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Hobbs CL, Gadson AK, Sadikman S, Tsai S, Enemuo F, Raker C, Eaton JL. An investigation of racial and ethnic disparities in donor sperm availability in the United States. Fertil Steril 2024:S0015-0282(24)00452-7. [PMID: 38750876 DOI: 10.1016/j.fertnstert.2024.05.142] [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: 02/04/2024] [Revised: 05/01/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To determine whether the racial and ethnic distribution of sperm donors contributing to US sperm banks differs from the demographics of the US population and those of US donor sperm recipients undergoing treatment with in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). DESIGN Cross-sectional study. SETTING United States donor sperm banks, US Census, and fertility clinics reporting to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System. PATIENTS Sperm donors from 18 banks, men aged 18-39 years on the basis of the 2021 Census Current Population Survey, and recipients of donor sperm for IVF and ICSI treatments in clinics reporting to the Assisted Reproductive Technology Clinic Outcome Reporting System from January 1, 2018, to December 31, 2020. INTERVENTION None. MAIN OUTCOME MEASURE Proportions of sperm donors and donor sperm recipients undergoing IVF and ICSI treatments identifying as each racial and ethnic group. RESULTS Eighteen donor sperm banks were identified, encompassing 1,503 donors. Of these donors, 60.9% identified as White compared with 55.1% of the US male population and 67.7% of donor sperm recipients. Proportions of donors identifying as Asian or 2 or more races were larger than those of US men and donor sperm recipients (Asian: 18.6% vs. 6.5%, and 18.6% vs. 10.2%; 2 or more races: 11.6% vs. 2.2%, and 11.6% vs. 1.7%). In contrast, Black donors were underrepresented when compared with the US population of men and donor sperm recipients (2.8% vs. 12.9% and 2.8% vs. 13.0%). Hispanic donors were underrepresented when compared with the US population of men (6.0% vs. 22.2%). The percentages of Hispanic sperm donors and donor sperm recipients were similar (6.0% vs. 7.0%). CONCLUSION The racial and ethnic distribution of sperm donors differs significantly from the demographics of the US male population and donor sperm recipients undergoing IVF and ICSI treatments. These findings suggest a need for targeted recruitment efforts for Black sperm donors.
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Affiliation(s)
- Cassie L Hobbs
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island.
| | - Alexis K Gadson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island
| | - Sophia Sadikman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island
| | - Shelun Tsai
- Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical College, New York, New York
| | - Franklin Enemuo
- Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Christina Raker
- Department of Obstetrics and Gynecology, Division of Research, Women and Infants Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Jennifer L Eaton
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, Women & Infants Hospital, Providence, Rhode Island
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Badreddine J, Sellke N, Rhodes S, Thirumavalavan N, Abou Ghayda R. The association of socioeconomic status with semen parameters in a cohort of men in the United States. Andrology 2024. [PMID: 38436127 DOI: 10.1111/andr.13614] [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: 05/26/2023] [Revised: 01/13/2024] [Accepted: 01/18/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Socioeconomic differences are present within the population of men who experience infertility and seek treatment. OBJECTIVE To study the association of socioeconomic status with semen parameters in a group of men using mail-in semen analyses. MATERIALS AND METHODS The records of 11,134 men that used mail-in semen analyses from a fertility company were identified. Their demographic information, semen parameters, and ZIP codes were collected. Area deprivation index (ADI) was used as a proxy for socioeconomic status and was calculated for each individual using their ZIP codes in order to measure their level of socioeconomic deprivation. A higher ADI signifies a more deprived area. The association between ADI and the semen parameters of this group was measured using linear regression analysis adjusted for age. RESULTS 11,134 men were included in the study with a median age of 35 years (interquartile range (IQR): 32-40) and a median ADI of 83 (IQR: 68-97). The cohort had a median sperm concentration of 31 million/mL (IQR: 14-59), median total sperm count of 123 million (IQR: 57-224), median total motile sperm of 35 million (IQR: 9-95), median total motility of 32% (IQR: 15-52), progressive motility of 22% (IQR: 9-38), and morphology percent normal of 4% (IQR: 2-7). Higher ADI, indicating lower socioeconomic status, was negatively associated with various semen parameters, including sperm concentration, total sperm count, total motile sperm, and total and progressive motility. DISCUSSION AND CONCLUSION Men who live in more deprived areas are more likely to have worse semen parameters. Further research is needed to thoroughly examine the impact of socioeconomic status on male fertility. A comprehensive approach that targets upstream social, economic, and healthcare factors can possibly alleviate the negative association of socioeconomic status with fertility and semen parameters.
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Affiliation(s)
- Jad Badreddine
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Nicholas Sellke
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Stephen Rhodes
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Nannan Thirumavalavan
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ramy Abou Ghayda
- Division of Men's Health, Urology Institute, University Hospitals, Cleveland, Ohio, USA
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Mai H, Ke J, Zheng Z, Luo J, Li M, Qu Y, Jiang F, Cai S, Zuo L. Association of diet and lifestyle factors with semen quality in male partners of Chinese couples preparing for pregnancy. Reprod Health 2023; 20:173. [PMID: 37996913 PMCID: PMC10666430 DOI: 10.1186/s12978-023-01718-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND Semen quality significantly influences conception, and its preservation is crucial for couples seeking pregnancy. We investigated dietary and lifestyle risk factors impacting semen quality. METHODS A total of 466 males from the Guangzhou Women and Children's Medical Center's pre-pregnancy consultation clinic were recruited between January 2021 and March 2023 for inclusion. Semen analysis was performed, and diet and lifestyle data were gathered via questionnaire. Logistic regression was utilized to examine the link between diet, lifestyle variables, and semen quality. RESULTS Smoking worsened progressive sperm motility (38.0% vs. 36.0%, t = 2.262; P = 0.049). Alcohol consumption impaired progressive motility (40.5 ± 17.8% vs. 34.7 ± 16.1%, t = 3.396; P < 0.001) and total motility (56.0% vs. 64.0%; P = 0.001). Using plastic beverage bottles for oil or seasonings lowered sperm concentrations (40.4% vs. 59.0% vs. 65.5%; P = 0.032). A sweet diet correlated with higher total sperm motility (55.0% vs. 60.0%, 62.0% vs. 63.2%; P = 0.017). Higher milk product intake improved sperm concentration (41.6106 vs. 63.7106 vs. 66.1*106; P = 0.021) and motility (54.5% vs. 56.0% vs. 63.0%; P = 0.033). More frequent egg consumption increased semen volume (3.1 mL vs. 3.8 mL vs. 4.0 mL; P = 0.038). Roughage intake enhanced sperm concentration (160.8106 vs. 224.6106; P = 0.027), and adequate sleep improved progressive sperm motility rate (35.4% ± 18.2% vs. 40.2 ± 16.3%, F = 3.747; P = 0.024) and total motility (52.7% vs. 61.5%; P = 0.013). The regression model showed that using plastic containers for condiments was a protective factor for semen volume (OR: 0.12; CI 0.03-0.55; P = 0.006), sperm concentration (OR: 0.001, CI 0.00-0.30; P = 0.012), and count (OR: 0.12, CI 0.03-0.48; P = 0.003). Milk and egg consumption were also protective for semen volume (OR: 0.18, CI 0.06-0.51; P = 0.001 and OR: 0.11, CI 0.03-0.55; P = 0.006, respectively), while sufficient sleep benefitted total sperm motility (OR: 0.47, CI 0.24-0.95; P = 0.034). CONCLUSIONS Smoking and drinking, type of condiment container, diet preference, sleep duration, and milk, roughage, and egg consumption may reduce semen quality.
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Affiliation(s)
- Hanran Mai
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Junyi Ke
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Zilin Zheng
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Jieyi Luo
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Miaomiao Li
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Yanxia Qu
- Department of Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Fan Jiang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, Guangdong, China
| | - Simian Cai
- Department of Science, Education and Data Management, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, Guangdong, China
| | - Liandong Zuo
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China.
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Mai H, Ke J, Li M, He M, Qu Y, Jiang F, Cai S, Xu Y, Fu L, Pi L, Zhou H, Yu H, Che D, Gu X, Zhang J, Zuo L. Association of living environmental and occupational factors with semen quality in chinese men: a cross-sectional study. Sci Rep 2023; 13:15671. [PMID: 37735181 PMCID: PMC10514289 DOI: 10.1038/s41598-023-42927-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/16/2023] [Indexed: 09/23/2023] Open
Abstract
Sperm quality can be easily influenced by living environmental and occupational factors. This study aimed to discover potential semen quality related living environmental and occupational factors, expand knowledge of risk factors for semen quality, strengthen men's awareness of protecting their own fertility and assist the clinicians to judge the patient's fertility. 465 men without obese or underweight (18.5 < BMI < 28.5 kg/m2), long-term medical history and history of drug use, were recruited between June 2020 to July 2021, they are in reproductive age (25 < age < 45 years). We have collected their semen analysis results and clinical information. Logistic regression was applied to evaluate the association of semen quality with different factors. We found that living environment close to high voltage line (283.4 × 106/ml vs 219.8 × 106/ml, Cohen d = 0.116, P = 0.030) and substation (309.1 × 106/ml vs 222.4 × 106/ml, Cohen d = 0.085, P = 0.015) will influence sperm count. Experienced decoration in the past 6 months was a significant factor to sperm count (194.2 × 106/ml vs 261.0 × 106/ml, Cohen d = 0.120, P = 0.025). Living close to chemical plant will affect semen PH (7.5 vs 7.2, Cohen d = 0.181, P = 0.001). Domicile close to a power distribution room will affect progressive sperm motility (37.0% vs 34.0%, F = 4.773, Cohen d = 0.033, P = 0.030). Using computers will affect both progressive motility sperm (36.0% vs 28.1%, t = 2.762, Cohen d = 0.033, P = 0.006) and sperm total motility (57.0% vs 41.0%, Cohen d = 0.178, P = 0.009). After adjust for potential confounding factors (age and BMI), our regression model reveals that living close to high voltage line is a risk factor for sperm concentration (Adjusted OR 4.03, 95% CI 1.15-14.18, R2 = 0.048, P = 0.030), living close to Chemical plants is a protective factor for sperm concentration (Adjusted OR 0.15, 95% CI 0.05-0.46, R2 = 0.048, P = 0.001) and total sperm count (Adjusted OR 0.36, 95% CI 0.13-0.99, R2 = 0.026, P = 0.049). Time spends on computer will affect sperm total motility (Adjusted OR 2.29, 95% CI 1.11-4.73, R2 = 0.041, P = 0.025). Sum up, our results suggested that computer using, living and working surroundings (voltage line, substation and chemical plants, transformer room), and housing decoration may association with low semen quality. Suggesting that some easily ignored factors may affect male reproductive ability. Couples trying to become pregnant should try to avoid exposure to associated risk factors. The specific mechanism of risk factors affecting male reproductive ability remains to be elucidated.
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Affiliation(s)
- Hanran Mai
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Junyi Ke
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Miaomiao Li
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China
| | - Menghua He
- Department of Laboratory, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510260, China
| | - Yanxia Qu
- Department of Gynecology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Fan Jiang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, Guangdong, China
| | - Simian Cai
- Department of Science, Education and Data Management, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, Guangdong, China
| | - Yufen Xu
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Lanyan Fu
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Lei Pi
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Huazhong Zhou
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Hongyan Yu
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Di Che
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Xiaoqiong Gu
- Department of Clinical Biological Resource Bank, Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jinxin Zhang
- Department of Medical Statistics, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Liandong Zuo
- Department of Andrology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, 9 Jinsui Road, Guangzhou, 510623, Guangdong, China.
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Eisenberg ML, Esteves SC, Lamb DJ, Hotaling JM, Giwercman A, Hwang K, Cheng YS. Male infertility. Nat Rev Dis Primers 2023; 9:49. [PMID: 37709866 DOI: 10.1038/s41572-023-00459-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/16/2023]
Abstract
Clinical infertility is the inability of a couple to conceive after 12 months of trying. Male factors are estimated to contribute to 30-50% of cases of infertility. Infertility or reduced fertility can result from testicular dysfunction, endocrinopathies, lifestyle factors (such as tobacco and obesity), congenital anatomical factors, gonadotoxic exposures and ageing, among others. The evaluation of male infertility includes detailed history taking, focused physical examination and selective laboratory testing, including semen analysis. Treatments include lifestyle optimization, empirical or targeted medical therapy as well as surgical therapies that lead to measurable improvement in fertility. Although male infertility is recognized as a disease with effects on quality of life for both members of the infertile couple, fewer data exist on specific quantification and impact compared with other health-related conditions.
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Affiliation(s)
- Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.
- Department of Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
| | - Sandro C Esteves
- ANDROFERT Andrology and Human Reproduction Clinic, Campinas, Brazil
- Division of Urology, Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil
| | - Dolores J Lamb
- Center for Reproductive Genomics, Weill Cornell Medical College, New York, NY, USA
- Englander Institute for Precision Medicine, Weill Cornell Medical College, New York, NY, USA
- Department of Urology, Weill Cornell Medical College, New York, NY, USA
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Kathleen Hwang
- University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Yu-Sheng Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Horns JJ, Fendereski K, Ramsay JM, Halpern J, Iko IN, Ferlic E, Emery BR, Aston K, Hotaling J. The impact of socioeconomic status on bulk semen parameters, fertility treatment, and fertility outcomes in a cohort of subfertile men. Fertil Steril 2023; 120:72-79. [PMID: 36813124 PMCID: PMC10293094 DOI: 10.1016/j.fertnstert.2023.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/13/2023] [Accepted: 02/14/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE To study the effect of socioeconomic status on the use of fertility treatment and the rate of live birth in men with subfertility. DESIGN A retrospective, time-to-event analysis of men with subfertility in Utah stratified by socioeconomic status. SETTING Patients seen in fertility clinics throughout Utah. PATIENT(S) All men in Utah undergoing semen analysis between 1998 and 2017 at the state's 2 largest health care networks. INTERVENTION(S) Socioeconomic status (defined as area deprivation index of patients' residential location). MAIN OUTCOME MEASURE(S) Categorical use of fertility treatment, the count of fertility treatments (in patients with ≥1 treatment), and live birth after semen analysis. RESULT(S) When controlling for age, ethnicity, and semen parameters (count and concentration), men from low socioeconomic areas were only 60%-70% as likely to use fertility treatment depending on type compared with men from high socioeconomic areas (intrauterine insemination [IUI] hazards ratio [HR] = 0.691 (0.581-0.821), P<.001; in vitro fertilization [IVF] HR = 0.602 (0.466-0.778), P<.001). Of men undergoing fertility treatment, those from low socioeconomic areas had 75%-80% the number of treatments as men from high socioeconomic areas depending on type (IUI incident rate ratio = 0.740 (0.645-0.847), P<.001; IVF incident rate ratios = 0.803 (0.585-1.094), P=.170). When controlling for age, ethnicity, semen parameters, and use of fertility treatment, men from low socioeconomic areas were only 87% as likely to experience a live birth as men from high socioeconomic areas (HR = 0.871 (0.820-0.925), P<.001). Given the overall higher likelihood of live birth in men from high socioeconomic areas, as well as their greater chance of using fertility treatment, we predicted an annual disparity of 5 additional live births in high socioeconomic men compared with low for every 100 men. CONCLUSION(S) Men from low socioeconomic areas undergoing semen analyses are significantly less likely to use fertility treatment and experience a live birth than their counterparts from high socioeconomic areas. Mitigation programs to increase access to fertility treatment may help to reduce this bias; however, our results suggest that additional discrepancies beyond fertility treatment require addressing.
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Affiliation(s)
| | | | | | - Joshua Halpern
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
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7
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Belladelli F, Chen T, Basran S, Greenberg DR, Del Giudice F, Mulloy E, Chen CH, Cheng YS, Salonia A, Eisenberg ML. The Association between Monthly, Yearly, and Lifetime Cannabis Use, and Semen Parameters in Asian-American Men. World J Mens Health 2022:40.e61. [PMID: 36047080 DOI: 10.5534/wjmh.220106] [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: 05/23/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/15/2022] Open
Abstract
PURPOSE Medicinal and recreational cannabis use has grown exponentially, however, its effect on testicular function and spermatogenesis remains uncertain. The aim of this study was to evaluate the association between cannabis use and semen parameters in a cohort of Asian-American men with unknown fertility. MATERIALS AND METHODS Asian men were recruited to complete an online survey and submit a semen sample. Semen analysis, demographic data, lifestyle factors, and cannabis use habits were collected. Linear and logistic regression analyses were used to determine. RESULTS Among the 112 men included in this study, 51 used cannabis at least once in their lifetime, 30 men used cannabis at least once in the last 12 months, and 26 men used cannabis at least once in the last 30 days. Adjusted linear regression analyses identified an association between cannabis use in the previous 30 days and worse sperm morphology (β: -0.45, p=0.025) and sperm motility (β: -1.64, p=0.016). However, when stratifying by subfertile semen quality (i.e., WHO criteria), no association was identified between semen quality and cannabis use. Lower sperm morphology and motility are partially associated with recent cannabis use, while all other semen parameters are not. CONCLUSIONS We did not observe any consistent associations between cannabis use on any semen parameters in Asian-American men. Further studies within the field are needed to explore racial and ethnic differences in semen quality and lifestyle factors.
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Affiliation(s)
- Federico Belladelli
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy.,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy.,Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Tony Chen
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Satvir Basran
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Daniel R Greenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Francesco Del Giudice
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA.,Department of Urology, University Sapienza, Rome, Italy
| | - Evan Mulloy
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Che-Hong Chen
- Department of Chemical and Systems Biology, School of Medicine, Stanford University, Stanford, CA, USA
| | - Yu-Sheng Cheng
- Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology; URI; IRCCS Ospedale San Raffaele, Milan, Italy.,School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, CA, USA.
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Li Y, Sun C, Ma H, Zhu H, Zhang F, Jiang F. Basic Phenotyping of Male Fertility from 2019 to 2020 at the Human Sperm Bank of Fudan University. PHENOMICS (CHAM, SWITZERLAND) 2022; 2:211-218. [PMID: 36939761 PMCID: PMC9590568 DOI: 10.1007/s43657-022-00047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 11/25/2022]
Abstract
The aim of this cross-sectional survey was to analyze the semen parameters of volunteers from the Human Sperm Bank of Fudan University, as well as the related factors influencing these parameters. From January 2019 to December 2020, semen parameters from a total of 5214 men were included in this survey. The Kruskal-Wallis test was used to detect differences associated with several independent variables. A total of 5214 volunteers were included. The volunteers were registered in 33 provinces, autonomous regions, municipalities (including Macau and Taiwan) and 294 prefecture-level cities. The average age of volunteers was 27.40 years. Overall, 76.50% of the volunteers had a college education or higher. Volunteers with BMI values of 18.5-23.9 kg/m2 accounted for 60.70% of participants. Semen parameters were significantly different according to season, education level, duration of abstinence, age group and BMI. The basic male fertility phenotypes (semen parameters) showed new trends in the study period, and accurate long-term tracking of male semen parameters will help researchers to better understand the changes in male fertility phenotypes (semen).
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Affiliation(s)
- Yadong Li
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Can Sun
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Haitao Ma
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Hong Zhu
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
| | - Feng Zhang
- Obstetrics and Gynecology Hospital of Fudan University, NHC Key Laboratory of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, State Key Laboratory of Genetic Engineering at School of Life Sciences, Fudan University, Shanghai, 200011 China
| | - Feng Jiang
- Human Sperm Bank of Fudan University, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, 200011 China
- Shanghai Ji Ai Genetics and IVF Institute, Obstetrics and Gynecology Hospital of Fudan University, Fudan University, Shanghai, 200011 China
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9
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Evolution of the World Health Organization semen analysis manual: where are we? Nat Rev Urol 2022; 19:439-446. [PMID: 35523961 DOI: 10.1038/s41585-022-00593-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 12/13/2022]
Abstract
The WHO (World Health Organization) manuals provide state-of-the-art guidance on how a semen analysis should be carried out. The much anticipated sixth edition of the WHO semen analysis manual has been released 10 years after its previous version and includes essential updates, such as new reference standards for semen volume and microscopic sperm characteristics of recent fathers. A well-conducted semen analysis remains an essential foundation of the infertility evaluation process and affects patient referral, diagnosis and treatment. However, a male infertility work-up primarily based on routine semen analysis does not provide men with an optimal fertility pathway; the primary reasons for routine semen analysis inadequacy in this context include its low predictive value for natural and assisted conception success, its inability to detect sperm DNA and epigenetic deficiencies that might negatively affect embryo development, implantation and offspring well-being, and the substantial overlap between semen parameters of fertile and subfertile individuals. Ideally, a full andrological assessment should be carried out by reproductive urologists in all men dealing with couple infertility and should include a detailed history analysis, physical examination, semen analysis, endocrine assessment and other tests as needed. Only through a complete male infertility work-up will relevant underlying medical and infertility conditions be revealed and potentially treated or alleviated. The ultimate goals of a comprehensive andrological assessment are to positively influence overall male health, pregnancy prospects and offspring well-being.
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10
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Perry MJ, Arrington S, Freisthler MS, Ibe IN, McCray NL, Neumann LM, Tajanlangit P, Trejo Rosas BM. Pervasive structural racism in environmental epidemiology. Environ Health 2021; 20:119. [PMID: 34784917 PMCID: PMC8595076 DOI: 10.1186/s12940-021-00801-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 10/22/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Epistemological biases in environmental epidemiology prevent the full understanding of how racism's societal impacts directly influence health outcomes. With the ability to focus on "place" and the totality of environmental exposures, environmental epidemiologists have an important opportunity to advance the field by proactively investigating the structural racist forces that drive disparities in health. OBJECTIVE This commentary illustrates how environmental epidemiology has ignored racism for too long. Some examples from environmental health and male infertility are used to illustrate how failing to address racism neglects the health of entire populations. DISCUSSION While research on environmental justice has attended to the structural sources of environmental racism, this work has not been fully integrated into the mainstream of environmental epidemiology. Epidemiology's dominant paradigm that reduces race to a mere data point avoids the social dimensions of health and thus fails to improve population health for all. Failing to include populations who are Black, Indigenous, and people of color (BIPOC) in health research means researchers actually know very little about the effect of environmental contaminants on a range of population health outcomes. This commentary offers different practical solutions, such as naming racism in research, including BIPOC in leadership positions, mandating requirements for discussing "race", conducting far more holistic analyses, increasing community participation in research, and improving racism training, to address the myriad of ways in which structural racism permeates environmental epidemiology questions, methods, results and impacts.
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Affiliation(s)
- Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA.
| | - Suzanne Arrington
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Marlaina S Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Ifeoma N Ibe
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Nathan L McCray
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Laura M Neumann
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Patrick Tajanlangit
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
| | - Brenda M Trejo Rosas
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave NW Suite 400, Washington, DC, 20052, USA
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11
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Del Giudice F, Eisenberg ML. Does semen analysis testing reveal disparities? Nat Rev Urol 2021; 18:515. [PMID: 34075226 DOI: 10.1038/s41585-021-00485-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy.,Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA. .,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA.
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12
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Aly J, Plowden TC, Christy AY. Factors contributing to persistent disparate outcomes of in vitro fertilization treatment. Curr Opin Obstet Gynecol 2021; 33:335-342. [PMID: 34101661 DOI: 10.1097/gco.0000000000000726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Disparate healthcare outcomes are ubiquitous and occur across all fields of medicine, specifically for racial and ethnic minorities. Within reproductive health, minority women face disparate access to care, particularly infertility services, poor outcomes of fertility treatment, alarmingly higher rates of maternal morbidity and mortality as well as higher rates of preterm birth, lower live birth rates when they conceive spontaneously or when they conceive with assisted reproductive technology. The objective of this review is to highlight factors contributing to the persistent racial/ethnic disparities in in vitro fertilization (IVF) outcomes. RECENT FINDINGS Recent studies document poorer outcomes after IVF treatment. Black women have been shown to have lower live birth rates following IVF treatment for more than 15 years. SUMMARY In an effort to better understand these negative outcomes, scientists and clinicians have investigated possible biological contributing factors including the vaginal microbiome, differences in oocyte quality, embryo viability, endometrial factors, and hormonal differences. Multiple social/cultural factors also play a role including access to care, particularly for people with low income, patient (mis)education, and medical racism/bias.
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Affiliation(s)
- Jasmine Aly
- Program in Reproductive Endocrinology and Infertility, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland
| | - Torie C Plowden
- Department of Gynecologic Surgery and Obstetrics, Womack Army Medical Center, Fort Bragg, North Carolina
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13
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McCray NL, Young HA, Irwig MS, Frankfurter D, Schwartz AM, Witmyer J, Hynes M, Jayanthi VV, Marcus M, Patel M, Perry MJ. The Association Between Race, Obesity, and Sperm Quality Among Men Attending a University Physician Practice in Washington, DC. Am J Mens Health 2021; 14:1557988320925985. [PMID: 32602769 PMCID: PMC7328221 DOI: 10.1177/1557988320925985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
A decades-long decline in sperm counts in Western countries has coincided with an
increase in obesity rates, prompting study into their association. Few of these
studies have incorporated men of color, the sperm health of whom is relatively
unknown. The present exploratory study evaluated the association between body
mass index (BMI), race, ethnicity, and sperm parameters among a diverse sample
of U.S. men attending a Washington, DC physician practice. Semen samples were
collected and processed at a single laboratory and sperm concentration,
motility, morphology, and count were evaluated according to World Health
Organization (WHO) 5th edition criteria. Multivariate models accounted for
covariates related to sperm health. The study population (n =
128) was largely obese (45.3%) or overweight (34.4%), and 36.0% were black or
Hispanic. Black men had lower adjusted sperm concentration compared to white men
(75.0 million/mL to 107.4 million/mL, p = .01) and were more
likely to have oligozoospermia (p = .01), asthenozoospermia
(p = .004), and low sperm count (p <
.0001). Hispanic men had higher adjusted sperm concentration compared to
non-Hispanic men (124.5 million/mL to 62.1 million/mL, p =
.007) and were less likely to have teratozoospermia (p = .001).
Obesity and BMI were associated with lower sperm motility and count in crude
models only. Given the study’s sample size its findings should be interpreted
with caution but align with the limited epidemiological literature to date that
has evaluated racial and ethnic differences in semen quality. Heightened
clinical research attention is needed to ensure men of color are included in
representative numbers in studies of urologic and andrologic health.
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Affiliation(s)
- Nathan L McCray
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Heather A Young
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Michael S Irwig
- Division of Endocrinology, Diabetes & Metabolism, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - David Frankfurter
- Department of Obstetrics & Gynecology, The George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Arnold M Schwartz
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA.,Department of Pathology, School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Jeannine Witmyer
- Department of Obstetrics & Gynecology, The George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Marijane Hynes
- Department of Medicine, The George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Vimala V Jayanthi
- Department of Medicine, The George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Mia Marcus
- Department of Medicine, The George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Mihir Patel
- Department of Medicine, The George Washington University Medical Faculty Associates, Washington, DC, USA
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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Osadchuk L, Shantanova L, Troev I, Kleshchev M, Osadchuk A. Regional and ethnic differences in semen quality and reproductive hormones in Russia: A Siberian population-based cohort study of young men. Andrology 2021; 9:1512-1525. [PMID: 33884771 PMCID: PMC8596582 DOI: 10.1111/andr.13024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 04/12/2021] [Accepted: 04/16/2021] [Indexed: 12/28/2022]
Abstract
Background This is the first large‐scale Russian study describing semen quality and reproductive hormone levels among young men. Objectives The aim of the study was to compare semen quality and reproductive hormone levels in young men of four cities and three ethnic groups living in the Siberian region of Russia and to find out ethnic or environmental reasons for regional differences. Materials and methods The study population consisted of 1291 young men from Novosibirsk, Kemerovo, Ulan‐Ude, and Yakutsk, including 1013 men of three most numerous ethnic groups: Slavs, Buryats, and Yakuts. Each participant provided one sperm and blood sample, information about lifestyle and ethnicity. Anthropometric parameters, semen quality and reproductive hormone levels, were evaluated. Results Significant regional and ethnic differences were detected for semen and reproductive hormone parameters. Median sperm concentrations in Novosibirsk, Kemerovo, Ulan‐Ude, and Yakutsk were 54.6, 39.9, 34.7, 33.1 × 106/ml; total sperm counts—202.5, 138.7, 97.9, 93.4 × 106; percentages of morphologically normal spermatozoa—7.8%, 6.5%, 6.3%, 5.0%, respectively. Median sperm concentrations in Slavs, Buryats, and Yakuts were 43.7, 37.0, 30.6 × 106/ml; total sperm counts—150.0, 102.3 and 74.8 × 106; percentages of morphologically normal spermatozoa—6.8%, 6.8%, 4.8%, respectively. Discussion The young men in Novosibirsk and Kemerovo, populated by Slavs, had a higher semen quality compared to Ulan‐Ude and Yakutsk, populated by Buryats and Yakuts, apparently due to the higher testicular function in Slavic compared to Asian ethnicity. Impaired spermatogenesis in young men in Kemerovo compared to Novosibirsk, located in the same climatic zone and having a socio‐cultural and ethnic identity, may be due to the influence of a polluted environment. Conclusion The findings suggest that ethnic composition and environment may be responsible for regional differences in semen and reproductive hormone parameters.
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Affiliation(s)
- Ludmila Osadchuk
- Federal Research Center 'Institute of Cytology and Genetics', the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Larisa Shantanova
- Institute of General and Experimental Biology, the Siberian Branch of the Russian Academy of Sciences, Ulan-Ude, Russia
| | - Ivan Troev
- M.K. Ammosov North-Eastern Federal University, Yakutsk, Russia
| | - Maxim Kleshchev
- Federal Research Center 'Institute of Cytology and Genetics', the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Alexander Osadchuk
- Federal Research Center 'Institute of Cytology and Genetics', the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
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15
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Walker Z, Rucker L, Owen J, Wiltshire A, Kendall L, Edmonds J, Gunn D. Investigation of racial disparities in semen parameters among white, black, and Asian men. Andrology 2021; 9:1086-1091. [PMID: 33630395 DOI: 10.1111/andr.12992] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/04/2021] [Accepted: 02/22/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Male factor infertility is the primary cause of infertility in 20% of couples. Primary evaluation of male factor infertility includes a semen analysis (SA). The World Health Organization (WHO) criteria are widely used to interpret SA. However, the current normative values seen in WHO criteria have led to research showing racial disparities in prevalence of abnormal SA. OBJECTIVE To assess the relationship between different self-reported racial groups and rates of abnormal SA. MATERIALS & METHODS We conducted a retrospective cohort study at a single large tertiary care facility. All men who underwent a SA for evaluation of suspected male infertility, unexplained infertility, intrauterine insemination, and in vitro fertilization between January 1, 2017 and December 31, 2019, were considered for inclusion in the study. Exclusion criteria were unreported race or ethnicity, SA for fertility preservation only, history of varicocele or testicular surgery, chromosomal abnormalities, congenital bilateral absence of vas deferens, prior testosterone use, or prior exposure to chemotherapy and/or radiation. Samples obtained via testicular sperm extraction or post-ejaculatory urine collection, or those analyzed ≥1 h from ejaculation, were also excluded. RESULTS 872 SAs were identified, of which 615 met inclusion criteria, yielding 384 normal and 231 abnormal results. Only race (p < 0.0001) and age (p = 0.002) were statistically significant. Black men had the highest rate of abnormal SA (54%) and were significantly more likely to have lower semen volume, sperm concentration, total sperm count, percent motile sperm, and total motile sperm (p < 0.05). In a logistic regression model, controlling for age and using White Non-Hispanic as the referent group, only Blacks had lower odds for a normal SA (OR = 0.41, 95% CI 0.28, 0.60). DISCUSSION AND CONCLUSIONS Black men are more likely to have an abnormal SA based on the 2010 WHO criteria. Black men seeking infertility treatment should be educated on the incidence of abnormal SA and actively seek infertility evaluation.
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Affiliation(s)
- Zachary Walker
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lindsay Rucker
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John Owen
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ashley Wiltshire
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lacey Kendall
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Johnathan Edmonds
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Deidre Gunn
- Department of Obstetrics & Gynecology, Division of Reproductive Endocrinology & Infertility, University of Alabama at Birmingham, Birmingham, AL, USA
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16
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McCray N, Thompson L, Branch F, Porter N, Peterson J, Perry MJ. Talking About Public Health With African American Men: Perceptions of Environmental Health and Infertility. Am J Mens Health 2021; 14:1557988320901375. [PMID: 31973636 PMCID: PMC6984439 DOI: 10.1177/1557988320901375] [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] [Indexed: 01/29/2023] Open
Abstract
While the past two decades have seen rapid advances in research demonstrating links between environmental health and reproductive capacity, African American men have largely been overlooked as study participants. To give voice to the perceptions of urban African American men, the present qualitative study conducted focus groups of men recruited from street- and internet-based advertisements in Washington, DC. Participants were asked for their perspectives on their environment, reproductive health and fertility, and factors that would influence their participation in public health research. Participants expressed concern about ubiquitous environmental exposures characteristic of their living environments, which they attributed in part to gentrification and urban development. Infertility was seen as a threat to masculinity and a taboo subject in the African American community and several participants shared personal stories describing a general code of silence about the subject. Each group offered multiple suggestions for recruiting African American men into research studies; facilitators for study participation included cultural relevance, incentives, transparent communication, internet- and community-based recruitment, and use of African Americans and/or recruiters of color as part of the research team. When asked whether participants would participate in a hypothetical study on fertility that involved providing a sperm sample, there was a mixed reaction, with some expressing concern about how such a sample would be used and others describing a few facilitators for participation in such a study. These are unique perspectives that are largely missing from current-day evidence on the inclusion of African American men in environmental health and reproductive health research.
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Affiliation(s)
- Nathan McCray
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Lance Thompson
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Francesca Branch
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Nicholas Porter
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - James Peterson
- Department of Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
| | - Melissa J Perry
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, DC, USA
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17
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Douglas C, Parekh N, Kahn LG, Henkel R, Agarwal A. A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men. World J Mens Health 2019; 39:172-185. [PMID: 31749341 PMCID: PMC7994658 DOI: 10.5534/wjmh.190088] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 12/13/2022] Open
Abstract
Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP's potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.
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Affiliation(s)
- Christopher Douglas
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Neel Parekh
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Linda G Kahn
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Pediatrics, New York University School of Medicine, New York City, NY, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.
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18
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Male Infertility and Future Cardiometabolic Health: Does the Association Vary by Sociodemographic Factors? Urology 2019; 133:121-128. [DOI: 10.1016/j.urology.2019.06.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/03/2019] [Accepted: 06/24/2019] [Indexed: 12/31/2022]
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19
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Muhamad S, Sengupta P, Ramli R, Nasir A. Sociodemographic factors associated with semen quality among Malaysian men attending fertility clinic. Andrologia 2019; 51:e13383. [DOI: 10.1111/and.13383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/21/2019] [Accepted: 07/10/2019] [Indexed: 01/25/2023] Open
Affiliation(s)
- Suriyani Muhamad
- School of Social and Economic Development Universiti Malaysia Terengganu Kuala Nerus Malaysia
| | - Pallav Sengupta
- Faculty of Medicine and Biomedical Sciences MAHSA University Jenjarom Malaysia
| | - Roszaman Ramli
- Kulliyyah of Medicine International Islamic University Malaysia Kuantan Malaysia
| | - Aslina Nasir
- School of Informatics and Applied Mathematics Universiti Malaysia Terengganu Kuala Nerus Malaysia
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20
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Punjani N, Nayan M, Jarvi K, Lo K, Lau S, Grober ED. The effect of ethnicity on semen analysis and hormones in the infertile patient. Can Urol Assoc J 2019; 14:31-35. [PMID: 31348744 DOI: 10.5489/cuaj.5897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to study the association of ethnicity on semen parameters and hormones in patients presenting with infertility. METHODS Data from men presenting for infertility assessment were prospectively collected and retrospectively reviewed. Demographic and clinical history was self-reported. Semen analysis included volume, count, motility, morphology, and vitality. The 2010 World Health Organization cutoffs were used. Baseline total testosterone and follicle-stimulating hormone (FSH) levels were recorded. Ethnicity data was classified as Caucasian, African Canadian, Asian, Indo-Canadian, Native Canadian, Hispanic, and Middle Eastern. All patients with complete data were included and statistical analysis was performed. RESULTS A total of 9079 patients were reviewed, of which 3956 patients had complete data. Of these, 839 (21.2%) were azoospermic. After adjusting for age, African Canadians (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.28-2.25) and Asians (1.34; 95% CI 1.11-1.62) were more likely to be azoospermic compared to Caucasians. Similarly, African Canadians (OR 1.75; 95% CI 1.33-2.29) were more likely to be oligospermic and Asians (OR 0.82; 95% CI 0.70-0.97) less likely to be oligospermic. Low volume was found in African Canadian (OR 1.42; 95% CI 1.05-1.91), Asians (OR 1.23; 95% CI 1.01-1.51), and Indo-Canadians (OR 1.47; 95% CI 1.01-2.13). Furthermore, Asians (OR 0.73; 95% CI 0.57-0.93) and Hispanics (OR 0.58; 95% CI 034-0.99) were less likely to have asthenospermia. Asians (OR 0.73; 95% CI 0.57-0.94) and Indo-Canadians (OR 0.58; 95% CI 0.35-0.99) were less likely to have teratozospermia. No differences were seen for vitality. No differences were seen for FSH levels, however, Asians (p<0.01) and Indo-Canadians (p<0.01) were more likely to have lower testosterone. CONCLUSIONS Our study illustrates that variations in semen analyses and hormones exist in men with infertility. This may provide insight into the workup and management for infertile men from different ethnicities.
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Affiliation(s)
- Nahid Punjani
- Division of Urology, Western University, London, ON, Canada
| | - Madhur Nayan
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Keith Jarvi
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Kirk Lo
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Susan Lau
- Division of Urology, University of Toronto, Toronto, ON, Canada
| | - Ethan D Grober
- Division of Urology, University of Toronto, Toronto, ON, Canada
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21
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Marsh C, McCracken M, Gray M, Nangia A, Gay J, Roby KF. Low total motile sperm in transgender women seeking hormone therapy. J Assist Reprod Genet 2019; 36:1639-1648. [PMID: 31250175 DOI: 10.1007/s10815-019-01504-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 06/11/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE This study was undertaken to compare semen quality, hormonal status, and social factors in transgender women seeking fertility preservation with those of fertile cisgender men. Long-range goals are to establish standard practice measures ensuring optimum semen quality for cryopreservation and fertility preservation in transgender women. METHODS This is a case-control study carried out at an academic medical center. Cases are transgender women seeking fertility preservation prior to initiation of hormone therapy. Controls are cisgender men recently fathering a child. All participants completed the Depression Anxiety Stress Scales 21 survey and additional survey questions related to personal behaviors. Complete semen analysis was carried out in a clinical andrology laboratory according to WHO guidelines, 5th edition. Serum follicle stimulating hormone, estradiol, and testosterone were measured at the time of semen analysis. RESULTS Sperm concentration, total sperm per ejaculate, total motile sperm, volume, and normal sperm morphology were significantly lower in transgender females compared with fertile cisgender men. Other measures of semen parameters and hormone concentrations were not different between groups. Survey results indicated transgender women were more likely to have symptoms of depression, anxiety, and stress and utilize tucking and tight undergarments, compared with controls; however, both groups reported similar numbers of ejaculations per week. CONCLUSIONS Although semen parameters were low, cryopreservation of sperm prior to hormone therapy is a viable fertility preservation option for most transgender women. The etiology of the differences in semen parameters is not known. Enhanced education related to personal behaviors or treatment to reduce effects of stressors prior to cryopreservation may improve future fertility potential.
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Affiliation(s)
- Courtney Marsh
- Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA.
- Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
| | - Megan McCracken
- Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA
| | - Meredith Gray
- Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Ajay Nangia
- Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA
- Department of Urology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - Judy Gay
- Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA
| | - Katherine F Roby
- Department of Obstetrics & Gynecology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
- Center for Advanced Reproductive Medicine, University of Kansas Medical Center, Overland Park, KS, 66211, USA.
- Institute for Reproduction and Perinatal Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
- Department of Anatomy & Cell Biology, University of Kansas Medical Center, Kansas City, KS, 66160, USA.
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