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Mukherjee AG, Gopalakrishnan AV. Anti-sperm Antibodies as an Increasing Threat to Male Fertility: Immunological Insights, Diagnostic and Therapeutic Strategies. Reprod Sci 2024:10.1007/s43032-024-01610-y. [PMID: 38831152 DOI: 10.1007/s43032-024-01610-y] [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: 11/29/2023] [Accepted: 05/29/2024] [Indexed: 06/05/2024]
Abstract
It is a fact that sperm possess antigenic properties. Substantial scientific research suggests that specific antibodies that attach to sperm antigens can induce infertility in both humans and other species. Antisperm antibodies (ASA) represent a significant etiology of infertility in humans, leading to immunoinfertility. The association between ASA and infertility is multifaceted. The observation of sperm agglutination, although not conclusive for the diagnosis of immunological infertility, may suggest the presence of ASA. Nevertheless, ASA may also manifest in the lack of any sperm agglutination. Managing ASA from an andrological perspective depends on the underlying cause and the specific approaches healthcare professionals adopt. The precise etiology of male infertility resulting from ASA remains unclear. Current research has examined the impact of ASA and its prevalence among infertile males to understand the relationship between ASA and changes in semen parameters. However, the findings have been inconclusive. Numerous techniques have been documented for the management of immunoinfertility. This review examines the importance of ASA in the context of infertility, encompassing the postulated mechanisms underlying the development of ASA, the various assays employed for detecting them, and the available treatments.
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Affiliation(s)
- Anirban Goutam Mukherjee
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Bio-Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, 632014, India.
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Akhigbe R, Odetayo A, Akhigbe T, Hamed M, Ashonibare P. Pathophysiology and management of testicular ischemia/reperfusion injury: Lessons from animal models. Heliyon 2024; 10:e27760. [PMID: 38694115 PMCID: PMC11058307 DOI: 10.1016/j.heliyon.2024.e27760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/24/2024] [Accepted: 03/06/2024] [Indexed: 05/03/2024] Open
Abstract
Testicular torsion is a urological emergency that involves the twisting of the spermatic cord along its course. Compelling pieces of evidence have implicated oxidative stress-sensitive signaling in pathogenesis of testicular I/R injury. Although, surgical detorsion is the mainstay management; blockade of the pathways involved in the pathogenesis may improve the surgical outcome. Experimental studies using various testicular I/R models have been reported in a bid to explore the mechanisms associated with testicular I/R and evaluate the benefits of potential therapeutic measures; however, most are limited by their shortcomings. Thus, this review was intended to describe the details of the available testicular I/R models as well as their merits and drawbacks, the pathophysiological basis and consequences of testicular I/R, and the pharmacological agents that have being proposed to confer testicular benefits against testicular I/R. This provides an understanding of the pathophysiological events and available models used in studying testicular I/R. In addition, this research provides evidence-based molecules with therapeutic potentials as well as their mechanisms of action in testicular I/R.
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Affiliation(s)
- R.E. Akhigbe
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
| | - A.F. Odetayo
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Physiology, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - T.M. Akhigbe
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Breeding and Plant Genetics Unit, Department of Agronomy, Osun State University, Osun State, Nigeria
| | - M.A. Hamed
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
- Department of Medical Laboratory Science, Afe Babalola University, Ado-Ekiti, Ekiti State, Nigeria
- The Brainwill Laboratory, Osogbo, Osun State, Nigeria
| | - P.J. Ashonibare
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria
- Reproductive Biology and Toxicology Research Laboratory, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria
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3
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Abouelgreed TA, Amer MA, Mamdouh H, El-Sherbiny AF, Aboelwafa H, Omar OA, Abdelshakour M, Elesawy M, Sonbol M, Maawad AN, Zayed EM, Eldestawy MT. Effects of antisperm antibodies post vasectomy reversal on pregnancy rates. Arch Ital Urol Androl 2024:12335. [PMID: 38700009 DOI: 10.4081/aiua.2024.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE To investigate the correlation between antisperm antibodies (ASAs), pregnancy rates, and the method of conception following vasectomy reversal. This is particularly relevant as patients undergoing vasectomy reversal often express concerns about the potential inhibitory effects of ASAs on achieving pregnancy. Additionally, the American Urological Association guidelines for vasectomy emphasize the need for further research to address this question. PATIENT AND METHODS We conducted a retrospective analysis involving chart reviews and phone interviews with individuals who underwent vasectomy reversal at our institution between May 2015 and April 2023. Patients who underwent vasectomy reversal for reasons other than fertility, as well as those lacking postoperative semen analysis with ASA data, were excluded. We classified patients based on low (below 50%) or high (50% or above) ASA levels determined by their initial postoperative semen analysis. The primary outcome measured was the pregnancy rate, including details on the method of conception. RESULTS A total of 145 patients were subjected to chart review. The median age at the time of surgery was 43 years, with a median obstruction interval of 7.7 years. The median age of their partners was 29 years. The majority (80%) of patients underwent bilateral vasovasostomy. Among them, 60 patients (41.4%) exhibited low (< 50%) ASA levels, while 85 (58.6%) had high (≥ 50%) ASA levels. Follow-up phone interviews were completed by 48 patients. Among them, the 19 men with low ASA levels, 13 (68.4%) achieved pregnancy, with 6 (31.6%) experiencing spontaneous conception. For the 29 men with high ASA levels, 21 (72.4%) achieved pregnancy, including 11 (38%) through spontaneous conception. The p-value from Fisher's exact test was 0.2. CONCLUSIONS Our findings suggest that ASA levels do not show a significant association with either the pregnancy rate or the method of conception following vasectomy reversal.
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Affiliation(s)
- Tamer A Abouelgreed
- Gulf medical university, Ajman, United Arab Emirates; Department of Urology, Al-Azhar University, Cairo.
| | - Mohamed A Amer
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Hassan Mamdouh
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Ahmed F El-Sherbiny
- Department of Andrology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo.
| | - Hany Aboelwafa
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Omar A Omar
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | | | - Mohammad Elesawy
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Mohamed Sonbol
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Ahmed N Maawad
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Elsayed M Zayed
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
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Falcone M, Bocu K, Keskin H, Solorzano Vazquez JF, Banthia R, Mahendran T, Deger MD, Kv V, Mirko P, Harraz AM, Saleh R, Shah R, Agarwal A. Anti-sperm Antibody Positivity in Men with Varicocele: A Systematic Review and Meta-Analysis. World J Mens Health 2024; 42:42.e43. [PMID: 38606868 DOI: 10.5534/wjmh.240003] [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: 01/02/2024] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE Despite the significant role of varicocele in the pathogenesis of male infertility, its association with anti-sperm antibodies (ASA) remains controversial. This systematic review and meta-analysis (SRMA) aims to investigate the frequency of ASA positivity in men with varicocele. MATERIALS AND METHODS This SRMA is conducted in accordance with the Meta-analysis of Observational Studies in Epidemiology guidelines. We investigated the frequency of ASA positivity in ejaculates or serum of men with varicocele as compared to men without varicocele (controls). A literature search was performed using the Scopus and PubMed databases following the Population Exposure Comparison Outcome, Study Design model. Data extracted from eligible studies were meta-analyzed and expressed as odds ratios (ORs) and confidence intervals (CIs). RESULTS Out of 151 abstracts identified during the initial screening, 6 articles met the inclusion criteria and were included in the meta-analysis. Using mixed antiglobulin reaction (MAR) assay, 61 out of the 153 (39.8%) patients with varicocele tested positive for ASA in their ejaculates as compared to 22 out of the 129 control subjects (17%, OR=4.34 [95% CI: 1.09-17.28]; p=0.04). Using direct or indirect immunobead test, 30 out of 60 cases diagnosed with varicocele (50%) had shown ASA positivity in their ejaculates as compared to 16 out of 104 controls (15.4%, OR=3.57 [95% CI: 0.81-15.68]; p=0.09). Using enzyme-linked immunosorbent assay (ELISA), out of 89 varicocele patients, 33 (37.1%) tested positive for serum ASA as compared to 9 out of 57 participants in the control group (15.8%, OR=7.87 [95% CI: 2.39-25.89]; p<0.01). CONCLUSIONS This SRMA indicates that ASA positivity is significantly higher among men with varicocele when tested by direct method (MAR) or indirect method (ELISA). This data suggests an immunological pathology in infertile men with varicocele and may have implications for the management of these patients.
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Affiliation(s)
- Marco Falcone
- Department of Urology, Molinette Hospital, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, University of Turin, Torino, Italy
- Global Andrology Forum, Moreland Hills, OH, USA
| | - Kadir Bocu
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Silopi State Hospital, Sirnak, Turkey
| | - Hakan Keskin
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, School of Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ravi Banthia
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Western General Hospital, Edinburgh, UK
| | - Tara Mahendran
- Global Andrology Forum, Moreland Hills, OH, USA
- Andrology Center, Coimbatore, India
| | - Muslim Dogan Deger
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Edirne Sultan 1st Murat State Hospital, Edirne, Turkey
| | - Vinod Kv
- Global Andrology Forum, Moreland Hills, OH, USA
- Centre for Urological Research and Evaluation, Thiruvananthapuram, India
| | - Preto Mirko
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Urology, Molinette Hospital A.O.U. Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Ahmed M Harraz
- Global Andrology Forum, Moreland Hills, OH, USA
- Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
- General Surgery Department, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
- Department of Urology, Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
| | - Ramadan Saleh
- Global Andrology Forum, Moreland Hills, OH, USA
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
- Ajyal IVF Center, Ajyal Hospital, Sohag, Egypt
| | - Rupin Shah
- Global Andrology Forum, Moreland Hills, OH, USA
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- Cleveland Clinic Foundation, Cleveland, OH, USA.
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5
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Nam CS, Tooke BP, Strasser O, Hameed MA, Chinnusamy S, Van Til M, Daignault-Newton S, Dupree JM. Antisperm Antibody Levels After Vasectomy Reversal Are Not Associated With Pregnancy Rates or Method of Conception. Urology 2024; 186:154-161. [PMID: 38417465 DOI: 10.1016/j.urology.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/10/2024] [Accepted: 02/21/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To examine the relationship between antisperm antibody (ASA), pregnancy rates, and method of conception following vasectomy reversal, given that before and after vasectomy reversal, patients wonder if ASAs will prevent them from achieving pregnancy and American Urological Association vasectomy guidelines call for additional research to answer this question. METHODS We performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 to 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (≥50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher exact test. RESULTS Two hundred and four patients were chart reviewed. Median age at time of surgery was 40years and median obstruction interval was 7.3years. Median partner age was 32years. One hundred sixty-four (80%) patients underwent bilateral vasovasostomy. Eighty-five patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥50%) ASA levels. Sixty-seven patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher exact test P-value was .2. CONCLUSION ASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal.
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Affiliation(s)
- Catherine S Nam
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI.
| | - Benjamin P Tooke
- Department of Urology, University of California Los Angeles, Los Angeles, CA
| | | | - Mujtaba A Hameed
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | - Sadhana Chinnusamy
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | - Monica Van Til
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | | | - James M Dupree
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
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Rago V, Perri A. SARS-CoV-2 Infection and the Male Reproductive System: A Brief Review. Life (Basel) 2023; 13:life13020586. [PMID: 36836943 PMCID: PMC9966870 DOI: 10.3390/life13020586] [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: 01/04/2023] [Revised: 02/09/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Many studies have suggested that SARS-CoV-2, directly or indirectly, can affect the male reproductive system, although the underlined mechanisms have not been completely elucidated yet. The purpose of this review is to provide a summary of the current data concerning the impact of SARS-CoV-2 infection on the male urogenital tract, with a particular emphasis on the testes and male fertility. The main data regarding the morphological alterations in the testes emerged from autoptic studies that revealed interstitial congestion, micro thrombosis, reduction of Sertoli, Leydig, and germinal cells, infiltrated immune cells, and atrophic seminiferous tubules consistent with orchitis. Furthermore, men with severe infection exhibit sperm parameter alterations, together with abnormalities of the hypothalamic-pituitary-testis axis, strongly suggesting that SARS-CoV-2 could increase the risk of male infertility. However, despite the inadequate number of longitudinal studies, spermatogenesis and sex hormone imbalance seem to improve after infection resolution. The yet unresolved question is whether the virus acts in a direct or/and indirect manner, as discordant data related to its presence in the testis and semen have been reported. Regardless of the direct effect, it has been postulated that the cytokine storm and the related local and systemic inflammation could strongly contribute to the onset of testis dysfunction, leading to male infertility. Therefore, multicentric and longitudinal studies involving a large number of patients are needed to understand the real impact of SARS-CoV-2 infection on male reproduction.
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Affiliation(s)
- Vittoria Rago
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, CS, Italy
- Correspondence: ; Tel.: +39-0984-496210; Fax: +39-0984-493271
| | - Anna Perri
- Department of Experimental and Clinical Medicine, University of Catanzaro “Magna Græcia”, 88100 Catanzaro, CZ, Italy
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Zaki AKA, Aldahmashi FS, Madboli AENA, Attia KA, Almulhim FS, Albarrak SM. Therapeutic approaches for anti-sperm-antibodies in the testicular sperm aspiration rat model. Vet World 2023; 16:296-308. [PMID: 37042009 PMCID: PMC10082712 DOI: 10.14202/vetworld.2023.296-308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/09/2023] [Indexed: 02/17/2023] Open
Abstract
Background and Aim: Anti-sperm antibodies (ASAs) treatment continued to be neglected. This study aimed to generate ASAs using the testicular sperm aspiration (TSA) rat model, which allowed for investigation of four distinct therapeutic approaches to find potential treatments for ASAs.
Materials and Methods: Adult Wistar albino male rats were divided into six equal groups (n = 12). The negative control group underwent scrotal sac surgery without having their testicles punctured. Punctures were made in the remaining 5 groups, with one group left untreated to serve as the positive control group. The remaining 4 groups were treated with either dexamethasone (DEX), azathioprine (AZA), frankincense, or anti-ASAs secondary antibodies. For 10 weeks, serum samples were collected every 2 weeks for specific quantification of ASAs. Testis and epididymis tissues were collected for histopathological analysis.
Results: The ASAs concentrations of the positive controls were significantly higher (p ≤ 0.001) than their negative control counterparts during the examined weeks. However, The ASAs indices (%) differed according to the treatment type. While the ASAs indices at the 2nd and 4th weeks in the AZA-treated group were significantly reduced compared to the positive control group (p ≤ 0.001), no significant differences were observed at any of the sample collection week for the DEX-treated rats. The ASAs indices were significantly decreased only at weeks 6 and 8 of treatment in the frankincense-treated group (p ≤ 0.001). In the secondary antibodies-treated group, the antibody indices were significantly decreased in all weeks except for samples collected at week 4 (p ≤ 0.001). The testosterone levels reverted to normal only in TSA rats treated with either Frankincense or secondary antibodies, as they were significantly higher than the positive controls (p ≤ 0.05). Tissue samples from the secondary antibody-treated rats showed a generally normal histological appearance.
Conclusion: This study tried to offer realistic therapy suggestions; however, caution should be applied when extrapolating findings from experimental models to meet clinical requirements.
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Affiliation(s)
- Abdel-Kader A. Zaki
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia; Department of Physiology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Fahad S. Aldahmashi
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia; Ministry of Environment, Water and Agriculture, Qassim Region, Saudi Arabia
| | - Abd El-Nasser A. Madboli
- Department of Animal Reproduction and Artificial Insemination, National Research Center, Veterinary Research Institute, Giza, Egypt
| | - Kamal A. Attia
- Department of Biology, Al-Jammoum University College, Umm-Alqura University, Makkah, Saudi Arabia
| | - Fahad S. Almulhim
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia; Ministry of Environment, Water and Agriculture, Qassim Region, Saudi Arabia
| | - Saleh M. Albarrak
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Saudi Arabia
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Pallotti F, Esteves SC, Faja F, Buonacquisto A, Conflitti AC, Hirsch MN, Lenzi A, Paoli D, Lombardo F. COVID-19 and its treatments: lights and shadows on testicular function. Endocrine 2023; 79:243-251. [PMID: 36260234 PMCID: PMC9579574 DOI: 10.1007/s12020-022-03221-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/02/2022] [Indexed: 02/06/2023]
Abstract
PURPOSE The SARS-CoV-2 pandemic has rapidly spread worldwide and, among the others, the male gender was quickly recognized as an independent risk factor for both the disease and its consequences. Since the possibility of long-term hormonal axis changes and male gamete impairment have been hypothesized but a relatively low levels of evidence has been reached, we focused this narrative mini-review on summarizing key state-of-the-art knowledge on male reproductive effects of COVID-19 as a quick reference for reproductive health specialists. METHODS A comprehensive Medline/PubMed and Embase search was performed selecting all relevant, peer-reviewed papers in English published from 2020. Other relevant papers were selected from the reference lists. RESULTS Available evidence indicates that the likelihood of direct testicular damage from SARS-CoV-2 is somewhat low, but there are many indirect ways (fever, cytokine imbalance, and drugs) through which the pituitary-gonadal axis and spermatogenesis may be disrupted. These alterations are probably transient, but as available evidence is low quality, it cannot be excluded that previous pathologies or comorbidities might modulate the risk of their persistence. On the other hand, available evidence shows high safety regarding andrological health for available vaccines, although studies are mainly focused on mRNA vaccines. CONCLUSION A careful andrological evaluation of men recovering from COVID-19 is highly recommended. Since available evidence is relatively scarce, a careful andrological follow-up and counseling of these patients are mandatory.
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Affiliation(s)
- Francesco Pallotti
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Sandro C Esteves
- Andrology and Human Reproduction Clinic, Av. Dr. Heitor Penteado, 1464, Campinas, Brazil
- Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Fabiana Faja
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Alessandra Buonacquisto
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Anna Chiara Conflitti
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Maria Neve Hirsch
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Andrea Lenzi
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Donatella Paoli
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy
| | - Francesco Lombardo
- Laboratory of Seminology - Sperm Bank "Loredana Gandini", Department of Experimental Medicine, Sapienza Università di Roma, Rome, Italy.
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9
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Paoli D, Pallotti F, Anzuini A, Bianchini S, Caponecchia L, Carraro A, Ciardi MR, Faja F, Fiori C, Gianfrilli D, Lenzi A, Lichtner M, Marcucci I, Mastroianni CM, Nigro G, Pasculli P, Pozza C, Rizzo F, Salacone P, Sebastianelli A, Lombardo F. Male reproductive health after 3 months from SARS-CoV-2 infection: a multicentric study. J Endocrinol Invest 2023; 46:89-101. [PMID: 35943723 PMCID: PMC9362397 DOI: 10.1007/s40618-022-01887-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 07/27/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE While SARS-CoV-2 infection appears not to be clinically evident in the testes, indirect inflammatory effects and fever may impair testicular function. To date, few long-term data of semen parameters impairment after recovery and comprehensive andrological evaluation of recovered patients has been published. The purpose of this study was to investigate whether SARS-CoV-2 infection affect male reproductive health. METHODS Eighty patients were recruited three months after COVID-19 recovery. They performed physical examination, testicular ultrasound, semen analysis, sperm DNA integrity evaluation (TUNEL), anti-sperm antibodies (ASA) testing, sex hormone profile evaluation (Total testosterone, LH, FSH). In addition, all patients were administered International Index of Erectile Function questionnaire (IIEF-15). Sperm parameters were compared with two age-matched healthy pre-COVID-19 control groups of normozoospermic (CTR1) and primary infertile (CTR2) subjects. RESULTS Median values of semen parameters from recovered SARS-CoV-2 subjects were within WHO 2010 fifth percentile. Mean percentage of sperm DNA fragmentation (%SDF) was 14.1 ± 7.0%. Gelatin Agglutination Test (GAT) was positive in 3.9% of blood serum samples, but no positive semen plasma sample was found. Only five subjects (6.2%) had total testosterone levels below the laboratory reference range. Mean bilateral testicular volume was 31.5 ± 9.6 ml. Erectile dysfunction was detected in 30% of subjects. CONCLUSION Our data remark that COVID-19 does not seem to cause direct damage to the testicular function, while indirect damage appears to be transient. It is possible to counsel infertile couples to postpone the research of parenthood or ART procedures around three months after recovery from the infection.
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Affiliation(s)
- D Paoli
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - F Pallotti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Anzuini
- Hormone Laboratory, Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy
| | - S Bianchini
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - L Caponecchia
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - A Carraro
- Infectious Diseases Unit, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - M R Ciardi
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - F Faja
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Fiori
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - D Gianfrilli
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Lenzi
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Lichtner
- Infectious Diseases Unit, Santa Maria Goretti Hospital, Sapienza University of Rome, Latina, Italy
| | - I Marcucci
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - C M Mastroianni
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - G Nigro
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - P Pasculli
- Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - C Pozza
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - F Rizzo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - P Salacone
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - A Sebastianelli
- Andrology and Pathophysiology of Reproduction Unit, Santa Maria Goretti Hospital, Latina, Italy
| | - F Lombardo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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10
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Chen J, Chen J, Fang Y, Shen Q, Zhao K, Liu C, Zhang H. Microbiology and immune mechanisms associated with male infertility. Front Immunol 2023; 14:1139450. [PMID: 36895560 PMCID: PMC9989213 DOI: 10.3389/fimmu.2023.1139450] [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: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 02/23/2023] Open
Abstract
Up to 50% of infertility is caused by the male side. Varicocele, orchitis, prostatitis, oligospermia, asthenospermia, and azoospermia are common causes of impaired male reproductive function and male infertility. In recent years, more and more studies have shown that microorganisms play an increasingly important role in the occurrence of these diseases. This review will discuss the microbiological changes associated with male infertility from the perspective of etiology, and how microorganisms affect the normal function of the male reproductive system through immune mechanisms. Linking male infertility with microbiome and immunomics can help us recognize the immune response under different disease states, providing more targeted immune target therapy for these diseases, and even the possibility of combined immunotherapy and microbial therapy for male infertility.
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Affiliation(s)
- Jin Chen
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinyu Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiwei Fang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuzi Shen
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Liu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiping Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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11
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The Possible Role of SARS-CoV-2 in Male Fertility: A Narrative Review. ENDOCRINES 2022. [DOI: 10.3390/endocrines3030046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The spread of severe acute respiratory syndrome—Coronavirus 2 (SARS-CoV-2) around the world has rapidly sparked the interest of the scientific community to discover its implications in human health. Many studies have suggested that SARS-CoV-2 is directly or indirectly involved in the male reproductive tract impairment. Some evidence supports the possible role of the virus in male infertility. Therefore, this review aims to summarize the relationship between the male urogenital tract, male fertility, and the gonadal hormone profile. The testis is one of the organs with the highest expression of the angiotensin-converting enzyme (ACE) 2-receptor that allows the virus to penetrate human cells. Orchitis is a possible clinical manifestation of COVID-19 and testicular damage has been found on autopsy in the testes of patients who died from the disease. SARS-CoV-2 infection can compromise the blood-testis barrier, favoring testicular damage and the production of anti-sperm autoantibodies. Some studies have detected the presence of SARS-CoV-2 in semen and a high percentage of patients with COVID-19 have altered sperm parameters compared to controls. Finally, lower testosterone levels, higher luteinizing hormone (LH) levels, and decreased follicle-stimulating (FSH)/LH and testosterone/LH ratios suggest primary testicular damage. In conclusion, further studies are needed to evaluate the exact mechanisms by which SARS-CoV-2 affects the male reproductive system and fertility and to evaluate the reversibility of its long-term effects.
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12
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Krishan A, Vukina J, Pearce I, Modgil V. Male factor infertility: A contemporary overview of investigation, diagnosis and management. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/20514158221078474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Infertility, defined as the failure to achieve a clinical pregnancy after 1 year of regular, unprotected sexual intercourse, is a public health issue of global concern. It affects up to 12% of couples worldwide. While traditionally, research and treatment have focused on female causes of infertility, male factors contribute to up to 70% of cases and therefore deserve appropriate recognition. The purpose of this comprehensive review is to detail the diagnostic work-up, investigations and management of male factor infertility. We discuss much-debated pathologies, such as varicocele, and novel investigations, including sperm DNA fragmentation and reactive oxygen species. Level of evidence: Not applicable
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Affiliation(s)
- Anil Krishan
- University Hospitals Birmingham NHS Foundation Trust, UK
| | - Josip Vukina
- University of Pittsburgh School of Medicine, USA
| | - Ian Pearce
- Manchester University NHS Foundation Trust, UK
| | - Vaibhav Modgil
- Manchester University NHS Foundation Trust, UK
- Department of Urology, Manchester Royal Infirmary, UK
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13
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Gupta S, Sharma R, Agarwal A, Boitrelle F, Finelli R, Farkouh A, Saleh R, Abdel-Meguid TAA, Gül M, Zilaitiene B, Ko E, Rambhatla A, Zini A, Leisegang K, Kuroda S, Henkel R, Cannarella R, Palani A, Cho CL, Ho CCK, Zylbersztejn DS, Pescatori E, Chung E, Dimitriadis F, Pinggera GM, Busetto GM, Balercia G, Salvio G, Colpi GM, Çeker G, Taniguchi H, Kandil H, Park HJ, Maldonado Rosas I, de la Rosette J, Cardoso JPG, Ramsay J, Alvarez J, Molina JMC, Khalafalla K, Bowa K, Tremellen K, Evgeni E, Rocco L, Rodriguez Peña MG, Sabbaghian M, Martinez M, Arafa M, Al-Marhoon MS, Tadros N, Garrido N, Rajmil O, Sengupta P, Vogiatzi P, Kavoussi P, Birowo P, Kosgi R, Bani-Hani S, Micic S, Parekattil S, Jindal S, Le TV, Mostafa T, Toprak T, Morimoto Y, Malhotra V, Aghamajidi A, Durairajanayagam D, Shah R. Antisperm Antibody Testing: A Comprehensive Review of Its Role in the Management of Immunological Male Infertility and Results of a Global Survey of Clinical Practices. World J Mens Health 2022; 40:380-398. [PMID: 35021297 PMCID: PMC9253805 DOI: 10.5534/wjmh.210164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility.
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Affiliation(s)
- Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ala'a Farkouh
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Taha Abo-Almagd Abdel-Meguid
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya, Turkey
| | - Birute Zilaitiene
- Institute of Endocrinology, Lithuanian University of Health Sciences, Kaunas, Lithuania, USA
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Amarnath Rambhatla
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Shinnosuke Kuroda
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
- LogixX Pharma, Theale, Berkshire, UK
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Chak-Lam Cho
- SH Ho Urology Center, Department of Surgery, Chinese University of Hong Kong, Hong Kong
| | - Christopher C K Ho
- Department of Surgery, School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | | | | | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane, QLD, Australia
| | - Fotios Dimitriadis
- 1st Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, Ospedali Riuniti of Foggia, University of Foggia, Foggia, Italy
| | - Giancarlo Balercia
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | - Gianmaria Salvio
- Department of Endocrinology and Metabolic Diseases, Polytechnic University of Marche, Ancona, Italy
| | | | - Gökhan Çeker
- Department of Urology, Samsun Vezirköprü State Hospital, Samsun, Turkey
| | - Hisanori Taniguchi
- Department of Urology and Andrology, Kansai Medical University, Hirakata, Osaka, Japan
| | | | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | - Jean de la Rosette
- Department of Urology, Istanbul Medipol Mega University Hospital, Istanbul, Turkey
| | - Joao Paulo Greco Cardoso
- Divisao de Urologia, Hospital das Clínicas HCFMUSP, Universidade de Sao Paulo, São Paulo, Brazil
| | | | - Juan Alvarez
- Centro ANDROGEN, La Coruña, Spain
- Harvard Medical School, Boston, MA, USA
| | | | - Kareim Khalafalla
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, University of Illinois, Chicago, IL, USA
| | - Kasonde Bowa
- School of Medicine and Health Sciences, University of Lusaka, Lusaka, Zambia
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Bedford Park, Australia
| | | | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | | | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Osvaldo Rajmil
- Department of Andrology, Fundacio Puigvert, Barcelona, Spain
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Malaysia
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Ponco Birowo
- Department of Urology, Cipto Mangunkusumo General Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Raghavender Kosgi
- Department of Urology and Andrology, AIG Hospitals, Gachibowli, Hyderabad, India
| | - Saleem Bani-Hani
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Tan V Le
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Viet Nam
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicina, Cairo University, Cairo, Egypt
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | | | - Vineet Malhotra
- Department of Andrology and Urology, Diyos Hospital, New Delhi, India
| | - Azin Aghamajidi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Rupin Shah
- Division of Andrology, Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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14
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Leathersich S, Hart RJ. Immune infertility in men. Fertil Steril 2022; 117:1121-1131. [PMID: 35367058 DOI: 10.1016/j.fertnstert.2022.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/30/2022] [Accepted: 02/09/2022] [Indexed: 11/04/2022]
Abstract
Male factors are implicated as the cause of roughly half of cases of infertility, and the presence of antisperm antibodies (ASA) may be responsible for some of these. Their presence is associated with a reduction in natural conception and live birth and impacts the success of assisted reproductive technologies. Interpretation of the data regarding ASAs and fertility is complicated by a lack of standardization in testing methodology and test thresholds and a lack of data on their prevalence in the healthy fertile population. Although their pathogenesis remains elusive, and many cases are idiopathic, a disruption in the immunologic blood-testis barrier (BTB) appears to contribute to the formation of ASA. As delineation of the specific antigen targets of ASA advances, it has been recognized that they may affect almost all aspects of sperm function, and ASA against different targets likely have specific mechanisms of impairing fertility. Intracytoplasmic sperm injection (ICSI) appears to be the most reliable method by which to overcome fertility impairment due to ASA, achieving similar outcomes to ASA-negative patients with regard to fertilization rates, embryonic development, clinical pregnancy rates, and live birth rates. The lack of consistency in testing for and reporting ASA remains a substantial barrier to achieving clarity in describing their role in infertility and the optimal management approach, and future research should use a unified approach to the detection and description of ASA. Determination of the specific antigens targeted by ASA, and their function and clinical relevance, would contribute to improving the understanding of ASA-mediated impacts on fertility and tailoring treatment appropriately to achieve the best outcomes for patients.
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Affiliation(s)
- Sebastian Leathersich
- King Edward Memorial Hospital, Perth, Australia; Fertility Specialists of Western Australia, Claremont, Australia
| | - Roger J Hart
- King Edward Memorial Hospital, Perth, Australia; Fertility Specialists of Western Australia, Claremont, Australia; Division of Obstetrics and Gynaecology, University of Western Australia, Perth, Australia.
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15
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Ferlin A, Calogero AE, Krausz C, Lombardo F, Paoli D, Rago R, Scarica C, Simoni M, Foresta C, Rochira V, Sbardella E, Francavilla S, Corona G. Management of male factor infertility: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS) : Endorsing Organization: Italian Society of Embryology, Reproduction, and Research (SIERR). J Endocrinol Invest 2022; 45:1085-1113. [PMID: 35075609 DOI: 10.1007/s40618-022-01741-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Infertility affects 15-20% of couples and male factors are present in about half of the cases. For many aspects related to the diagnostic and therapeutic approach of male factor infertility, there is no general consensus, and the clinical approach is not uniform. METHODS In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), endorsed by the Italian Society of Embryology, Reproduction, and Research (SIERR), we propose evidence-based recommendations for the diagnosis, treatment, and management of male factor infertility to improve patient and couple care. RESULTS Components of the initial evaluation should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, and imaging are suggested in most men and recommended when specific risk factors for infertility exist or first-step analyses showed abnormalities. Full examination including genetic tests, testicular cytology/histology, or additional tests on sperm is clinically oriented and based on the results of previous investigations. For treatment purposes, the identification of the specific cause and the pathogenetic mechanism is advisable. At least, distinguishing pre-testicular, testicular, and post-testicular forms is essential. Treatment should be couple-oriented, including lifestyle modifications, etiologic therapies, empirical treatments, and ART on the basis of best evidence and with a gradual approach. CONCLUSION These Guidelines are based on two principal aspects: they are couple-oriented and place high value in assessing, preventing, and treating risk factors for infertility. These Guidelines also highlighted that male infertility and in particular testicular function might be a mirror of general health of a man.
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Affiliation(s)
- A Ferlin
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35121, Padua, Italy.
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - C Krausz
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - F Lombardo
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank "Loredana Gandini", University of Rome "La Sapienza", Rome, Italy
| | - D Paoli
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank "Loredana Gandini", University of Rome "La Sapienza", Rome, Italy
| | - R Rago
- Department of Gender, Parenting, Child and Adolescent Medicine, Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - C Scarica
- European Hospital, Centre for Reproductive Medicine, Rome, Italy
| | - M Simoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35121, Padua, Italy
| | - V Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - E Sbardella
- Department of Experimental Medicine, University of Rome "La Sapienza", Rome, Italy
| | - S Francavilla
- Department of Life, Health and Environmental Sciences, Unit of Andrology, University of L'Aquila, L'Aquila, Italy
| | - G Corona
- Medical Department, Endocrinology Unit, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
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16
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Omics and Male Infertility: Highlighting the Application of Transcriptomic Data. Life (Basel) 2022; 12:life12020280. [PMID: 35207567 PMCID: PMC8875138 DOI: 10.3390/life12020280] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 12/15/2022] Open
Abstract
Male infertility is a multifaceted disorder affecting approximately 50% of male partners in infertile couples. Over the years, male infertility has been diagnosed mainly through semen analysis, hormone evaluations, medical records and physical examinations, which of course are fundamental, but yet inefficient, because 30% of male infertility cases remain idiopathic. This dilemmatic status of the unknown needs to be addressed with more sophisticated and result-driven technologies and/or techniques. Genetic alterations have been linked with male infertility, thereby unveiling the practicality of investigating this disorder from the “omics” perspective. Omics aims at analyzing the structure and functions of a whole constituent of a given biological function at different levels, including the molecular gene level (genomics), transcript level (transcriptomics), protein level (proteomics) and metabolites level (metabolomics). In the current study, an overview of the four branches of omics and their roles in male infertility are briefly discussed; the potential usefulness of assessing transcriptomic data to understand this pathology is also elucidated. After assessing the publicly obtainable transcriptomic data for datasets on male infertility, a total of 1385 datasets were retrieved, of which 10 datasets met the inclusion criteria and were used for further analysis. These datasets were classified into groups according to the disease or cause of male infertility. The groups include non-obstructive azoospermia (NOA), obstructive azoospermia (OA), non-obstructive and obstructive azoospermia (NOA and OA), spermatogenic dysfunction, sperm dysfunction, and Y chromosome microdeletion. Findings revealed that 8 genes (LDHC, PDHA2, TNP1, TNP2, ODF1, ODF2, SPINK2, PCDHB3) were commonly differentially expressed between all disease groups. Likewise, 56 genes were common between NOA versus NOA and OA (ADAD1, BANF2, BCL2L14, C12orf50, C20orf173, C22orf23, C6orf99, C9orf131, C9orf24, CABS1, CAPZA3, CCDC187, CCDC54, CDKN3, CEP170, CFAP206, CRISP2, CT83, CXorf65, FAM209A, FAM71F1, FAM81B, GALNTL5, GTSF1, H1FNT, HEMGN, HMGB4, KIF2B, LDHC, LOC441601, LYZL2, ODF1, ODF2, PCDHB3, PDHA2, PGK2, PIH1D2, PLCZ1, PROCA1, RIMBP3, ROPN1L, SHCBP1L, SMCP, SPATA16, SPATA19, SPINK2, TEX33, TKTL2, TMCO2, TMCO5A, TNP1, TNP2, TSPAN16, TSSK1B, TTLL2, UBQLN3). These genes, particularly the above-mentioned 8 genes, are involved in diverse biological processes such as germ cell development, spermatid development, spermatid differentiation, regulation of proteolysis, spermatogenesis and metabolic processes. Owing to the stage-specific expression of these genes, any mal-expression can ultimately lead to male infertility. Therefore, currently available data on all branches of omics relating to male fertility can be used to identify biomarkers for diagnosing male infertility, which can potentially help in unravelling some idiopathic cases.
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17
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Crafa A, Cannarella R, LA Vignera S, Barbagallo F, Condorelli RA, Calogero AE. Semen analysis: a workflow for an appropriate assessment of the male fertility status. Minerva Endocrinol (Torino) 2021; 47:77-88. [PMID: 34825558 DOI: 10.23736/s2724-6507.21.03650-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infertility is a worldwide problem that affects 9-15% of couples of reproductive age. In about half of the cases, it recognizes, alone or in combination, a male cause. In addition to a reproductive problem, male infertility can result from a systemic disease. Consequently, semen analysis, a fundamental test in the diagnosis of male infertility, represents a useful indicator not only of a man's reproductive capacity but also of his health and lifestyle. Given the key role of semen analysis, only accredited laboratories should perform it and experienced clinicians should be called into play in its interpretation. In this article, we have extensively examined how the macroscopic and microscopic parameters of semen analysis, alone or associated with each other, allow clinicians to orient towards specific diagnoses that can be confirmed by further ad hoc tests. On this basis, we also proposed a diagnostic flowchart focused on the results of the semen analysis.
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Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandro LA Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Barbagallo
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy -
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18
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Bucak MN, Keskin N, Bodu M, Bülbül B, Kırbaş M, Öztürk AE, Frootan F, İli P, Özkan H, Başpınar N, Dursun Ş. Combination of trehalose and low boron in presence of decreased glycerol improves post-thawed ram sperm parameters: A model study in boron research. Andrology 2021; 10:585-594. [PMID: 34779585 DOI: 10.1111/andr.13130] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/20/2021] [Accepted: 11/10/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Sperm cryopreservation has been widely used in the field of reproductive biotechnology. It applies to certain males of economic and scientific values, including livestock breeds or endangered animal species. The development of a semen extender with a low cryoprotectant concentration and an appropriate amount of trehalose and boron can prevent the deterioration of sperm parameters. OBJECTIVE The main goal of this study is to establish a suitable ram extender model, by examining different combinations of high (5%) and low (3%) glycerol concentrations (to reduce its toxic effects on sperm freezing), a fixed amount of trehalose and an increased dose of boron to prevent the deterioration of sperm parameters, and investigate the levels of gene expressions. MATERIALS AND METHODS The Merino ram ejaculates were collected. The collected ejaculates providing the defined criteria were pooled. The pooled ejaculates were divided into eight aliquots and diluted with the Tris extender including different combinations of glycerol (5% and 3%) and boron (0.25, 0.5, and 1 mm) concentrations and a fixed amount of trehalose, then frozen. After freeze-thawing process, sperm motility, mitochondrial membrane activity, plasma membrane integrity, acrosomal membrane integrity, DNA damage (single cell gel electrophoresis (COMET) and TUNEL assays) as well as NAD(P)H quinone oxyreductase (NQO1), glutamate-cycteine ligase (GCLC), and glutathione S-transferase (GSTP1) for molecular mechanisms of sperm cell response to oxidative stress were assessed for different extender groups following freeze-thawing process: 5% glycerol + 0 mm boron (G5B0.00), 5% glycerol + 0.25 mm boron (G5B0.25), 5% glycerol + 0.5 mm boron (G5B0.50), 5% glycerol + 1 mm boron (G5B1.00), 3% glycerol + 0 mm boron (G3B.00), 3% glycerol + 0.25 mm boron (G3B0.25), 3% glycerol + 0.5 mm boron (G3B0.50), and 3% glycerol + 1 mm boron (G3B1.00). RESULTS G3B0.25 presented higher percentages of subjective motility, mitochondrial activity, and viability of spermatozoa comparing with G5B0.00 and groups with boron. Supplementation of 0.25 mm boron with and without trehalose (G3B0.25 and G5B0.25) showed higher acrosome integrity, compared with G5B0.00, G5B1.00, G3B0.50, and G3B1.00. For TUNEL analysis, G3B1.00 showed the highest DNA integrity among the experimental groups which was statistically significant only with G5B0.50 (p < 0.05). The mRNA levels of NQO1 were significantly decreased in G5B1.00, G3B0.50, and G3B1.00, when compared to G5B0.00. In comparison with G5B0.00, supplementation of 1 mm boron with and without trehalose had significantly lower expression of GCLC. The level of GSTP1 gene was significantly lower (approximately threefold) in G3B1.00, compared to G5B0.00 (p < 0.05). DISCUSSION AND CONCLUSION It can be assumed that the increase of the boron concentration in the extender may have important adverse effects on sperm parameters and antioxidant gene expression after thawing. The results obtained from this study will help to understand the toxicity limits of boron and eliminate the toxicity of glycerol in studies of gametes and tissue freezing. Therefore, it can be concluded that the use of sufficient boron can decrease cryodamages of cryopreservation of mammalian spermatozoa as well tissue engineering.
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Affiliation(s)
- Mustafa Numan Bucak
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Sciences, Selçuk University, Konya, Turkey
| | - Nazan Keskin
- Department of Histology and Embryology, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Mustafa Bodu
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Sciences, Selçuk University, Konya, Turkey
| | - Bülent Bülbül
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Sciences, Dokuz Eylül University, İzmir, Turkey
| | - Mesut Kırbaş
- Bahri Dagdas International Agricultural Research Institute, Konya, Turkey
| | - Ali Erdem Öztürk
- Department of Reproduction and Artificial Insemination, Faculty of Veterinary Sciences, Erciyes University, Kayseri, Turkey
| | - Fateme Frootan
- National Institute of Genetic Engineering & Biotechnology (NIGEB), Tehran, Iran
| | - Pınar İli
- Denizli Vocational School of Health Services, Pamukkale University, Denizli, Turkey
| | - Hüseyin Özkan
- Department of Genetics, Faculty of Veterinary Sciences, Mustafa Kemal University, Hatay, Turkey
| | - Nuri Başpınar
- Department of Biochemistry, Faculty of Veterinary Sciences, Selcuk University, Konya, Turkey
| | - Şükrü Dursun
- Department of Gynecology and Obstetrics, Faculty of Veterinary Sciences, Aksaray University, Aksaray, Turkey
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Chereshnev VA, Pichugova SV, Beikin YB, Chereshneva MV, Iukhta AI, Stroev YI, Churilov LP. Pathogenesis of Autoimmune Male Infertility: Juxtacrine, Paracrine, and Endocrine Dysregulation. PATHOPHYSIOLOGY 2021; 28:471-488. [PMID: 35366245 PMCID: PMC8830464 DOI: 10.3390/pathophysiology28040030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022] Open
Abstract
According to global data, there is a male reproductive potential decrease. Pathogenesis of male infertility is often associated with autoimmunity towards sperm antigens essential for fertilization. Antisperm autoantibodies (ASAs) have immobilizing and cytotoxic properties, impairing spermatogenesis, causing sperm agglutination, altering spermatozoa motility and acrosomal reaction, and thus preventing ovum fertilization. Infertility diagnosis requires a mandatory check for the ASAs. The concept of the blood–testis barrier is currently re-formulated, with an emphasis on informational paracrine and juxtacrine effects, rather than simple anatomical separation. The etiology of male infertility includes both autoimmune and non-autoimmune diseases but equally develops through autoimmune links of pathogenesis. Varicocele commonly leads to infertility due to testicular ischemic damage, venous stasis, local hyperthermia, and hypoandrogenism. However, varicocelectomy can alter the blood–testis barrier, facilitating ASAs production as well. There are contradictory data on the role of ASAs in the pathogenesis of varicocele-related infertility. Infection and inflammation both promote ASAs production due to “danger concept” mechanisms and because of antigen mimicry. Systemic pro-autoimmune influences like hyperprolactinemia, hypoandrogenism, and hypothyroidism also facilitate ASAs production. The diagnostic value of various ASAs has not yet been clearly attributed, and their cut-levels have not been determined in sera nor in ejaculate. The assessment of the autoimmunity role in the pathogenesis of male infertility is ambiguous, so the purpose of this review is to show the effects of ASAs on the pathogenesis of male infertility.
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Affiliation(s)
- Valeriy A. Chereshnev
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, 620049 Yekaterinburg, Russia; (V.A.C.); (S.V.P.); (M.V.C.)
| | - Svetlana V. Pichugova
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, 620049 Yekaterinburg, Russia; (V.A.C.); (S.V.P.); (M.V.C.)
- State Autonomous Healthcare Institution of the Sverdlovsk Region “Clinical and Diagnostic Center” (GAUZ SO “CDC” Clinical Diagnostic Center), 620144 Yekaterinburg, Russia;
| | - Yakov B. Beikin
- State Autonomous Healthcare Institution of the Sverdlovsk Region “Clinical and Diagnostic Center” (GAUZ SO “CDC” Clinical Diagnostic Center), 620144 Yekaterinburg, Russia;
| | - Margarita V. Chereshneva
- Institute of Immunology and Physiology, Ural Branch of the Russian Academy of Sciences, 620049 Yekaterinburg, Russia; (V.A.C.); (S.V.P.); (M.V.C.)
| | - Angelina I. Iukhta
- Laboratory of the Mosaics of Autoimmunity, Saint Petersburg State University, 199304 Saint Petersburg, Russia; (Y.I.S.); (L.P.C.)
- Correspondence:
| | - Yuri I. Stroev
- Laboratory of the Mosaics of Autoimmunity, Saint Petersburg State University, 199304 Saint Petersburg, Russia; (Y.I.S.); (L.P.C.)
| | - Leonid P. Churilov
- Laboratory of the Mosaics of Autoimmunity, Saint Petersburg State University, 199304 Saint Petersburg, Russia; (Y.I.S.); (L.P.C.)
- Saint Petersburg Research Institute of Phthisiopulmonology, 191036 Saint Petersburg, Russia
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20
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Fang Y, Su Y, Xu J, Hu Z, Zhao K, Liu C, Zhang H. Varicocele-Mediated Male Infertility: From the Perspective of Testicular Immunity and Inflammation. Front Immunol 2021; 12:729539. [PMID: 34531872 PMCID: PMC8438154 DOI: 10.3389/fimmu.2021.729539] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/16/2021] [Indexed: 01/14/2023] Open
Abstract
Background Varicocele (VC) is present in 35 - 40% of men with infertility. However, current surgical and antioxidant treatments are not completely effective. In addition to oxidative stress, it is likely that other factors such as testicular immune microenvironment disorder contribute to irreversible testicular. Evidence suggests that VC is associated with anti-sperm antibodies (ASAs), spermatogenesis and testosterone secretion abnormalities, and testicular cytokine production. Moreover, inhibition of inflammation can alleviate VC-mediated pathogenesis. The normal function of the testis depends on its immune tolerance mechanism. Testicular immune regulation is complex, and many infectious or non-infectious diseases may damage this precision system. Results The testicular immune microenvironment is composed of common immune cells and other cells involved in testicular immunity. The former includes testicular macrophages, T cells, dendritic cells (DCs), and mast cells, whereas the latter include Leydig cells and Sertoli cells (SCs). In animal models and in patients with VC, most studies have revealed an abnormal increase in the levels of ASAs and pro-inflammatory cytokines such as interleukin (IL)-1 and tumor necrosis factor (TNF)-alpha in the seminal plasma, testicular tissue, and even peripheral blood. It is also involved in the activation of potential inflammatory pathways, such as the nucleotide-binding oligomerization domain-like receptor family pyrin domain containing (NLRP)-3 pathway. Finally, the development of VC-mediated infertility (VMI) may be facilitated by abnormal permeability of proteins, such as claudin-11, that constitute the blood-testis barrier (BTB). Conclusions The testicular immune response, including the production of ASAs and inflammatory factors, activation of inflammatory pathways, and destruction of the BTB may be involved in the pathogenesis of VMI it is necessary to further explore how patient outcomes can be improved through immunotherapy.
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Affiliation(s)
- Yiwei Fang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yufang Su
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jia Xu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyong Hu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kai Zhao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunyan Liu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiping Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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21
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Akhigbe RE, Hamed MA, Odetayo AF, Akhigbe TM, Ajayi AF, Ajibogun FAH. Omega-3 fatty acid rescues ischaemia/perfusion-induced testicular and sperm damage via modulation of lactate transport and xanthine oxidase/uric acid signaling. Biomed Pharmacother 2021; 142:111975. [PMID: 34343894 DOI: 10.1016/j.biopha.2021.111975] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/14/2021] [Accepted: 07/26/2021] [Indexed: 12/27/2022] Open
Abstract
This study aimed to explore the potential antioxidant, anti-inflammatory, and anti-apoptotic effects of omega 3 fatty acid (Ω-3) in a rat model of testicular torsion/detorsion (T/D). Under ketamine/xylazine anaesthesia, age-matched adult male Wistar rats of comparable weight underwent sham-operation or testicular torsion by fixing the left testis rotated at 720° for two and half hours. After detorsion, animals were treated with either olive oil as vehicle or Ω-3 subcutaneously for three days. On post-operative day 3, rats were culled and the ipsilateral and contralateral testes, as well as obtained blood samples, were analyzed. Our findings revealed that T/D led to significant poor weight gain, distorted gross anatomy, and cytoarchitecture of the testes, low sperm quality, redox imbalance, and inflammation of the ipsilateral and contralateral testes. This was accompanied by reduced circulatory testosterone, a decline in testicular lactate metabolism and transport, upregulation of xanthine oxidase/uric acid signaling, and increased testicular DNA fragmentation. Administration of Ω-3 attenuated T/D-induced damage to the testes and sperm cells with a significant rise in the level of serum testosterone. Enhancement of lactate transport and down-regulation of xanthine oxidase/uric acid signaling by Ω-3 may be beneficial in protecting against T/D-related oxido-inflammatory damage and male infertility.
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Affiliation(s)
- R E Akhigbe
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria; Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria; Department of Chemical Sciences, Kings University, Odeomu, Osun, Nigeria.
| | - M A Hamed
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria; Buntai Medical and Diagnostic Laboratories, Osogbo, Nigeria.
| | - A F Odetayo
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria; Department of Physiology, University of Ilorin, Ilorin, Kwara State, Nigeria.
| | - T M Akhigbe
- Reproductive Biology and Toxicology Research Laboratories, Oasis of Grace Hospital, Osogbo, Osun State, Nigeria; Department of Crop Production and Soil Science, Faculty of Agricultural Sciences, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
| | - A F Ajayi
- Department of Physiology, Ladoke Akintola University of Technology, Ogbomoso, Oyo State, Nigeria.
| | - F A H Ajibogun
- Bioresources Development Centre, National Biotechnology Development Agency, Ministry of Science and Technology, Ogbomoso, Oyo State, Nigeria.
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22
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Kang C, Punjani N, Lee RK, Li PS, Goldstein M. Effect of varicoceles on spermatogenesis. Semin Cell Dev Biol 2021; 121:114-124. [PMID: 33965333 DOI: 10.1016/j.semcdb.2021.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 04/05/2021] [Indexed: 12/12/2022]
Abstract
Varicoceles are dilated veins within the spermatic cord and a relatively common occurrence in men. Fortunately, the large majority of men are asymptomatic, however, a proportion of men with varicoceles can suffer from infertility and testosterone deficiency. Sperm and testosterone are produced within the testis, and any alteration to the testicular environment can negatively affect the cells responsible for these processes. The negative impact of varicoceles on testicular function occurs mainly due to increased oxidative stress within the testicular parenchyma which is thought to be caused by scrotal hyperthermia, testicular hypoxia, and blood-testis barrier disruption. Management of varicoceles involves ligation or percutaneous embolization of the dilated veins. Repair of varicoceles can improve semen parameters and fertility, along with serum testosterone concentration. In this review, we discuss the pathophysiology of varicoceles, their impact on testicular function, and management.
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Affiliation(s)
- Caroline Kang
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, New York, NY 10065, United States.
| | - Nahid Punjani
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, New York, NY 10065, United States.
| | - Richard K Lee
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, New York, NY 10065, United States.
| | - Philip S Li
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, New York, NY 10065, United States.
| | - Marc Goldstein
- Department of Urology, Weill Cornell Medicine, New York-Presbyterian Hospital, 525 East 68th Street, Starr 900, New York, NY 10065, United States.
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23
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Kolbasi B, Bulbul MV, Karabulut S, Altun CE, Cakici C, Ulfer G, Mudok T, Keskin I. Chronic unpredictable stress disturbs the blood-testis barrier affecting sperm parameters in mice. Reprod Biomed Online 2021; 42:983-995. [PMID: 33653651 DOI: 10.1016/j.rbmo.2020.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/19/2022]
Abstract
RESEARCH QUESTION Does chronic stress affect the key proteins and sperm parameters of the blood-testis barrier (BTB)? DESIGN C57Bl/6 mice were divided into two groups: a non-treated control group and a chronic unpredictable stress (CUS) applied group. The stress status of the animals was confirmed with behavioural tests. Histopathologic evaluation was conducted by haematoxylin and eosin staining and electron microscope. Malondialdehyde, corticosterone and testosterone levels were evaluated in peripheral blood. Expression levels of BTB proteins, namely zonula occludens-1 (ZO-1), claudin-11 (CLDN11) and clathrin in Sertoli cells, were assessed by Western blotting and immunofluorescence techniques. Sperm samples were collected from cauda epididymis, and sperm parameters analysed. RESULTS The stress model was confirmed by behavioural tests. Histopathological evaluation of the testes demonstrated a mild degeneration in seminiferous tubules. Malondialdehyde (P = 0.008) and corticosterone levels increased (P = 0.004) and testosterone levels decreased (P = 0.005) in the CUS group. Electron microscopic evaluation confirmed the damage in BTB integrity in the CUS group. Western blot analysis showed that ZO-1 and CLDN11 levels were significantly decreased, although clathrin levels were unchanged. Although sperm concentration and total motility rate were not significantly different between the groups, progressive motility (P = 0.03), normal sperm morphology (P = 0.04), chromatin integrity (toluidine blue) (P = 0.002) and the acrosomal reaction rate (P = 0.002) were significantly decreased, and acrosomal abnormality rate was dramatically increased (P = 0.04) in the CUS group. CONCLUSIONS In mice, CUS disrupted BTB integrity and impaired sperm parameters. A decrease in ZO-1 and CLDN11 expression levels may be proposed as the causative factor.
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Affiliation(s)
- Bircan Kolbasi
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University Istanbul, Turkey; Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University Istanbul, Turkey
| | - Muhammet Volkan Bulbul
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University Istanbul, Turkey; Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University Istanbul, Turkey
| | - Seda Karabulut
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University Istanbul, Turkey; Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University Istanbul, Turkey
| | - Ceren Erdem Altun
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University Istanbul, Turkey; Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University Istanbul, Turkey
| | - Cagri Cakici
- Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University Istanbul, Turkey; Department of Biochemistry, Istanbul Medipol University Istanbul, Turkey
| | - Gozde Ulfer
- Department of Biochemistry, Istanbul Medipol University Hospital Istanbul, Turkey
| | - Tangul Mudok
- Department of Histology and Embryology, Faculty of Dentistry, Istanbul Kent University Istanbul, Turkey
| | - Ilknur Keskin
- Department of Histology and Embryology, School of Medicine, Istanbul Medipol University Istanbul, Turkey; Regenerative and Restorative Medicine Research Center (REMER), Research Institute for Health Sciences and Technologies (SABITA), Istanbul Medipol University Istanbul, Turkey.
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Hlaváčová J, Flegr J, Řežábek K, Calda P, Kaňková Š. Association between latent toxoplasmosis and fertility parameters of men. Andrology 2021; 9:854-862. [PMID: 33420759 DOI: 10.1111/andr.12969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/14/2020] [Accepted: 01/03/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND About a third of people in the world are infected with Toxoplasma gondii. This parasite has been found in the reproductive organs and semen of males of many animal species as well as humans. The effects of toxoplasmosis on sperm count, motility and morphology were confirmed in rats. A higher prevalence of toxoplasmosis has been observed in infertile men. On the other hand, no significant effect of infection on semen parameters in men was found in one already published study. OBJECTIVES To compare the prevalence of toxoplasmosis in men with and without semen pathology and to examine in detail the possible impact of infection on semen volume, sperm count, motility and morphology. MATERIALS AND METHODS The pre-registered cross-sectional study included 669 men who visited the Centre for Assisted Reproduction in Prague from June 2016 until June 2018. RESULTS The incidence of fertility problems was significantly higher in the 163 Toxoplasma-infected men (48.47%) than in the 506 Toxoplasma-free men (42.29%), τ = 0.049, P = 0.029. After correction for multiple tests, we found significantly lower sperm concentration, concentration of progressively motile sperm, and concentration of non-progressively motile sperm in Toxoplasma-positive men than in Toxoplasma-negative men using partial Kendall correlation with age controlled. In addition, toxoplasmosis correlated with sperm quality in smokers but not in non-smokers. DISCUSSION AND CONCLUSION Our results suggest that latent toxoplasmosis affects certain semen parameters (sperm count and motility), but does not seem to affect sperm morphology and semen volume. Impairment of semen parameters may be either a side effect of the presence of Toxoplasma gondii in male reproductive organs or a product of manipulation activity of the parasite aimed to increase the efficiency of the sexual route of its transmission. Tobacco smoking also appears to exacerbate the negative impact of toxoplasmosis on semen parameters.
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Affiliation(s)
- Jana Hlaváčová
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jaroslav Flegr
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic
| | - Karel Řežábek
- Centre for Assisted Reproduction, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Pavel Calda
- Fetal Medicine Centre, Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Šárka Kaňková
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Prague, Czech Republic
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El-Sherbiny AF, Ali TA, Hassan EA, Mehaney AB, Elshemy HA. The prognostic value of seminal anti-sperm antibodies screening in men prepared for ICSI: a call to change the current antibody-directed viewpoint of sperm autoimmunity testing. Ther Adv Urol 2021; 13:1756287220981488. [PMID: 33519975 PMCID: PMC7816526 DOI: 10.1177/1756287220981488] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 11/26/2020] [Indexed: 01/19/2023] Open
Abstract
Aims We aimed to prospectively evaluate the prognostic value of seminal anti-sperm antibodies (ASA) screening in couples prepared for intracytoplasmic sperm injection (ICSI). Methods A prospective comparative study was conducted, including 184 non-azoospermic infertile men scheduled for ICSI. For each patient, detection of ASA in seminal plasma using the ELISA technique was done and its relation to standard semen parameters and ICSI outcomes, including fertilization, embryo development, and pregnancy rates, was analyzed. Results Sperm count, motility, and morphology were negatively affected by existence of seminal ASA (p = 0.012, 0.006, and 0.011, respectively). However, no statistically significant difference was detected between patients with positive and negative seminal ASA regarding the median values of fertilization (56.3% versus 66.7%, p = 0.091), percentage of couples with grade A embryo development (91.4% versus 89.9%, p = 0.520), and pregnancy rates (31.4% versus 32.2%, p = 0.98) after ICSI. Conclusion ICSI seems able to overcome the problem of ASA in semen. The routine screening of ASA in men prepared for ICSI has no additional prognostic value and cannot be recommended for the time being, until more specific antigen-concerned testing can be developed.
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Affiliation(s)
- Ahmed F El-Sherbiny
- Department of Andrology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt
| | | | - Eman A Hassan
- Department of Embryology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt
| | - Amira B Mehaney
- Department of Embryology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo, Egypt
| | - Heba A Elshemy
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Seminal antigenicity affects mitochondrial membrane potential and acrosome reaction ability of the spermatozoa during cryopreservation. Theriogenology 2021; 159:132-139. [DOI: 10.1016/j.theriogenology.2020.10.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 10/01/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022]
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Dcunha R, Hussein RS, Ananda H, Kumari S, Adiga SK, Kannan N, Zhao Y, Kalthur G. Current Insights and Latest Updates in Sperm Motility and Associated Applications in Assisted Reproduction. Reprod Sci 2020; 29:7-25. [PMID: 33289064 PMCID: PMC7721202 DOI: 10.1007/s43032-020-00408-y] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/08/2020] [Accepted: 11/01/2020] [Indexed: 02/07/2023]
Abstract
Spermatozoon is a motile cell with a special ability to travel through the woman’s reproductive tract and fertilize an oocyte. To reach and penetrate the oocyte, spermatozoa should possess progressive motility. Therefore, motility is an important parameter during both natural and assisted conception. The global trend of progressive reduction in the number and motility of healthy spermatozoa in the ejaculate is associated with increased risk of infertility. Therefore, developing approaches for maintaining or enhancing human sperm motility has been an important area of investigation. In this review we discuss the physiology of sperm, molecular pathways regulating sperm motility, risk factors affecting sperm motility, and the role of sperm motility in fertility outcomes. In addition, we discuss various pharmacological agents and biomolecules that can enhance sperm motility in vitro and in vivo conditions to improve assisted reproductive technology (ART) outcomes. This article opens dialogs to help toxicologists, clinicians, andrologists, and embryologists in understanding the mechanism of factors influencing sperm motility and various management strategies to improve treatment outcomes.
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Affiliation(s)
- Reyon Dcunha
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Reda S Hussein
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Obstetrics and Gynecology, Assiut University, Assiut City, Egypt
| | - Hanumappa Ananda
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Sandhya Kumari
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Satish Kumar Adiga
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Nagarajan Kannan
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, 55905, USA.,Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN, 55905, USA
| | - Yulian Zhao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Guruprasad Kalthur
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India. .,Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
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Haddad M, Stewart J, Xie P, Cheung S, Trout A, Keating D, Parrella A, Lawrence S, Rosenwaks Z, Palermo GD. Thoughts on the popularity of ICSI. J Assist Reprod Genet 2020; 38:101-123. [PMID: 33155089 PMCID: PMC7823003 DOI: 10.1007/s10815-020-01987-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/18/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose Intracytoplasmic sperm injection (ICSI) is the most widely utilized assisted reproductive technique (ART) worldwide. In this feature, we review the early assisted fertilization attempts that eventually led to the development of ICSI, and discuss its current utilization in cases of male and non-male factor infertility. Methods We researched the literature related to the development, indications, and current use of ICSI, such as sperm structural abnormalities, male genetic indications, surgically retrieved sperm, high sperm chromatin fragmentation, oocyte dysmorphism, and preimplantation genetic testing (PGT). We also describe the potential future applications of ICSI. Results This review summarizes the early micromanipulation techniques that led to the inception of ICSI. We also explore its current indications, including non-male factor infertility, where its use is more controversial. Finally, we consider the benefits of future advancements in reproductive biology that may incorporate ICSI, such as in vitro spermatogenesis, neogametogenesis, and heritable genome editing. Conclusion The versatility, consistency, and reliability of ICSI have made it the most prevalently utilized ART procedure worldwide.
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Affiliation(s)
- Mounia Haddad
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Joshua Stewart
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Philip Xie
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Stephanie Cheung
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Aysha Trout
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Derek Keating
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Alessandra Parrella
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Sherina Lawrence
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Gianpiero D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, NY, USA.
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29
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Haghpanah A, Masjedi F, Alborzi S, Hosseinpour A, Dehghani A, Malekmakan L, Roozbeh J. Potential mechanisms of SARS-CoV-2 action on male gonadal function and fertility: Current status and future prospects. Andrologia 2020; 53:e13883. [PMID: 33108833 PMCID: PMC7645932 DOI: 10.1111/and.13883] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 02/06/2023] Open
Abstract
The novel coronavirus was recognised in December 2019 and caught humanity off guard. The virus employs the angiotensin‐converting enzyme 2 (ACE2) receptor for entry into human cells. ACE2 is expressed on different organs, which is raising concern as to whether these organs can be infected by the virus or not. The testis appears to be an organ enriched with levels of ACE2, while the possible mechanisms of involvement of the male reproductive system by SARS‐CoV‐2 are not fully elucidated. The major focus of the present studies is on the short‐term complications of the coronavirus and gains importance on studying the long‐term effects, including the possible effects of the virus on the male reproductive system. The aim of this review was to provide new insights into different possible mechanisms of involvement of male gonads with SARS‐CoV‐2 including investigating the ACE2 axis in testis, hormonal alterations in patients with COVID‐19, possible formation of anti‐sperm antibodies (ASA) and subsequently immunological infertility as a complication of SARS‐CoV‐2 infection. Finally, we suggest measuring the sperm DNA fragmentation index (DFI) as a determiner of male fertility impairment in patients with COVID‐19 along with other options such as sex‐related hormones and semen analysis. Invasion of SARS‐CoV‐2 to the spermatogonia, Leydig cells and Sertoli cells can lead to sex hormonal alteration and impaired gonadal function. Once infected, changes in ACE2 signalling pathways followed by oxidative stress and inflammation could cause spermatogenesis failure, abnormal sperm motility, DNA fragmentation and male infertility.
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Affiliation(s)
- Abdolreza Haghpanah
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Urology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Masjedi
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeed Alborzi
- Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Department of Gynecology and Obstetrics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Hosseinpour
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Anahita Dehghani
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Leila Malekmakan
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Jamshid Roozbeh
- Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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30
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Fair S, Meade KG, Reynaud K, Druart X, de Graaf SP. The biological mechanisms regulating sperm selection by the ovine cervix. Reproduction 2020; 158:R1-R13. [PMID: 30921769 DOI: 10.1530/rep-18-0595] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/28/2019] [Indexed: 01/11/2023]
Abstract
In species where semen is deposited in the vagina, the cervix has the unique function of facilitating progress of spermatozoa towards the site of fertilisation while also preventing the ascending influx of pathogens from the vagina. For the majority of species, advances in assisted reproduction techniques facilitate the bypassing of the cervix and therefore its effect on the transit of processed spermatozoa has been largely overlooked. The exception is in sheep, as it is currently not possible to traverse the ovine cervix with an inseminating catheter due to its complex anatomy, and semen must be deposited at the external cervical os. This results in unacceptably low pregnancy rates when frozen-thawed or liquid stored (>24 h) semen is inseminated. The objective of this review is to discuss the biological mechanisms which regulate cervical sperm selection. We assess the effects of endogenous and exogenous hormones on cervical mucus composition and discuss how increased mucus production and flow during oestrus stimulates sperm rheotaxis along the crypts and folds of the cervix. Emerging results shedding light on the sperm-cervical mucus interaction as well as the dialogue between spermatozoa and the innate immune system are outlined. Finally, ewe breed differences in cervical function and the impact of semen processing on the success of fertilisation, as well as the most fruitful avenues of further investigation in this area are proposed.
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Affiliation(s)
- S Fair
- Laboratory of Animal Reproduction, School of Natural Sciences, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | - K G Meade
- Animal & Bioscience Research Department, Animal & Grassland Research and Innovation Centre, Teagasc, Grange, Co Meath, Ireland
| | - K Reynaud
- UMR PRC, INRA 85, CNRS 7247, Université de Tours, IFCE, Physiologie de la Reproduction et des Comportements, Institut National de la Recherche Agronomique, Nouzilly, France
| | - X Druart
- UMR PRC, INRA 85, CNRS 7247, Université de Tours, IFCE, Physiologie de la Reproduction et des Comportements, Institut National de la Recherche Agronomique, Nouzilly, France
| | - S P de Graaf
- The University of Sydney, School of Life and Environmental Sciences, Faculty of Science, Sydney, New South Wales, Australia
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31
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Barbăroșie C, Agarwal A, Henkel R. Diagnostic value of advanced semen analysis in evaluation of male infertility. Andrologia 2020; 53:e13625. [PMID: 32458468 DOI: 10.1111/and.13625] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 04/03/2020] [Accepted: 04/08/2020] [Indexed: 12/13/2022] Open
Abstract
Conventional semen analysis is the standard of care to initially evaluate the fertility status of a male patient. However, it has some limitations and among these are failure to correctly identify the aetiology underlying fertility problems, intra- and inter-observer variability and incomplete information about sperm function. Considering these drawbacks, advanced semen tests have been developed to assess male infertility, including sperm function tests, oxidative stress (OS) and sperm DNA fragmentation (SDF) tests. This review illustrates the commonly utilised sperm function techniques, along with the assays used to assess SDF and OS and their diagnostic value.
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Affiliation(s)
- Cătălina Barbăroșie
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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32
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Baskaran S, Finelli R, Agarwal A, Henkel R. Diagnostic value of routine semen analysis in clinical andrology. Andrologia 2020; 53:e13614. [PMID: 32400107 DOI: 10.1111/and.13614] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/01/2020] [Indexed: 01/11/2023] Open
Abstract
Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.
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Affiliation(s)
- Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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33
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Otani Y, Ichii O, Masum MA, Kimura J, Nakamura T, Elewa YHA, Kon Y. BXSB/MpJ-Yaa mouse model of systemic autoimmune disease shows increased apoptotic germ cells in stage XII of the seminiferous epithelial cycle. Cell Tissue Res 2020; 381:203-216. [PMID: 32248303 DOI: 10.1007/s00441-020-03190-0] [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: 10/01/2019] [Accepted: 02/17/2020] [Indexed: 02/06/2023]
Abstract
In mammals, the reproductive system and autoimmunity regulate mutual functions. Importantly, systemic autoimmune diseases are thought to cause male infertility but the underlying pathological mechanism remains unclear. In this study, the morpho-function of the testes in BXSB/MpJ-Yaa mice was analyzed as a representative mouse model for systemic autoimmune diseases to investigate the effect of excessive autoimmunity on spermatogenesis. At 12 and 24 weeks of age, BXSB/MpJ-Yaa mice showed splenomegaly and increased levels of serum autoantibodies, whereas no controls showed a similar autoimmune condition. In histological analysis, the enlarged lumen of the seminiferous tubules accompanied with scarce spermatozoa in the epididymal ducts were observed in some of the BXSB/MpJ-Yaa and BXSB/MpJ mice but not in C57BL/6N mice. Histoplanimetrical analysis revealed significantly increased residual bodies and apoptotic germ cells in the seminiferous tubules in BXSB/MpJ-Yaa testes without apparent inflammation. Notably, in stage XII of the seminiferous epithelial cycles, the apoptotic germ cell number was remarkably increased, showing a significant correlation with the indices of systemic autoimmune disease in BXSB/MpJ-Yaa mice. Furthermore, the Sertoli cell number was reduced at the early disease stage, which likely caused subsequent morphological changes in BXSB/MpJ-Yaa testes. Thus, our histological study revealed the altered morphologies of BXSB/MpJ-Yaa testes, which were not observed in controls and statistical analysis suggested the effects of an autoimmune condition on this phenotype, particularly the apoptosis of meiotic germ cells. BXSB/MpJ-Yaa mice were shown to be an efficient model to study the relationship between systemic autoimmune disease and the local reproductive system.
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Affiliation(s)
- Yuki Otani
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan
| | - Osamu Ichii
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan.,Laboratory of Agrobiomedical Science, Faculty of Agriculture, Hokkaido University, Kita 9 Nishi 9, Kita-ku, Sapporo, Japan
| | - Md Abdul Masum
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan
| | - Junpei Kimura
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan
| | - Teppei Nakamura
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan.,Section of Biological Science, Chitose Laboratory, Japan Food Research Laboratories, 2-3, Bunyo, Chitose, Japan
| | - Yaser Hosny Ali Elewa
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan.,Department of Histology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Yasuhiro Kon
- Laboratory of Anatomy, Department of Basic Veterinary Sciences, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo, Japan.
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34
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Krzastek SC, Smith RP, Kovac JR. Future diagnostics in male infertility: genomics, epigenetics, metabolomics and proteomics. Transl Androl Urol 2020; 9:S195-S205. [PMID: 32257860 PMCID: PMC7108983 DOI: 10.21037/tau.2019.10.20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
A male factor is involved in 50% of couples with infertility. Unfortunately, the etiology of male factor infertility remains classified as idiopathic in nearly 50% of cases. The semen analysis (SA) continues to be first line for the workup of male infertility, but it is an imperfect test with high variability between samples. This lack of diagnostic capability has led to the desire to develop minimally invasive tests to aid with understanding the etiology of male factor infertility. Genetic factors are known to play a role in male infertility, and much work has been done to identify the many genes involved. The study of the genes involved, the impact of epigenetic modifications, proteins and metabolites produced are attractive targets for development of biomarkers which may be used to diagnose the etiology of male infertility. This review aims to explore recent advances in these fields as they pertain to the diagnosis of male infertility.
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Affiliation(s)
- Sarah C Krzastek
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Ryan P Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
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35
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Westerman R. Biomarkers for demographic research: sperm counts and other male infertility biomarkers. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2020; 65:73-87. [PMID: 32065536 DOI: 10.1080/19485565.2019.1706150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Some male infertility biomarkers are etiologically linked to idiopathic infertility in men, the direct cause of which often cannot be determined with conventional sperm count parameters. Open questions remain regarding the universal and generic infertility definitions that cover and combine the clinical, epidemiological, and demographic perspectives. The main effort in the application of these infertility biomarkers are accounted by more or less strict discrimination criteria. For male infertility, beyond classical sperm count assessments, the DNA fragmentation index (DFI) is an adequate biomarker. DFI strongly correlates with pregnancy rates and even strict discrimination criteria for infertility outcomes. Other common biomarkers are reactive oxygen species (ROS) and antisperm antibodies (ASAs), which can explain some biomedical infertility disorders within major constraints. More frequently applied in demographic research, telomere length component analysis is based on identifying the genetic impact of cellular longevity. Sperm telomere length is becoming established as a potential biomarker in infertility research. The aim of this review is to provide an overview of the current status and limitations to the application of novel biomarkers, including TEX101, for infertility research. The review also discusses potential options for the use of biomarkers in population-based studies.Abbreviations: ASAs: antisperm antibodies; DFI: DNA fragmentation index; DNA: deoxyribonucleic acid; ECM1: extracellular matrix protein 1; FSH: follicle stimulating hormone; HS: hypospermatogenesis: IVF: in vitro fertilization; LDHC: L-lactata dehydrogenase C chain; MA: maturation arrest; microTESE: microdissection testicular sperm extraction; NOA: nonobstructive azoospermia; NP: nonprogressive; OA: obstructive azoospermia; pH: potential Hyrogenii (pH-value); PR: progressive; PTGDS: prostaglandin D synthese; ROS: reactive oxygen species; SA: semen analysis; SCO: sertoli cell only; SCSA: sperm chromatin structure assay (SCSA); TL: telomere length; TESE: testicular sperm extraction; TEX101: a glycoprotein that belongs to Ly6/urokinase type plasminogen activator receptor-like protein (uPAR)(LU) superfamily, to be a germ-cell-specific molecular sperm extraction; TUNEL: terminal deoxnucleotidyl dispersion tranferase dUTP nick-end labeling; WHO: World Health Organization.
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Affiliation(s)
- Ronny Westerman
- Competence Center Mortality-Follow-Up, German National Cohort, Federal Institute for Population Research, Wiesbaden, Germany
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36
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Characterization of antisperm antibody binding patterns in relation to sperm phenotypic attributes and field fertility in dairy bulls. Theriogenology 2020; 141:161-167. [DOI: 10.1016/j.theriogenology.2019.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/23/2019] [Accepted: 09/13/2019] [Indexed: 12/26/2022]
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37
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A. S. V, Dhama K, Chakraborty S, Abdul Samad H, K. Latheef S, Sharun K, Khurana SK, K. A, Tiwari R, Bhatt P, K. V, Chaicumpa W. Role of Antisperm Antibodies in Infertility, Pregnancy, and Potential forContraceptive and Antifertility Vaccine Designs: Research Progress and Pioneering Vision. Vaccines (Basel) 2019; 7:E116. [PMID: 31527552 PMCID: PMC6789593 DOI: 10.3390/vaccines7030116] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 08/22/2019] [Accepted: 09/04/2019] [Indexed: 02/07/2023] Open
Abstract
Sperm of humans, non-human primates, and other mammalian subjects is considered to be antigenic. The effect of changes in autoimmunity on reproductive cells such as spermatozoa and oocytes play a critical but indistinct role in fertility. Antisperm antibodies (ASAs) are invariably present in both females and males. However, the degree of ASA occurrence may vary according to individual and gender. Although the extent of infertility due to ASAs alone is yet to be determined, it has been found in almost 9-12% of patients who are infertile due to different causes. Postcoital presence of spermatozoa in the reproductive tract of women is not a contributory factor in ASA generation. However, ASA generation may be induced by trauma to the vaginal mucosa, or by anal or oral sex resulting in the deposition of sperm inside the digestive tract. It is strongly believed that, in humans and other species, at least some antibodies may bind to sperm antigens, causing infertility. This form of infertility is termed as immunological infertility, which may be accompanied by impairment of fertility, even in individuals with normozoospermia. Researchers target ASAs for two major reasons: (i) to elucidate the association between ASAs and infertility, the reason ASAs causes infertility, and the mechanism underlying ASA-mediated infertility; and (ii) to assess the potential of ASAs as a contraceptive in humans in case ASAs influences infertility. Therefore, this review explores the potential application of ASAs in the development of anti-spermatozoa vaccines for contraceptive purposes. The usefulness of ASAs for diagnosing obstructive azoospermia, salpingitis, and oligoasthenoteratozoospermia has been reviewed extensively. Important patents pertaining to potential candidates for spermatozoa-derived vaccines that may be utilized as contraceptives are discussed in depth. Antifertility vaccines, as well as treatments for ASA-related infertility, are also highlighted. This review will address many unresolved issues regarding mechanisms involving ASAs in the diagnosis, as well as prognoses, of male infertility. More documented scientific reports are cited to support the mechanisms underlying the potential role of ASA in infertility. The usefulness of sperm antigens or ASAs (recombinant) in human and wild or captive animal contraceptive vaccines has been revealed through research but is yet to be validated via clinical testing.
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Affiliation(s)
- Vickram A. S.
- Department of Biotechnology, Saveetha School of Engineering, Young Scientist DST-SERB, Govt. of India, Saveetha Institute of Technical and Medical Sciences, Chennai 600077, Tamil Nadu, India
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Sandip Chakraborty
- Department of Veterinary Microbiology, College of Veterinary Sciences and Animal Husbandry, R.K. Nagar, West Tripura 799008, India;
| | - Hari Abdul Samad
- Division of Physiology and Climatology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Shyma K. Latheef
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Khan Sharun
- Division of Surgery, ICAR-Indian Veterinary Research Institute, Izatnagar, Bareilly 243122, Uttar Pradesh, India;
| | - Sandip Kumar Khurana
- ICAR-Central Institute for Research on Buffaloes, Sirsa Road, Hisar 125001, Haryana, India;
| | - Archana K.
- Department of Biotechnology, School of Biosciences and Technology, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India; (A.K.); (V.K.)
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU), Mathura 281001, India;
| | - Prakash Bhatt
- Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Govind Ballabh Pant University of Agriculture and Technology, Pantnagar 263145 (Udham Singh Nagar), Uttarakhand, India;
| | - Vyshali K.
- Department of Biotechnology, School of Biosciences and Technology, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India; (A.K.); (V.K.)
| | - Wanpen Chaicumpa
- Center of Research Excellence on Therapeutic Proteinsand Antibody Engineering, Department of Parasitology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
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38
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Archana SS, Selvaraju S, Binsila BK, Arangasamy A, Krawetz SA. Immune regulatory molecules as modifiers of semen and fertility: A review. Mol Reprod Dev 2019; 86:1485-1504. [DOI: 10.1002/mrd.23263] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 08/22/2019] [Indexed: 12/16/2022]
Affiliation(s)
- S. Siddalingappa Archana
- Reproductive Physiology Laboratory, Animal Physiology DivisionICAR‐National Institute of Animal Nutrition and Physiology Bengaluru India
- Department of BiochemistryJain University Bengaluru India
| | - Sellappan Selvaraju
- Reproductive Physiology Laboratory, Animal Physiology DivisionICAR‐National Institute of Animal Nutrition and Physiology Bengaluru India
| | - B. Krishnan Binsila
- Reproductive Physiology Laboratory, Animal Physiology DivisionICAR‐National Institute of Animal Nutrition and Physiology Bengaluru India
| | - Arunachalam Arangasamy
- Reproductive Physiology Laboratory, Animal Physiology DivisionICAR‐National Institute of Animal Nutrition and Physiology Bengaluru India
| | - Stephen A. Krawetz
- Department of Obstetrics and GynecologyWayne State University School of Medicine Detroit Michigan
- Center for Molecular Medicine and GeneticsC.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine Detroit Michigan
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39
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Jacobsen FM, Rudlang TM, Fode M, Østergren PB, Sønksen J, Ohl DA, Jensen CFS. The Impact of Testicular Torsion on Testicular Function. World J Mens Health 2019; 38:298-307. [PMID: 31081295 PMCID: PMC7308234 DOI: 10.5534/wjmh.190037] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 03/17/2019] [Indexed: 12/02/2022] Open
Abstract
Torsion of the spermatic cord is a urological emergency that must be treated with acute surgery. Possible long-term effects of torsion on testicular function are controversial. This review aims to address the impact of testicular torsion (TT) on the endocrine- and exocrine-function of the testis, including possible negative effects of torsion on the function of the contralateral testis. Testis tissue survival after TT is dependent on the degree and duration of TT. TT has been demonstrated to cause long-term decrease in sperm motility and reduce overall sperm counts. Reduced semen quality might be caused by ischemic damage and reperfusion injury. In contrast, most studies find endocrine parameters to be unaffected after torsion, although few report minor alterations in levels of gonadotropins and testosterone. Contralateral damage after unilateral TT has been suggested by histological abnormalities in the contralateral testis after orchiectomy of the torsed testis. The evidence is, however, limited as most human studies are small case-series. Theories as to what causes contralateral damage mainly derive from animal studies making it difficult to interpret the results in a human context. Large long-term follow-up studies are needed to clearly uncover changes in testicular function after TT and to determine the clinical impact of such changes.
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Affiliation(s)
- Frederik M Jacobsen
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark.
| | - Trine M Rudlang
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Mikkel Fode
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Peter B Østergren
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jens Sønksen
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Dana A Ohl
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
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Barbonetti A, Castellini C, D’Andrea S, Cordeschi G, Santucci R, Francavilla S, Francavilla F. Prevalence of anti-sperm antibodies and relationship of degree of sperm auto-immunization to semen parameters and post-coital test outcome: a retrospective analysis of over 10 000 men. Hum Reprod 2019; 34:834-841. [DOI: 10.1093/humrep/dez030] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 01/16/2019] [Accepted: 02/17/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Barbonetti
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - C Castellini
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - S D’Andrea
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - G Cordeschi
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - R Santucci
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - S Francavilla
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
| | - F Francavilla
- Andrology Unit, Department of Life, Health and Environment Sciences, University of L’Aquila, L’Aquila, Italy
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Berger GK, Smith‐Harrison LI, Sandlow JI. Sperm agglutination: Prevalence and contributory factors. Andrologia 2019; 51:e13254. [DOI: 10.1111/and.13254] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 01/03/2019] [Accepted: 01/27/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Garrett K. Berger
- Department of Urology Medical College of Wisconsin Milwaukee Wisconsin
| | | | - Jay I. Sandlow
- Department of Urology Medical College of Wisconsin Milwaukee Wisconsin
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Namekawa T, Imamoto T, Kato M, Komiya A, Ichikawa T. Vasovasostomy and vasoepididymostomy: Review of the procedures, outcomes, and predictors of patency and pregnancy over the last decade. Reprod Med Biol 2018; 17:343-355. [PMID: 30377390 PMCID: PMC6194271 DOI: 10.1002/rmb2.12207] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 04/22/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In the era of improving assisted reproductive technology (ART), patients with obstructive azoospermia (OA) have 2 options: vasal repair or testicular sperm extraction with intracytoplasmic sperm injection. Vasal repair, including vasovasostomy (VV) and vasoepididymostomy (VE), is the only option that leads to natural conception. METHODS This article reviews the surgical techniques, outcomes, and predictors of postoperative patency and pregnancy, with a focus on articles that have reported over the last 10 years, using PubMed database searches. MAIN FINDINGS The reported mean patency rate was 87% and the mean pregnancy rate was 49% for a patient following microscopic VV and/or VE for vasectomy reversal. Recently, robot-assisted techniques were introduced and have achieved a high rate of success. The predictors and predictive models of postoperative patency and pregnancy also have been reported. The obstructive interval, presence of a granuloma, and intraoperative sperm findings predict postoperative patency. These factors also predict postoperative fertility. In addition, the female partner's age and the same female partner correlate with pregnancy after surgery. CONCLUSION In the era of ART, the physician should present and discuss with both the patient with OA and his partner the most appropriate procedure to conceive by using these predictors.
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Affiliation(s)
- Takeshi Namekawa
- Department of UrologyGraduate School of MedicineChiba UniversityChibaJapan
| | - Takashi Imamoto
- Department of UrologyGraduate School of MedicineChiba UniversityChibaJapan
| | - Mayuko Kato
- Department of UrologyGraduate School of MedicineChiba UniversityChibaJapan
| | - Akira Komiya
- Department of UrologyGraduate School of MedicineChiba UniversityChibaJapan
| | - Tomohiko Ichikawa
- Department of UrologyGraduate School of MedicineChiba UniversityChibaJapan
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SINGH AK, CHEEMA RANJNAS. Prevalence of naturally occurring antisperm antibodies (ASA) in blood serum and seminal plasma, and their relationship with cryopreserved semen quality and fertility of buffalo bulls. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2018. [DOI: 10.56093/ijans.v88i2.79316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The present study was undertaken to determine the levels of antisperm antibodies (ASA), sperm-bound immunoglobulins A and G (IgA and IgG) in blood serum and seminal plasma of breeding buffalo bulls, and establish their relationship with quality and fertility of cryopreserved semen. Frozen semen (50 straws/bull) was procured from thirty Murrah buffalo bulls. Additionally, fresh semen of same ejaculate of each bull was also separated for seminal plasma for ASA analysis. Blood samples of all bulls were collected in non-heparinized vials and serum was harvested from them. The ASA, IgA- and IgG-bound spermatozoa were analyzed in blood serum and seminal plasma by immuno-peroxidase assay (IPA) and immunobead-binding assay (IBA). On the basis of per cent ASA, IgA- and IgG-type, all bulls were divided into 2 groups viz. group 1 (< 40% ASA, IgA and IgG in serum; < 20% ASA, IgA and IgG in seminal plasma) and group 2 (> 40% ASA, IgA and IgG in serum; > 20% ASA, IgA and IgG in seminal plasma) for further comparisons. The frozen-thawed semen was also evaluated for percent motility (total and progressive), concentration, viability, abnormality, HOST, acrosome integrity, acrosome reaction, CMPT and first FSCR. The percentage of ASA (37.1±3.8 vs 22.3±1.5), IgA- (44.2±3.1 vs 21.6±2.7) and IgG-bound spermatozoa (35.5±3.0 vs 19.7±4.6) were significantly higher in serum than in seminal plasma. In blood serum, sperm motility, acrosome reaction, CMPT and FSCR were significantly higher in bulls with < 40% ASA as compared to their counterparts. In seminal plasma, bulls with < 20% ASA exhibited significantly higher sperm concentration as compared to their contemporary mates. Sperm concentration (982.2±50.4 vs 874.9±36.3%) in blood serum and acrosome reaction (56.6±2.7 vs 49.9±2.3%) in seminal plasma were the only parameters that were significantly higher in bulls with < 40% and < 20% IgA, respectively than in their counterparts. For IgG-type, sperm concentration and acrosome reaction were significantly higher in bulls with < 40% than in those with > 40% IgG in blood serum. In seminal plasma, acrosome reaction and FSCR were significantly higher in bulls with < 20% IgG than in their contemporary mates. In conclusion, detection of surface-bound ASA was associated with changes in quality and fertility of buffalo bull semen.
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Wang MZ, Qiu ZL, Cai XS, Li JJ, She MQ, Xu YF, Wu YS. Secretory expression of a novel human spermatozoa antigen in E. coli and its application to a protein chip. Biotechnol Lett 2017; 39:1529-1535. [PMID: 28600648 DOI: 10.1007/s10529-017-2377-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 05/30/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To produce a recombinant spermatozoa antigen peptide using the E. coli: PhoA system on a protein chip for screening anti-sperm antibodies (ASA). RESULTS The purity of the recombinant spermatozoa antigen exceeded 95% after two-step purification, as assessed using SDS-PAGE and HPLC. The diagnostic performance of a protein chip coated with the recombinant antigen peptide was evaluated by examining ASA in 51 infertile patients in comparison with a commercial ELISA kit. The area under the receiver operating characteristic curve (AUC) was 0.944, which indicated that the protein chip coated with recombinant spermatozoa antigen peptide was consistent with ELISA for ASA detection. CONCLUSION A recombinant spermatozoa antigen was expressed in the E. coli PhoA secretory expression system and its potential application for clinical ASA detection was validated.
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Affiliation(s)
- Ming-Zhu Wang
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| | - Zhuo-Lin Qiu
- Reproductive center of Obstetrics and Gynecology, Southern Medical University, Guangzhou, 510515, People's Republic of China
| | - Xiang-Sheng Cai
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| | - Jing-Jing Li
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China
| | - Miao-Qin She
- Guangzhou Kangsui Biotechnology Inc., Guangzhou, 510663, People's Republic of China
| | - Yuan-Feng Xu
- Guangzhou Kangsui Biotechnology Inc., Guangzhou, 510663, People's Republic of China
| | - Ying-Song Wu
- Institute of Antibody Engineering, School of Laboratory Medical and Biotechnology, Southern Medical University, Guangzhou, People's Republic of China.
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Liu MM, Liu L, Chen L, Yin XJ, Liu H, Zhang YH, Li PL, Wang S, Li XX, Yu CH. Sleep Deprivation and Late Bedtime Impair Sperm Health Through Increasing Antisperm Antibody Production: A Prospective Study of 981 Healthy Men. Med Sci Monit 2017; 23:1842-1848. [PMID: 28412762 PMCID: PMC5402839 DOI: 10.12659/msm.900101] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effects of sleep duration and bedtime on sperm health, and the possible mechanism involved. MATERIAL AND METHODS We randomly divided 981 healthy Chinese men into groups according to research-set bedtimes (A=8-10 PM, B=after 10 PM, and C=after midnight) and sleep durations: group 1=<6.0 h (short), group 2=7.0-8.0 h (average), and group 3=>9.0 h (long). Sperm morphology, count, survival, and motility were examined according to sleep patterns. Antisperm antibody (ASA) production in semen was determined. RESULTS Sperm counts and their survival rates were lower in the short sleepers as compared to others within each group (all P<0.01). The lower counts and survival rates were observed in different bedtimes, with significant differences found between measurements of C1 vs. A1 and C2 vs. A2 or B2 (all P<0.05 or 0.01). Semen motility was lower in the short sleepers as compared to the average and long sleepers (all P<0.01). There were differences in the bedtime-related results between measurements of C1 vs. A1 or B1 (P<0.05 or 0.01). Additionally, the population proportion for the ASA-positive participates and incidence of the ASA-expressed population obviously increased in the short sleepers as compared to others within each group (all P<0.05). CONCLUSIONS Short and long sleep durations and late bedtime were associated with impaired sperm health in the study cohort, partly through increasing ASA production in the semen.
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Affiliation(s)
- Mei-Mei Liu
- Department of Obstetrics and Gynecology, Second Affiliated Hospital Harbin, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Li Liu
- Department of Obstetrics and Gynecology, Harbin Red Cross Central Hospital, Harbin, Heilongjiang, China (mainland)
| | - Liang Chen
- Department of Obstetrics and Gynecology, Second Affiliated Hospital Harbin, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Xiao-Jing Yin
- Department of Obstetrics and Gynecology, Chaoyang Central Hospital, Chaoyang, Heilongjiang, China (mainland)
| | - Hui Liu
- Department of Obstetrics and Gynecology, Second Affiliated Hospital Harbin, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Yan-Hua Zhang
- Department of Obstetrics and Gynecology, Second Affiliated Hospital Harbin, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Pei-Ling Li
- Department of Obstetrics and Gynecology, Second Affiliated Hospital Harbin, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Shan Wang
- Department of Obstetrics and Gynecology, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Xiao-Xiao Li
- Department of Obstetrics and Gynecology, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
| | - Cai-Hong Yu
- Department of Obstetrics and Gynecology, Harbin Medical University, Harbin, Heilongjiang, China (mainland)
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Conservative Nonhormonal Options for the Treatment of Male Infertility: Antibiotics, Anti-Inflammatory Drugs, and Antioxidants. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4650182. [PMID: 28164122 PMCID: PMC5253172 DOI: 10.1155/2017/4650182] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 12/04/2016] [Accepted: 12/05/2016] [Indexed: 01/08/2023]
Abstract
The nonhormonal medical treatment can be divided into empirical, when the cause has not been identified, and nonempirical, if the pathogenic mechanism causing male infertility can be solved or ameliorated. The empirical nonhormonal medical treatment has been proposed for patients with idiopathic or noncurable oligoasthenoteratozoospermia and for normozoospermic infertile patients. Anti-inflammatory, fibrinolytic, and antioxidant compounds, oligo elements, and vitamin supplementation may be prescribed. Infection, inflammation, and/or increased oxidative stress often require a specific treatment with antibiotics, anti-inflammatory drugs, and/or antioxidants. Combined therapies can contribute to improve sperm quality.
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Jiang D, Coscione A, Li L, Zeng BY. Effect of Chinese Herbal Medicine on Male Infertility. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2017; 135:297-311. [DOI: 10.1016/bs.irn.2017.02.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Krnić D, Družijanić N, Štula I, Čapkun V, Krnić D. Incarcerated Inguinal Hernia Mesh Repair: Effect on Testicular Blood Flow and Sperm Autoimmunity. Med Sci Monit 2016; 22:1524-33. [PMID: 27149257 PMCID: PMC4920094 DOI: 10.12659/msm.898727] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background The aim of our study was to determine an influence of incarcerated inguinal hernia mesh repair on testicular circulation and to investigate consequent sperm autoimmunity as a possible reason for infertility. Material/Methods This prospective study was performed over a 3-year period, and 50 male patients were included; 25 of these patients underwent elective open mesh hernia repair (Group I). Group II consisted of 25 patients who had surgery for incarcerated inguinal hernia. Doppler ultrasound evaluation of the testicular blood flow and blood samplings for antisperm antibodies (ASA) was performed in all patients before the surgery, on the second day, and 5 months after. Main outcome ultrasound measures were resistive index (RI) and pulsative index (PI), as their values are inversely proportional to testicular blood flow. Results In Group I, RI, and PI temporarily increased after surgery and then returned to basal values in the late postoperative period. Friedman analysis showed a significant difference in RI and PI for all measurements in Group II (p<0.05), with a significant decrease between the preoperative, early, and late postoperative periods. All final values were within reference range, including ASA, despite significant increase of ASA in the late postoperative period. Conclusions Although statistically significant differences in values of testicular flow parameters and immunologic sensitization in observed time, final values remained within the reference ranges in all patients. Our results suggest that the polypropylene mesh probably does not cause any clinically significant effect on testicular flow and immunologic response in both groups of patients.
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Affiliation(s)
- Dragan Krnić
- Department of Surgery, University Hospital Split, Split University School of Medicine, Split, Croatia
| | - Nikica Družijanić
- Department of Surgery, University Hospital Split, Split University School of Medicine, Split, Croatia
| | - Ivana Štula
- Department of Diagnostic and Interventional Radiology, University Hospital Split, Split University School of Medicine, Split, Croatia
| | - Vesna Čapkun
- Department ofNuclear Medicine, University Hospital Split, Split University School of Medicine, Split, Croatia
| | - Duška Krnić
- Department ofPsychiatry, University Hospital Split, Split University School of Medicine, Split, Croatia
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Verón GL, Molina RI, Tissera AD, Estofan GM, Marín-Briggiler CI, Vazquez-Levin MH. Incidence of Sperm Surface Autoantibodies and Relationship with Routine Semen Parameters and Sperm Kinematics. Am J Reprod Immunol 2016; 76:59-69. [PMID: 27139084 DOI: 10.1111/aji.12519] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 04/07/2016] [Indexed: 01/01/2023] Open
Abstract
PROBLEM Antisperm antibodies (ASA) are associated with male subfertility. However, results on sperm surface autoantibodies are controversial, the relationship between ASA and semen parameters (WHO, 2010) is unknown, and data on ASA and sperm kinematics are scarce. METHOD OF STUDY A retrospective study carried out in men undergoing routine semen analysis (WHO 2010), ASA evaluation (direct SpermMAR(™) (IgG) test), and computer-assisted sperm analysis (CASA). RESULTS A 2.6% and a 5.9% incidence of ASA-positive cases were found (cut-off 50% and 10%, respectively; n = 7492). ASA-positive samples had lower (P < 0.0001) sperm concentration, count, motility, and hypo-osmotic swelling (HOS) test score. HOS results did not correlate with sperm vitality in normozoospermic samples with high ASA levels. In unselected samples, ASA-positive samples (cut-off 50%) showed decreased sperm kinematics (VSL, VAP, LIN, ALH, STR, BCF, WOB), but in normozoospermic samples, ASA-positive and ASA-negative subgroups had similar CASA results. CONCLUSIONS ASA evaluation is highly relevant in full semen assessment.
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Affiliation(s)
- Gustavo Luis Verón
- Instituto de Biología y Medicina Experimental (IBYME; CONICET-FIBYME), Ciudad Autónoma de Buenos Aires, Argentina
| | | | | | | | - Clara Isabel Marín-Briggiler
- Instituto de Biología y Medicina Experimental (IBYME; CONICET-FIBYME), Ciudad Autónoma de Buenos Aires, Argentina
| | - Mónica Hebe Vazquez-Levin
- Instituto de Biología y Medicina Experimental (IBYME; CONICET-FIBYME), Ciudad Autónoma de Buenos Aires, Argentina
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Aitken RJ, Baker MA, Nixon B. Are sperm capacitation and apoptosis the opposite ends of a continuum driven by oxidative stress? Asian J Androl 2016; 17:633-9. [PMID: 25999358 PMCID: PMC4492056 DOI: 10.4103/1008-682x.153850] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
This chapter explores the possibility that capacitation and apoptosis are linked processes joined by their common dependence on the continued generation of reactive oxygen species (ROS). According to this model capacitation is initiated in spematozoa following their release into the female reproductive tract as a consequence of intracellular ROS generation, which stimulates intracellular cAMP generation, inhibits tyrosine phosphatase activity and enhances the formation of oxysterols prior to their removal from the sperm surface by albumin. The continued generation of ROS by capacitating populations of spermatozoa eventually overwhelms the limited capacity of these cells to protect themselves from oxidative stress. As a result the over-capacitation of spermatozoa leads to a state of senescence and the activation of a truncated intrinsic apoptotic cascade characterized by enhanced mitochondrial ROS generation, lipid peroxidation, motility loss, caspase activation and phosphatidylserine externalization. The latter may be particularly important in instructing phagocytic leukocytes that the removal of senescent, moribund spermatozoa should be a silent process unaccompanied by the generation of proinflammatory cytokines. These observations reveal the central role played by redox chemistry in defining the life and death of spermatozoa. A knowledge of these mechanisms may help us to engineer novel solutions to both support and preserve the functionality of these highly specialized cells.
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Affiliation(s)
- Robert J Aitken
- Priority Research Centre in Reproductive Science, Discipline of Biological Sciences and Hunter Medical Research Institute, University of Newcastle, NSW 2308, Australia
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