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Shi X, Chan CPS, Waters T, Chi L, Chan DYL, Li TC. Lifestyle and demographic factors associated with human semen quality and sperm function. Syst Biol Reprod Med 2018; 64:358-367. [PMID: 30033774 DOI: 10.1080/19396368.2018.1491074] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Xiao Shi
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Carol Pui Shan Chan
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Tarah Waters
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ling Chi
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - David Yiu Leung Chan
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Tin-Chiu Li
- Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, SAR, China
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252
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Chen L, Xie YM, Pei JH, Kuang J, Chen HM, Chen Z, Li ZW, Fu XY, Wang L, Lai SQ, Zhang ST, Chen ZJ, Lin JX. Sugar-sweetened beverage intake and serum testosterone levels in adult males 20-39 years old in the United States. Reprod Biol Endocrinol 2018; 16:61. [PMID: 29935533 PMCID: PMC6015465 DOI: 10.1186/s12958-018-0378-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This population-based study was designed to investigate whether consumption of sugar-sweetened beverages (SSB) is associated with lower serum total testosterone concentration in men 20-39 years old. METHODS All data for this study were retrieved from the National Health and Nutrition Examination Survey (NHANES) 2011-2012. The primary outcome was serum testosterone concentration, and main independent variable was SSB intake. Other variables included age, race/ethnicity, poverty/income ratio, body mass index (BMI), serum cotinine, heavy drinking, and physical activity. RESULTS Among all subjects (N = 545), 486 (90.4%) had normal testosterone levels (defined as ≥231 ng/dL) and 59 (9.6%) had low testosterone levels (defined as < 231 ng/dL). Multivariate logistic regression revealed the odds of low testosterone was significantly greater with increasing SSB consumption (Q4 [≥442 kcal/day] vs. Q1 [≤137 kcal/day]), adjusted odds ratio [aOR] = 2.29, p = 0.041]. After adjusting for possible confounding variables, BMI was an independent risk factor for low testosterone level; subjects with BMI ≥ 25 kg/m2 had a higher risk of having a low testosterone level than those with BMI < 25 kg/m2 (aOR = 3.68, p = 0.044). CONCLUSION SSB consumption is significantly associated with low serum testosterone in men 20-39 years old in the United States.
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Affiliation(s)
- Liang Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Yu-Mei Xie
- GuangDong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jian-Hao Pei
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Jian Kuang
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Hong-Mei Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Zhong Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Zhong-Wen Li
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Xiao-Ying Fu
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Long Wang
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Shui-Qing Lai
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Shu-Ting Zhang
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Zhi-Jiang Chen
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
| | - Jin-xin Lin
- The First Division in the Department of Endocrinology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, 106th of Zhongshan Er Road, Guangzhou, 510080 China
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253
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Mohammadi P, Hassani-Bafrani H, Tavalaee M, Dattilo M, Nasr-Esfahani MH. One-carbon cycle support rescues sperm damage in experimentally induced varicocoele in rats. BJU Int 2018; 122:480-489. [DOI: 10.1111/bju.14385] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Parisa Mohammadi
- Department of Reproductive Biotechnology; Reproductive Biomedicine Research Center; Royan Institute for Biotechnology; Academic Center for Education; Culture and Research (ACECR); Isfahan Iran
- Anatomical Sciences Research Center; Kashan University of Medical Sciences; Kashan Iran
| | - Hassan Hassani-Bafrani
- Anatomical Sciences Research Center; Kashan University of Medical Sciences; Kashan Iran
- Gametogenesis Research Center; Kashan University of Medical Sciences; Kashan Iran
| | - Marziyeh Tavalaee
- Department of Reproductive Biotechnology; Reproductive Biomedicine Research Center; Royan Institute for Biotechnology; Academic Center for Education; Culture and Research (ACECR); Isfahan Iran
| | | | - Mohammad H. Nasr-Esfahani
- Department of Reproductive Biotechnology; Reproductive Biomedicine Research Center; Royan Institute for Biotechnology; Academic Center for Education; Culture and Research (ACECR); Isfahan Iran
- Isfahan Fertility and Infertility Center; Isfahan Iran
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254
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Impact of prepubertal exposure to dietary protocatechuic acid on the hypothalamic-pituitary-testicular axis in rats. Chem Biol Interact 2018; 290:99-109. [DOI: 10.1016/j.cbi.2018.05.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/05/2018] [Accepted: 05/25/2018] [Indexed: 11/23/2022]
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255
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Fish Oil Ameliorates High-Fat Diet Induced Male Mouse Reproductive Dysfunction via Modifying the Rhythmic Expression of Testosterone Synthesis Related Genes. Int J Mol Sci 2018; 19:ijms19051325. [PMID: 29710834 PMCID: PMC5983658 DOI: 10.3390/ijms19051325] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 04/23/2018] [Accepted: 04/28/2018] [Indexed: 11/16/2022] Open
Abstract
The present study aims to investigate the protective effects of ω-3 polyunsaturated fatty acids (ω-3PUFAs) against high-fat diet induced male mouse reproductive dysfunction and to explore circadian regulation mechanisms. Male C57BL/6 mice were randomly divided into three groups and fed a normal chow diet (control group, CON), a high-fat diet (HFD group) or a HFD supplemented with fish oil (FO group) for 12 weeks. After 12 weeks of feeding, the body weight and the ratio of perinephric and epididymal fat weight to body weight were significantly higher in the HFD group compared with the CON group. The supplement of fish oil rich in ω-3PUFAs only slightly reduced the HFD-induced obesity but remarkably ameliorated HFD-induced dyslipidemia, sexual hormones disorder, testicle lesions and germ cell apoptosis. Fish oil supplementation restored the expression of steroid synthesis associated genes in HFD fed mouse and flattened the HFD-induced oscillations in circadian genes’ expression. Fish oil supplementation prevented HFD-induced male mouse reproductive dysfunction and modified the rhythmic expression of testosterone synthesis related genes.
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256
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Gaskins AJ. Moving the science forward on dietary patterns and male fertility. Fertil Steril 2018; 109:783. [PMID: 29680314 DOI: 10.1016/j.fertnstert.2018.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 03/01/2018] [Indexed: 12/31/2022]
Affiliation(s)
- Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Channing Division of Network Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
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257
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Bui AD, Sharma R, Henkel R, Agarwal A. Reactive oxygen species impact on sperm DNA and its role in male infertility. Andrologia 2018; 50:e13012. [DOI: 10.1111/and.13012] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2018] [Indexed: 02/07/2023] Open
Affiliation(s)
- A. D. Bui
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland OH USA
- Ohio University Heritage College of Osteopathic Medicine; Athens OH USA
| | - R. Sharma
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland OH USA
| | - R. Henkel
- Department of Medical Bioscience; University of the Western Cape; Bellville South Africa
| | - A. Agarwal
- American Center for Reproductive Medicine; Cleveland Clinic; Cleveland OH USA
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258
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Gaskins AJ, Chavarro JE. Diet and fertility: a review. Am J Obstet Gynecol 2018; 218:379-389. [PMID: 28844822 PMCID: PMC5826784 DOI: 10.1016/j.ajog.2017.08.010] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 08/07/2017] [Accepted: 08/16/2017] [Indexed: 01/17/2023]
Abstract
The literature on the relationship between diet and human fertility has greatly expanded over the last decade, resulting in the identification of a few clear patterns. Intake of supplemental folic acid, particularly at doses higher than those recommended for the prevention of neural tube defects, has been consistently related to lower frequency of infertility, lower risk of pregnancy loss, and greater success in infertility treatment. On the other hand and despite promising evidence from animal models, vitamin D does not appear to exert an important role in human fertility in the absence of deficiency. Antioxidant supplementation does not appear to offer any benefits to women undergoing infertility treatment, but it appears to be beneficial when it is the male partner who is supplemented. However, the available evidence does not allow discerning which specific antioxidants, or at which doses, are responsible for this benefit. Long-chain omega-3 fatty acids appear to improve female fertility, although it remains unclear to what extent contamination of shared food sources, such as fish with high levels of environmental toxicants, can dampen this benefit. Lastly, adherence to healthy diets favoring seafood, poultry, whole grains, fruits, and vegetables are related to better fertility in women and better semen quality in men. The cumulative evidence has also piled against popular hypotheses. Dairy and soy, once proposed as reproductive toxicants, have not been consistently related to poor fertility. In fact, soy and soy supplements appear to exert a beneficial effect among women undergoing infertility treatment. Similarly, because data from large, high-quality studies continue to accumulate, the evidence of a potentially deleterious effect of moderate alcohol and caffeine intake on the ability to become pregnant seems less solid than it once did. While a complete picture of the role of nutrition on fertility is far from complete, much progress has been made. The most salient gaps in the current evidence include jointly considering female and male diets and testing the most consistent findings in randomized trials.
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Affiliation(s)
- Audrey J Gaskins
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
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259
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López-Lemus UA, Garza-Guajardo R, Barboza-Quintana O, Rodríguez-Hernandez A, García-Rivera A, Madrigal-Pérez VM, Guzmán-Esquivel J, García-Labastida LE, Soriano-Hernández AD, Martínez-Fierro ML, Rodríguez-Sánchez IP, Sánchez-Duarte E, Cabrera-Licona A, Ceja-Espiritu G, Delgado-Enciso I. Association Between Nonalcoholic Fatty Liver Disease and Severe Male Reproductive Organ Impairment (Germinal Epithelial Loss): Study on a Mouse Model and on Human Patients. Am J Mens Health 2018; 12:639-648. [PMID: 29577833 PMCID: PMC5987961 DOI: 10.1177/1557988318763631] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Metabolic syndrome (MS) has been associated with testicular damage. Nonalcoholic fatty liver disease (NAFLD) is a multisystemic disease that affects different organs, but its effect on the testes is unknown. A study analyzing germ cell involvement on BALB/c mice was carried out. A parallel comparative study was conducted that investigated alterations in the germinal epithelium of male humans that died from an unrelated acute event. The complete medical histories and histologic samples of the thoracic aorta, liver tissue, and testicular tissue from the deceased subjects were collected. The degree of germinal epithelial loss (DGEL) was evaluated and the clinical and histologic data were compared between individuals with and without NAFLD. The only metabolic or morphologic variable that caused a significant difference in the DGEL, in both the animal model and humans, was the presence of liver steatosis. The percentage of steatosis was also correlated with the percentage of the DGEL. In humans, steatosis (greater than 20%) increased the risk 12-fold for presenting with a severe DGEL (OR: 12.5; 95% CI [1.2, 128.9]; p = .03). There was no association with age above 50 years or MS components. Steatosis grade was also correlated with atherosclerosis grade. NAFLD was a strongly associated factor implicated in severe DGEL, as well as the testis was identified as a probable target organ for damage caused by the disease. This finding could result in the search for new approach strategies in the management of men with fertility problems. Further studies are required to confirm these results.
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Affiliation(s)
| | - Raquel Garza-Guajardo
- 2 Department of Pathological Anatomy and Cytopathology, University Hospital "Dr José Eleuterio González," Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
| | - Oralia Barboza-Quintana
- 2 Department of Pathological Anatomy and Cytopathology, University Hospital "Dr José Eleuterio González," Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
| | | | | | | | - José Guzmán-Esquivel
- 3 Unidad de Investigación del Hospital General de Zona Nº 1. IMSS, Colima, Mexico
| | - Laura E García-Labastida
- 2 Department of Pathological Anatomy and Cytopathology, University Hospital "Dr José Eleuterio González," Autonomous University of Nuevo León, Monterrey, Nuevo León, Mexico
| | | | - Margarita L Martínez-Fierro
- 5 Molecular Medicine Laboratory, Academic Unit of Human Medicine and Health Sciences. Universidad Autónoma de Zacatecas, Zacatecas, Mexico
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260
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Ferramosca A, Di Giacomo M, Moscatelli N, Zara V. Obesity and Male Infertility: Role of Fatty Acids in the Modulation of Sperm Energetic Metabolism. EUR J LIPID SCI TECH 2018. [DOI: 10.1002/ejlt.201700451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Alessandra Ferramosca
- Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali; Università del Salento; Lecce Italy
- Center for Biomolecular Nanotechnologies @UNILE; Istituto Italiano di Tecnologia; Arnesano (LE) Italy
| | - Mariangela Di Giacomo
- Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali; Università del Salento; Lecce Italy
| | - Natalina Moscatelli
- Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali; Università del Salento; Lecce Italy
- Center for Biomolecular Nanotechnologies @UNILE; Istituto Italiano di Tecnologia; Arnesano (LE) Italy
| | - Vincenzo Zara
- Dipartimento di Scienze e Tecnologie Biologiche ed Ambientali; Università del Salento; Lecce Italy
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261
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Durairajanayagam D. Lifestyle causes of male infertility. Arab J Urol 2018; 16:10-20. [PMID: 29713532 PMCID: PMC5922227 DOI: 10.1016/j.aju.2017.12.004] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/05/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023] Open
Abstract
Objective To examine the potential effects of lifestyle factors on male reproductive health. Evidence of a global decline in human sperm quality over recent decades has been accumulating. Environmental, occupational, and modifiable lifestyle factors may contribute to this decline. This review focuses on key lifestyle factors that are associated with male infertility such as smoking cigarettes, alcohol intake, use of illicit drugs, obesity, psychological stress, advanced paternal age, dietary practices, and coffee consumption. Other factors such as testicular heat stress, intense cycling training, lack of sleep and exposure to electromagnetic radiation from mobile phone use are briefly discussed. Materials and method A comprehensive literature search was performed to identify and synthesise all relevant information, mainly from within the last decade, on the major lifestyle factors associated with male infertility and semen quality. Database searches were limited to reports published in English only. A manual search of bibliographies of the reports retrieved was conducted to identify additional relevant articles. Results In all, 1012 articles were identified from the database search and after reviewing the titles and abstract of the reports, 104 articles met the inclusion criteria. Of these, 30 reports were excluded as the full-text could not be retrieved and the abstract did not have relevant data. The remaining 74 reports were reviewed for data on association between a particular lifestyle factor and male infertility and were included in the present review. Conclusion The major lifestyle factors discussed in the present review are amongst the multiple potential risk factors that could impair male fertility. However, their negative impact may well be mostly overcome by behaviour modification and better lifestyle choices. Greater awareness and recognition of the possible impact of these lifestyle factors are important amongst couples seeking conception.
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Key Words
- AAS, anabolic–androgenic steroids
- APA, advanced paternal age
- ART, assisted reproductive technology
- ASIH, anabolic steroid-induced hypogonadism
- BMI, body mass index
- Chk1, checkpoint kinase 1
- ECS, endogenous cannabinoid system
- GnIH, gonadotropin-inhibitory hormone
- HADS, Hospital Anxiety and Depression Score
- HPA, hypothalamus–pituitary–adrenal
- HPG, hypothalamus–pituitary–gonadal
- ICSI, intracytoplasmic sperm injection
- IUI, intrauterine insemination
- IVF, in vitro fertilisation
- Lifestyle
- MMP, mitochondrial membrane potential
- Male infertility
- ROS, reactive oxygen species
- Risk factors
- SOD, superoxide dismutase
- Semen quality
- Sperm DNA fragmentation
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Affiliation(s)
- Damayanthi Durairajanayagam
- Address: Discipline of Physiology, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia. Fax: +60 3 6126 5224.
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262
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Çekici H, Akdevelioğlu Y. The association between trans fatty acids, infertility and fetal life: a review. HUM FERTIL 2018; 22:154-163. [DOI: 10.1080/14647273.2018.1432078] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Hande Çekici
- College of Health, Department of Nutrition and Dietetics, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Yasemin Akdevelioğlu
- Faculty of Health Science, Department of Nutrition and Dietetics, Gazi University, Ankara, Turkey
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263
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Affiliation(s)
| | - Hans-Christian Schuppe
- Funktionsbereich Andrologie, Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsklinikum Gießen und Marburg GmbH - Standort Gießen, Standort Gießen, Deutschland
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264
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Drobnis EZ, Nangia AK. Phosphodiesterase Inhibitors (PDE Inhibitors) and Male Reproduction. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1034:29-38. [PMID: 29256125 DOI: 10.1007/978-3-319-69535-8_5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The nonspecific PDE inhibitors, particularly the methylxanthines: caffeine, pentoxifylline (PTX), and theophylline, are known to stimulate sperm motility in vitro and have been used to treat sperm prior to insemination. The in vivo effects are less dramatic. A beneficial effect of caffeine, which is a constituent of some medications, remains controversial. Very high doses of caffeine do have negative effects on fertility endpoints in men and experimental species. The specific PDE5 inhibitors, particularly sildenafil and tadalafil, are prescribed for erectile dysfunction, as well as pulmonary hypertension, lower urinary tract symptoms, and premature ejaculation. PDE5 is expressed throughout the contractile tissues of the male reproductive tract, generally increasing contractility. Some PDE5 inhibitors tend to increase circulating testosterone levels somewhat. For short-term exposure consistent with use prior to intercourse, there appears to be minimal effects on semen quality. Several large, randomized controlled trials (RCTs) in healthy men have not found adverse effects of long-term use of these drugs on semen quality. RCTs in infertile men have demonstrated a modest increase in semen quality. Animal studies at human equivalent doses (HED) have produced similar results in young males, but a study in aging male rats found progressive decreases in epididymal sperm quality accompanied by consistent degeneration of the seminal tubules suggesting that studies in older men might be warranted. A concerning study in mice found lower fertilization rates in males treated with HED of sildenafil and mated the next day to untreated females than for control males. Fertility studies in humans are needed.
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Affiliation(s)
- Erma Z Drobnis
- Obstetrics, Gynecology and Women's Health, University of Missouri School of Medicine, Columbia, MO, USA
| | - Ajay K Nangia
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA
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