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Zańko A, Martynowicz I, Citko A, Konopka P, Paszko A, Pawłowski M, Szczerbiński Ł, Siewko K, Krętowski AJ, Kuczyński W, Milewski R. The Influence of Lifestyle on Male Fertility in the Context of Insulin Resistance-Identification of Factors That Influence Semen Quality. J Clin Med 2024; 13:2797. [PMID: 38792339 PMCID: PMC11122489 DOI: 10.3390/jcm13102797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/29/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Background: Male fertility is known to have been negatively influenced by the progress of civilization. Another condition whose incidence has been on the increase for the same reason is insulin resistance (IR). In addition, men increasingly often resign from the pursuit of active forms of leisure, preferring more sedentary ones. Considering these trends, this aim of this study was to investigate the relationships between lifestyle factors, insulin resistance, and male fertility in men with and without the condition. A further aim was to select those lifestyle factors that would make it possible to predict the level of male fertility, especially when IR is concerned. Methods: This study was performed in a group of 73 participants, divided into groups based on their insulin resistance status. Their physical activity, diet, perceived stress, sleep quality, libido level, and duration of sexual abstinence were assessed on the basis of a number of parameters, including indices proposed by the authors. In addition, relevant anthropometric measurements were taken and tests related to glucose metabolism and semen quality were carried out. On the basis of these data, statistical tests were performed to establish or disprove relationships between lifestyle choices and semen quality, as measured my sperm motility. Results: The results of this study highlighted the associations between a number of parameters, i.e., micronutrient and vitamin intake, diet quality, body composition, insulin resistance, and the duration of sexual abstinence, and semen quality, as measured by sperm motility. Significantly, the presence or absence of IR was linked to male fertility. A multivariate model was developed, incorporating parameters such as the Matsuda index, vitamin intake, and sexual abstinence duration, to predict motility scores. Conclusions: This study underscores the negative impact of modern civilization's lifestyle choices on male fertility. Notably, vitamin and mineral consumption, especially from antioxidant-rich diets like the Mediterranean diet, emerged as key modifiable factors affecting fertility. Routine diagnostics for insulin resistance in fertility-related interventions is recommended. This study also highlights the importance of considering sexual abstinence duration during semen collection for accurate diagnostic results. Future research should focus on validating the proposed multivariate model and exploring the effects of lifestyle modifications, particularly vitamin supplementation, on fertility outcomes in men, especially in the context of IR.
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Affiliation(s)
- Adrianna Zańko
- Doctoral School, Medical University of Bialystok, 15-276 Bialystok, Poland;
| | - Iwo Martynowicz
- Center for Reproductive Medicine KRIOBANK, 15-879 Bialystok, Poland; (I.M.); (W.K.)
| | - Anna Citko
- Clinical Research Center, Medical University of Bialystok, 15-276 Bialystok, Poland; (A.C.); (P.K.); (A.P.)
| | - Paulina Konopka
- Clinical Research Center, Medical University of Bialystok, 15-276 Bialystok, Poland; (A.C.); (P.K.); (A.P.)
| | - Adam Paszko
- Clinical Research Center, Medical University of Bialystok, 15-276 Bialystok, Poland; (A.C.); (P.K.); (A.P.)
| | - Michał Pawłowski
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, 15-295 Bialystok, Poland;
| | - Łukasz Szczerbiński
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland; (Ł.S.); (K.S.); (A.J.K.)
| | - Katarzyna Siewko
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland; (Ł.S.); (K.S.); (A.J.K.)
| | - Adam Jacek Krętowski
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, 15-276 Bialystok, Poland; (Ł.S.); (K.S.); (A.J.K.)
| | - Waldemar Kuczyński
- Center for Reproductive Medicine KRIOBANK, 15-879 Bialystok, Poland; (I.M.); (W.K.)
| | - Robert Milewski
- Department of Biostatistics and Medical Informatics, Medical University of Bialystok, 15-295 Bialystok, Poland;
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Sonigo C, Robin G, Boitrelle F, Fraison E, Sermondade N, Mathieu d'Argent E, Bouet PE, Dupont C, Creux H, Peigné M, Pirrello O, Trombert S, Lecorche E, Dion L, Rocher L, Arama E, Bernard V, Monnet M, Miquel L, Birsal E, Haïm-Boukobza S, Plotton I, Ravel C, Grzegorczyk-Martin V, Huyghe É, Dupuis HGA, Lefebvre T, Leperlier F, Bardet L, Lalami I, Robin C, Simon V, Dijols L, Riss J, Koch A, Bailly C, Rio C, Lebret M, Jegaden M, Fernandez H, Pouly JL, Torre A, Belaisch-Allart J, Antoine JM, Courbiere B. [First-line management of infertile couple. Guidelines for clinical practice of the French College of Obstetricians and Gynecologists 2022]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2024; 52:305-335. [PMID: 38311310 DOI: 10.1016/j.gofs.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE To update the 2010 CNGOF clinical practice guidelines for the first-line management of infertile couples. MATERIALS AND METHODS Five major themes (first-line assessment of the infertile woman, first-line assessment of the infertile man, prevention of exposure to environmental factors, initial management using ovulation induction regimens, first-line reproductive surgery) were identified, enabling 28 questions to be formulated using the Patients, Intervention, Comparison, Outcome (PICO) format. Each question was addressed by a working group that had carried out a systematic review of the literature since 2010, and followed the Grading of Recommendations Assessment, Development and Evaluation (GRADE®) methodology to assess the quality of the scientific data on which the recommendations were based. These recommendations were then validated during a national review by 40 national experts. RESULTS The fertility work-up is recommended to be prescribed according to the woman's age: after one year of infertility before the age of 35 and after 6months after the age of 35. A couple's initial infertility work-up includes a single 3D ultrasound scan with antral follicle count, assessment of tubal permeability by hysterography or HyFOSy, anti-Mullerian hormone assay prior to assisted reproduction, and vaginal swabbing for vaginosis. If the 3D ultrasound is normal, hysterosonography and diagnostic hysteroscopy are not recommended as first-line procedures. Chlamydia trachomatis serology does not have the necessary performance to predict tubal patency. Post-coital testing is no longer recommended. In men, spermogram, spermocytogram and spermoculture are recommended as first-line tests. If the spermogram is normal, it is not recommended to check the spermogram. If the spermogram is abnormal, an examination by an andrologist, an ultrasound scan of the testicles and hormonal test are recommended. Based on the data in the literature, we are unable to recommend a BMI threshold for women that would contraindicate medical management of infertility. A well-balanced Mediterranean-style diet, physical activity and the cessation of smoking and cannabis are recommended for infertile couples. For fertility concern, it is recommended to limit alcohol consumption to less than 5 glasses a week. If the infertility work-up reveals no abnormalities, ovulation induction is not recommended for normo-ovulatory women. If intrauterine insemination is indicated based on an abnormal infertility work-up, gonadotropin stimulation and ovulation monitoring are recommended to avoid multiple pregnancies. If the infertility work-up reveals no abnormality, laparoscopy is probably recommended before the age of 30 to increase natural pregnancy rates. In the case of hydrosalpinx, surgical management is recommended prior to ART, with either salpingotomy or salpingectomy depending on the tubal score. It is recommended to operate on polyps>10mm, myomas 0, 1, 2 and synechiae prior to ART. The data in the literature do not allow us to systematically recommend asymptomatic uterine septa and isthmoceles as first-line surgery. CONCLUSION Based on strong agreement between experts, we have been able to formulate updated recommendations in 28 areas concerning the initial management of infertile couples.
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Affiliation(s)
- Charlotte Sonigo
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Antoine-Béclère, 157, rue de la Porte-Trivaux, 92140 Clamart, France; Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France
| | - Geoffroy Robin
- Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, Lille, France
| | - Florence Boitrelle
- Service de biologie de la reproduction, préservation de fertilité, CECOS, CHI de Poissy, Poissy, France; INRAe, ENVA, BREED, UVSQ, université Paris Saclay, Jouy-en Josas, France
| | - Eloïse Fraison
- Département médecine de la reproduction, CHU Lyon, hôpital Femme-Mère-Enfant, 59, boulevard Pinel, 69500 Bron, France
| | - Nathalie Sermondade
- Service de biologie de la reproduction CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Inserm US938, centre de recherche Saint-Antoine, Sorbonne université, 75012 Paris, France
| | - Emmanuelle Mathieu d'Argent
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Pierre-Emmanuel Bouet
- Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France
| | - Charlotte Dupont
- Service de biologie de la reproduction - CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75012 Paris, France
| | - Hélène Creux
- Centre AMP, polyclinique Saint-Roch, 550, avenue du Colonel-André-Pavelet, 34070 Montpellier cedex, France
| | - Maeliss Peigné
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Jean-Verdier-Béclère, avenue du 14-Juillet, Bondy, France
| | - Olivier Pirrello
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Sabine Trombert
- Laboratoire Cerba, 6-11, rue de l'Équerre, 95310 Saint-Ouen L'Aumône, France
| | - Emmanuel Lecorche
- Laboratoire Cerba, 6-11, rue de l'Équerre, 95310 Saint-Ouen L'Aumône, France
| | - Ludivine Dion
- Département de gynécologie-obstétrique et reproduction humaine - CECOS, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - Laurence Rocher
- Service de radiologie diagnostique et interventionnelle, site Bicêtre, hôpitaux Paris Sud, 94270 Le Kremlin-Bicêtre, France; Université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Service hospitalier Frédéric-Joliot, imagerie par résonance magnétique médicale et multimodalités, CNRS UMR8081, université Paris Sud, 4, place du Gal-Leclerc, 91401 Orsay cedex, France
| | - Emmanuel Arama
- Service de radiologie diagnostique et interventionnelle, site Bicêtre, hôpitaux Paris Sud, 94270 Le Kremlin-Bicêtre, France; Université Paris Sud, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Service hospitalier Frédéric-Joliot, imagerie par résonance magnétique médicale et multimodalités, CNRS UMR8081, université Paris Sud, 4, place du Gal-Leclerc, 91401 Orsay cedex, France
| | - Valérie Bernard
- Service de chirurgie gynécologique, gynécologie médicale et médecine de la reproduction, centre Aliénor d'Aquitaine, CHU Pellegrin, Bordeaux, France
| | - Margaux Monnet
- Département de gynécologie médicale, maternité régionale de Nancy, hôpitaux universitaires de Nancy, Nancy, France
| | - Laura Miquel
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | - Eva Birsal
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France
| | | | - Ingrid Plotton
- Service d'hormonologie, endocrinologie moléculaire et maladies rares, CPBE, groupement hospitalier Lyon-Est, Lyon-Bron, France; Université Claude-Bernard, Lyon 1, Lyon, France; Unité Inserm 1208, Lyon, France
| | - Célia Ravel
- Département de gynécologie-obstétrique et reproduction humaine - CECOS, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, 35000 Rennes, France
| | - Véronika Grzegorczyk-Martin
- Centre d'assistance médicale à la procréation et de préservation de la fertilité, clinique Mathilde, 76100 Rouen, France
| | - Éric Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; Inserm 1203, UMR DEFE, université de Toulouse, université de Montpellier, Montpellier, France
| | - Hugo G A Dupuis
- Service d'urologie et d'andrologie, CHU - hôpitaux de Rouen, CHU Charles-Nicolle, 76031 Rouen, France
| | - Tiphaine Lefebvre
- Service de médecine et biologie de la reproduction - gynécologie médicale, centre hospitalier universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France
| | - Florence Leperlier
- Service de médecine et biologie de la reproduction - gynécologie médicale, centre hospitalier universitaire de Nantes, 38, boulevard Jean-Monnet, 44093 Nantes, France
| | - Léna Bardet
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Imane Lalami
- Service de gynécologie-obstétrique et de médecine de la reproduction, grand hôpital de l'Est Francilien - site de Meaux, 6-8, rue Saint-Fiacre, 77100 Meaux, France
| | - Camille Robin
- Service d'assistance médicale à la procréation et préservation de la fertilité, CHU de Lille, Lille, France
| | - Virginie Simon
- Unité fonctionnelle de gynécologie endocrinienne, service de gynécologie médicale, orthogénie et sexologie, hôpital Jeanne-de-Flandre, CHU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France
| | - Laura Dijols
- Service de médecine de la reproduction et préservation de la fertilité, hôpital Bretonneau, CHU de Tours, Tours, France
| | - Justine Riss
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Antoine Koch
- Service d'aide médicale à la procréation, centre médicochirurgical obstétrique (CMCO), CHU de Strasbourg, 19, rue Louis-Pasteur, 67303 Schiltigheim, France
| | - Clément Bailly
- Service de biologie de la reproduction CECOS, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Inserm US938, centre de recherche Saint-Antoine, Sorbonne université, 75012 Paris, France
| | - Constance Rio
- Service de gynécologie-obstétrique, centre hospitalier universitaire d'Angers, 4, rue Larrey, 49000 Angers, France
| | - Marine Lebret
- Service de gynécologie-obstétrique, CHU Charles-Nicolle, 37, boulevard Gambetta, 76000 Rouen, France
| | - Margaux Jegaden
- Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie gynécologique et obstétrique, hôpital Bicêtre, GHU-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Hervé Fernandez
- Faculté de médecine, université Paris-Sud Saclay, 63, rue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France; Département de chirurgie gynécologique et obstétrique, hôpital Bicêtre, GHU-Sud, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Jean-Luc Pouly
- Service de gynécologie chirurgicale, CHU Estaing, 1, place Lucie-et-Raymond-Aubrac, 63003 Clermont-Ferrand, France
| | - Antoine Torre
- Centre d'assistance médicale à la procréation clinicobiologique, centre hospitalier Sud Francilien Corbeil-Essonnes, 40, avenue Serge-Dassault, 91106 Corbeil-Essonnes, France
| | - Joëlle Belaisch-Allart
- Service de médecine de la reproduction, pôle Femme-Enfant, Centre hospitalier des 4 villes, rue Charles-Lauer, 92210 Saint-Cloud, France
| | - Jean-Marie Antoine
- Service de gynécologie-obstétrique et médecine de la reproduction, Dmu Origyne, hôpital Tenon, GHU Sorbonne université, AP-HP, 4, rue de la Chine, 75020 Paris, France
| | - Blandine Courbiere
- Service d'assistance médicale à la procréation, pôle Femmes-Parents-Enfants, hôpital de la Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France; IMBE, CNRS, IRD, Aix-Marseille université, Avignon université, Marseille, France.
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Nadjarzadeh A, Fallahzadeh A, Abasi A, Poornematy MM, Farahzadi HR, Fatemi Aghda SA. Determining the content and needs assessment a mobile-based self-care program in infertile men. BMC Med Inform Decis Mak 2023; 23:258. [PMID: 37957627 PMCID: PMC10644630 DOI: 10.1186/s12911-023-02366-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/06/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Infertility is a public health problem in the world, using new technology, such as mobile phones, is increasing in the field of health. This study aimed to determine the Necessity of self-care training contents by performing a needs analysis among men with infertility problems to design a mobile phone-based application. METHODS Followed by reviewing the related literature, a questionnaire including 40 educational items and seven software features was designed in three general sections and distributed among 30 specialists in nutrition (n = 18) and infertility (n = 12). The validity of the questionnaire was confirmed by a panel of experts in nutrition, infertility, and medical informatics. The questionnaire's reliability was also corroborated by Cronbach's alpha of 86.4. RESULTS All items related to the software features and most items in the questionnaire were deemed necessary by participants. However, the items: "Occupation and history of chronic diseases" in the demographic information section and "Effects of infertility and food allergy" in the educational section were not confirmed. CONCLUSION The present findings could not only highlight the patients' roles in managing their disease but also increase the healthcare workers' awareness in designing the hospital information system.
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Affiliation(s)
- Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Fallahzadeh
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arezoo Abasi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Poornematy
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hamid Reza Farahzadi
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Ali Fatemi Aghda
- Research Center for Health Technology Assessment and Medical Informatics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Brinson AK, da Silva SG, Hesketh KR, Evenson KR. Impact of Physical Activity and Sedentary Behavior on Spontaneous Female and Male Fertility: A Systematic Review. J Phys Act Health 2023; 20:600-615. [PMID: 37146984 PMCID: PMC7614776 DOI: 10.1123/jpah.2022-0487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/10/2023] [Accepted: 02/28/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Before pregnancy is recognized, ovulation, fertilization, and implantation must all occur. Physical activity and sedentary behavior may impact pregnancy success by altering each or all of these processes. The aim of this review was to review the association between physical activity and sedentary behavior with spontaneous female and male fertility. METHOD PubMed/MEDLINE, Web of Science, CINAHL, SPORTDiscus, and Embase were searched from inception to August 9, 2021. Eligible studies included randomized controlled trials or observational studies, published in English, describing an association between physical activity or sedentary behavior (exposures) and spontaneous fertility (outcome) among women or men. RESULTS Thirty-four studies from 31 unique populations were included in this review (12 cross-sectional studies, 10 cohort studies, 6 case-control studies, 5 randomized controlled trials, and one case-cohort study). Of the 25 studies among women, the majority identified mixed results (n = 11) or no association (n = 9) between physical activity and female fertility. Seven studies reported on female fertility and sedentary behavior, and 2 found sedentary behavior was associated with decreased female fertility. Of the 11 studies among men, most of the studies (n = 6) found that physical activity was associated with increased male fertility. Two of the studies reported on male fertility and sedentary behavior, and neither identified an association. CONCLUSIONS The association between spontaneous fertility and physical activity in both men and women remains unclear, and the association with sedentary behavior remains largely unexplored.
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Affiliation(s)
| | - Shana G. da Silva
- Federal University of Fronteira Sul, Passo Fundo, RS, Brazil University of North Carolina—Chapel Hill, Chapel Hill, NC, USA
| | - Kathryn R. Hesketh
- University of North Carolina—Chapel Hill, Chapel Hill, NC, USA UCL Great Ormond Street Institute of Child Health, London, UK MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
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Liu H, Luo Z, Chen J, Zheng H, Zeng Q. Treatment progress of cryptozoospermia with Western Medicine and traditional Chinese medicine: A literature review. Health Sci Rep 2022; 6:e1019. [PMID: 36582629 PMCID: PMC9793827 DOI: 10.1002/hsr2.1019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/05/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Background and Aims Cryptozoospermia is an extreme oligozoospermia with an unsatisfactory treatment effect, with an incidence rate of approximately 8.73% in male infertility, whose effective solution has become the call of the times. Western Medicine has achieved certain effects through drugs, surgery, and assisted reproductive therapy, but this is still not ideal. Traditional Chinese medicine (TCM) has made many achievements in other disciplines; however, there is still a lack of evidence-based medical evidence to improve sperm production. Methods The relevant literatures from the China National Knowledge Internet (CNKI) and PubMed in the past 10 years were collected in this article, of which the mechanisms, advantages, or current controversies of various treatment methods of Western Medicine and TCM were analyzed, to find new treatment methods and research directions. Results With the development of modern science and technology, medical treatments for cryptozoospermia have become increasingly abundant; however, there is still no universally recognized unified and effective guiding plan. Although TCM has not been fully verified by evidence-based medicine, most TCM combined with Western Medicine can achieve unexpected results. Conclusion The combination of TCM and Western Medicine may become a bane for cryptozoospermia and bring good news to infertile men worldwide.
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Affiliation(s)
- Huang Liu
- The First School of Clinical MedicineNanjing University of Chinese MedicineNanjingChina,NHC Key Laboratory of Male Reproduction and Genetics, Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital)Human Sperm Bank of Guangdong ProvinceGuangzhouChina
| | - Zefang Luo
- NHC Key Laboratory of Male Reproduction and Genetics, Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital)Human Sperm Bank of Guangdong ProvinceGuangzhouChina
| | - Jinghua Chen
- Reproductive Medical Centre of Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Houbin Zheng
- NHC Key Laboratory of Male Reproduction and Genetics, Department of Andrology, Guangdong Provincial Reproductive Science Institute (Guangdong Provincial Fertility Hospital)Human Sperm Bank of Guangdong ProvinceGuangzhouChina
| | - Qingqi Zeng
- The First School of Clinical MedicineNanjing University of Chinese MedicineNanjingChina,Department of Integrated Chinese and Western MedicineJiangsu Health Vocational CollegeNanjingChina
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Boulicault M, Perret M, Galka J, Borsa A, Gompers A, Reiches M, Richardson S. The future of sperm: a biovariability framework for understanding global sperm count trends. HUM FERTIL 2022; 25:888-902. [PMID: 33969777 DOI: 10.1080/14647273.2021.1917778] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The past 50 years have seen heated debate in the reproductive sciences about global trends in human sperm count. In 2017, Levine and colleagues published the largest and most methodologically rigorous meta-regression analysis to date and reported that average total sperm concentration among men from 'Western' countries has decreased by 59.3% since 1973, with no sign of halting. These results reverberated in the scientific community and in public discussions about men and masculinity in the modern world, in part because of scientists' public-facing claims about the societal implications of the decline of male fertility. We find that existing research follows a set of implicit and explicit assumptions about how to measure and interpret sperm counts, which collectively form what we term the Sperm Count Decline hypothesis (SCD). Using the study by Levine and colleagues, we identify weaknesses and inconsistencies in the SCD, and propose an alternative framework to guide research on sperm count trends: the Sperm Count Biovariability hypothesis (SCB). SCB asserts that sperm count varies within a wide range, much of which can be considered non-pathological and species-typical. Knowledge about the relationship between individual and population sperm count and life-historical and ecological factors is critical to interpreting trends in average sperm counts and their relationships to health and fertility.
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Affiliation(s)
- Marion Boulicault
- Department of Philosophy and Linguistics, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Philosophy, University of Adelaide, Adelaide, Australia
| | - Meg Perret
- Department of the History of Science, Harvard University, Cambridge, MA, USA
| | - Jonathan Galka
- Department of the History of Science, Harvard University, Cambridge, MA, USA
| | - Alex Borsa
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - Annika Gompers
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Meredith Reiches
- Department of Anthropology, University of Massachusetts, Boston, MA, USA
| | - Sarah Richardson
- Department of the History of Science, Harvard University, Cambridge, MA, USA.,Committee on Degrees in Studies of Women, Gender, and Sexuality, Harvard University, Cambridge, MA, USA
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Tang F, Jiang Z, Jin M, Sheng H, Feng L, Chen J, Li Y, Huang J, Xu L, Lou J. Association of occupations with decreased semen quality in eastern China: a cross-sectional study of 12 301 semen donors. BMJ Open 2022; 12:e061354. [PMID: 36028265 PMCID: PMC9422844 DOI: 10.1136/bmjopen-2022-061354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study aims to examine the association between occupational factors and semen quality in semen donors in eastern China. METHODS We recruited 12 301 semen donors from 2006 to 2020 as the studying population. A self-designed questionnaire was applied for collecting lifestyle and work style information. Semen samples were analysed according to WHO guidelines. A crude and adjusted linear regression model was used to analyse the association between occupational factors and semen quality. RESULTS College students accounted for 36.2% of all semen donors. The majority (81.3%) of semen donors were between 18 year and 30 years. Soldiers or the police had the highest semen volume (the median value=3.8 mL), however, they had the lowest sperm concentration (53.6×106/ml) and sperm motility (45.5%). Workers in finance or insurance had an elevated risk of low semen volume, sperm concentration and total sperm count (OR=1.43, 1.57 and 1.98, respectively). Unemployed men had a high risk of low sperm concentration and low total sperm count (OR=1.84 and 1.58, respectively). Working in the information technology industry had a deleterious effect on the progressive motility of sperm (OR=1.27, 95% CI 1.03 to 1.57). CONCLUSION Our study indicated that sedentary work style and intensive sports in certain professions might be associated with decreased semen quality. We reported evidence of becoming unemployed on the damage to semen quality. Hence, we advocate a healthy work style to improve semen quality in eastern China.
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Affiliation(s)
- Feng Tang
- Human Sperm Bank, Zhejiang Mater Child and Reproductive Health Center, Hangzhou, Zhejiang, China
| | - Zhaoqiang Jiang
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Mingying Jin
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Huiqiang Sheng
- Human Sperm Bank, Zhejiang Mater Child and Reproductive Health Center, Hangzhou, Zhejiang, China
| | - Lingfang Feng
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Junfei Chen
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Yongxin Li
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Jing Huang
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Ling Xu
- Human Sperm Bank, Zhejiang Mater Child and Reproductive Health Center, Hangzhou, Zhejiang, China
| | - Jianlin Lou
- School of Public Health, Hangzhou Medical College, Hangzhou, Zhejiang, China
- School of Medicine, and The First Affiliated Hospital, Huzhou University, Huzhou, Zhejiang, China
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8
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Matorras R, Navarro A, Ramos D, Malaina I, Irazusta J, Vendrell A, Fernandez A, Ferrando M, Quintana F. Physical activity and sperm quality: influence in sperm donors. Reprod Biol Endocrinol 2022; 20:83. [PMID: 35610619 PMCID: PMC9128101 DOI: 10.1186/s12958-022-00946-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 04/22/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To ascertain whether physical activity (PA) is associated with better sperm quality in sperm donors. METHODS A prospective case-control study was designed in an IVF center setting. A total of 207 sperm donation candidates from a relatively small geographical area were included in the study with no intervention. Donor candidates were subjected to conventional sperm analysis according to WHO criteria. Moreover, they answered a standardized questionnaire regarding their last week PA (IPAQ), with PA expressed in metabolic equivalents (METs)-min/week. Donors were classified into 4 groups: low, moderate, high and very high PA. Specific sports were included in the questionnaire. Semen samples from 43 accepted donors were used in artificial insemination by donor (AID) and IVF. The fertilization rates (FR) and pregnancy rates (PR) were studied. RESULTS Semen volume, sperm concentration, progressive spermatozoa, non-progressive spermatozoa, total motile progressive spermatozoa and sperm morphology were similar in the four PA groups. No correlation between various semen parameters studied and METs was found. Running or cycling > 1 h/week did not influence sperm parameters. The AID PR was similar in the different PA groups. However, in IVF the mean donor FR was significantly higher in the high PA group and in the very high PA group. CONCLUSIONS No detrimental effect was associated with PA, or even very high PA, regarding conventional sperm parameters. Moreover, a better FR was associated with high and very high PA in IVF cycles, which merits more studies.
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Affiliation(s)
- Roberto Matorras
- IVIRMA BILBAO, Lejona, Spain
- Obstetrics and Gynecology Department, Department of Medical-Surgical Specialties, Cruces University Hospital, Basque Country University, Baracaldo, Spain
- Biocruces Health Research Institute, Baracaldo, Spain
| | | | | | - Iker Malaina
- Department of Mathematics, Basque Country University, Lejona, Spain
| | - Jon Irazusta
- Department of Physiology, Basque Country University, Lejona, Spain
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9
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Assidi M. Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics. Cells 2022; 11:cells11101711. [PMID: 35626747 PMCID: PMC9139678 DOI: 10.3390/cells11101711] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/05/2023] Open
Abstract
Male infertility is an increasing and serious medical concern, though the mechanism remains poorly understood. Impaired male reproductive function affects approximately half of infertile couples worldwide. Multiple factors related to the environment, genetics, age, and comorbidities have been associated with impaired sperm function. Present-day clinicians rely primarily on standard semen analysis to diagnose male reproductive potential and develop treatment strategies. To address sperm quality assessment bias and enhance analysis accuracy, the World Health Organization (WHO) has recommended standardized sperm testing; however, conventional diagnostic and therapeutic options for male infertility, including physical examination and semen standard analysis, remain ineffective in relieving the associated social burden. Instead, assisted reproductive techniques are becoming the primary therapeutic approach. In the post-genomic era, multiomics technologies that deeply interrogate the genome, transcriptome, proteome, and/or the epigenome, even at single-cell level, besides the breakthroughs in robotic surgery, stem cell therapy, and big data, offer promises towards solving semen quality deterioration and male factor infertility. This review highlights the complex etiology of male infertility, especially the roles of lifestyle and environmental factors, and discusses advanced technologies/methodologies used in characterizing its pathophysiology. A comprehensive combination of these innovative approaches in a global and multi-centric setting and fulfilling the suitable ethical consent could ensure optimal reproductive and developmental outcomes. These combinatorial approaches should allow for the development of diagnostic markers, molecular stratification classes, and personalized treatment strategies. Since lifestyle choices and environmental factors influence male fertility, their integration in any comprehensive approach is required for safe, proactive, cost-effective, and noninvasive precision male infertility theranostics that are affordable, accessible, and facilitate couples realizing their procreation dream.
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Affiliation(s)
- Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia; ; Tel.: +966-(012)-6402000 (ext. 69267)
- Medical Laboratory Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
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10
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Diagnostic and therapeutic workup of male infertility: results from a Delphi consensus panel. Int J Impot Res 2021:10.1038/s41443-021-00511-x. [PMID: 34853436 DOI: 10.1038/s41443-021-00511-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/11/2022]
Abstract
Male factor infertility (MFI) is a rising issue worldwide with significant socioeconomic costs and negative psychological consequences for the couple. Current guidelines provide recommendations for its diagnosis and treatment but several gaps in the management of MFI are encountered in clinical practice due to the lack of available evidence in published literature. Uncertainty in the management of MFI cases leads to a high degree of variability in therapeutic approaches. We planned a Delphi consensus method to provide insights and help bridge the gaps that separate clinical guidelines from real-world practice. The Advisory Board collected 41 statements on debated topics in the management of MFI, each including multiple items designed as a 5-point Likert scale. The questionnaire was sent by e-mail to a panel of Italian experts for a first round of voting; members of the panel were later invited to a second round of voting, preceded by discussion of the "hot topics" identified in the first round. At both rounds of the Delphi consensus 68 experts participated to the voting process. After the first round 25 statements were identified as hot topics, and these underwent the second round of voting. Consensus was reached on many, but not all cases, leaving vagueness on few debated topics where decisions are unsupported by clinical studies or driven by controversial results. In conclusion, indications emerging from this large panel of experts may help guide the management of male factor infertility in clinical practice. Studies are needed to address unanswered questions left by cases for whom no consensus was reached.
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11
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Who cares about oligozoospermia when we have ICSI. Reprod Biomed Online 2021; 44:769-775. [DOI: 10.1016/j.rbmo.2021.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 11/19/2021] [Indexed: 12/26/2022]
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12
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Evans EPP, Scholten JTM, Mzyk A, Reyes-San-Martin C, Llumbet AE, Hamoh T, Arts EGJM, Schirhagl R, Cantineau AEP. Male subfertility and oxidative stress. Redox Biol 2021; 46:102071. [PMID: 34340027 PMCID: PMC8342954 DOI: 10.1016/j.redox.2021.102071] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/14/2021] [Accepted: 07/14/2021] [Indexed: 02/08/2023] Open
Abstract
To date 15% of couples are suffering from infertility with 45-50% of males being responsible. With an increase in paternal age as well as various environmental and lifestyle factors worsening these figures are expected to increase. As the so-called free radical theory of infertility suggests, free radicals or reactive oxygen species (ROS) play an essential role in this process. However, ROS also fulfill important functions for instance in sperm maturation. The aim of this review article is to discuss the role reactive oxygen species play in male fertility and how these are influenced by lifestyle, age or disease. We will further discuss how these ROS are measured and how they can be avoided during in-vitro fertilization.
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Affiliation(s)
- Emily P P Evans
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Jorien T M Scholten
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Aldona Mzyk
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands; Institute of Metallurgy and Materials Science, Polish Academy of Sciences, Reymonta 25, 30-059, Krakow, Poland
| | - Claudia Reyes-San-Martin
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Arturo E Llumbet
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands; Laboratory of Genomic of Germ Cells, Biomedical Sciences Institute, Faculty of Medicine, University of Chile. Independencia, 1027, Independencia Santiago, Chile
| | - Thamir Hamoh
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands
| | - Eus G J M Arts
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Romana Schirhagl
- Department of Biomedical Engineering, Groningen University University Medical Center Groningen, Antonius Deusinglaan 1, 9713AW, Groningen, the Netherlands.
| | - Astrid E P Cantineau
- Department of Obstetrics and Gynaecology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
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13
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Sperm donor lifestyle survey: modifiable risk factors for potential sperm donors. J Assist Reprod Genet 2021; 38:2965-2974. [PMID: 34554361 DOI: 10.1007/s10815-021-02322-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To examine the association between modifiable lifestyle factors and the main semen parameter values, the number of qualified sperm donors, and to provide some sensible guidance for sperm donors. METHODS Healthy men screened as potential sperm donors were recruited in the Hunan Province Human Sperm Bank of China from March 2019 to December 2019. Participants were invited to complete interviewer-assisted questionnaires on eleven items of information. Univariate and multivariate analyses were conducted to analyze which lifestyle factors collected by the questionnaire had an impact on the eligibility and main semen parameters of sperm donors. RESULTS The eligibility of men as sperm donors was strongly influenced by the duration of abstinence (P = 0.002). The rate of eligibility sperm donors increased significantly with the number of days of abstinence. In addition, semen volume increased with abstinence time (P = 0.000). Exercise frequency (P = 0.025) and abstinence time (P = 0.000) were positively correlated with sperm concentration, and masturbation frequency was negatively correlated with sperm concentration (P = 0.013). Progressive sperm motility was significantly affected by abstinence time (P = 0.000) and bedtime (P = 0.047). CONCLUSIONS Abstinence time was highly associated with semen parameters and donor qualification. Increase the abstinence time before donation may be meaningful in improving the proportion of eligible sperm donors.
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14
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Minhas S, Bettocchi C, Boeri L, Capogrosso P, Carvalho J, Cilesiz NC, Cocci A, Corona G, Dimitropoulos K, Gül M, Hatzichristodoulou G, Jones TH, Kadioglu A, Martínez Salamanca JI, Milenkovic U, Modgil V, Russo GI, Serefoglu EC, Tharakan T, Verze P, Salonia A. European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2021 Update on Male Infertility. Eur Urol 2021; 80:603-620. [PMID: 34511305 DOI: 10.1016/j.eururo.2021.08.014] [Citation(s) in RCA: 223] [Impact Index Per Article: 74.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 08/20/2021] [Indexed: 12/19/2022]
Abstract
CONTEXT The European Association of Urology (EAU) has updated its guidelines on sexual and reproductive health for 2021. OBJECTIVE To present a summary of the 2021 version of the EAU guidelines on sexual and reproductive health, including advances and areas of controversy in male infertility. EVIDENCE ACQUISITION The panel performed a comprehensive literature review of novel data up to January 2021. The guidelines were updated and a strength rating for each recommendation was included that was based either on a systematic review of the literature or consensus opinion from the expert panel, where applicable. EVIDENCE SYNTHESIS The male partner in infertile couples should undergo a comprehensive urological assessment to identify and treat any modifiable risk factors causing fertility impairment. Infertile men are at a higher risk of harbouring and developing other diseases including malignancy and cardiovascular disease and should be screened for potential modifiable risk factors, such as hypogonadism. Sperm DNA fragmentation testing has emerged as a novel biomarker that can identify infertile men and provide information on the outcomes from assisted reproductive techniques. The role of hormone stimulation therapy in hypergonadotropic hypogonadal or eugonadal patients is controversial and is not recommended outside of clinical trials. Furthermore, there is insufficient evidence to support the widespread use of other empirical treatments and surgical interventions in clinical practice (such as antioxidants and surgical sperm retrieval in men without azoospermia). There is low-quality evidence to support the routine use of testicular fine-needle mapping as an alternative diagnostic and predictive tool before testicular sperm extraction (TESE) in men with nonobstructive azoospermia (NOA), and either conventional or microdissection TESE remains the surgical modality of choice for men with NOA. CONCLUSIONS All infertile men should undergo a comprehensive urological assessment to identify and treat any modifiable risk factors. Increasing data indicate that infertile men are at higher risk of cardiovascular mortality and of developing cancers and should be screened and counselled accordingly. There is low-quality evidence supporting the use of empirical treatments and interventions currently used in clinical practice; the efficacy of these therapies needs to be validated in large-scale randomised controlled trials. PATIENT SUMMARY Approximately 50% of infertility will be due to problems with the male partner. Therefore, all infertile men should be assessed by a specialist with the expertise to not only help optimise their fertility but also because they are at higher risk of developing cardiovascular disease and cancer long term and therefore require appropriate counselling and management. There are many treatments and interventions for male infertility that have not been validated in high-quality studies and caution should be applied to their use in routine clinical practice.
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Affiliation(s)
- Suks Minhas
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK.
| | | | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Joana Carvalho
- CPUP: Center for Psychology of Porto University, Faculty of Psychology and Educational Sciences, Porto University, Porto, Portugal
| | - Nusret Can Cilesiz
- Department of Urology, Taksim Training & Research Hospital, Istanbul, Turkey
| | - Andrea Cocci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Giovanni Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Konstantinos Dimitropoulos
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK; Department of Urology, Aberdeen Royal Infirmary, NHS Grampian, Aberdeen, UK
| | - Murat Gül
- School of Medicine, Department of Urology, Selcuk University, Konya, Turkey
| | | | - Thomas Hugh Jones
- Centre for Diabetes and Endocrinology, Barnsley Hospital NHS Trust, Barnsley, UK
| | - Ates Kadioglu
- Department of Urology, İstanbul University İstanbul School of Medicine, İstanbul, Turkey
| | | | - Uros Milenkovic
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Vaibhav Modgil
- Manchester Andrology Centre, Manchester Royal Infirmary, Manchester University Hospitals NHS Foundation Trust, UK
| | - Giorgio Ivan Russo
- Urology Section, Department of Surgery, University of Catania, Catania, Italy
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | - Tharu Tharakan
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Paolo Verze
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, Fisciano, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
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15
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Boedt T, Matthys C, Lie Fong S, De Neubourg D, Vereeck S, Seghers J, Van der Gucht K, Weyn B, Geerts D, Spiessens C, Dancet EAF. Systematic development of a mobile preconception lifestyle programme for couples undergoing IVF: the PreLiFe-programme. Hum Reprod 2021; 36:2493-2505. [PMID: 34379119 DOI: 10.1093/humrep/deab166] [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: 10/30/2020] [Revised: 06/04/2021] [Indexed: 12/14/2022] Open
Abstract
STUDY QUESTION Can we develop a preconception lifestyle programme for couples undergoing IVF that is in line with their needs. SUMMARY ANSWER A mobile preconception lifestyle programme was systematically developed based on expert opinion, literature and needs of IVF-patients. WHAT IS KNOWN ALREADY A healthy lifestyle prior to conception is not only beneficial for the general health of couples, but evidence on its importance for their reproductive health and the health of their children is also emerging. So far, the vast majority of fertility clinics do not offer a lifestyle programme for couples undergoing IVF. Therefore, the present study aimed to develop a lifestyle programme for IVF-couples. STUDY DESIGN, SIZE, DURATION The development of the PreLiFe-programme was guided by the steps of the Medical Research Council (MRC) framework for developing complex interventions, a systematic approach for developing theory- and evidence-based health promotion interventions. PARTICIPANTS/MATERIALS, SETTINGS, METHODS First, the evidence base on lifestyle programmes for IVF-couples was reviewed. Second, several iterations between an expert panel, the literature, and quantitative and qualitative data from IVF-patients identified the content, the format, behaviour change techniques and theory of the programme. Third, the PreLiFe-programme was produced and the expected process and outcomes of a randomized controlled trial assessing it were modelled. Finally, user tests among experts and patients and pilot tests among patients were conducted. MAIN RESULTS AND ROLE OF CHANCE The finally developed PreLiFe-programme is a mobile application to be used autonomously by both partners of IVF-couples during the first year of IVF, in combination with motivational interviewing over the telephone every three months (i.e. blended care). The PreLiFe-programme provides advice and skills training on physical activity, diet and mindfulness based stress reduction and is in part tailored based on monitoring and tracking the lifestyle of patients. Based on the literature the expert panel considers it plausible that all three components contribute to IVF-success rates. The PreLiFe-programme is likely to be acceptable to patients as it meets the need of patients for lifestyle advice and treatment information. LIMITATIONS, REASON FOR CAUTION The pilot in IVF-couples had a 3-month duration. The feasibility of the PreLiFe-programme in other infertile populations and/or upon longer use is yet to be examined. Whether the PreLiFe-programme effectively improves lifestyle and IVF-success rates is currently being examined in a trial randomizing heterosexual couples starting IVF to the PreLiFe-programme or an attention-control group for 12 months. WIDER IMPLICATIONS OF THE FINDINGS If the PreLiFe-programme improves lifestyle and the chance of IVF-success, it will be a powerful tool and provide guidance for implementing lifestyle programmes in fertility clinics. STUDY FUNDING/COMPETING INTEREST(S) Funded by the Research Foundation Flanders (FWO-TBM (Applied Biomedical Research with a Primary Social finality); reference: T005417N). The authors have no conflict of interest to report. TRIAL REGISTRATION NUMBER NCT03790449.
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Affiliation(s)
- T Boedt
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.,Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium
| | - C Matthys
- Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Leuven, Belgium.,Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - S Lie Fong
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - D De Neubourg
- Centre for Reproductive Medicine, Antwerp University Hospital, Edegem, Belgium
| | - S Vereeck
- Centre for Reproductive Medicine, Antwerp University Hospital, Edegem, Belgium
| | - J Seghers
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - K Van der Gucht
- Leuven Mindfulness Centre, KU Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - B Weyn
- Department of Electric Engineering, Leuven, Belgium
| | - D Geerts
- Meaningful Interactions Lab, KU Leuven, Leuven, Belgium
| | - C Spiessens
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - E A F Dancet
- Leuven University Fertility Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
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16
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Amiri A, Chovanec M, Oliva V, Sedliak M, Mego M, Ukropec J, Ukropcová B. Chemotherapy-induced toxicity in patients with testicular germ cell tumors: The impact of physical fitness and regular exercise. Andrology 2021; 9:1879-1892. [PMID: 34245663 DOI: 10.1111/andr.13078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Testicular germ cell tumors (TGCTs) represent ∼95% of testicular malignancies and are the most common type of malignancy in young male adults. While the incidence of TGCTs has increased during the last decades, the advances in treatment, namely introducing cisplatin into the chemotherapy regimen, have made TGCTs highly curable with the 10-year survival rate exceeding 95%. However, in parallel with increased cure rates, survivors may experience acute and late adverse effects of treatment, which increase morbidity, reduce the quality of life, and can be potentially life-threatening. Chemotherapy-related toxicities include cardiovascular and metabolic diseases, secondary cancer, avascular necrosis, cognitive impairment, cancer-related fatigue, poor mental health-related quality of life, nephrotoxicity, hypogonadism, neurotoxicity, pulmonary toxicity, anxiety, and depression. These treatment-related adverse effects have emerged as important survivorship dilemmas in TGCT cancer survivors. Recently, regular physical exercise has increasingly attracted research and clinical attention as an adjunct therapy for cancer patients. PURPOSE Herein, we review the most common chemotherapy-related adverse effects in TGCT survivors and clinical relevance of exercise and increased cardio-respiratory fitness in modulating chemotherapy-related toxicity and quality of life in this population. RESULTS AND CONCLUSION Exercise has positive effects on a spectrum of physical and psychosocial outcomes during and after cancer treatment, and current guidelines on exercise prescription in chronic diseases define the recommended dose (volume and intensity) of regular exercise for cancer survivors, highlighting regular, sufficiently intensive physical activity as an essential part of patients' care.
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Affiliation(s)
- Ali Amiri
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Michal Chovanec
- 2nd, Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Viktor Oliva
- Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
| | - Milan Sedliak
- Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
| | - Michal Mego
- 2nd, Department of Oncology, Faculty of Medicine, Comenius University and National Cancer Institute, Bratislava, Slovakia
| | - Jozef Ukropec
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Barbara Ukropcová
- Department of Metabolic Disease Research & Center of Physical Activity Research, Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.,Institute of Pathophysiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
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17
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Boedt T, Vanhove AC, Vercoe MA, Matthys C, Dancet E, Lie Fong S. Preconception lifestyle advice for people with infertility. Cochrane Database Syst Rev 2021; 4:CD008189. [PMID: 33914901 PMCID: PMC8092458 DOI: 10.1002/14651858.cd008189.pub3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Infertility is a prevalent problem that has significant consequences for individuals, families, and the community. Modifiable lifestyle factors may affect the chance of people with infertility having a baby. However, no guideline is available about what preconception advice should be offered. It is important to determine what preconception advice should be given to people with infertility and to evaluate whether this advice helps them make positive behavioural changes to improve their lifestyle and their chances of conceiving. OBJECTIVES To assess the safety and effectiveness of preconception lifestyle advice on fertility outcomes and lifestyle behavioural changes for people with infertility. SEARCH METHODS We searched the Cochrane Gynaecology and Fertility Group Specialised Register of controlled trials, CENTRAL, MEDLINE, Embase, PsycINFO, AMED, CINAHL, trial registers, Google Scholar, and Epistemonikos in January 2021; we checked references and contacted field experts to identify additional studies. SELECTION CRITERIA We included randomised controlled trials (RCTs), randomised cross-over studies, and cluster-randomised studies that compared at least one form of preconception lifestyle advice with routine care or attention control for people with infertility. DATA COLLECTION AND ANALYSIS We used standard methodological procedures recommended by Cochrane. Primary effectiveness outcomes were live birth and ongoing pregnancy. Primary safety outcomes were adverse events and miscarriage. Secondary outcomes included reported behavioural changes in lifestyle, birth weight, gestational age, clinical pregnancy, time to pregnancy, quality of life, and male factor infertility outcomes. We assessed the overall quality of evidence using GRADE criteria. MAIN RESULTS We included in the review seven RCTs involving 2130 participants. Only one RCT included male partners. Three studies compared preconception lifestyle advice on a combination of topics with routine care or attention control. Four studies compared preconception lifestyle advice on one topic (weight, alcohol intake, or smoking) with routine care for women with infertility and specific lifestyle characteristics. The evidence was of low to very low-quality. The main limitations of the included studies were serious risk of bias due to lack of blinding, serious imprecision, and poor reporting of outcome measures. Preconception lifestyle advice on a combination of topics versus routine care or attention control Preconception lifestyle advice on a combination of topics may result in little to no difference in the number of live births (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.79 to 1.10; 1 RCT, 626 participants), but the quality of evidence was low. No studies reported on adverse events or miscarriage. Due to very low-quality evidence, we are uncertain whether preconception lifestyle advice on a combination of topics affects lifestyle behavioural changes: body mass index (BMI) (mean difference (MD) -1.06 kg/m², 95% CI -2.33 to 0.21; 1 RCT, 180 participants), vegetable intake (MD 12.50 grams/d, 95% CI -8.43 to 33.43; 1 RCT, 264 participants), alcohol abstinence in men (RR 1.08, 95% CI 0.74 to 1.58; 1 RCT, 210 participants), or smoking cessation in men (RR 1.01, 95% CI 0.91 to 1.12; 1 RCT, 212 participants). Preconception lifestyle advice on a combination of topics may result in little to no difference in the number of women with adequate folic acid supplement use (RR 0.98, 95% CI 0.95 to 1.01; 2 RCTs, 850 participants; I² = 4%), alcohol abstinence (RR 1.07, 95% CI 0.99 to 1.17; 1 RCT, 607 participants), and smoking cessation (RR 1.01, 95% CI 0.98 to 1.04; 1 RCT, 606 participants), on low quality evidence. No studies reported on other behavioural changes. Preconception lifestyle advice on weight versus routine care Studies on preconception lifestyle advice on weight were identified only in women with infertility and obesity. Compared to routine care, we are uncertain whether preconception lifestyle advice on weight affects the number of live births (RR 0.94, 95% CI 0.62 to 1.43; 2 RCTs, 707 participants; I² = 68%; very low-quality evidence), adverse events including gestational diabetes (RR 0.78, 95% CI 0.48 to 1.26; 1 RCT, 317 participants; very low-quality evidence), hypertension (RR 1.07, 95% CI 0.66 to 1.75; 1 RCT, 317 participants; very low-quality evidence), or miscarriage (RR 1.50, 95% CI 0.95 to 2.37; 1 RCT, 577 participants; very low-quality evidence). Regarding lifestyle behavioural changes for women with infertility and obesity, preconception lifestyle advice on weight may slightly reduce BMI (MD -1.30 kg/m², 95% CI -1.58 to -1.02; 1 RCT, 574 participants; low-quality evidence). Due to very low-quality evidence, we are uncertain whether preconception lifestyle advice affects the percentage of weight loss, vegetable and fruit intake, alcohol abstinence, or physical activity. No studies reported on other behavioural changes. Preconception lifestyle advice on alcohol intake versus routine care Studies on preconception lifestyle advice on alcohol intake were identified only in at-risk drinking women with infertility. We are uncertain whether preconception lifestyle advice on alcohol intake affects the number of live births (RR 1.15, 95% CI 0.53 to 2.50; 1 RCT, 37 participants; very low-quality evidence) or miscarriages (RR 1.31, 95% CI 0.21 to 8.34; 1 RCT, 37 participants; very low-quality evidence). One study reported on behavioural changes for alcohol consumption but not as defined in the review methods. No studies reported on adverse events or other behavioural changes. Preconception lifestyle advice on smoking versus routine care Studies on preconception lifestyle advice on smoking were identified only in smoking women with infertility. No studies reported on live birth, ongoing pregnancy, adverse events, or miscarriage. One study reported on behavioural changes for smoking but not as defined in the review methods. AUTHORS' CONCLUSIONS Low-quality evidence suggests that preconception lifestyle advice on a combination of topics may result in little to no difference in the number of live births. Evidence was insufficient to allow conclusions on the effects of preconception lifestyle advice on adverse events and miscarriage and on safety, as no studies were found that looked at these outcomes, or the studies were of very low quality. This review does not provide clear guidance for clinical practice in this area. However, it does highlight the need for high-quality RCTs to investigate preconception lifestyle advice on a combination of topics and to assess relevant effectiveness and safety outcomes in men and women with infertility.
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Affiliation(s)
- Tessy Boedt
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Anne-Catherine Vanhove
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
- Belgian Centre for Evidence-Based Medicine - Cochrane Belgium, Leuven, Belgium
| | - Melissa A Vercoe
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Christophe Matthys
- Department of Chronic Diseases and Metabolism, KU Leuven, Leuven, Belgium
| | - Eline Dancet
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Sharon Lie Fong
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynaecology, Leuven University Fertility Center, University Hospitals Leuven, Leuven, Belgium
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Läänelaid S, Ortega FB, Kunovac Kallak T, Joelsson L, Ruiz JR, Hreinsson J, Wånggren K, Stavreus-Evers A, Kalda R, Salumets A, Altmäe S. Physical and Sedentary Activities in Association with Reproductive Outcomes among Couples Seeking Infertility Treatment: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2718. [PMID: 33800259 PMCID: PMC7967443 DOI: 10.3390/ijerph18052718] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The aim of this study was to investigate the association of physical activity (PA) with assisted reproductive technology (ART) treatment and pregnancy outcomes among couples seeking infertility treatment. METHODS This prospective cohort study was carried out among 128 infertile individuals (64 couples), entering the infertility clinic for ART procedures. Baseline PA (before entering any treatment) was assessed using accelerometry for both women and men. For every couple the infertility treatment outcomes were recorded. RESULTS The couples that required invasive ART procedures such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) spent less time in vigorous PA (-73 min/week per couple, woman + man) than those couples who became spontaneously pregnant after entering the study (p = 0.001). We observed no significant associations between the time spent in physical activities and positive pregnancy test or live birth. CONCLUSIONS Our results do not support a positive nor negative relation between the time the couples spent in physical activities and the chances of getting pregnant or having a baby among patients seeking infertility treatment. However, couples undergoing invasive ART procedures did less vigorous PA than couples that became spontaneously pregnant, suggesting that PA may interfere with their reproductive health.
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Affiliation(s)
- Siret Läänelaid
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia; (S.L.); (R.K.)
- Department of Nursing and Midwifery, Tartu Health Care College, Nooruse 5, 50411 Tartu, Estonia
| | - Francisco B. Ortega
- Department of Physical Education and Sports, University of Granada, Carretera de Alfacar, S/N CP, 18071 Granada, Spain; (F.B.O.); (J.R.R.)
- Department of Biosciences and Nutrition, Karolinska Institutet, NEO, SE-14183 Huddinge, Sweden
| | - Theodora Kunovac Kallak
- Department of Women’s and Children’s Health, Uppsala University, SE-751 85 Uppsala, Sweden; (T.K.K.); (L.J.); (K.W.); (A.S.-E.)
| | - Lana Joelsson
- Department of Women’s and Children’s Health, Uppsala University, SE-751 85 Uppsala, Sweden; (T.K.K.); (L.J.); (K.W.); (A.S.-E.)
| | - Jonatan R. Ruiz
- Department of Physical Education and Sports, University of Granada, Carretera de Alfacar, S/N CP, 18071 Granada, Spain; (F.B.O.); (J.R.R.)
- Department of Biosciences and Nutrition, Karolinska Institutet, NEO, SE-14183 Huddinge, Sweden
| | - Julius Hreinsson
- Minerva Fertility Clinic, Kålsängsgränd 10 d, 753 19 Uppsala, Sweden;
| | - Kjell Wånggren
- Department of Women’s and Children’s Health, Uppsala University, SE-751 85 Uppsala, Sweden; (T.K.K.); (L.J.); (K.W.); (A.S.-E.)
| | - Anneli Stavreus-Evers
- Department of Women’s and Children’s Health, Uppsala University, SE-751 85 Uppsala, Sweden; (T.K.K.); (L.J.); (K.W.); (A.S.-E.)
| | - Ruth Kalda
- Institute of Family Medicine and Public Health, University of Tartu, Ravila 19, 50411 Tartu, Estonia; (S.L.); (R.K.)
| | - Andres Salumets
- Department of Obstetrics and Gynaecology, Institute of Clinical Medicine, University of Tartu, L. Puusepa 8, 50406 Tartu, Estonia;
- Competence Centre on Health Technologies, Teaduspargi 13, 50411 Tartu, Estonia
- Institute of Genomics, University of Tartu, Riia 23b, 51010 Tartu, Estonia
| | - Signe Altmäe
- Competence Centre on Health Technologies, Teaduspargi 13, 50411 Tartu, Estonia
- Department of Biochemistry and Molecular Biology, Faculty of Sciences, University of Granada, Avenida de la Fuente Nueva S/N, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Parque Tecnológico de la Salud, 18016 Granada, Spain
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Lavín-Pérez AM, Collado-Mateo D, Villafaina S, Calle-Guisado V. The Role of Exercise to Reduce the Impact of Diabetes in the Seminal Quality: A Systematic Review. ACTA ACUST UNITED AC 2021; 57:medicina57020159. [PMID: 33578871 PMCID: PMC7916555 DOI: 10.3390/medicina57020159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 01/01/2023]
Abstract
Background and Objectives: One of the most relevant consequences of diabetes mellitus is the temporal or complete infertility which can happen in young individuals. Therefore, the current systematic review aimed to investigate the effects of exercise to reduce the impact of Type 2 Diabetes Mellitus (T2DM) in seminal quality and related parameters. Materials and Methods: A systematic search was conducted in Pubmed and Web of Science databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA). The inclusion criteria were: (1) the study included at least one experimental and one comparison group, (2) the sample of the study was comprised of humans or animals with diabetes mellitus, (3) an intervention based on physical exercise was conducted, and (4) the study reported variables related to the seminal quality. Results: A total of 115 articles were identified. However, only six accomplished the inclusion and exclusion criteria. This systematic review includes a sample size of 260 participants (180 rats and 80 humans). Intervention ranged from 6 to 14 weeks, with 3–6 days per week. All interventions performed endurance training (50–70% VO2max or maximum heart rate). Physical exercise increased sperm count, motility, and morphology, as well as improved testosterone, Luteinizing Hormone (LH), and Follicle Stimulating Hormone (FSH) levels. Moreover, physical exercise intervention reduced the percentages of sperms with negative Tubular Differentiation Index (TDI) and Spermiogenesis Index (SPI), DNA fragmentation, and also ameliorated the diabetes-induced apoptosis and improved sperm apoptosis index. Conclusions: Physical exercise could ameliorate diabetic pathological effects on sperm quality and related parameters that cause infertility or subfertility conditions. However, further homogeneous studies are needed to confirm these findings.
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Affiliation(s)
- Ana Myriam Lavín-Pérez
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain; (A.M.L.-P.); (D.C.-M.)
- GO fitLAB, Ingesport, 28003 Madrid, Spain
| | - Daniel Collado-Mateo
- Centre for Sport Studies, Rey Juan Carlos University, Fuenlabrada, 28943 Madrid, Spain; (A.M.L.-P.); (D.C.-M.)
| | - Santos Villafaina
- Physical Activity and Quality of Life Research Group (AFYCAV), Faculty of Sport Sciences, University of Extremadura, 10004 Cáceres, Spain
- Correspondence:
| | - Violeta Calle-Guisado
- Department of Specific Didactics, Faculty of Human Sciences and Education, Experimental Sciences Area, University of Zaragoza, 50009 Zaragoza, Spain;
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Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, Arafa M, Panner Selvam MK, Shah R. Male infertility. Lancet 2021; 397:319-333. [PMID: 33308486 DOI: 10.1016/s0140-6736(20)32667-2] [Citation(s) in RCA: 406] [Impact Index Per Article: 135.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 02/06/2023]
Abstract
It is estimated that infertility affects 8-12% of couples globally, with a male factor being a primary or contributing cause in approximately 50% of couples. Causes of male subfertility vary highly, but can be related to congenital, acquired, or idiopathic factors that impair spermatogenesis. Many health conditions can affect male fertility, which underscores the need for a thorough evaluation of patients to identify treatable or reversible lifestyle factors or medical conditions. Although semen analysis remains the cornerstone for evaluating male infertility, advanced diagnostic tests to investigate sperm quality and function have been developed to improve diagnosis and management. The use of assisted reproductive techniques has also substantially improved the ability of couples with infertility to have biological children. This Seminar aims to provide a comprehensive overview of the assessment and management of men with infertility, along with current controversies and future endeavours.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- SH Ho Urology Center, Department of Surgery, Chinese University of Hong Kong, Hong Kong
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA; Department of Medical Bioscience, University of Western Cape, Bellville, South Africa; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Sarah Vij
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Mohamed Arafa
- Male Infertility Unit, Urology Department, Hamad Medical Corporation, Doha, Qatar; Andrology Department, Cairo University, Cairo, Egypt
| | | | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Center, Mumbai, India
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21
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Sharma A, Minhas S, Dhillo WS, Jayasena CN. Male infertility due to testicular disorders. J Clin Endocrinol Metab 2021; 106:e442-e459. [PMID: 33295608 PMCID: PMC7823320 DOI: 10.1210/clinem/dgaa781] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 12/13/2022]
Abstract
CONTEXT Male infertility is defined as the inability to conceive following 1 year of regular unprotected intercourse. It is the causative factor in 50% of couples and a leading indication for assisted reproductive techniques (ART). Testicular failure is the most common cause of male infertility, yet the least studied to date. EVIDENCE ACQUISITION The review is an evidence-based summary of male infertility due to testicular failure with a focus on etiology, clinical assessment, and current management approaches. PubMed-searched articles and relevant clinical guidelines were reviewed in detail. EVIDENCE SYNTHESIS/RESULTS Spermatogenesis is under multiple levels of regulation and novel molecular diagnostic tests of sperm function (reactive oxidative species and DNA fragmentation) have since been developed, and albeit currently remain as research tools. Several genetic, environmental, and lifestyle factors provoking testicular failure have been elucidated during the last decade; nevertheless, 40% of cases are idiopathic, with novel monogenic genes linked in the etiopathogenesis. Microsurgical testicular sperm extraction (micro-TESE) and hormonal stimulation with gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors are recently developed therapeutic approaches for men with the most severe form of testicular failure, nonobstructive azoospermia. However, high-quality clinical trials data is currently lacking. CONCLUSIONS Male infertility due to testicular failure has traditionally been viewed as unmodifiable. In the absence of effective pharmacological therapies, delivery of lifestyle advice is a potentially important treatment option. Future research efforts are needed to determine unidentified factors causative in "idiopathic" male infertility and long-term follow-up studies of babies conceived through ART.
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Affiliation(s)
- Aditi Sharma
- Section of Endocrinology and Investigative Medicine, Imperial College London, UK
| | - Suks Minhas
- Department of Urology, Charing Cross Hospital, London, UK
| | - Waljit S Dhillo
- Section of Endocrinology and Investigative Medicine, Imperial College London, UK
| | - Channa N Jayasena
- Section of Endocrinology and Investigative Medicine, Imperial College London, UK
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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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Lotti F, Frizza F, Balercia G, Barbonetti A, Behre HM, Calogero AE, Cremers J, Francavilla F, Isidori AM, Kliesch S, La Vignera S, Lenzi A, Marcou M, Pilatz A, Poolamets O, Punab M, Peraza Godoy MF, Rajmil O, Salvio G, Shaeer O, Weidner W, Maseroli E, Cipriani S, Baldi E, Degl’Innocenti S, Danza G, Caldini AL, Terreni A, Boni L, Krausz C, Maggi M. The European Academy of Andrology (EAA) ultrasound study on healthy, fertile men: clinical, seminal and biochemical characteristics. Andrology 2020; 8:1005-1020. [DOI: 10.1111/andr.12808] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/16/2020] [Accepted: 04/27/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Francesco Lotti
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Francesca Frizza
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Giancarlo Balercia
- Endocrinology Unit Ospedali Riuniti Ancona Polytechnic University of Marche Ancona Italy
| | - Arcangelo Barbonetti
- Andrology Unit Department of Life, Health and Environmental Sciences University of L’Aquila L’Aquila Italy
| | - Hermann M. Behre
- Center for Reproductive Medicine and Andrology Martin Luther University Halle‐Wittenberg Halle Germany
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine University of Catania Italy
| | - Jann‐Frederik Cremers
- Department of Clinical and Surgical Andrology Centre of Reproductive Medicine and Andrology Münster University Hospital Münster Germany
| | - Felice Francavilla
- Andrology Unit Department of Life, Health and Environmental Sciences University of L’Aquila L’Aquila Italy
| | - Andrea M. Isidori
- Department of Experimental Medicine Sapienza University of Rome Rome Italy
| | - Sabine Kliesch
- Department of Clinical and Surgical Andrology Centre of Reproductive Medicine and Andrology Münster University Hospital Münster Germany
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine University of Catania Italy
| | - Andrea Lenzi
- Department of Experimental Medicine Sapienza University of Rome Rome Italy
| | - Marios Marcou
- Center for Reproductive Medicine and Andrology Martin Luther University Halle‐Wittenberg Halle Germany
| | - Adrian Pilatz
- Department of Urology Pediatric Urology and Andrology Justus Liebig University Giessen Germany
| | | | - Margus Punab
- Andrology Unit Tartu University Hospital Tartu Estonia
| | - Maria Fernanda Peraza Godoy
- Andrology Department Fundació Puigvert Universitat Autònoma de Barcelona Instituto de Investigaciones Biomédicas Sant Pau (IIB‐Sant Pau) Barcelona Spain
| | - Osvaldo Rajmil
- Andrology Department Fundació Puigvert Universitat Autònoma de Barcelona Instituto de Investigaciones Biomédicas Sant Pau (IIB‐Sant Pau) Barcelona Spain
| | - Gianmaria Salvio
- Endocrinology Unit Ospedali Riuniti Ancona Polytechnic University of Marche Ancona Italy
| | - Osama Shaeer
- Department of Andrology Kasr El Aini Faculty of Medicine Cairo University Cairo Egypt
| | - Wolfgang Weidner
- Department of Urology Pediatric Urology and Andrology Justus Liebig University Giessen Germany
| | - Elisa Maseroli
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Sarah Cipriani
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Elisabetta Baldi
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Selene Degl’Innocenti
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Giovanna Danza
- Endocrinology Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | | | | | - Luca Boni
- Clinical Trials Coordinating Center Toscano Cancer Institute University Hospital Careggi Florence Italy
| | - Csilla Krausz
- Andrology, Female Endocrinology and Gender Incongruence Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
| | - Mario Maggi
- Endocrinology Unit Department of Experimental and Clinical Biomedical Sciences “Mario Serio” University of Florence Florence Italy
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Danielewicz A, Morze J, Przybyłowicz M, Przybyłowicz KE. Association of the Dietary Approaches to Stop Hypertension, Physical Activity, and Their Combination with Semen Quality: A Cross-Sectional Study. Nutrients 2019; 12:nu12010039. [PMID: 31877862 PMCID: PMC7019803 DOI: 10.3390/nu12010039] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 12/17/2019] [Accepted: 12/19/2019] [Indexed: 12/16/2022] Open
Abstract
The influence of individual lifestyle factors is widely described in studies on semen quality. However, their synergistic effect is often neglected. The aim of the study was to examine the association between semen quality and dietary approaches to stop hypertension (DASH) diet, physical activity (PA), and the two separately and in combination. A cross-sectional study was carried out among 207 men aged 20–55. Dietary data were collected by a food frequency questionnaire (FFQ) and analysed according to the DASH scoring index. Physical activity was evaluated by the International Physical Activity Questionnaire. Semen parameters were assessed via the computer-aided semen analysis (CASA). Adherence to the DASH diet was associated with higher sperm count (ΔT3-T1 = 82.1 mln/ej) and concentration (ΔT3-T1 = 24.6 mln/mL). Higher PA was related to higher sperm count (ΔT3-T1 = 69.4 mln/ej), total (ΔT3-T1 = 11.9%), and progressive motility (ΔT3-T1 = 8.5%) and morphology (ΔT3-T1 = 2.8%) in the crude model and remained significant after adjustment. The combination of the DASH diet and PA, was significantly positively associated with sperm count (ΔT3-T1 = 98.1 mln/ej), sperm concentration (ΔT3-T1 = 17.5 mln/mL), total (ΔT3-T1 = 11.8%), and progressive motility (ΔT3-T1 = 10.0%) and morphology (ΔT3-T1 = 3.3%) in both models. Adherence to the DASH diet was related to higher sperm count and concentration, whereas after its combination with physical activity it was also positively correlated with sperm motility and morphology.
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Affiliation(s)
- Anna Danielewicz
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, ul. Słoneczna 45F, 10-718 Olsztyn, Poland; (J.M.); (K.E.P.)
- Correspondence: ; Tel.: +48-89-524-55-12
| | - Jakub Morze
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, ul. Słoneczna 45F, 10-718 Olsztyn, Poland; (J.M.); (K.E.P.)
- Department of Cardiology and Cardiac Surgery, School of Medicine, University of Warmia and Mazury in Olsztyn, al. Warszawska 30, 10-082 Olsztyn, Poland
| | - Mariusz Przybyłowicz
- Department of Oncological Gynecology, Provincial Specialist Hospital in Olsztyn, ul. Żołnierska 18, 10-561 Olsztyn, Poland;
- Center of Gynecology, Endocrinology and Reproductive Medicine Artemida in Olsztyn; ul. Jagiellońska 78, 10-229 Olsztyn, Poland
| | - Katarzyna Eufemia Przybyłowicz
- Department of Human Nutrition, Faculty of Food Sciences, University of Warmia and Mazury in Olsztyn, ul. Słoneczna 45F, 10-718 Olsztyn, Poland; (J.M.); (K.E.P.)
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25
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Nätt D, Kugelberg U, Casas E, Nedstrand E, Zalavary S, Henriksson P, Nijm C, Jäderquist J, Sandborg J, Flinke E, Ramesh R, Örkenby L, Appelkvist F, Lingg T, Guzzi N, Bellodi C, Löf M, Vavouri T, Öst A. Human sperm displays rapid responses to diet. PLoS Biol 2019; 17:e3000559. [PMID: 31877125 PMCID: PMC6932762 DOI: 10.1371/journal.pbio.3000559] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/18/2019] [Indexed: 11/25/2022] Open
Abstract
The global rise in obesity and steady decline in sperm quality are two alarming trends that have emerged during recent decades. In parallel, evidence from model organisms shows that paternal diet can affect offspring metabolic health in a process involving sperm tRNA-derived small RNA (tsRNA). Here, we report that human sperm are acutely sensitive to nutrient flux, both in terms of sperm motility and changes in sperm tsRNA. Over the course of a 2-week diet intervention, in which we first introduced a healthy diet followed by a diet rich in sugar, sperm motility increased and stabilized at high levels. Small RNA-seq on repeatedly sampled sperm from the same individuals revealed that tsRNAs were up-regulated by eating a high-sugar diet for just 1 week. Unsupervised clustering identified two independent pathways for the biogenesis of these tsRNAs: one involving a novel class of fragments with specific cleavage in the T-loop of mature nuclear tRNAs and the other exclusively involving mitochondrial tsRNAs. Mitochondrial involvement was further supported by a similar up-regulation of mitochondrial rRNA-derived small RNA (rsRNA). Notably, the changes in sugar-sensitive tsRNA were positively associated with simultaneous changes in sperm motility and negatively associated with obesity in an independent clinical cohort. This rapid response to a dietary intervention on tsRNA in human sperm is attuned with the paternal intergenerational metabolic responses found in model organisms. More importantly, our findings suggest shared diet-sensitive mechanisms between sperm motility and the biogenesis of tsRNA, which provide novel insights about the interplay between nutrition and male reproductive health.
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Affiliation(s)
- Daniel Nätt
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
| | - Unn Kugelberg
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
| | - Eduard Casas
- Josep Carreras Leukaemia Research Institute (IJC), Program for Predictive and Personalized Medicine of Cancer (PMPPC-IGTP), Barcelona, Spain
| | - Elizabeth Nedstrand
- Linköping University, Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, Linköping, Sweden
| | - Stefan Zalavary
- Linköping University, Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, Linköping, Sweden
| | - Pontus Henriksson
- Karolinska Institute, Department of Biosciences and Nutrition, Huddinge, Sweden
- Linköping University, Department of Medical and Health Sciences, Division of Community Medicine, Linköping, Sweden
| | - Carola Nijm
- Linköping University, Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, Linköping, Sweden
| | - Julia Jäderquist
- Linköping University, Department of Clinical and Experimental Medicine, Division of Obstetrics and Gynecology, Linköping, Sweden
| | - Johanna Sandborg
- Karolinska Institute, Department of Biosciences and Nutrition, Huddinge, Sweden
- Linköping University, Department of Medical and Health Sciences, Division of Community Medicine, Linköping, Sweden
| | - Eva Flinke
- Linköping University, Department of Medical and Health Sciences, Division of Community Medicine, Linköping, Sweden
| | - Rashmi Ramesh
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
| | - Lovisa Örkenby
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
| | - Filip Appelkvist
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
| | - Thomas Lingg
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
| | - Nicola Guzzi
- Lund University, Stem Cell Center, Department of Laboratory Medicine, Division of Molecular Hematology, Lund, Sweden
| | - Cristian Bellodi
- Lund University, Stem Cell Center, Department of Laboratory Medicine, Division of Molecular Hematology, Lund, Sweden
| | - Marie Löf
- Karolinska Institute, Department of Biosciences and Nutrition, Huddinge, Sweden
- Linköping University, Department of Medical and Health Sciences, Division of Community Medicine, Linköping, Sweden
| | - Tanya Vavouri
- Josep Carreras Leukaemia Research Institute (IJC), Program for Predictive and Personalized Medicine of Cancer (PMPPC-IGTP), Barcelona, Spain
| | - Anita Öst
- Linköping University, Department of Clinical and Experimental Medicine, Division of Neurobiology, Linkoping, Sweden
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26
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Yan X, Dong L, Liu Y, Yang F, Tan K, Li J, Chang D, Yu X. Effects of physical exercises on semen quality and reproductive outcomes in male infertility: A protocol for systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2019; 98:e17494. [PMID: 31593115 PMCID: PMC6799391 DOI: 10.1097/md.0000000000017494] [Citation(s) in RCA: 5] [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: 09/14/2019] [Accepted: 09/16/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Infertility has troubled the world's 186 million people, and male infertility accounts for more than half. The literature of physical exercise related to semen quality has shown inconsistent results, and there is currently no systematic review to evaluate the effects of exercise on reproductive outcomes in male infertility patients. This study aims to assessing the effects of exercise interventions based on randomized controlled trials (RCTs) on semen quality and reproductive outcomes in male infertility. METHODS English and Chinese literature about physical exercise treatment for male infertility published before July 31, 2019 will be systematic searched in PubMed, Embase, Web of Science, Cochrane Library, Open Grey, Clinicaltrials.gov, Chinese Clinical Trial Registry, WANFANG, VIP Chinese Science and Technology Journal Database, CNKI, Chinese biomedical document service system (SinoMed). Only RCTs of patients with male infertility will be included. Literature screening, data extraction, and the assessment of risk of bias will be independently conducted by 2 reviewers, and the 3rd reviewer will be consulted if any different opinions existed. Live-birth rate, pregnancy rate, adverse events (including miscarriage), sperm concentration, progressive motility, sperm morphology, and sperm DNA fragmentation will be evaluated. Systematic review and meta-analysis will be produced by RevMan 5.3 and Stata 14.0. This protocol reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION We will assess the efficacy and safety of physical exercise on semen quality and reproductive outcomes in infertile men. The findings will be published in a peer-reviewed journal to provide evidence-based medical evidence for clinical decision making and the patient's lifestyle guidance. REGISTRATION INFORMATION PROSPERO CRD42019140294.
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Affiliation(s)
- Xuhong Yan
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Liang Dong
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine
| | - Yinghong Liu
- School of Sports Medicine and Health Chengdu Sport institute, Chengdu Sport University, Chengdu, Sichuan, China
| | - Fang Yang
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine
| | - Kun Tan
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine
| | - Junjun Li
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine
| | - Degui Chang
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Xujun Yu
- Hospital of Chengdu University of Traditional Chinese Medicine
- Department of Andrology, The Reproductive & Women-Children Hospital, Chengdu University of Traditional Chinese Medicine
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27
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Ibañez-Perez J, Santos-Zorrozua B, Lopez-Lopez E, Irazusta J, Prieto B, Aparicio V, Corcostegui B, Gracia-Orad Á, Matorras R. Impact of physical activity on semen quality among men from infertile couples. Eur J Obstet Gynecol Reprod Biol 2019; 237:170-174. [PMID: 31063967 DOI: 10.1016/j.ejogrb.2019.04.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 03/18/2019] [Accepted: 04/17/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To determine the implication of general physical activity and some specific sports in semen quality in men from infertile couples. STUDY DESIGN This is an observational study performed in men from infertile couples (n = 454). The interventions performed involved analyzing semen quality parameters according to 2010 WHO criteria and assessing physical activity by means of an International Physical Activity Questionnaire. RESULT(S) There was no association between different levels of general physical activity and semen parameters. We neither found association with running, cycling and racquet sports. Interestingly, people who practice weightlifting more than two hours per week presented significantly lower sperm concentration (linear coefficient = -24.80) and lower total sperm count (linear coefficient = -70.87) in comparison with participants that did not practice regular exercise. CONCLUSION(S) From a reproductive point of view, there does not seem to be any reason to recommend the increase or the decrease in general physical activity in males from infertile couples. However, additional studies are needed to investigate the relationship between weightlifting and sperm quality.
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Affiliation(s)
- Jone Ibañez-Perez
- Cruces University Hospital, Human Reproduction Unit, Barakaldo, 48903, Bizkaia, Spain; Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, 48940, Bizkaia, Spain; BioCruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Bizkaia, Spain
| | - Borja Santos-Zorrozua
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, 48940, Bizkaia, Spain
| | - Elixabet Lopez-Lopez
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, 48940, Bizkaia, Spain; BioCruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Bizkaia, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Leioa, 48940, Bizkaia, Spain
| | - Begoña Prieto
- Cruces University Hospital, Human Reproduction Unit, Barakaldo, 48903, Bizkaia, Spain; BioCruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Bizkaia, Spain
| | - Victoria Aparicio
- Cruces University Hospital, Human Reproduction Unit, Barakaldo, 48903, Bizkaia, Spain
| | - Beatriz Corcostegui
- Cruces University Hospital, Human Reproduction Unit, Barakaldo, 48903, Bizkaia, Spain
| | - África Gracia-Orad
- Department of Genetics, Physical Anthropology and Animal Physiology, University of the Basque Country UPV/EHU, Leioa, 48940, Bizkaia, Spain; BioCruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Bizkaia, Spain
| | - Roberto Matorras
- Cruces University Hospital, Human Reproduction Unit, Barakaldo, 48903, Bizkaia, Spain; BioCruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Barakaldo, Bizkaia, Spain; Department of Medical-Surgical Specialties, University of the Basque Country UPV/EHU, Leioa, 48940, Bizkaia, Spain.
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