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Sperm mitochondrial DNA copy number in relation to semen quality: A cross-sectional study of 1164 potential sperm donors

OBJECTIVE

To investigate the association between mitochondrial DNA copy number (mtDNAcn) and semen quality.

DESIGN

A cross-sectional study.

SETTING

Hubei Province Human Sperm Bank of China (from April 2017 to July 2018).

POPULATION

A total of 1164 healthy male sperm donors with 5739 specimens.

MAIN OUTCOME MEASURES

Real-time quantitative polymerase chain reaction (RT-PCR) was used to measure sperm mtDNAcn. We also determined semen volume, concentration and motility parameters (progressive motility, nonprogressive motility and immotility).

METHODS

Mixed-effect models and general linear models were uses.

RESULTS

After adjusting for relevant confounding factors, mixed-effect models revealed diminished sperm motility (progressive and total), concentration, and total count across the quartiles of mtDNAcn (all P < 0.05). Compared with men in the lowest quartile, men in the highest quartile of mtDNAcn had lower progressive sperm motility, total motility, concentration and total count of -8.9% (95% CI -12.7% to -5.0%), -8.0% (95% CI -11.6% to -4.4%), -42.8% (95% CI -47.7% to -37.4%), and - 44.3% (95% CI -50.1% to -37.7%), respectively. These inverse dose-response relationships were further confirmed in the cubic spline models, where mtDNAcn was modelled as a continuous variable.

CONCLUSIONS

We found that mtDNAcn was inversely associated with semen quality in a dose-dependent manner. Our results provide novel clues that sperm mtDNAcn may serve as a useful predictor of human semen characteristics.

TWEETABLE ABSTRACT

Sperm mitochondrial DNA copy number was markedly associated with diminished sperm motility (progressive and total), concentration and total count.

Apoptosis and blood-testis barrier disruption during male reproductive dysfunction induced by PAHs of different molecular weights

The association between polycyclic aromatic hydrocarbons (PAHs) and male reproductive dysfunction has attracted increasing attention. The purpose of this study was to compare the male reproductive toxicity of multiple PAHs and to investigate the underlying molecular mechanisms. TM4 cells (mouse testicular Sertoli cells, SCs) were treated with benzo(a)pyrene (BaP), pyrene (Py), fluoranthene (Fl) and phenanthrene (Phe) (0, 0.1, 1, 10, 50, or 100 μM) for varying time points (4, 12, 24, or 48 h), and male C57BL/6 mice were administered BaP and Py (0, 10, 50, or 100 mg/kg body weight) for 14 days based on the cell experimental results. Histopathological examination, western blotting, ELISA, biochemical assays, RT-PCR, flow cytometry, JC-1 staining and trans-epithelium electrical resistance (TEER) measurements were used to assess apoptosis, blood-testis barrier (BTB) integrity, intracellular calcium ([Ca²⁺]_i) concentrations and oxidative stress (OS). The results revealed that the mRNA levels and enzymatic activities of CYP450 and GST family members; levels of ROS, MDA, cleaved caspase 3 (c-caspase 3), caspase 9, Bax, and cytochrome C (CytC); and numbers of TUNEL-positive cells were significantly increased by BaP and Py, while levels of AhR, GSH, SOD, CAT, Bcl-2 and ΔΨm were decreased. Additionally, BaP and Py notably interfered with tight junctions (TJs) and adherens junctions (AJs) in the BTB. Intriguingly, BaP, but not Py, induced [Ca²⁺]_i overload and gap junction (GJ) destruction. There was no dramatic effect of Fl and/or Phe on any of the above parameters except that slight cytotoxicity was observed with higher doses of Fl. Collectively, these findings showed that BaP and Py elicited SC apoptosis and BTB disruption involving mitochondrial dysfunction and OS, but [Ca²⁺]_i fluctuation and GJ injury were only observed with BaP-induced reproductive toxicity. The male reproductive toxicity of the selected PAHs was ranked in the order of BaP > Py > Fl > Phe.

The expression of human testis-specific actin capping protein predicts in vitro fertilization outcomes: A novel biomarker of sperm function for assisted reproductive technology

PURPOSE

Sperm function tests do not adequately assess fertilization potential, and new indices are required. We have previously reported that human testis-specific actin capping proteins may be involved in both sperm morphology and function. This study aimed to determine whether testis-specific actin capping proteins can be a predictive marker of IVF success.

METHODS

Ninety-seven infertile couples who underwent IVF at an infertility clinic were included. Sperm were immunohistochemically stained to evaluate capping protein expression, and the percentage of sperms with normal staining was calculated. The relationship between actin capping protein expression and IVF outcomes was examined.

RESULTS

The couples were divided into four groups according to the percentage of normally expressing actin capping protein as follows: ≥90% Group Ⅰ, 80%-90% Group Ⅱ, 70%-80% Group Ⅲ, and <70% Group Ⅳ. Multiple regression analysis showed a significant trend in fertilization rates across the 4 groups (p for trend =0.008).There was no significant trend in pregnancy rates (p for trend =0.276).

CONCLUSION

The human testis-specific actin capping protein may be a marker of male contributing factors that predict IVF outcomes.

Cutting-Edge Evaluation of Male Infertility

A male factor is a contributor in 50% of cases of infertility. Although assisted reproductive techniques can often bypass the need to improve semen parameters, the evaluation of the infertile man remains critical. Current methods for evaluating the infertile man are discussed, beginning with the basic workup that all suspected infertile men should undergo, followed by subsequent evaluation steps. Although the fundamental components of the evaluation have remained consistent, several new tools are available to assist in identifying the underlying etiology. As our understanding of male fertility expands, the technologies available to diagnose and ultimately treat it continue to evolve.

Male Infertility is a Women's Health Issue-Research and Clinical Evaluation of Male Infertility Is Needed

Infertility is a devastating experience for both partners as they try to conceive. Historically, when a couple could not conceive, the woman has carried the stigma of infertility; however, men and women are just as likely to contribute to the couple’s infertility. With the development of assisted reproductive technology (ART), the treatment burden for male and unexplained infertility has fallen mainly on women. Equalizing this burden requires reviving research on male infertility to both improve treatment options and enable natural conception. Despite many scientific efforts, infertility in men due to sperm dysfunction is mainly diagnosed by a semen analysis. The semen analysis is limited as it only examines general sperm properties such as concentration, motility, and morphology. A diagnosis of male infertility rarely includes an assessment of internal sperm components such as DNA, which is well documented to have an impact on infertility, or other components such as RNA and centrioles, which are beginning to be adopted. Assessment of these components is not typically included in current diagnostic testing because available treatments are limited. Recent research has expanded our understanding of sperm biology and suggests that these components may also contribute to the failure to achieve pregnancy. Understanding the sperm’s internal components, and how they contribute to male infertility, would provide avenues for new therapies that are based on treating men directly for male infertility, which may enable less invasive treatments and even natural conception.

Associations of ambient air pollutant exposure with seminal plasma MDA, sperm mtDNA copy number, and mtDNA integrity

BACKGROUND

Current available evidence regarding the detrimental effects of low-level ambient air pollution on conventional semen parameters is inconclusive. In nonreproductive systems, air pollutant exposure has been demonstrated to induce oxidative stress (OS), which is a crucial mechanism that mediates sperm damage and male infertility. Thus, it may be essential to investigate the effects of air pollution on sperm quality in terms of the perspectives of OS and relative molecular damage.

OBJECTIVES

We assessed the associations of major air pollutant exposure to oxidative stress-mediated alterations in semen, including seminal plasma malondialdehyde (MDA), sperm mtDNA copy number, and integrity.

METHODS

The present study used data gathered from 516 young men participating in the Male Reproductive Health in Chongqing College student (MARCHS) cohort study during the follow-up stage in 2014 (n = 427 on the old campus, which is located in an urban area and has worse air quality, and n = 89 on the new campus, which is not urban and has better air quality). Data regarding major air pollutant exposure during 0-90, 0-9, 10-14 and 70-90 days before each semen examination (corresponding to the entire and three key periods of sperm development, respectively) were collected. The Mann-Whitney U nonparametric test was employed to compare distributions of major air pollutants and to explore differences in MDA, mtDNA copy number, and mtDNA integrity between the two campuses. A linear regression model was used as multivariable analysis to investigate associations of major air pollutant exposure with these biomarkers of oxidative damage to sperm and to adjust for potential confounders.

RESULTS

During all four key periods of sperm development, compared with college students on the new campus, college students on the old campus were exposed to higher levels of PM10, PM2.5, NO₂, and CO, and had higher air quality index (AQI) values, indicating that these participants suffered from worse air quality. The levels of seminal plasma MDA in college students on the old campus were higher than those for the new campus (2.0 nmol/ml; 0.7, 3.6 vs. 1.6 nmol/ml; 0.4, 3.4, p < 0.001) (medians with 5th and 95th percentiles). There were no significant differences in sperm mtDNA copy number and mtDNA integrity between the two campuses. Furthermore, daily average PM10 exposure during 0-90 days before semen ejaculation was found to be significantly and positively associated with seminal plasma MDA level (10.4; 95% CI, 4.4, 16.4) (percentage change per 10-unit increase in air pollutant concentration; same meanings for the results below); daily average SO₂ exposure for 70-90 days and NO₂ exposure for 0-9 days prior to sampling were also positively associated with MDA level (74.7; 95% CI, 32.1, 119 and 11.9; 95% CI, 4.8, 19.0, respectively). AQI for 0-90 days and 70-90 days prior to sampling positively correlated with seminal plasma MDA concentrations (11.4; 95% CI, 4.7, 18.1 and 12.2; 95% CI, 5.3, 19.1, respectively). Additionally, daily average SO₂ exposures for 10-14 and 0-9 days prior to sampling were negatively associated with sperm mtDNA copy number and mtDNA integrity, respectively (-9.0; 95% CI, -16.4, -1.6 and -38.3; 95% CI, -64.1, -11.8, respectively). However, only the correlations between SO₂ exposure and AQI value for 70-90 days prior to sampling and MDA levels remained significant after multiplicity adjustment.

CONCLUSIONS

The results indicate that bad air quality, especially SO₂ exposure during certain periods of sperm development, might be correlated with oxidative damage to sperm. These findings can deepen the understanding of the potential impacts of air pollution on sperm quality.

ICSI using fresh and frozen PESA-TESA spermatozoa to examine assisted reproductive outcome retrospectively

OBJECTIVE

The male reproductive system generates, accumulates, and transports the sperm. In this study, 2 methods of surgically retrieving sperm, namely, testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA), are discussed and studied in men aged ≤38 years to achieve successful conception using assisted reproductive technology. The purpose was to assess the fertilization rate (FA), clinical pregnancy, and live birth rate (LBR) with sperm.

METHODS

A total of 287 semen samples were divided into 4 groups as follows: fresh PESA (n=73), frozen PESA (n=65), fresh TESA (n=128), and frozen TESA (n=21). The DNA fragmentation test using sperm chromatin dispersion assay was measured and reported.

RESULTS

FA was 70.3% and 65.5%, (P<0.022) for fresh and frozen epididymal sperm and 53.8% and 49.5%, (P<0.032) for fresh and frozen testicular sperm. LBR was 33.6% and 30.2% (P<0.075) for fresh and frozen epididymal sperm (PESA) and 22.7% and 18.2% (P<0.063) for fresh and frozen-thawed TESA sperm.

CONCLUSION

Exposure to tissue shearing may adversely affect sperm quality. Increased sperm DNA damage due to long-term exposure while teasing enhances reactive oxygen species production foremost to membrane damage because of the oxidation of polyunsaturated fatty acid in lipids (lipid peroxidation), oxidation of amino acid in proteins, and inactivation of specific enzymes, all leading to enzymatic dipping and possibility of less fertilization and conception as indicated by the increase in LBR with fresh/frozen PESA compared to with fresh/frozen TESA.

Semen Quality in Chinese College Students: Associations With Depression and Physical Activity in a Cross-Sectional Study

OBJECTIVE

Behavioral and psychosocial factors have been associated with a decline of the quality of semen. However, the relationship of depression and physical activity (PA) with semen quality remains unclear.

METHODS

Data were obtained from 587 young male Chinese college students in June 2013. Participants completed a questionnaire assessing life-style factors, the Zung self-rated depression scale, and three items related to PA. They underwent a physical examination and provided a semen sample and a blood sample for reproductive hormones (testosterone, estrogen, progesterone, follicle-stimulating hormone, luteinizing hormone, and prolactin).

RESULTS

Men with high depression scores (n = 63, 10.7%) had lower sperm concentration (M (SD) = 66.9 (74.5) versus 72.6 (56.9) [10/ml], p = .043) and total sperm count (M (SD) = 241.6 (299.7) versus 257.0 (204.0) [10], p = .024) than nondepressed men. Participants with low PA levels (n = 99, 16.9%) had lower total sperm count (M (SD) = 204.4 (153.7) versus 265.8 (225.8) [10/ml], p = .017) than participants with higher activity levels. After adjusting for potential confounders, depressed men had 18.90% (95% confidence interval [CI] = 1.14%-33.47%) lower sperm concentration and 21.84% (95% CI = 3.39%-36.90%) lower total sperm count than nondepressed men. Men with low PA levels had 23.03% (95% CI = 2.80%-46.89%) lower total sperm count than physically active participants. An interaction effect between depression and PA on sperm concentration was detected (p = .033). There were no significant associations of depression and PA with reproductive hormones (p > .05).

CONCLUSIONS

Depression and low levels of PA are associated with lower levels of semen quality, which may have implications for reproductive health.

Social support modifies an association between work stress and semen quality: Results from 384 Chinese male workers

OBJECTIVE

Psychosocial factors have been associated with a decline of the quality of semen. The study was aimed at (i) estimating the association between work stress and semen quality and (ii) exploring the moderating effect of social support in semen parameters among Chinese male workers.

METHODS

Data were obtained from 384 adult male workers recruited from April 2014 to December 2015 in Chongqing, China. Participants completed a questionnaire assessing demographic and life-style factors. Work stress and social support was measured by the Chinese version of a 22-item Job Content Questionnaire (JCQ). They underwent a physical examination and provided a semen sample.

RESULTS

Subjects with high work stress were associated with a higher risk of being classified below WHO's thresholds for "normal," defined by sperm concentration (OR 2.14, 95% CI 1.24-3.68, p = .006) or total sperm count (OR 1.95, 95% CI 1.13-3.36, p = .02) criteria than subjects with low work stress were. However, these adverse associations were not observed among subjects with high social support (p = .80 for sperm concentration, and p = .39 for total sperm count). Interaction effects between social support and work stress on sperm concentration (p = .002) and total sperm count (p = .02) were detected.

CONCLUSION

Work stress is associated with lower levels of semen quality. Social support attenuates the negative association between work stress and semen quality, which may have implications for reproductive health.

A step-by-step guide to office-based sperm retrieval for obstructive azoospermia

A variety of surgical options exists for sperm retrieval in the setting of obstructive azoospermia (OA). With appropriate preparation, the majority of these techniques can safely be performed in the office with local anesthesia and with or without monitored anesthesia care (MAC). The available techniques include percutaneous options such as percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA), as well as open techniques that include testicular sperm extraction (TESE) and microsurgical epididymal sperm aspiration (MESA). In addition to providing a step-by-step description of each available approach, we introduce and describe a new technique for sperm retrieval for OA called minimally invasive epididymal sperm aspiration (MIESA). The MIESA utilizes a tiny keyhole incision, and the epididymis is exposed without testicular delivery. Epididymal aspiration is performed in the style of MESA, except using loupe magnification rather than an operating microscope. MIESA is a safe, office-based procedure in which millions of motile sperm can be retrieved for cryopreservation. While we prefer the MIESA technique for OA, there remain distinct advantages of each open and percutaneous approach. In the current era of assisted reproductive technology, sperm retrieval rates for OA should approach 100% regardless of the technique. This reference provides a roadmap for both advanced and novice male reproductive surgeons to guide them through every stage of sperm retrieval for OA, including preoperative evaluation, patient selection, procedural techniques, and complications. With the incredible advances in in vitro fertilization (IVF), combined with innovative surgical treatment for male factor infertility in recent years, OA is no longer a barrier for men to become biologic fathers.

Mitochondrial Biomarkers Reflect Semen Quality: Results from the MARCHS Study in Chongqing, China

Unexplained infertility requires that more sensitive and mechanism-based biomarkers should be developed and used independently of or in addition to conventional semen parameters for an infertility diagnosis. In the present study, semen samples were collected from young men participating in the Male Reproductive Health in Chongqing College students (MARCHS) cohort study in the follow-up stage in 2014. Conventional semen parameters were measured in all 656 participants, whereas sperm mitochondrial membrane potential (MMP), mitochondrial DNA copy number (mtDNAcn), mtDNA integrity and apoptotic parameters were measured among 627, 386, 362, and 628 participants, respectively. We found that sperm MMP was significantly positively correlated with all of conventional semen parameters including semen volume (r = 0.090, p = 0.025), sperm concentration (r = 0.301, p<0.01), total sperm count (r = 0.324, p<0.01), and progressive motility (r = 0.399, p<0.01); sperm MMP was also negatively correlated with Annexin V⁺ sperm (r = -0.553, p<0.01); mtDNAcn was significantly negatively correlated with sperm concentration (r = -0.214, p<0.01), total sperm count (r = -0.232, p<0.01), and progressive motility (r = -0.164, p = 0.01); mtDNA integrity was also significantly positively correlated with sperm concentration (r = 0.195, p<0.01), total sperm count (r = 0.185, p<0.01), and progressive motility (r = 0.106, p = 0.043). After adjusting for potential confounders, these relationships remained significant. Furthermore, we explored the potential effects of lifestyles on such mitochondrial biomarkers and found that the current drinkers displayed a higher level of sperm MMP; additionally, mt DNAcn was increased with age. The results indicated that certain mitochondrial biomarkers could serve as predictors of semen quality in a general population, and the study provides a baseline for the effects of population characteristics and lifestyles on such mitochondrial markers.

Shorter sperm telomere length in association with exposure to polycyclic aromatic hydrocarbons: Results from the MARHCS cohort study in Chongqing, China and in vivo animal experiments

It has been well demonstrated that polycyclic aromatic hydrocarbons (PAHs) can cause reproductive toxicity, and shorter telomere length in sperm may be one of the factors causing male infertility. However, whether exposure to PAHs is associated with sperm telomere length (STL) has never been evaluated. The present study aimed to assess the potential association between PAHs exposure and STL, and to explore potential biomarkers that may predict the effects of low-level exposure to PAHs on human sperm. Questionnaires and biological samples were collected from 666 volunteers participating in the Male Reproductive Health in Chongqing College Students (MARHCS) cohort study in 2014. Semen parameters were measured for 656 participants, while urinary PAH metabolites, STL and sperm apoptosis were successfully measured for 492, 444 and 628 participants, respectively. The linear regression analysis revealed that increased levels of urinary 1-hydroxypyrene (1-OHPyr) and 1-hydroxynapthalene (1-OHNap) were associated with decreased STL (-0.385; 95% CI, -0.749, -0.021 for 1-OHPyr; and -0.079; 95% CI, -0.146, -0.011 for 1-OHNap). The significant negative associations remained after adjusting for potential confounders. However, no significant associations were observed between urinary PAH metabolites and semen quality or sperm apoptosis. We also administrated rats with benzo[a]pyrene (B[a]P; 0, 1, 5, and 10mg/kg) for 4weeks and found shorter STL and decreased telomerase expression in germ cells in a dose-dependent manner. In conclusion, environmental exposure to some PAHs may be associated with decreased human STL, and the in vivo animal results also demonstrate the adverse effects of B[a]P on telomere of male germ cells.

Lifestyles Associated With Human Semen Quality: Results From MARHCS Cohort Study in Chongqing, China

Decline of semen quality in past decades is suggested to be potentially associated with environmental and sociopsychobehavioral factors, but data from population-based cohort studies is limited. The male reproductive health in Chongqing College students (MARHCS) study was established in June 2013 as a perspective cohort study that recruited voluntary male healthy college students from 3 universities in Chongqing. The primary objectives of the MARHCS study are to investigate the associations of male reproductive health in young adults with sociopsychobehavioral factors, as well as changes of environmental exposure due to the relocation from rural campus (in University Town) to metro-campus (in central downtown). A 93-item questionnaire was used to collect sociopsychobehavioral information in manner of interviewer-interviewing, and blood, urine and semen samples were collected at the same time. The study was initiated with 796 healthy young men screened from 872 participants, with a median age of 20. About 81.8% of this population met the WHO 2010 criteria on semen quality given to the 6 routine parameters. Decreases of 12.7%, 19.8%, and 17.0%, and decreases of 7.7%, 17.6%, and 14.7% in total sperm count and sperm concentration, respectively, were found to be associated with the tertiles of accumulated smoking amount. Fried food consumption (1-2  times/wk or ≥3  times/wk vs nonconsumers) was found to be associated with decreased total sperm count (10.2% or 24.5%) and sperm concentration (13.7% or 17.2%), respectively. Coffee consumption was found to be associated with increased progressive and nonprogressive motility of 8.9% or 15.4% for subjects consuming 1-2  cups/wk or ≥3  cups/wk of coffee, respectively. Cola consumption appeared an association with decreased semen volume at 4.1% or 12.5% for 1-2  bottles/wk or ≥3  bottles/wk. A cohort to investigate the effects of environmental/sociopsychobehavioral factors act on semen quality was successfully set up. We found smoking, coffee/cola/fried foods consumption to be significantly associated with semen quality from the baseline investigation.