerous other reproductive and nonreproductive hormones. Disruption of this fine hormonal balance and their crosstalk leads to a spectrum of endocrinopathies, inducing subfertility or infertility in men. This review article will discuss the most essential endocrinopathies associated with male factor infertility to aid precise understanding of the endocrine disruptions-mediated male infertility to encourage further research to reveal the detailed etiology of male infertility and perhaps to develop more customized therapies for endocrinopathy-induced male infertility.
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54
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Wu H, Yu X, Wang Q, Zeng Q, Chen Y, Lv J, Wu Y, Zhou H, Zhang H, Liu M, Zheng M, Zhao Q, Guo P, Feng W, Zhang X, Tian L. Beyond the mean: Quantile regression to differentiate the distributional effects of ambient PM 2.5 constituents on sperm quality among men. CHEMOSPHERE 2021; 285:131496. [PMID: 34329140 DOI: 10.1016/j.chemosphere.2021.131496] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/16/2021] [Accepted: 07/07/2021] [Indexed: 02/05/2023]
Abstract
Ambient PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter) constituents have been related to mean changes in semen quality, but focusing on the mean response may not well capture distributional and heterogeneous effects of PM2.5 constituents on semen quality. In this study, 2314 semen samples of 622 men between Jan 1, 2019 and Dec 31, 2019 from Guangdong Human Sperm Bank were subjected to semen quality analysis. Daily average concentrations of PM2.5 constituents including 4 water-soluble ions and 15 metals/metalloid were measured for 7 days per month at 3 fixed atmospheric pollutant monitoring stations. We used quantile regression for longitudinal data to examine whether the associations between PM2.5 constituents and quality indicators of semen varied across quantiles of outcome distribution. Heterogeneous associations were found between PM2.5 constituents and sperm quality across different quantiles. An interquartile range (14.0 μg/m3) increase in PM2.5 mass was negatively associated with lower tails of sperm concentration and upper tails of sperm count distribution. PM2.5 vanadium exposure was significantly related to the 90th percentile of sperm count distribution, but not to the lower quantiles. In addition, those subjects with relatively high sperm motility were more susceptible to sulfate, chromium, and manganese constituents in PM2.5. Our results indicate that PM2.5 and certain constituents were associated with sperm quality, especially sperm motility, and the associations are more pronounced in men with relatively high or low sperm motility.
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Affiliation(s)
- Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Qiling Wang
- National Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou, 510600, China; Department of Andrology, Family Planning Special Hospital of Guangdong Province, Guangzhou, 510600, China; Human Sperm Bank of Guangdong Province, Guangzhou, 510600, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Jiayun Lv
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Yan Wu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Hongwei Zhou
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Hongfeng Zhang
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Miao Liu
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Murui Zheng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China
| | - Qingguo Zhao
- National Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou, 510600, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China.
| | - Wenru Feng
- Guangzhou Center for Disease Control and Prevention, Guangzhou, 510440, China.
| | - Xinzong Zhang
- National Health Commission Key Laboratory of Male Reproduction and Genetics, Guangzhou, 510600, China; Department of Andrology, Family Planning Special Hospital of Guangdong Province, Guangzhou, 510600, China; Human Sperm Bank of Guangdong Province, Guangzhou, 510600, China.
| | - Linwei Tian
- Division of Epidemiology and Biostatistics, School of Public Health, The University of Hong Kong, Hong Kong
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55
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Lal A, Pike JFW, Polley EL, Huang S, Sanni M, Hailat T, Zimmerman S, Clay-Gilmour A, Bruce TF, Marcus KR, Roudebush WE, Chosed RJ. Comparison of RNA content from hydrophobic interaction chromatography-isolated seminal plasma exosomes from intrauterine insemination (IUI) pregnancies. Andrologia 2021; 54:e14325. [PMID: 34837240 DOI: 10.1111/and.14325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/14/2021] [Indexed: 11/26/2022] Open
Abstract
Male factors account for roughly half of infertility cases, with most male infertility diagnosed as idiopathic. Researchers predicting intrauterine insemination success rates have identified multiple prognostic factors, including semen parameters and seminal fluid composition. Seminal plasma contains extracellular exosomes, which contain RNAs and proteins involved in spermatogenesis. The contents of seminal plasma exosomes may be an indicator of overall sperm quality or fertility potential; therefore, analysis of exosomes may provide a measure for sperm viability and fertilization potential. In our study, exosomes were isolated and purified from seminal plasma obtained from IUI treatments with known pregnancy outcomes. We used a unique method to isolate the exosomes which made use of the hydrophobic interaction chromatography method. RNASeq was performed on RNAs from the purified exosomes. This analysis revealed holistic trends, including increased expression associated with RNA originating from chromosomes 1, 10, 12, 16 and 21. Overall, total RNA was significantly decreased and rRNA was significantly increased in successful IUI attempts. Furthermore, we found specific mRNAs and lincRNAs associated with positive versus negative pregnancy outcomes. Our study isolated and purified seminal plasma exosomes without ultracentrifugation, and it provides further evidence for differences in seminal plasma exosome molecular contents associated with pregnancy status.
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Affiliation(s)
- Arnav Lal
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - James Frederick W Pike
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - Emily L Polley
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - Sisi Huang
- Department of Chemistry, Clemson University, Clemson, South Carolina, USA
| | - Mustapha Sanni
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - Tareq Hailat
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | | | - Alyssa Clay-Gilmour
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Greenville, South Carolina, USA
| | - Terri F Bruce
- Department of Bioengineering, Clemson University, Clemson, South Carolina, USA
| | - Kenneth R Marcus
- Department of Chemistry, Clemson University, Clemson, South Carolina, USA
| | - William E Roudebush
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
| | - Renee J Chosed
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA
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56
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The Effects of Flavonoid Apigenin on Male Reproductive Health: Inhibition of Spermatogonial Proliferation through Downregulation of Prmt7/ Akt3 Pathway. Int J Mol Sci 2021; 22:ijms222212209. [PMID: 34830091 PMCID: PMC8621337 DOI: 10.3390/ijms222212209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/06/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022] Open
Abstract
Apigenin, a common dietary flavonoid abundantly present in a variety of fruits and vegetables, has promising anticancer properties. As an effector of apigenin in myoblasts, protein arginine methyltransferase 7 (Prmt7) is required for male germ cell development. However, whether apigenin may influence male reproductive health through Prmt7 is still unclear. To this end, mouse spermatogonia were treated with different concentrations (2.5 to 50 μM) of apigenin for 48 h, which showed that apigenin could cause reduced cell proliferation in conjunction with longer S phase and G2/M phase (with concentrations of 10 and 20 μM, respectively), and increased apoptosis of spermatogonia (with concentration of 20 μM). Reduced Prmt7 expression was found in 20 μM apigenin-treated spermatogonia. Moreover, siRNA-induced Prmt7 knockdown exhibited similar influence on spermatogonia as that of apigenin treatment. In mechanistic terms, transcriptome analysis revealed 287 differentially expressed genes between Prmt7-downregulated and control spermatogonia. Furthermore, rescue experiments suggested that the effects of apigenin on spermatogonia might be mediated through the Prmt7/Akt3 pathway. Overall, our study supports that apigenin can interfere with mouse spermatogonial proliferation by way of the downregulated Prmt7/Akt3 pathway, which demonstrates that the concentration should be taken into account in future applications of apigenin for cancer therapy of men.
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57
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Morgan M, Kumar L, Li Y, Baptissart M. Post-transcriptional regulation in spermatogenesis: all RNA pathways lead to healthy sperm. Cell Mol Life Sci 2021; 78:8049-8071. [PMID: 34748024 DOI: 10.1007/s00018-021-04012-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/11/2021] [Accepted: 10/25/2021] [Indexed: 01/22/2023]
Abstract
Multiple RNA pathways are required to produce functional sperm. Here, we review RNA post-transcriptional regulation during spermatogenesis with particular emphasis on the role of 3' end modifications. From early studies in the 1970s, it became clear that spermiogenesis transcripts could be stored for days only to be translated at advanced stages of spermatid differentiation. The transition between the translationally repressed and active states was observed to correlate with the shortening of the transcripts' poly(A) tail, establishing a link between RNA 3' end metabolism and male germ cell differentiation. Since then, numerous RNA metabolic pathways have been implicated not only in the progression through spermatogenesis, but also in the maintenance of genomic integrity. Recent studies have characterized the elusive 3' biogenesis of Piwi-interacting RNAs (piRNAs), identified a critical role for messenger RNA (mRNA) 3' uridylation in meiotic progression, established the mechanisms that destabilize transcripts with long 3' untranslated regions (3'UTRs) in post-mitotic cells, and defined the physiological relevance of RNA exonucleases and deadenylases in male germ cells. In this review, we discuss RNA processing in the male germline in the light of the most recent findings. A brief recollection of different RNA-processing events will aid future studies exploring post-transcriptional regulation in spermatogenesis.
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Affiliation(s)
- Marcos Morgan
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, 27709, USA.
| | - Lokesh Kumar
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, 27709, USA
| | - Yin Li
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, 27709, USA
| | - Marine Baptissart
- Reproductive and Developmental Biology Laboratory, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, 27709, USA
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58
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Naidu R, Biswas B, Willett IR, Cribb J, Kumar Singh B, Paul Nathanail C, Coulon F, Semple KT, Jones KC, Barclay A, Aitken RJ. Chemical pollution: A growing peril and potential catastrophic risk to humanity. ENVIRONMENT INTERNATIONAL 2021; 156:106616. [PMID: 33989840 DOI: 10.1016/j.envint.2021.106616] [Citation(s) in RCA: 121] [Impact Index Per Article: 40.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 05/14/2023]
Abstract
Anthropogenic chemical pollution has the potential to pose one of the largest environmental threats to humanity, but global understanding of the issue remains fragmented. This article presents a comprehensive perspective of the threat of chemical pollution to humanity, emphasising male fertility, cognitive health and food security. There are serious gaps in our understanding of the scale of the threat and the risks posed by the dispersal, mixture and recombination of chemicals in the wider environment. Although some pollution control measures exist they are often not being adopted at the rate needed to avoid chronic and acute effects on human health now and in coming decades. There is an urgent need for enhanced global awareness and scientific scrutiny of the overall scale of risk posed by chemical usage, dispersal and disposal.
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Affiliation(s)
- Ravi Naidu
- Global Centre for Environmental Remediation (GCER), The University of Newcastle, ATC Building, Callaghan, NSW 2308, Australia; Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building, The University of Newcastle, Callaghan, NSW 2308, Australia.
| | - Bhabananda Biswas
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building, The University of Newcastle, Callaghan, NSW 2308, Australia; Future Industries Institute, UniSA STEM, University of South Australia, Mawson Lakes, SA 5095, Australia
| | - Ian R Willett
- School of Agriculture & Food Systems, The University of Melbourne, VIC 3052, Australia
| | - Julian Cribb
- Australian National Centre for the Public Awareness of Science (as an adjunct), Australian National University, Canberra 0200, Australia
| | - Brajesh Kumar Singh
- Hawkesbury Institute for the Environment, Western Sydney University, Penrith, NSW 2753, Australia
| | | | - Frederic Coulon
- Cranfield University, School of Water, Energy and Environment, Cranfield MK43 0AL, United Kingdom
| | - Kirk T Semple
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, United Kingdom
| | - Kevin C Jones
- Lancaster Environment Centre, Lancaster University, Lancaster LA1 4YQ, United Kingdom
| | - Adam Barclay
- Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), ATC Building, The University of Newcastle, Callaghan, NSW 2308, Australia
| | - Robert John Aitken
- Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; Priority Research Centre for Reproductive Science, The University of Newcastle, Callaghan, NSW 2308, Australia
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59
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De Cosmi V, Parazzini F, Agostoni C, Noli S, Cipriani S, La Vecchia I, Ferrari S, Esposito G, Bravi F, Ricci E. Antioxidant Vitamins and Carotenoids Intake and the Association With Poor Semen Quality: A Cross-Sectional Analysis of Men Referring to an Italian Fertility Clinic. Front Nutr 2021; 8:737077. [PMID: 34671631 PMCID: PMC8520935 DOI: 10.3389/fnut.2021.737077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/10/2021] [Indexed: 11/13/2022] Open
Abstract
Several studies suggested that male's diet affects fertility. This cross-sectional analysis from a prospective cohort study aims to explore the relation between antioxidants intake and sperm parameters in sub-fertile couples referring to a Fertility center. Socio-demographic characteristics, health history, lifestyle habits, and diet information were obtained. A semen sample was analyzed to proceed with assisted reproduction. Three hundred and twenty-three men were enrolled: 19.1% had semen volume (SV) < 1.5 mL, 31.4% sperm concentration (SC) < 15.0 mil/mL, 26.8% sperm motility < 32%, and 33.0% had total sperm count (TSC) < 39.0 mil. Higher levels of α-carotene were associated to lower risk of low SC [4th vs. 1st quartile, adjusted OR (aOR) 0.43, 95% CI 0.20–0.91) and low TSC (aOR 0.46, 95% CI 0.22–0.95). Higher intake of β-carotene was inversely associated with risk of low TSC. Lycopene intake was associated with higher risk for these conditions (aOR 2.46, 95%CI 1.01–5.98, SC), and (aOR 3.11, 95%CI 1.29–7.50, TSC). Risk of low semen volume was lower in men with higher level of vitamin D intake (aOR 0.25, 95%CI 0.09–0.66)]. Further research, especially, well-designed randomized clinical trials (RCT), is needed to understand how diet modifications may have a role in modulating male fertility and fecundability.
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Affiliation(s)
- Valentina De Cosmi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,SIGENP (Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition), Milan, Italy
| | - Fabio Parazzini
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Department of Woman, Newborn and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,SIGENP (Italian Society of Pediatric Gastroenterology, Hepatology, and Nutrition), Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Noli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Sonia Cipriani
- Department of Woman, Newborn and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Stefania Ferrari
- Department of Woman, Newborn and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Esposito
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Francesca Bravi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Elena Ricci
- Department of Woman, Newborn and Child, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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60
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Abstract
The purpose of this American Society for Reproductive Medicine Practice Committee report is to provide clinicians with principles and strategies for the evaluation and treatment of couples with infertility associated with obesity. This revised document replaces the Practice Committee document titled "Obesity and reproduction: an educational bulletin" last published in 2015 (Fertil Steril 2015;104:1116-26).
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Affiliation(s)
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- American Society for Reproductive Medicine, Birmingham, Alabama
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61
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Oxidative Stress, Testicular Inflammatory Pathways, and Male Reproduction. Int J Mol Sci 2021; 22:ijms221810043. [PMID: 34576205 PMCID: PMC8471715 DOI: 10.3390/ijms221810043] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/11/2021] [Accepted: 09/15/2021] [Indexed: 12/16/2022] Open
Abstract
Inflammation is among the core causatives of male infertility. Despite male infertility being a serious global issue, "bits and pieces" of its complex etiopathology still remain missing. During inflammation, levels of proinflammatory mediators in the male reproductive tract are greater than usual. According to epidemiological research, in numerous cases of male infertility, patients suffer from acute or chronic inflammation of the genitourinary tract which typically occurs without symptoms. Inflammatory responses in the male genital system are inextricably linked to oxidative stress (OS). OS is detrimental to male fertility parameters as it causes oxidative damage to reproductive cells and intracellular components. Multifarious male infertility causative factors pave the way for impairing male reproductive functions via the common mechanisms of OS and inflammation, both of which are interlinked pathophysiological processes, and the occurrence of any one of them induces the other. Both processes may be simultaneously found in the pathogenesis of male infertility. Thus, the present article aims to explain the role of inflammation and OS in male infertility in detail, as well as to show the mechanistic pathways that link causative factors of male reproductive tract inflammation, OS induction, and oxidant-sensitive cellular cascades leading to male infertility.
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62
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Zhang Y, Yuan H, Peng M, Hu Z, Fan Z, Xu J, He L, Wang Y, Wang W, Su Y, Liu C, Zhang H, Zhao K. Folic acid deficiency damages male reproduction via endoplasmic reticulum stress-associated PERK pathway induced by Caveolin-1 in mice. Syst Biol Reprod Med 2021; 67:383-394. [PMID: 34474604 DOI: 10.1080/19396368.2021.1954724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Folic acid is critical to maintaining normal male reproductive function. Endoplasmic reticulum (ER) stress plays a crucial role in folic acid deficiency. Studies have shown that Caveolin-1 (Cav-1) is involved in ER stress, but the specific mechanism in male reproduction is still unclear. This study aimed to investigate the effects of folic acid deficiency on spermatogenesis and elucidate the underlying mechanisms. C57BL/6 mice fed with folic acid deficiency induced diet(0.3 mg/kg) were used. A significant decrease in the sperm concentration in the folic acid deficiency group was observed. Meanwhile, folic acid deficiency decreased Cav-1 expression in the testis tissue and increased endoplasmic reticulum stress-related PERK, eIF2α, ATF4, CHOP gene expression. Our results suggest that folic acid deficiency can affect male reproduction through the Cav-1-PERK-eIFα-ATF4-CHOP pathway.Abbreviations: ATF4: activating transcription factor 4; Ca2+: calcium ion; Cav-1: Caveolin-1; CCK-8: cell counting kit-8; CHOP: CCAAT-enhancer-binding protein homologous protein; DNA: Deoxyribonucleic acid; DSB: double strand breakage; eIF2α: eukaryotic Initiation Factor 2 alpha; ER: endoplasmic reticulum; FD: folic acid deficiency; FITC: fluorescein isothiocyanate; HE: hematoxylin and eosin; H3K4me3: histone H3 lysine 4 trimethylation; PERK: protein kinase RNA-like endoplasmic reticulum kinase; PI: propidium iodide; RT-qPCR: quantitative reverse transcription PCR; TUNEL: TdT mediated dUTP Nick End Labeling.
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Affiliation(s)
- Yuan Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hongfang Yuan
- Department of Obstetrics And Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meilin Peng
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyong Hu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zunpan Fan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Xu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liting He
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongfeng Wang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yufang Su
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Liu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiping Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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63
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Idiopathic Infertility as a Feature of Genome Instability. Life (Basel) 2021; 11:life11070628. [PMID: 34209597 PMCID: PMC8307193 DOI: 10.3390/life11070628] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 12/18/2022] Open
Abstract
Genome instability may play a role in severe cases of male infertility, with disrupted spermatogenesis being just one manifestation of decreased general health and increased morbidity. Here, we review the data on the association of male infertility with genetic, epigenetic, and environmental alterations, the causes and consequences, and the methods for assessment of genome instability. Male infertility research has provided evidence that spermatogenic defects are often not limited to testicular dysfunction. An increased incidence of urogenital disorders and several types of cancer, as well as overall reduced health (manifested by decreased life expectancy and increased morbidity) have been reported in infertile men. The pathophysiological link between decreased life expectancy and male infertility supports the notion of male infertility being a systemic rather than an isolated condition. It is driven by the accumulation of DNA strand breaks and premature cellular senescence. We have presented extensive data supporting the notion that genome instability can lead to severe male infertility termed “idiopathic oligo-astheno-teratozoospermia.” We have detailed that genome instability in men with oligo-astheno-teratozoospermia (OAT) might depend on several genetic and epigenetic factors such as chromosomal heterogeneity, aneuploidy, micronucleation, dynamic mutations, RT, PIWI/piRNA regulatory pathway, pathogenic allelic variants in repair system genes, DNA methylation, environmental aspects, and lifestyle factors.
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Candela L, Boeri L, Capogrosso P, Cazzaniga W, Pozzi E, Belladelli F, Baudo A, Ravizzoli A, Ventimiglia E, Viganò P, Alfano M, Abbate C, Cornelius J, Mattei A, Montorsi F, Salonia A. Correlation among isolated teratozoospermia, sperm DNA fragmentation and markers of systemic inflammation in primary infertile men. PLoS One 2021; 16:e0251608. [PMID: 34097690 PMCID: PMC8184012 DOI: 10.1371/journal.pone.0251608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/28/2021] [Indexed: 01/03/2023] Open
Abstract
Aim To assess the prevalence of isolated teratozoospermia (iTZS) in a cohort of infertile and fertile men; explore the relationship between iTZS, inflammatory parameters and sperm DNA fragmentation index (SDF) in the same cohort. Materials and methods 1824 infertile men and 103 fertile controls. Semen analysis, the neutrophil-to-lymphocyte ratio (NLR) and serum hormones were investigated. DFI was tested in infertile men only. According to 2010 WHO semen analysis, patients were categorized in 3 sub-groups of isolated sperm defects: isolated oligozoospermia (iOZS), isolated asthenozoospermia (iAZS) and iTZS. Descriptive statistics and linear regression models tested the association between clinical variables and inflammatory markers. Results Among infertile men, iAZS, iTZS, and iOZS were found in 13.9%, 11.9% and 4.1% participants, respectively. iTZS was found in 37 (35.9%) fertile men. Infertile men with iTZS had higher NLR values than those with iOZS, iAZS and men with normal semen parameters (all p<0.001). FSH and LH were higher and inhibin B lower in iOZS infertile men compared to all other groups (p≤0.001). Hormonal characteristics were similar between iTZS infertile and fertile men. Similarly, iTZS infertile men had higher SDF than all other groups (all p<0.001). Infertile men with iTZS had higher NLR values than fertile men with iTZS (p<0.01). Linear regression analysis showed that, in infertile men, iTZS was associated with SDF and NLR (all p≤0.01). Conclusions iTZS was found in 11.9% of infertile men but it was even more prevalent in fertile controls. Infertile men with iTZS had higher NLR than fertile controls and increased SDF values than infertile participant with iAZS, iOZS, or normal semen parameters. No differences in hormonal characteristics were found between infertile and fertile men with iTZS.
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Affiliation(s)
- Luigi Candela
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology, Foundation IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation,Varese, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Baudo
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Ravizzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Costantino Abbate
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Julian Cornelius
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Agostino Mattei
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
- * E-mail:
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65
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Regeai SO, Abusrer SA, Shibani NS. Low semen quality and adverse histological changes in testes of adult male mice treated with bee venom ( Apis mellifera). Open Vet J 2021; 11:70-79. [PMID: 33898286 PMCID: PMC8057216 DOI: 10.4314/ovj.v11i1.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
Background Male infertility has been on the rise since the past seven decades. Recently, in Libya, bee venom therapy (BVT) has become a popular method among alternative healthcare practitioners for treating male infertility. However, a literature search did not find any published studies that investigated the use of BVT for infertility treatment. Aim To investigate the effect of bee venom on the male reproductive status through measurements of semen quality parameters and testicular histological changes in adult male mice. Methods A total of 48 male mice were randomly divided into three experimental groups (which were subdivided into two subgroups with eight mice each) as follows: control, bee venom sting (BVS), and bee venom injection (BVI). The normal control subgroup mice were not subjected to any treatment, while the vehicle control subgroup mice were injected (i.p.) with 200 μl of 0.9% saline solution. In the BVS-treated subgroups, each mouse was stung by one live bee for five times (BVS-5) or seven times (BVS-7) every third day for 2 or 3 weeks. While each mouse in the BVI-treated subgroups received 23 μg/kg in a dose volume of 200 μl BVIs (i.p.) for five times (BVI-5) or seven times (BVI-7) every third day for 15 or 21 days. Results The findings of this study showed that repeated bee venom treatment by sting or injection to adult male mice resulted in a significant decline in testosterone levels, sperm count, sperm motility, and a very significant increase in the percentage of abnormal sperm morphology; also, there were harmful testicular histological changes in the structural organization of seminiferous tubules and degenerative changes in the germinal epithelium compared to control group. Conclusion The results of this study provide evidence for the low semen quality and adverse testicular histological changes in male mice treated with bee venom. Hence, there is a desperate need for educating alternative healthcare practitioners and infertile couples about the harmful effects of BVT on reproductive status.
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Affiliation(s)
- Sassia O Regeai
- Department of Life Sciences, School of Basic Science, Libyan Academy of Postgraduate Studies, Janzour, Libya.,Zoology Department, Faculty of Science, University of Tripoli, Tripoli, Libya
| | - Salma A Abusrer
- Zoology Department, Faculty of Science, University of Tripoli, Tripoli, Libya
| | - Naema S Shibani
- Department of Life Sciences, School of Basic Science, Libyan Academy of Postgraduate Studies, Janzour, Libya.,Zoology Department, Faculty of Science, University of Tripoli, Tripoli, Libya
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66
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Influence of age on sperm characteristics evaluated by light and electron microscopies. Sci Rep 2021; 11:4989. [PMID: 33654135 PMCID: PMC7925541 DOI: 10.1038/s41598-021-84051-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/10/2021] [Indexed: 12/13/2022] Open
Abstract
The impact of male aging on male fertility has only recently become of interest to the scientific community. This study aims to assess the relationship between age and fertility among a sample of men, considering the individual and pathological characteristics. In this retrospective study data of semen analysis and medical history of 1294 Italian male patients were considered. Semen analysis was performed by light microscopy and transmission electron microscopy mathematically elaborated. A generalized linear model was used to explore the influence of male age on semen quality, considering as confounders wine consumption, smoking habits, presence of varicocele, consanguinity and positive semen bacteriological analysis and urethral swab. The mean age of the participants was 36.41 ± 6.379. Male aging without impact of confounders was correlated with a decrease in sperm concentration and motility and an increased in sperm necrosis. Sperm concentration and progressive motility were negatively related to the presence of confounders as wine consumption (sperm motility), urogenital infection (sperm concentration and motility), varicocele (sperm concentration) and consanguinity (sperm motility). Urogenital infection, varicocele and consanguinity positively correlated with sperm necrosis. The most important finding was the observation of a negative effect of male aging on sperm parameters such as concentration, motility, and viability. It is possible to hypothesize age-dependent changes of testicular environment, probably related to reactive oxygen species production. The demonstration, in a large sample of patients, that aging influences sperm quality strongly motivates further research focused on the mechanisms involved in this phenomenon and its effects on offspring fitness.
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67
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Krzastek SC, Farhi J, Gray M, Smith RP. Impact of environmental toxin exposure on male fertility potential. Transl Androl Urol 2021; 9:2797-2813. [PMID: 33457251 PMCID: PMC7807371 DOI: 10.21037/tau-20-685] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Idiopathic infertility is the most common individual diagnosis in male infertility, representing nearly 44% of cases. Research studies dating over the last half-century consistently demonstrate a decline in male fertility that is incompletely explained by obesity, known genetic causes, or diet and lifestyle changes alone. Human exposures have changed dramatically over the same time course as this fertility decline. Synthetic chemicals surround us. Some are benevolent; however, many are known to cause disruption of the hypothalamic-pituitary-gonadal axis and impair spermatogenesis. More than 80,000 chemicals are registered with the United States National Toxicology Program and nearly 2,000 new chemicals are introduced each year. Many of these are known toxins, such as phthalates, polycyclic aromatic hydrocarbons, aromatic amines, and organophosphate esters, and have been banned or significantly restricted by other countries as they carry known carcinogenic effects and are reproductively toxic. In the United States, many of these chemicals are still permissible in exposure levels known to cause reproductive harm. This contrasts to other chemical regulatory legislature, such as the European Union’s REACH (Registration, Evaluation, Authorization and Restriction of Chemicals) regulations which are more comprehensive and restrictive. Quantification of these diverse exposures on an individual level has proven challenging, although forthcoming technologies may soon make this data available to consumers. Establishing causality and the proportion of idiopathic infertility attributable to environmental toxin exposures remains elusive, however, continued investigation, avoidance of exposure, and mitigation of risk is essential to our reproductive health. The aim of this review is to examine the literature linking changes in male fertility to some of the most common environmental exposures. Specifically, pesticides and herbicides such as dichlorodiphenyltrichloroethane (DDT), dibromochloropropane (DBCP), organophosphates and atrazine, endocrine disrupting compounds including plastic compounds phthalates and bisphenol A (BPA), heavy metals, natural gas/oil, non-ionizing radiation, air and noise pollution, lifestyle factors including diet, obesity, caffeine use, smoking, alcohol and drug use, as well as commonly prescribed medications will be discussed.
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Affiliation(s)
- Sarah C Krzastek
- Department of Urology, University of Virginia, Charlottesville, VA, USA.,Division of Urology, Virginia Commonwealth University, Richmond, VA, USA.,Division of Urology, Hunter Holmes McGuire VAMC, Richmond, VA, USA
| | - Jack Farhi
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Marisa Gray
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Ryan P Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
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Bhartiya D, Kaushik A. Testicular Stem Cell Dysfunction Due to Environmental Insults Could Be Responsible for Deteriorating Reproductive Health of Men. Reprod Sci 2021; 28:649-658. [PMID: 33409879 DOI: 10.1007/s43032-020-00411-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 11/22/2020] [Indexed: 02/06/2023]
Abstract
Reproductive health of men has declined over time including reduced semen quality specifically sperm count, increased incidence of infertility, and testicular cancers. Our recent findings suggest that these disease states possibly arise as a result of disruption of testicular stem cells biology by perinatal insults including exposure to endocrine disrupting chemicals. Testicular stem cells include relatively quiescent, very small embryonic-like stem cells (VSELs), and actively dividing spermatogonial stem cells (SSCs). Both VSELs and SSCs express estrogen receptors and are directly vulnerable to endocrine disruption. Exposing mice pups to estradiol (20 μg/pup/day on days 5-7) or diethylstilbestrol (2 μg/pup/day on days 1-5) affected spermatogenesis during adult life with reduced numbers of tubules in stage VIII, tetraploid cells and sperm. These mice were infertile and majority of diethylstilbestrol treated mice revealed testicular cancer-like changes. An increase in VSEL numbers, observed by both flow cytometry and qRT-PCR, was associated with marked reduction of c-KIT positive spermatogonial cells. VSELs undergo epigenetic changes due to endocrine disruption that results in blocked differentiation (impaired spermatogenesis) leading to reduced sperm count and infertility, and their excessive self-renewal initiates cancer-like changes in adult life. Thus, testicular dysgenesis syndrome (TDS) has a stem cell rather than a genetic basis.
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Affiliation(s)
- Deepa Bhartiya
- Stem Cell Biology Department, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400 012, India.
| | - Ankita Kaushik
- Stem Cell Biology Department, ICMR-National Institute for Research in Reproductive Health, Jehangir Merwanji Street, Parel, Mumbai, 400 012, India
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69
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The Seminiferous Epithelial Cycle of Spermatogenesis: Role of Non-receptor Tyrosine Kinases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1288:1-20. [PMID: 34453729 DOI: 10.1007/978-3-030-77779-1_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Non-receptor tyrosine kinases (NRTKs) are implicated in various biological processes including cell proliferation, differentiation, survival, and apoptosis, as well as cell adhesion and movement. NRTKs are expressed in all mammals and in different cell types, with extraordinarily high expression in the testis. Their association with the plasma membrane and dynamic subcellular localization are crucial parameters in their activation and function. Many NRTKs are found in endosomal protein trafficking pathways, which suggests a novel mechanism to regulate the timely junction restructuring in the mammalian testis to facilitate spermiation and germ cell transport across the seminiferous epithelium.
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70
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Zhang X, Zhang T, Ren X, Chen X, Wang S, Qin C. Pyrethroids Toxicity to Male Reproductive System and Offspring as a Function of Oxidative Stress Induction: Rodent Studies. Front Endocrinol (Lausanne) 2021; 12:656106. [PMID: 34122335 PMCID: PMC8190395 DOI: 10.3389/fendo.2021.656106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022] Open
Abstract
Pyrethroids may be related to male reproductive system damage. However, the results of many previous studies are contradictory and uncertain. Therefore, a systematic review and a meta-analysis were performed to assess the relationship between pyrethroid exposure and male reproductive system damage. A total of 72 articles were identified, among which 57 were selected for meta-analysis, and 15 were selected for qualitative analysis. Pyrethroid exposure affected sperm count (SMD= -2.0424; 95% CI, -2.4699 to -1.6149), sperm motility (SMD=-3.606; 95% CI, -4.5172 to -2.6948), sperm morphology (SMD=2.686; 95% CI, 1.9744 to 3.3976), testis weight (SMD=-1.1591; 95% CI, -1.6145 to -0.7038), epididymal weight (SMD=-1.1576; 95% CI, -1.7455 to -0.5697), and serum testosterone level (SMD=-1.9194; 95% CI, -2.4589 to -1.3798) in the studies of rats. We found that gestational and lactational exposure to pyrethroids can reduce sperm count (SMD=1.8469; 95% CI, -2.9010 to -0.7927), sperm motility (SMD=-2.7151; 95% CI, -3.9574 to -1.4728), testis weight (SMD=-1.4361; 95% CI, -1.8873 to -0.9848), and epididymal weight (SMD=-0.6639; 95% CI, -0.9544 to -0.3733) of F1 offspring. Exposure to pyrethroids can increase malondialdehyde (SMD=3.3451; 95% CI 1.9914 to 4.6988) oxide in testes and can reduce the activities of glutathione (SMD=-2.075; 95% CI -3.0651 to -1.0848), superoxide dismutase (SMD=-2.4856; 95% CI -3.9612 to -1.0100), and catalase (SMD=-2.7564; 95% CI -3.9788 to -1.5340). Pyrethroid exposure and oxidative stress could damage male sperm quality. Gestational and lactational pyrethroid exposure affects the reproductive system of F1 offspring.
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Affiliation(s)
| | | | | | | | | | - Chao Qin
- *Correspondence: Chao Qin, ; ShangQian Wang,
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71
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Tsao Y, Yang C, Wen Y, Chang T, Matsuura K, Chen Y, Cheng C. Point-of-care semen analysis of patients with infertility via smartphone and colorimetric paper-based diagnostic device. Bioeng Transl Med 2021; 6:e10176. [PMID: 33532582 PMCID: PMC7823130 DOI: 10.1002/btm2.10176] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 12/28/2022] Open
Abstract
Male infertility affects millions of males worldwide and is rising in prevalence due to social and environmental conditions. However, men often feel too embarrassed to receive a semen analysis in the hospital due to social stigmas. To overcome this problem, we developed a 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide test strip to distinguish semen samples with low total motile sperm concentration from those with normal motile sperm concentration. This is a point-of-care colorimetric semen analytical method with a one-step, inexpensive, equipment-free evaluation process, and adequate accuracy validated in a 42-sample clinical trial. In this study, results were evaluated visually and with a smartphone application. Using visual observation methods, the area under the curve (AUC) was 0.71 (95% of confidence interval = 0.55-0.86; p = 0.021), sensitivity was 41%, specificity was 95%, positive predictive value was 90%, negative predictive value (NPV) was 59.4%, and accuracy was 67%. Using a smartphone recording and analytical system, AUC was 0.766 (95% of confidence interval = 0.612-0.92; p = 0.003), sensitivity was 96%, specificity was 65%, PPV was 75%, NPV was 92.9%, and accuracy was 80.9%. This work demonstrated a screening tool that could elevate semen analysis to the level of routine healthcare and provide for private, in-home self-assessment.
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Affiliation(s)
- Yu‐Ting Tsao
- Institute of Biomedical EngineeringNational Tsing Hua UniversityHsinchuTaiwan
- Department of EducationChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
| | - Chung‐Yao Yang
- Department of Research and DevelopmentHygeia Touch Inc.TaipeiTaiwan
| | - Yun‐Chiao Wen
- Department of EducationChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
- School of Traditional Chinese MedicineChang Gung University College of MedicineTaoyuanTaiwan
| | - Ting‐Chang Chang
- Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
| | - Koji Matsuura
- Department of Biomedical Engineering, Faculty of EngineeringOkayama University of ScienceOkayamaJapan
| | - Yu Chen
- Department of UrologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
| | - Chao‐Min Cheng
- Institute of Biomedical EngineeringNational Tsing Hua UniversityHsinchuTaiwan
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Boeri L, Belladelli F, Capogrosso P, Cazzaniga W, Candela L, Pozzi E, Valsecchi L, Papaleo E, Viganò P, Abbate C, Pederzoli F, Alfano M, Montorsi F, Salonia A. Normal sperm parameters per se do not reliably account for fertility: A case-control study in the real-life setting. Andrologia 2020; 53:e13861. [PMID: 33125742 DOI: 10.1111/and.13861] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/07/2020] [Accepted: 09/12/2020] [Indexed: 12/15/2022] Open
Abstract
A proportion of men are infertile despite having normal medical history/physical examination and normal semen analysis. We aimed to assess whether normal sperm parameters per se account for male factor fertility. 1,957 infertile men were compared with 103 age-comparable fertile controls. Semen analysis was based on 2010 World Health Organization reference criteria. Of all, 12.1% of infertile men and 40.8% of fertile men presented with normal sperm parameters. Among fertile men, 36.9% had isolated sperm abnormalities and 22.3% men showed two or more concomitant sperm abnormalities. Serum total testosterone was higher in infertile men with normal sperm parameters compared to those with ≥2 sperm abnormalities or azoospermia, but similar to those with isolated sperm abnormalities (p ≤ .001). Circulating hormones were similar among sperm parameters groups in fertile men. At multivariable analyses, testicular volume (OR 1.12, p ≤ .001) and FSH (OR 0.8, p ≤ .001) were associated with normal sperm parameters. Overall, the longer the infertility period, the greater the number of sperm parameters abnormalities (p < .01). In conclusion, we found that 12% of infertile men and only 41% of fertile men present with normal sperm parameters. Normal sperm parameters per se do not reliably account for fertility in the real-life setting.
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Affiliation(s)
- Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Luigi Candela
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Luca Valsecchi
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy.,Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy.,Reproductive Sciences Laboratory, Division of Genetics and Cell Biology, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Costantino Abbate
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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73
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Influence of Lifestyle and Environmental Factors on Semen Quality in Ghanaian Men. Int J Reprod Med 2020; 2020:6908458. [PMID: 33150165 PMCID: PMC7603604 DOI: 10.1155/2020/6908458] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 12/30/2022] Open
Abstract
Introduction Male infertility is known to contribute about half of all infertility cases. In Ghana, the prevalence of male infertility is higher (15.8%) than in females (11.8%). Sperm quality is associated with the likelihood of pregnancy and known to be the cause of male fertility problems 90% of the time. Exposure to certain environmental factors reduces semen quality in men. The study examined the effects of environmental and lifestyle factors on semen quality in Ghanaian men. Materials and Methods This was a cross-sectional study involving 80 apparent healthy adult males in their reproductive age. Participants were males referred to the laboratory (Immunology Unit of the Korle-Bu Teaching Hospital) for semen analysis test and/or culture and sensitivity. Participants were made to fill out a questionnaire which entailed selected environmental factors (accidents or trauma, exposure to chemicals, radiation, and heat) and lifestyle habits (including alcohol consumption, smoking, and whether participants sat more or less than 4 hours per day). Semen samples were then collected by masturbation into sterile containers and analysed in accordance with WHO guidance for semen analysis within 60 minutes after ejaculation and collection. Results About 69% of participants had semen pH within the normal range compared to 15% whose pH were lower than 7.2. There was a significantly high number of immotile sperm cells (p value = 0.017) in participants who sat for more than 4 hours as compared to those that sat for less than 4 hours in a day. Active sperm motility and viability showed significant increase (p value = 0.002 and 0.009, respectively) in participants who kept their cell phones in their side pockets. Smoking produced a twofold decrease in sperm count as smokers had a significantly lower sperm count (12.28 ± 10.95 × 106/ml) compared to the smoke-free (23.85 ± 22.14 × 106/ml). For exposure to STDs, no significant differences were recorded among study groups concerning semen quality. Conclusion Sperm quality in Ghanaian men is associated with lifestyle habits. Smoking and sitting for long hours influenced sperm motility and count, respectively. Knowledge of the factors that influence sperm quality in this geographical region can contribute to informed decisions on effective management of infertility in Ghanaian men.
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Hlisníková H, Petrovičová I, Kolena B, Šidlovská M, Sirotkin A. Effects and Mechanisms of Phthalates' Action on Reproductive Processes and Reproductive Health: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6811. [PMID: 32961939 PMCID: PMC7559247 DOI: 10.3390/ijerph17186811] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022]
Abstract
The production of plastic products, which requires phthalate plasticizers, has resulted in the problems for human health, especially that of reproductive health. Phthalate exposure can induce reproductive disorders at various regulatory levels. The aim of this review was to compile the evidence concerning the association between phthalates and reproductive diseases, phthalates-induced reproductive disorders, and their possible endocrine and intracellular mechanisms. Phthalates may induce alterations in puberty, the development of testicular dysgenesis syndrome, cancer, and fertility disorders in both males and females. At the hormonal level, phthalates can modify the release of hypothalamic, pituitary, and peripheral hormones. At the intracellular level, phthalates can interfere with nuclear receptors, membrane receptors, intracellular signaling pathways, and modulate gene expression associated with reproduction. To understand and to treat the adverse effects of phthalates on human health, it is essential to expand the current knowledge concerning their mechanism of action in the organism.
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Affiliation(s)
- Henrieta Hlisníková
- Department of Zoology and Anthropology, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia; (I.P.); (B.K.); (M.Š.); (A.S.)
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Natural killer and NKT cells in the male reproductive tract. J Reprod Immunol 2020; 142:103178. [PMID: 32739646 DOI: 10.1016/j.jri.2020.103178] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/01/2020] [Accepted: 07/09/2020] [Indexed: 01/01/2023]
Abstract
Natural killer (NK) cells are important effector lymphocytes that play a pivotal role in the innate and adaptive immune responses to tumors and viral infection. NKT cells are a heterogeneous group of T cells that share properties with both T cells and NK cells. They display immunoregulatory properties as they facilitate the cell-mediated immune response to tumors and infectious diseases, and inhibit cell-mediated immunity associated with autoimmune diseases and allograft rejection. However, the roles of NK and NKT cells in the male reproductive tract remain largely unexplored, in particular, NKT cells, tissue distribution, and state of health or disease. Infection and inflammation of the male genital tract are thought to be the primary etiological factors of male infertility. In this review, we considered this complex and rapidly growing field. We summarize the recent findings and the characterization and roles of NK and NKT cells in the male reproductive tract, including the testis, epididymis, prostate, seminal vesicle, and semen, to enhance our understanding of the immunological mechanisms of male infertility and for the design effective vaccines for male reproductive health in the future.
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76
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Wu HP, Lin YS, Chang CF, Lu SY, Chao PM. Dietary Exposure to Oxidized Frying Oil from Fetus to Adulthood Suppresses Male Reproductive Development by Altering Testicular Cholesterol and Testosterone Homeostasis in Sprague Dawley Rats. J Nutr 2020; 150:1713-1721. [PMID: 32286625 DOI: 10.1093/jn/nxaa091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Dietary frying oil may have endocrine-disrupting effects, as a feminization effect was observed in cohorts of C57BL/6J male mice fetuses from dams consuming oxidized frying oil (OFO) during pregnancy. OBJECTIVE The aim of present study was to test the hypothesis that OFO is an anti-androgen. METHODS In experiment 1, male progeny of Sprague Dawley female rats fed fresh oil or an OFO diet (10 g fat/100 g, from fresh or 24-h-fried soybean oil; [control diet (C) and OFO groups, respectively] from midgestation through lactation were studied. Pups were weaned at 3 wk of age and then consumed their mothers' diet until 9 wk of age. In addition, a group of dams and pups that consumed a high-fat diet (HF; 10 g fried and 20 g fresh soybean oil/100 g) was included to counteract body-weight loss associated with OFO ingestion. Indices of male reproductive development and testosterone homeostasis were measured. In experiment 2, male rats were allocated to C and OFO groups (treated as above) and indices of male fertility compared at 9-10 wk of age. RESULTS In experiment 1, final body weights of the HF group were lower (17%) than the C group but higher (14%) than the OFO group (P < 0.0001 for each). In addition to abnormalities in seminiferous tubules, HF and OFO groups did not differ from one another, but, compared with the C group, had delayed preputial separation (4.9 d) and reductions in serum testosterone concentrations (17-74%), anogenital distance (8-20%), weights of androgen-dependent tissues (8-30%), testicular testosterone and cholesterol concentrations (30-40%), and mRNA levels of genes involved in steroidogenesis and cholesterol homeostasis (30-70%). In experiment 2, OFO-exposed males had 20% lower sperm motility (P < 0.05); however, when mated to normal females, pregnancy rates and litter sizes did not differ between OFO and C groups. CONCLUSIONS The anti-androgenic effect of OFO in Sprague Dawley rats was attributed to decreased testicular concentrations of cholesterol (testosterone precursor) and not body-weight loss.
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Affiliation(s)
- Hai-Ping Wu
- Department of Nutrition, China Medical University, Taichung, Taiwan
| | - Yu-Shun Lin
- Department of Nutrition, China Medical University, Taichung, Taiwan
| | - Chi-Fen Chang
- Department of Anatomy, School of Medicine, China Medical University, Taichung, Taiwan
| | - Shui-Yuan Lu
- Department of Applied Toxicology, Taiwan Agricultural Chemicals and Toxic Substances Research Institute, Taichung, Taiwan
| | - Pei-Min Chao
- Department of Nutrition, China Medical University, Taichung, Taiwan
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Cabry R, Merviel P, Madkour A, Lefranc E, Scheffler F, Desailloud R, Bach V, Benkhalifa M. The impact of endocrine disruptor chemicals on oocyte/embryo and clinical outcomes in IVF. Endocr Connect 2020; 9:R134-R142. [PMID: 32380469 PMCID: PMC7354731 DOI: 10.1530/ec-20-0135] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 05/07/2020] [Indexed: 12/17/2022]
Abstract
The negative impact of endocrine-disrupting pesticides on human fertility is now a key issue in reproductive health. There are much fewer literature data about the impact of pesticide exposure on women than on men and very few studies of women participating in an in vitro fertilization (IVF) programme. In the present review, we found that (1) various pesticides with an endocrine-disrupting action are associated with poor oocyte maturation and competency, embryonic defects and poor IVF outcomes, and (2) some pesticide compounds are linked to specific causes of female infertility, such as premature ovarian insufficiency, polycystic ovarian syndrome, and endometriosis. IVF participants living in agricultural regions should be informed about the fertility decline, low ongoing pregnancy rates, and elevated risk of miscarriage associated with exposure to high doses of pesticides.
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Affiliation(s)
| | | | - Aicha Madkour
- Mohammed V University of Rabat, Reproductive Medicine, Rabat, Morocco
| | | | | | | | | | - Moncef Benkhalifa
- Amiens University, Amiens, Haut-de-France, France
- Correspondence should be addressed to M Benkhalifa:
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Kohn JR, Haney NM, Nichols PE, Rodriguez KM, Kohn TP. Varicocele Repair Prior to Assisted Reproductive Technology: Patient Selection and Special Considerations. Res Rep Urol 2020; 12:149-156. [PMID: 32426301 PMCID: PMC7196200 DOI: 10.2147/rru.s198934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/21/2020] [Indexed: 01/02/2023] Open
Abstract
Clinical varicoceles are one of the most commonly identified physical exam abnormalities in men presenting with infertility. Clinical varicoceles can cause impaired spermatogenesis and surgical correction can improve semen parameters in select men. Increasingly, andrologists are performing varicocele repairs prior to intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) to boost male fertility potential. In this review, we evaluated the available literature 1) to determine if varicocelectomy prior to IUI or assisted reproductive technologies proved to improve sperm production or pregnancy outcomes; and 2) to identify who may be the ideal candidate for pre-IUI/ART varicocelectomy. Overall, few studies have explored this topic and little can be concluded about the impact of varicocelectomy prior to IUI. The evidence, however, does support that correcting a clinical varicocele can increase pregnancy outcomes in couples who plan to pursue IVF or ICSI. When selecting patients for varicocelectomy prior to IUI or ART, clinicians should evaluate female age as improvement in semen parameters can take 6 months after varicocelectomy and this duration of time may be deleterious in cases of advanced maternal age when each cycle becomes increasingly important. Overall, the currently limited literature regarding clinical varicoceles correction demonstrates that pregnancy rates can be increased when comparing patients who have undergone varicocelectomy prior to ART with those who had clinical varicocele but did not undergo surgery.
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Affiliation(s)
- Jaden R Kohn
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nora M Haney
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Katherine M Rodriguez
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Abstract
PURPOSE Approximately 50% of men reporting to clinics for assisted reproduction have abnormal sperm parameters; we therefore considered whether they differ from fertile males in terms of the frequency of KIR and HLA-C genes, suggesting the involvement of NK cells and some T cells in the inflammatory reaction that can occur in the testes, vas deferens, or epididymis. METHOD We tested a total of 1064 men: 445 of them were patients who, together with their female partners, participated in in vitro fertilization (IVF), 298 men whose female partners suffered from recurrent spontaneous abortion. Three hundred twenty-one fertile men constituted the control group. KIRs were genotyped using KIR Ready Gene kits and HLA-C by PCR-SSP methods. RESULTS We found differences in KIR gene frequencies between men who became fathers via natural conception and men who participated in in vitro fertilization for KIR2DL2 (p/pcorr. = 0.0015/0.035, OR = 1.61), KIR2DL5 gr.2 (p/pcorr. = 0.0023/0.05, OR = 1.64), KIR2DS2 (p/pcorr. = 0.0019/0.044, OR = 1.59), and KIR2DS3 (p/pcorr. = 0.0016/0.037, OR = 1.67). KIRs in Cen AA region were significantly overrepresented in fertile males than in IVF males (p/pcorr. = 0.0076/0.03, OR = 0.67), whereas Cen AB + Cen BB frequency was higher in IVF males than in fertile males (p/pcorr. = 0.0076/0.03, OR = 1.50). We also observed a limited association in KIR-HLA-C combinations. CONCLUSION Fertile men differ in profile of KIR genes and KIR-HLA-C combinations from men participating in IVF.
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Van Cauwenbergh O, Di Serafino A, Tytgat J, Soubry A. Transgenerational epigenetic effects from male exposure to endocrine-disrupting compounds: a systematic review on research in mammals. Clin Epigenetics 2020; 12:65. [PMID: 32398147 PMCID: PMC7218615 DOI: 10.1186/s13148-020-00845-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 04/08/2020] [Indexed: 12/13/2022] Open
Abstract
Assessing long-term health effects from a potentially harmful environment is challenging. Endocrine-disrupting compounds (EDCs) have become omnipresent in our environment. Individuals may or may not experience clinical health issues from being exposed to the increasing environmental pollution in daily life, but an issue of high concern is that also the non-exposed progeny may encounter consequences of these ancestral exposures. Progress in understanding epigenetic mechanisms opens new perspectives to estimate the risk of man-made EDCs. However, the field of epigenetic toxicology is new and its application in public health or in the understanding of disease etiology is almost non-existent, especially if it concerns future generations. In this review, we investigate the literature on transgenerational inheritance of diseases, published in the past 10 years. We question whether persistent epigenetic changes occur in the male germ line after exposure to synthesized EDCs. Our systematic search led to an inclusion of 43 articles, exploring the effects of commonly used synthetic EDCs, such as plasticizers (phthalates and bisphenol A), pesticides (dichlorodiphenyltrichloroethane, atrazine, vinclozin, methoxychlor), dioxins, and polycyclic aromatic hydrocarbons (PAHs, such as benzo(a)pyrene). Most studies found transgenerational epigenetic effects, often linked to puberty- or adult-onset diseases, such as testicular or prostate abnormalities, metabolic disorders, behavioral anomalies, and tumor development. The affected epigenetic mechanisms included changes in DNA methylation patterns, transcriptome, and expression of DNA methyltransferases. Studies involved experiments in animal models and none were based on human data. In the future, human studies are needed to confirm animal findings. If not transgenerational, at least intergenerational human studies and studies on EDC-induced epigenetic effects on germ cells could help to understand early processes of inheritance. Next, toxicity tests of new chemicals need a more comprehensive approach before they are introduced on the market. We further point to the relevance of epigenetic toxicity tests in regard to public health of the current population but also of future generations. Finally, this review sheds a light on how the interplay of genetics and epigenetics may explain the current knowledge gap on transgenerational inheritance.
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Affiliation(s)
- Olivia Van Cauwenbergh
- Epidemiology Research Center, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven - University of Leuven, Leuven, Belgium
| | - Alessandra Di Serafino
- Epidemiology Research Center, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Psychological, Health and Territorial Sciences, School of Medicine and Health Sciences, University "G.d'Annunzio" of Chieti-Pescara, Chieti, Italy
| | - Jan Tytgat
- Toxicology and Pharmacology, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven - University of Leuven, Leuven, Belgium
| | - Adelheid Soubry
- Epidemiology Research Center, Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven - University of Leuven, Leuven, Belgium.
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Abstract
BACKGROUND Patients with severe oligospermia and nonobstructive azoospermia have very limited numbers of viable sperm in their epididymal and testicular samples. Thus, cryopreservation of their sperm is performed to avoid repeated sperm retrievals and to preserve their sperm from any side effects of any treatment regimens. MAIN BODY The development of intracytoplasmic sperm injection technology has extended the therapeutic capacity of assisted reproductive technology for men with azoospermia via the surgical or percutaneous isolation of sperm from the testis/epididymis. The conventional cryopreservation techniques are inadequate for preserving individually selected sperm. The technique for freezing single sperm was first developed in 1997 and has been explored from the perspective of frozen carriers, freezing programs, and cryoprotectant formulations. Among these methods, advances in frozen carriers have directly improved single-sperm freezing technology. In this review, we evaluate the different technologies for the cryopreservation of single sperm by discussing the advantages and disadvantages of different freezing methods, their clinical applications, and the outcomes for a range of frozen carriers. CONCLUSION Our review article describes the latest and current technologies implemented for the cryopreservation of single sperm that could potentially benefit patients with severe oligospermia and who rarely have any sperm in their ejaculate. This review provides a platform to understand the process and pitfalls of single-sperm cryopreservation to ensure further improvements in the cryopreservation technology in future studies.
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Affiliation(s)
- Shasha Liu
- grid.461863.e0000 0004 1757 9397Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu, 610041 China
- grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Disease of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041 China
| | - Fuping Li
- grid.461863.e0000 0004 1757 9397Human Sperm Bank, West China Second University Hospital, Sichuan University, Chengdu, 610041 China
- grid.419897.a0000 0004 0369 313XKey Laboratory of Birth Defects and Related Disease of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041 China
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Abstract
PURPOSE OF REVIEW To review the evidence regarding a decrease in worldwide sperm parameters and discuss potential causative factors. RECENT FINDINGS The topic of worldwide decline in sperm parameters is contentious; however, recent high-quality studies have demonstrated that there is indeed a decline in sperm parameters. Several retrospective and basic science studies have shown possible links for this decline in sperm parameters such as obesity, diet, and environmental toxins. SUMMARY There exist substantial data to suggest a decline in sperm counts over time. Although causative factors have yet to be fully elucidated, potential causes include, increased rates of obesity, poor diet, and exposure to environmental toxins. How this decline in sperm counts reflects fertility has yet to be determined. As such, further studies are necessary to evaluate whether this decline in sperm count correlates with decreased fecundity and how to identify and mitigate potential causative factors.
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Affiliation(s)
- Uday Mann
- Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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Ilgin S. The adverse effects of psychotropic drugs as an endocrine disrupting chemicals on the hypothalamic-pituitary regulation in male. Life Sci 2020; 253:117704. [PMID: 32339542 DOI: 10.1016/j.lfs.2020.117704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/18/2020] [Accepted: 04/18/2020] [Indexed: 02/01/2023]
Abstract
Adverse effects of drugs on male reproductive system can be categorized as pre-testicular, testicular, and post-testicular. Pre-testicular adverse effects disrupt the hypothalamic-pituitary-gonadal (HPG) axis, generally by interfering with endocrine function. It is known that the HPG axis has roles in the maintenance of spermatogenesis and sexual function. The hypothalamus secretes gonadotropin-releasing hormone (GnRH) which enters the hypophyseal portal system to stimulate the anterior pituitary. The anterior pituitary secretes gonadotropins, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) which are vital for spermatogenesis, into the blood. The FSH stimulates the Sertoli cells for the production of regulatory molecules and nutrients needed for the maintenance of spermatogenesis, while the LH stimulates the Leydig cells to produce and secrete testosterone. Many neurotransmitters influence the hypothalamic-pituitary regulation, consequently the HPG axis, and can consequently affect spermatogenesis and sexual function. Psychotropic drugs including antipsychotics, antidepressants, and mood stabilizers that all commonly modulate dopamine, serotonin, and GABA, can affect male spermatogenesis and sexual function by impairment of the hypothalamic-pituitary regulation, act like endocrine-disrupting chemicals. Otherwise, studies have shown the relationship between decreased sperm quality and psychotropic drugs treatment. Therefore, it is important to investigate the adverse reproductive effects of psychotropic drugs which are frequently used during reproductive ages in males and to determine the role of the hypothalamic-pituitary regulation axis on possible pathologies.
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Affiliation(s)
- Sinem Ilgin
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, Anadolu University, 26470 Eskisehir, Turkey.
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84
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Poli D, Andreoli R, Moscato L, Pelà G, de Palma G, Cavallo D, Petyx M, Pelosi G, Corradi M, Goldoni M. The Relationship Between Widespread Pollution Exposure and Oxidized Products of Nucleic Acids in Seminal Plasma and Urine in Males Attending a Fertility Center. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061880. [PMID: 32183208 PMCID: PMC7143937 DOI: 10.3390/ijerph17061880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/04/2020] [Accepted: 03/05/2020] [Indexed: 12/17/2022]
Abstract
Background: In recent decades, there has been an increase in male infertility, and in many cases, the etiology remains unclear. Several studies relate male hypo-fertility to xenobiotic exposure, even if no data exist about multiple exposure at the environmental level. Methods: The study involved 86 males with diagnosis of idiopathic male infertility (IMI), and 46 controls with no alteration in sperm characteristics. Seminal plasma (SP) and urine samples were analyzed by liquid chromatography tandem mass spectrometry (LC-MS/MS) to quantify biomarkers of exposure (the main metabolites of benzene, toluene, 1,3-butadiene, 3-monochloropropanediol, styrene, and naphthol) and effect (oxidized products of nucleic acids).Results: Biomarker concentrations were similar in subjects with IMI and controls even if a stronger correlation between biomarkers of exposure and effects were observed in SP. Data show that, both in SP and urine, most metabolites were inter-correlated, indicating a simultaneous co-exposure to the selected substances at the environmental level. Principal component analysis showed in SP the clustering of mercapturic acids indicating a preferential metabolic pathway with Glutathione (GSH) depletion and, consequently, an increase of oxidative stress. This result was also confirmed by multivariable analysis through the development of explanatory models for oxidized products of nucleic acids. Conclusions: This study highlights how oxidative stress on the male reproductive tract can be associated with a different representation of metabolic pathways making the reproductive tract itself a target organ for different environmental pollutants. Our results demonstrate that SP is a suitable matrix to assess the exposure and evaluate the effects of reproductive toxicants in environmental/occupational medicine. The statistical approach proposed in this work represents a model appropriate to study the relationship between multiple exposure and effect, applicable even to a wider variety of chemicals.
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Affiliation(s)
- Diana Poli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL Research, Via Fontana Candida1, 00078 Monte Porzio Catone, Rome, Italy; (D.P.); (D.C.); (M.P.)
| | - Roberta Andreoli
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy; (R.A.); (G.P.); (M.C.)
- Centre for Research in Toxicology (CERT), University of Parma, via A. Gramsci 14, 43126 Parma, Italy
| | - Lucia Moscato
- Center of Reproductive Infertility (CIR), University Hospital of Parma, via A. Gramsci 14, 43126 Parma, Italy;
| | - Giovanna Pelà
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy; (R.A.); (G.P.); (M.C.)
- University Hospital of Parma, via A. Gramsci 14, 43126 Parma, Italy
| | - Giuseppe de Palma
- Department of Medicine, Surgery, Radiological Sciences, Public Health and Human Sciences Unit, University of Brescia, 25121 Brescia, Italy;
| | - Delia Cavallo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL Research, Via Fontana Candida1, 00078 Monte Porzio Catone, Rome, Italy; (D.P.); (D.C.); (M.P.)
| | - Marta Petyx
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL Research, Via Fontana Candida1, 00078 Monte Porzio Catone, Rome, Italy; (D.P.); (D.C.); (M.P.)
| | - Giorgio Pelosi
- Centre for Research in Toxicology (CERT), University of Parma, via A. Gramsci 14, 43126 Parma, Italy
- Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Parco Area delle Scienze 11/a, 43124 Parma, Italy;
| | - Massimo Corradi
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy; (R.A.); (G.P.); (M.C.)
- Centre for Research in Toxicology (CERT), University of Parma, via A. Gramsci 14, 43126 Parma, Italy
- University Hospital of Parma, via A. Gramsci 14, 43126 Parma, Italy
| | - Matteo Goldoni
- Department of Medicine and Surgery, University of Parma, via A. Gramsci 14, 43126 Parma, Italy; (R.A.); (G.P.); (M.C.)
- Centre for Research in Toxicology (CERT), University of Parma, via A. Gramsci 14, 43126 Parma, Italy
- Correspondence:
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Fabig G, Kiewisz R, Lindow N, Powers JA, Cota V, Quintanilla LJ, Brugués J, Prohaska S, Chu DS, Müller-Reichert T. Male meiotic spindle features that efficiently segregate paired and lagging chromosomes. eLife 2020; 9:50988. [PMID: 32149606 PMCID: PMC7101234 DOI: 10.7554/elife.50988] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/08/2020] [Indexed: 01/25/2023] Open
Abstract
Chromosome segregation during male meiosis is tailored to rapidly generate multitudes of sperm. Little is known about mechanisms that efficiently partition chromosomes to produce sperm. Using live imaging and tomographic reconstructions of spermatocyte meiotic spindles in Caenorhabditis elegans, we find the lagging X chromosome, a distinctive feature of anaphase I in C. elegans males, is due to lack of chromosome pairing. The unpaired chromosome remains tethered to centrosomes by lengthening kinetochore microtubules, which are under tension, suggesting that a ‘tug of war’ reliably resolves lagging. We find spermatocytes exhibit simultaneous pole-to-chromosome shortening (anaphase A) and pole-to-pole elongation (anaphase B). Electron tomography unexpectedly revealed spermatocyte anaphase A does not stem solely from kinetochore microtubule shortening. Instead, movement of autosomes is largely driven by distance change between chromosomes, microtubules, and centrosomes upon tension release during anaphase. Overall, we define novel features that segregate both lagging and paired chromosomes for optimal sperm production.
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Affiliation(s)
- Gunar Fabig
- Experimental Center, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Robert Kiewisz
- Experimental Center, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | | | - James A Powers
- Light Microscopy Imaging Center, Indiana University, Bloomington, United States
| | - Vanessa Cota
- Department of Biology, San Francisco State University, San Francisco, United States
| | - Luis J Quintanilla
- Department of Biology, San Francisco State University, San Francisco, United States
| | - Jan Brugués
- Max Planck Institute of Molecular Cell Biology and Genetics, Dresden, Germany.,Max Planck Institute for the Physics of Complex Systems, Dresden, Germany.,Centre for Systems Biology Dresden, Dresden, Germany
| | | | - Diana S Chu
- Department of Biology, San Francisco State University, San Francisco, United States
| | - Thomas Müller-Reichert
- Experimental Center, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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86
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Kudavidanage EP, Dissanayake DMI, Keerthirathna WLR, Nishshanke NLW, Peiris LDC. Commercial Formulation of Chlorpyrifos Alters Neurological Behaviors and Fertility. BIOLOGY 2020; 9:biology9030049. [PMID: 32156097 PMCID: PMC7150932 DOI: 10.3390/biology9030049] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 11/23/2022]
Abstract
Pesticides are known to result in toxic insult. We aimed to evaluate Judo 40, the commercial formulation of chlorpyrifos on the neurological activities, fertility, and hormone levels of male rats. Male Wistar rats were treated orally with 1 mL of 20 or 50 mg/kg Judo 40. The doses were administered four times, twice a day. Sexual and exploratory behavior indices, fertility indices, serum androgen levels, blood acetylcholinesterase (BChE) levels, and neurological and muscular effects were evaluated. Serum testosterone and luteinizing hormone were significantly reduced in the rats receiving 50 mg/kg Judo 40. A reduction in viable implantation sites and live pups born were evident in the female rats mated with the male rats treated with the highest dose. Similarly, in the rats treated with the highest dose of Judo 40, a significant reduction in plasma BChE enzyme was observed. According to the results, prolonged Judo 40 exposure can cause impairment of the neurological alterations and sex hormones leading to impaired fertility. Therefore, chemical handlers should be educated on protection and risk minimization.
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Affiliation(s)
- Enoka P. Kudavidanage
- Department of Natural Sciences, Sabaragamuwa University, Belhiloya 70140, Sri Lanka;
| | - D. M. I. Dissanayake
- Department of Zoology, Faculty of Applied Sciences (Center for Biotechnology), University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (D.M.I.D.); (W.L.R.K.); (N.L.W.N.)
| | - W. L. Rangi Keerthirathna
- Department of Zoology, Faculty of Applied Sciences (Center for Biotechnology), University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (D.M.I.D.); (W.L.R.K.); (N.L.W.N.)
| | - N. Lasni Wathima Nishshanke
- Department of Zoology, Faculty of Applied Sciences (Center for Biotechnology), University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (D.M.I.D.); (W.L.R.K.); (N.L.W.N.)
| | - L. Dinithi C. Peiris
- Department of Zoology, Faculty of Applied Sciences (Center for Biotechnology), University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka; (D.M.I.D.); (W.L.R.K.); (N.L.W.N.)
- Correspondence: ; Tel.: +94-714-018-537
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87
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Hazem NM, Zalata A, Alghobary M, Comhaire F, Elabbasy LM. Evaluation of cannabinoid receptors Type 1 and Type 2 mRNA expression in mature versus immature spermatozoa from fertile and infertile males. Andrologia 2020; 52:e13532. [PMID: 32064664 DOI: 10.1111/and.13532] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/13/2019] [Accepted: 12/31/2019] [Indexed: 12/16/2022] Open
Abstract
The expression of the main cannabinoid receptors (CBR1 and CBR2) was investigated to evaluate the possible association with the sperm maturation from fertile and infertile individuals. One hundred subjects were classified into fertile (n = 50) and infertile groups (n = 50). Fresh semen samples were collected. Computer-assisted semen analysis and acrosin activity test were done. RNA was extracted from mature and immature sperm pellets. Reverse transcriptase reaction and real-time PCR were done to assess the levels of both CBR1 and CBR2 genes expression in all samples. Mature spermatozoa from both groups showed significantly higher levels of both CBR1 and CBR2 compared with the immature spermatozoa (p < .05). This increment was significantly more important in the fertile group (p < .05). In mature spermatozoa, CBR1 expression was significantly related to variation in sperm morphology, and CBR2 was significantly related to both sperm morphology and linearity index. In conclusion, CBR1 and CBR2 mRNA expression may closely direct the sperm maturation at different steps of the reproductive process.
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Affiliation(s)
- Noha M Hazem
- Medical Biochemistry Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Adel Zalata
- Medical Biochemistry Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Moheiddin Alghobary
- Dermatology and Andrology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Frank Comhaire
- Emeritus Professor of Andrology, Ghent University Hospital, Ghent, Belgium
| | - Lamiaa M Elabbasy
- Medical Biochemistry Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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88
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Ricci E, Noli S, Ferrari S, La Vecchia I, Castiglioni M, Cipriani S, Somigliana E, Parazzini F, Agostoni C. Fatty acids, food groups and semen variables in men referring to an Italian Fertility Clinic: Cross-sectional analysis of a prospective cohort study. Andrologia 2020; 52:e13505. [PMID: 31912922 DOI: 10.1111/and.13505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/24/2019] [Accepted: 12/06/2019] [Indexed: 02/06/2023] Open
Abstract
Diet has been suggested as a factor affecting sperm quality, both in healthy and infertile men. To study whether specific food groups and fatty acids (FA) intake were associated with sperm parameters of men from couples referring to an Italian Fertility Clinic, we conducted a cross-sectional analysis. A semen sample was collected and analysed before proceeding with assisted reproduction. To evaluate food groups and fatty acids intake, we used a questionnaire of food frequency. We calculated odds ratios (OR) and 95% confidence intervals (CI) for abnormal semen parameters. Among 323 men, 19% had semen volume (SV) <1.5 ml, 31% sperm concentration (SC) <15 mil/mL, 33% total sperm count (TSC) <39 mil and 27% sperm progressive motility <32%. Low SC was more frequent in men with higher saturated FA (SFA) and polyunsaturated FA (PUFA) intake. Better SC and TSC were related to higher monounsaturated FA (MUFA)/SFA ratio. Monounsaturated FA and linoleic/linolenic acid ratio were not related to any considered parameters. Low TSC was associated with low vegetable intake. In conclusion, normal sperm parameters were more frequent in men with low intake of SFA and PUFA, and high vegetable intake. Higher MUFA/SFA ratio was associated with better sperm quality parameters.
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Affiliation(s)
- Elena Ricci
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefania Noli
- Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
| | - Stefania Ferrari
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Irene La Vecchia
- Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
| | - Marta Castiglioni
- Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
| | - Sonia Cipriani
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Edgardo Somigliana
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
| | - Fabio Parazzini
- Department of Woman, Newborn and Child, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, Università di Milano, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico, Milan, Italy
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89
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Barrera N, Ordoqui R, Montes JM, Canepa M, Bonelli C, Surka C, Torrens A, Cantú L, Du Plessis SS. The Uruguayan semen donor population: A twenty-eight-year retrospective study. Andrologia 2019; 52:e13502. [PMID: 31876046 DOI: 10.1111/and.13502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 10/10/2019] [Accepted: 11/19/2019] [Indexed: 11/28/2022] Open
Abstract
Several studies have reported a global decline in seminal quality over the years. The objective of this study was to describe the semen donor population of Uruguay through comparing data of successive samples banked by the same donors and the analysis of their semen and physical characteristics, ancestry origin and educational level. A total of 3,449 ejaculated samples collected from 71 donors, cryobanked between 1989 and March 2017 at Fertilab, were analysed. Results revealed a mean age of 23.90 ± 3.98 years, an average weight of 74.95 ± 1.09 kg and a mean height of 1.78 ± 0.06 m. The majority of the donors trace their origin to Europe (74.65%, 53/71) and 66.19% (47/71) have a level of education higher than secondary school. We observed longitudinal differences in two parameters, that is sperm concentration and semen volume. Sperm concentration declined, while semen volume increased significantly over the 28-year period. The results of the present study are in accordance with that of previous articles that also reported a decline in sperm concentration over time. However, no differences were observed in total sperm number per ejaculate due to the increase in semen volume values, thus reflecting no real changes in sperm production over time.
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Affiliation(s)
- Natalibeth Barrera
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay.,IVF Laboratory, Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Rosina Ordoqui
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - José M Montes
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Mariel Canepa
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Carla Bonelli
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay.,IVF Laboratory, Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Carolina Surka
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Andrea Torrens
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay
| | - Lidia Cantú
- Andrology Laboratory, Fertilab Laboratorio de Análisis Clínicos, Montevideo, Uruguay.,IVF Laboratory, Centro de Esterilidad Montevideo, Montevideo, Uruguay
| | - Stefan S Du Plessis
- Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.,Department of Basic Medical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
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90
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Kaur S, Sadwal S. Studies on the phytomodulatory potential of fenugreek (
Trigonella foenum‐graecum
) on bisphenol‐A induced testicular damage in mice. Andrologia 2019; 52:e13492. [DOI: 10.1111/and.13492] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/29/2019] [Accepted: 10/16/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
| | - Shilpa Sadwal
- Department of Biophysics Panjab University Chandigarh India
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91
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In vitro effects of single and binary mixtures of regulated mycotoxins and persistent organochloride pesticides on steroid hormone production in MA-10 Leydig cell line. Toxicol In Vitro 2019; 60:272-280. [DOI: 10.1016/j.tiv.2019.06.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 06/03/2019] [Accepted: 06/09/2019] [Indexed: 01/29/2023]
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92
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Tiegs AW, Landis J, Garrido N, Scott RT, Hotaling JM. Total Motile Sperm Count Trend Over Time: Evaluation of Semen Analyses From 119,972 Men From Subfertile Couples. Urology 2019; 132:109-116. [DOI: 10.1016/j.urology.2019.06.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/05/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
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93
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Kumar JA, Balaji T, Priyadarshini CS, Subramanian M, Sundaramurthi I. Non Concurrent Multimodal Stress Decreases Sperm Quality and Motor Activity in Male Wister Albino Rats. BIOMEDICAL & PHARMACOLOGY JOURNAL 2019. [DOI: 10.13005/bpj/1781] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Every human being is exposed to the stress in one or the other form in the day to day life. Most of the existing studies on the impact of stress on the male reproduction were assessed by using single stressor, which may lead habituation to that stressor. The present study intends to estimate the consequence of stress on motor activity, sperm quality and histopathology of the testis in stress-induced male rats using multimodal stress one per day. Four weeks old Wister albino rats were randomly split into 4 groups and induced multimodal stress at different ages of life span. After induction of stress serum corticosterone levels, muscle strength and coordination, quality of sperm and histopathology of testes were estimated. Elevated serum corticosterone levels and body weight, reduced muscle strength, coordination. Sperm concentration and motility was significantly reduced and increased morphologically abnormal sperm in stress induced animals but sperm viability was not altered much. Histopathology of testes in stress received animals showed decreased tubular diameter and increased intertubular space. Multimodal stress caused elevated serum corticosterone and body weight, decreased motor activity, sperm quality and degenerative changes in the testis
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Affiliation(s)
- Jyothi Ashok Kumar
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu, India
| | - Thotakura Balaji
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu, India
| | - C. Swathi Priyadarshini
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu, India
| | - Manickam Subramanian
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu, India
| | - Indumathi Sundaramurthi
- Department of Anatomy, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu, India
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94
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Dissanayake DMIH, Keerthirathna WLR, Peiris LDC. Male Infertility Problem: A Contemporary Review on Present Status and Future Perspective. GENDER AND THE GENOME 2019. [DOI: 10.1177/2470289719868240] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Semen quality plays a pivotal role in maintaining healthy fertilizing ability of spermatozoa. Male infertility is a rising global problem with an increasing declining in male semen quality among men living in Africa, Europe, North American, and Asia. Though the sperm acquire proactive mechanisms during spermatogenesis and their epididymal maturation, they still remain viable for toxic insult. Declining semen quality is a major contributor to infertility. Studies have postulated that different factors, such as exposure to pesticides, industrial chemicals, heavy metals, obesity, alcoholism, tobacco smoking, sedentary lifestyles, poor nutrient intake, oxidative stress, physiological factors, genetic factors can influence male fertility. Routine semen analysis and assays for sperm chromatin integrity are the most widely utilized and best studied adjunctive diagnostics in male infertility. Over the years, scientists have developed different treatment options for male infertility. Male infertility with known etiology can be treated successfully, but other causes like genetic factors require pragmatic approaches. This article summarizes protective mechanisms of spermatogenesis, causes, diagnosis, and both modern and traditional treatment approaches of male infertility. Further, this article highlights present issues and direction for future exploration of the male infertility problem.
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Affiliation(s)
- D. M. I. H. Dissanayake
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - W. L. R. Keerthirathna
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - L. Dinithi C. Peiris
- Department of Zoology, Faculty of Applied Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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95
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Muhamad S, Sengupta P, Ramli R, Nasir A. Sociodemographic factors associated with semen quality among Malaysian men attending fertility clinic. Andrologia 2019; 51:e13383. [DOI: 10.1111/and.13383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 07/10/2019] [Indexed: 01/25/2023] Open
Affiliation(s)
- Suriyani Muhamad
- School of Social and Economic Development Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Pallav Sengupta
- Faculty of Medicine and Biomedical Sciences MAHSA University Jenjarom Malaysia
| | - Roszaman Ramli
- Kulliyyah of Medicine International Islamic University Malaysia Kuantan Malaysia
| | - Aslina Nasir
- School of Informatics and Applied Mathematics Universiti Malaysia Terengganu Kuala Nerus Malaysia
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96
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Borges E, Zanetti BF, Setti AS, Braga DPDAF, Provenza RR, Iaconelli A. Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertil Steril 2019; 112:483-490. [PMID: 31200969 DOI: 10.1016/j.fertnstert.2019.04.029] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/22/2019] [Accepted: 04/22/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To study the implications of sperm DNA fragmentation (SDF) in intracytoplasmic sperm injection cycles for non-male factor infertility. DESIGN Prospective cohort study. SETTING Private university-affiliated IVF center. PATIENT(S) Data from 475 cycles performed from June 2016 to June 2017. INTERVENTION(S) Cycles were divided according to SDF rate into two groups: <30% SDF (n = 433) and ≥30% SDF (n = 42). Laboratory and clinical outcomes were compared between groups by generalized linear models adjusted for potential confounders. MAIN OUTCOME MEASURE(S) Embryo quality and miscarriage rates. RESULT(S) Fertilization rate was similar between groups (≥30% SDF, 85.28% ± 1.06% vs. <30% SDF, 90.68% ± 3.61%). Significantly lower rates of normal cleavage speed (≥30% SDF, 61.12% ± 4.21% vs. <30% SDF, 72.53% ± 1.24%), high-quality embryos at day 3 (≥30% SDF, 23.07% ± 5.56% vs. <30% SDF, 36.41% ± 1.53%), blastocyst formation (≥30% SDF, 39.09% ± 2.73% vs. <30% SDF, 58.83% ± 7.59%), blastocyst quality (≥30% SDF, 11.97% ± 1.22% vs. <30% SDF, 30.09% ± 2.39%), and implantation (33.24% ± 1.66% vs. <30% SDF, 46.40% ± 4.61%) were observed in cycles with higher SDF, despite similar pregnancy rates (≥30% SDF, 30.40% vs. <30% SDF, 32.40%). A 2.5-fold miscarriage rate was observed in cycles with an SDF above the established cutoff (≥30% SDF, 42.8% vs. <30% SDF, 16.8%). CONCLUSION(S) Higher SDF is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in non-male factor infertility intracytoplasmic sperm injection cycles. Since defects in sperm may be hidden, the SDF test can bring additional information to the sperm quality evaluation of men with unknown infertility history.
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Affiliation(s)
- Edson Borges
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.
| | - Bianca Ferrarini Zanetti
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | | | | | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
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97
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Pokhrel G, Yihao S, Wangcheng W, Khatiwada SU, Zhongyang S, Jianqiao Y, Yucong Z, Xiaming L, Dan Z, Jihong L. The impact of sociodemographic characteristics, lifestyle, work exposure and medical history on semen parameters in young Chinese men: A cross-sectional study. Andrologia 2019; 51:e13324. [PMID: 31134681 DOI: 10.1111/and.13324] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/18/2019] [Accepted: 05/07/2019] [Indexed: 12/21/2022] Open
Abstract
There is an ongoing debate on the declining semen quality, and unfortunately, existing evidence is inconclusive and inconsistence. We evaluated the impact of sociodemographic characteristics, lifestyle, medical history and work exposure on semen quality. Univariate and multivariate analysis was used to investigate the association between different risk factors and semen quality parameters. Total sperm count (p = 0.041), sperm concentration (p = 0.007), normal morphology (p = 0.002), total motility (p = 0.004) and progressive motility (p = 0.009) decreased in men with varicocele. Sperm concentration increased in tea (p = 0.044); progressive and total motility increased in cola (p = 0.018, p = 0.012) consumers. Progressive and total motility decreased in urogenital surgery (p = 0.016, p = 0.014) and infection (p = 0.037, p = 0.022). However, age, coffee and alcohol drinking, physical activities, sleep duration and cell phone use were unrelated to any of semen parameters. Interestingly, semen volume (p < 0.0001), total sperm count (p < 0.0001) and concentration (p < 0.033) increased with longer abstinence period (>5 days); normal morphology (p = 0.013) improved in men with higher body mass index (BMI > 24), curvilinear velocity (p = 0.042) increased with smoking; semen volume (p = 0.050) increased in manual labourers. This study highlights the importance of sociodemographic characteristics, lifestyle, occupational exposure and medical history and provides time trends in semen quality, its clinical importance and direction for further research.
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Affiliation(s)
- Gaurab Pokhrel
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shi Yihao
- MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wang Wangcheng
- MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shikha Upadhyaya Khatiwada
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Sun Zhongyang
- MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Jianqiao
- MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhang Yucong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Xiaming
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zheng Dan
- MOE Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Jihong
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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98
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Wheatley A. 'One of the good guys': sperm donor masculinity and the falling Danish sperm count discourse. CULTURE, HEALTH & SEXUALITY 2019; 21:495-509. [PMID: 30295157 DOI: 10.1080/13691058.2018.1491062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 06/17/2018] [Indexed: 06/08/2023]
Abstract
Sperm banks in Denmark produce and export donor semen worldwide. The role of the sperm bank is to provide high-quality, safe semen from desirable donors. However, over the last 20 years, global sperm counts are reported to be falling. Along with these discourses comes the implication that poor fertility is a personal failing, which implies a conflation of 'fertility' with 'potency'. This paper draws on qualitative research with Danish sperm donors to explore how donors construct their identities as donors and as the producers of 'good sperm'. Accounts of the drive to produce the best sperm possible and the resultant confidence boost are bound up in ideas about masculine potency and potential and bodily performance and set against a backdrop of a moral panic surrounding the apparently declining Danish sperm count.
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Affiliation(s)
- Alison Wheatley
- a Science, Technology & Innovation Studies , School of Social and Political Science, University of Edinburgh , Edinburgh , United Kingdom
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99
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Ibañez-Perez J, Santos-Zorrozua B, Lopez-Lopez E, Matorras R, Garcia-Orad A. An update on the implication of physical activity on semen quality: a systematic review and meta-analysis. Arch Gynecol Obstet 2019; 299:901-921. [DOI: 10.1007/s00404-019-05045-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 01/05/2019] [Indexed: 01/07/2023]
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Ricci E, Bravi F, Noli S, Ferrari S, De Cosmi V, La Vecchia I, Cavadini M, La Vecchia C, Parazzini F. Mediterranean diet and the risk of poor semen quality: cross-sectional analysis of men referring to an Italian Fertility Clinic. Andrology 2019; 7:156-162. [PMID: 30663272 DOI: 10.1111/andr.12587] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/03/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several diet patterns have been suggested as involved in processes of spermatogenesis and thus in male subfertility. To study the relation between Mediterranean diet and abnormal sperm parameters in men of subfertile couples, we performed a cross-sectional analysis of baseline data from a prospective cohort study. METHODS Patients were enrolled in an Italian Fertility Clinic. Couples undergoing assisted reproduction techniques (ART) were interviewed to obtain information on personal and health history, lifestyle habits, and diet, on the day of oocyte retrieval. On the same day, a semen sample was also collected and analyzed to proceed with ART. Adherence to Mediterranean diet was evaluated using a Mediterranean Diet Score (MDS). Odds ratios (OR) and 95% confidence intervals (CI) were calculated for semen volume <1.5 mL, sperm concentration <15 mil/mL, and total count <39 mil. RESULTS Three hundred nine men, age range 27-60, were enrolled: 19.3% had semen volume < 1.5 mL, 30.5% sperm concentration <15 mil/mL, and 32.1% total count <39 mil. MDS was low (0-3) in 86 men (27.8%), intermediate (4-5) in 131 (42.4%), and high (6-9) in 92 (29.8%). Semen volume was not associated with MDS. Compared to the highest MDS category (6-9), the ORs for low sperm concentration were 1.34 (95% CI 0.69-2.50) for MDS 4-5 and 2.42 (95% CI 1.21-4.83) for MDS 0-3, with significant trend (p = 0.011). The corresponding estimates for total count were 1.26 (95% CI 0.66-2.42) and 2.08 (95% CI 1.05-4.12), with significant trend (p = 0.034). These findings were consistent in strata of history of reproductive organ diseases. CONCLUSIONS Mediterranean Diet Score was positively associated with normal sperm concentration and total count, but not with semen volume.
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Affiliation(s)
- E Ricci
- Dipartimento Donna-Bambino-Neonato, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - F Bravi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - S Noli
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | - S Ferrari
- Dipartimento Donna-Bambino-Neonato, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - V De Cosmi
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Università degli Studi di Milano, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ospedale Ca' Granda-Ospedale Maggiore Policlinico, Department of Clinical Sciences and Community Health, University of Milan, Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Milan, Italy
| | - I La Vecchia
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
| | - M Cavadini
- Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - C La Vecchia
- Department of Clinical Sciences and Community Health, Branch of Medical Statistics, Biometry, and Epidemiology "G. A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - F Parazzini
- Dipartimento Donna-Bambino-Neonato, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università di Milano, Milan, Italy
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