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Sharma R, Gupta S, Agarwal A, Henkel R, Finelli R, Parekh N, Saleh R, Arafa M, Ko E, Zini A, Tadros N, Shah R, Ambar RF, Elbardisi H, Sengupta P, Martinez M, Boitrelle F, Simopoulou M, Vogiatzi P, Gosalvez J, Kavoussi P, Kandil H, Palani A, Rodriguez Peña M, Rajmil O, Busetto GM, Anagnostopoulou C, Micic S, Alves MG, Rocco L, Mostafa T, Alvarez JG, Jindal S, Sallam HN, Maldonado Rosas I, Lewis SEM, AlSaid S, Altan M, Park HJ, Ramsay J, Parekattil S, Sabbaghian M, Tremellen K, Khalafalla K, Durairajanayagam D, Colpi GM. Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility. World J Mens Health 2022; 40:191-207. [PMID: 34169683 PMCID: PMC8987138 DOI: 10.5534/wjmh.210063] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 02/05/2023] Open
Abstract
The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×106/mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with poor sperm quality, increased level of sperm DNA fragmentation and low fertility potential. The presence of leukocytes and pathogens in the semen may be a sign of infection and/or localized inflammatory response in the male genital tract and the accessory glands. Common uro-pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, and Escherichia coli can cause epididymitis, epididymo-orchitis, or prostatitis. The relationship between leukocytospermia and infection is unclear. Therefore, we describe the pathogens responsible for male genital tract infections and their association with leukocytospermia. The review also examines the diagnostic tests available to identify seminal leukocytes. The role of leukocytospermia in male infertility and its management is also discussed.
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Affiliation(s)
- Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, Canada
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Rafael F Ambar
- Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Mara Simopoulou
- Department of Physiology, School of Medicine, National & Kapodistrian University of Athens, Maroussi, Athens, Greece
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
| | - Jaime Gosalvez
- Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Marcelo Rodriguez Peña
- Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
| | - Osvaldo Rajmil
- Clinical and training Centre of the European Academy of Andrology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
| | | | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Marco G Alves
- Department of Anatomy & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Juan G Alvarez
- Centro ANDROGEN, La Coruña, Spain
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Israel Maldonado Rosas
- Centerf Technological Innovation, and Reproductive Medicine (CITMER), Mexico City, Mexico
| | - Sheena E M Lewis
- Examenlab Ltd., Weavers Court Business Park, Linfield Road, Belfast, Northern Ireland, UK
| | - Sami AlSaid
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Mesut Altan
- Department of Urology, Haceppete University, Ankara, Turkey
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
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Choksi A, Harnisch B, Honig S. What Every Provider Should Know About the 2020–2021 Updated AUA/ASRM Guidelines on Male Factor Infertility. CURRENT SEXUAL HEALTH REPORTS 2022. [DOI: 10.1007/s11930-022-00325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Saber SM, Alduweesh NB, Abd El-Rahman HA, Omar AR. Effect of Filgrastim on adult male rats' fertility and reproductive performance. Saudi J Biol Sci 2021; 28:2558-2565. [PMID: 33911967 PMCID: PMC8071903 DOI: 10.1016/j.sjbs.2021.01.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/24/2021] [Accepted: 01/27/2021] [Indexed: 01/24/2023] Open
Abstract
Filgrastim is a recombinant protein used in treatment neutropenia caused by myelosuppressive medications for patients with non-myeloid cancer. However, its effect in male fertility is not clear. So, the current work aims to clarify the effect of Filgrastim on the reproductive state in Wistar rats. Eighteen (18) male Wistar rats were divided into three groups (6/each). Group (I) where the rats were injected with 0.5 ml/kg/day of distilled water and served as Control Group. The Group (II) animals received intraperitoneal injection of therapeutic dose of 30.83 mcg/kg/day of Filgrastim for one week. The Group (III) rats received the same dose by the same route of Filgrastim for two weeks. Sera of blood samples were processed for serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (TS). Semen analysis and resazurine reduction test (RRT) were performed. Assaying for malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) was done. The testes were retrieved for histopathological and immunohistochemical studies for caspase-3 detection. Our results revealed that filgrastim affects sperm morphology, significantly decreased the RRT and the reproductive hormones level, elevated the oxidative stress status and induced several histopathological changes in testes with an increased in immunoexpression of caspase-3 in testes tissues. The results of this work demonstrated that Filgrastim may had a deleterious effect on male fertility.
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Affiliation(s)
- Sara Mohamed Saber
- Department of Histopathology, National Organization for Drug Control and Research, (NODCAR), Egypt
| | - Nouf Bader Alduweesh
- Department of Zoology, Faculty of Science, Kuwait University, Kuwait
- Department of Zoology, Faculty of Science, Cairo University, Egypt
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The marker of alkyl DNA base damage, N7-methylguanine, is associated with semen quality in men. Sci Rep 2021; 11:3121. [PMID: 33542261 PMCID: PMC7862252 DOI: 10.1038/s41598-021-81674-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 11/18/2020] [Indexed: 12/13/2022] Open
Abstract
Sperm DNA contains a range of DNA base damage that can arise, in part, from exposure to methylating agents. However, the effects are not fully characterized and so the aim of this study was to investigate associations between semen quality and the levels of N7-methyldeoxyguanosine (N7-MedG), a marker of exposure to methylating agents, and other markers of DNA damage and DNA methylation. Sperm samples were collected from 105 men attending an assisted reproduction clinic as part of a couple undergoing treatment for infertility and semen quality assessed manually according to WHO guidelines. Semen levels of N7-MedG, quantified by immunoslotblot, were significantly higher in men with sperm concentration < 15 × 106/ml (p ≤ 0.01), semen volume < 1.5 ml (p ≤ 0.05) and also in men with any aspect of semen quality below WHO reference levels (p ≤ 0.001). Measures of neutral Comet DNA damage were correlated with semen quality in a univariate analysis but not after adjustment for N7-MedG levels. Sperm concentration was negatively associated with % methylation at the gene for DAZL but no other marker of global or gene-specific DNA methylation. Results support the hypothesis that the known toxic and DNA damaging properties of alkylating agent exposure may have direct deleterious consequences on semen quality.
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Barbonetti A, Bisogno T, Battista N, Piscitelli F, Micillo A, Francavilla S, Maccarrone M, Francavilla F. 2-arachidonoylglycerol levels are increased in leukocytospermia and correlate with seminal macrophages. Andrology 2016; 5:87-94. [DOI: 10.1111/andr.12283] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 08/01/2016] [Accepted: 08/05/2016] [Indexed: 12/11/2022]
Affiliation(s)
- A. Barbonetti
- San Raffaele Sulmona Institute; Sulmona Italy
- Andrology Unit; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - T. Bisogno
- Endocannabinoid Research Group; Institute of Biomolecular Chemistry; National Research Council; Pozzuoli Italy
- Department of Medicine; Campus Bio-Medico University of Rome; Rome Italy
| | - N. Battista
- Faculty of Bioscience and Technology for Food, Agriculture and Environment; University of Teramo; Teramo Italy
| | - F. Piscitelli
- Endocannabinoid Research Group; Institute of Biomolecular Chemistry; National Research Council; Pozzuoli Italy
| | - A. Micillo
- Andrology Unit; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - S. Francavilla
- Andrology Unit; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - M. Maccarrone
- Department of Medicine; Campus Bio-Medico University of Rome; Rome Italy
| | - F. Francavilla
- Andrology Unit; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
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Micillo A, Vassallo MRC, Cordeschi G, D'Andrea S, Necozione S, Francavilla F, Francavilla S, Barbonetti A. Semen leukocytes and oxidative-dependent DNA damage of spermatozoa in male partners of subfertile couples with no symptoms of genital tract infection. Andrology 2016; 4:808-15. [DOI: 10.1111/andr.12188] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/15/2016] [Accepted: 02/23/2016] [Indexed: 12/20/2022]
Affiliation(s)
- A. Micillo
- Andrology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - M. R. C. Vassallo
- Andrology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - G. Cordeschi
- Andrology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - S. D'Andrea
- Andrology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - S. Necozione
- Epidemiology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - F. Francavilla
- Andrology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
| | - S. Francavilla
- Andrology; Department of Life, Health and Environment Sciences; University of L'Aquila; L'Aquila Italy
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Condorelli RA, Calogero AE, Vicari E, Mongioi' L, Burgio G, Cannarella R, Giacone F, Iacoviello L, Morgia G, Favilla V, Cimino S, La Vignera S. Reduced Seminal Concentration of CD45pos Cells after Follicle-Stimulating Hormone Treatment in Selected Patients with Idiopathic Oligoasthenoteratozoospermia. Int J Endocrinol 2014; 2014:372060. [PMID: 24550984 PMCID: PMC3914479 DOI: 10.1155/2014/372060] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 11/20/2013] [Accepted: 11/20/2013] [Indexed: 11/17/2022] Open
Abstract
The present study evaluated the conventional sperm parameters and the seminal concentration of CD45pos cells (pan-leukocyte marker) of infertile patients with idiopathic oligoasthenoteratozoospermia (OAT). The patients were arbitrarily divided into three groups treated with recombinant follicle-stimulating hormone FSH: α (Group A = 20 patients), recombinant FSH- β (Group B = 20 patients), and highly purified human FSH (Group C = 14 patients). All treated groups achieved a similar improvement of the main sperm parameters (density, progressive motility, and morphology), but only the increase in the percentage of spermatozoa with normal morphology was significant compared to the baseline in all three examined groups. Moreover, all groups had a significant reduction of the seminal concentration of CD45pos cells and of the percentage of immature germ cells. Before and after the treatment, the concentration of CD45pos cells showed a positive linear correlation with the percentage of immature germ cells and a negative correlation with the percentage of spermatozoa with regular morphology. These results demonstrate that treatment with FSH is effective in patients with idiopathic OAT and that there are no significant differences between the different preparations. The novelty of this study is in the significant reduction of the concentration of CD45pos cells observed after the treatment.
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Affiliation(s)
- Rosita A. Condorelli
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Aldo E. Calogero
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Enzo Vicari
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Laura Mongioi'
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Giovanni Burgio
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Rossella Cannarella
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Filippo Giacone
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Linda Iacoviello
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
| | - Giuseppe Morgia
- Department of Urology, University of Catania, Catania, Italy
| | | | | | - Sandro La Vignera
- Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology and Internal Medicine, University of Catania, Policlinico “G. Rodolico”, Building 4, Rm 2C18, Via S. Sofia 78, 95123 Catania, Italy
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Eggert-Kruse W, Batschulat K, Demirakca T, Strowitzki T. Male immunity to the chlamydial 60 kDa heat shock protein (HSP 60) - associated with semen quality? Andrologia 2014; 47:66-76. [DOI: 10.1111/and.12224] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2013] [Indexed: 11/30/2022] Open
Affiliation(s)
- W. Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine; Women's Hospital; University of Heidelberg; Heidelberg Germany
| | - K. Batschulat
- Department of Gynecological Endocrinology and Reproductive Medicine; Women's Hospital; University of Heidelberg; Heidelberg Germany
| | - T. Demirakca
- Department of Gynecological Endocrinology and Reproductive Medicine; Women's Hospital; University of Heidelberg; Heidelberg Germany
| | - T. Strowitzki
- Department of Gynecological Endocrinology and Reproductive Medicine; Women's Hospital; University of Heidelberg; Heidelberg Germany
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Duan YG, Zhang Q, Liu Y, Mou L, Li G, Gui Y, Cai Z. Dendritic cells in semen of infertile men: association with sperm quality and inflammatory status of the epididymis. Fertil Steril 2014; 101:70-77.e3. [DOI: 10.1016/j.fertnstert.2013.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 08/18/2013] [Accepted: 09/04/2013] [Indexed: 10/26/2022]
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Schlehofer JR, Boeke C, Reuland M, Eggert-Kruse W. Presence of DNA of adeno-associated virus in subfertile couples, but no association with fertility factors. Hum Reprod 2012; 27:770-8. [PMID: 22215624 DOI: 10.1093/humrep/der427] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Based on previous reports suggesting a role of adeno-associated virus (AAV) in miscarriage, the prevalence of AAV DNA in genital tracts of male and female partners of subfertile couples was determined to assess a potential association of AAV infection with clinically relevant parameters of male and female fertility. METHODS A prospective study was performed in the outpatient infertility clinic of a university-based hospital. Semen samples and endocervical material obtained from 146 male and 134 female partners of asymptomatic subfertile couples were analyzed for the presence of AAV DNA (using nested PCR). Patients' medical histories and details of clinical examinations were recorded. Semen quality, including sperm functional capacity and the presence of antisperm antibodies (ASA) and seminal white blood cells (WBC), was assessed in aliquots of the same ejaculate. Detailed examinations of the cervical factor and other variables of female subfertility were performed. Both partners were screened for bacterial infection. RESULTS The presence of AAV DNA in semen was not significantly related to semen quality, including sperm functional capacity or local ASA, nor was it coupled to the presence of AAV in the endocervical material of female partners. The presence of AAV DNA was not associated with the presence of other micro-organisms of the lower genital tract or with seminal WBC in men. AAV DNA in endocervical material was not related to a reduced quality of cervical mucus or to other female infertility factors. CONCLUSIONS The presence of AAV DNA in semen samples or endocervical swabs showed no significant association with clinically relevant infertility factors. However, longitudinal studies may clarify previous suggestions of an influence of AAV infection on early pregnancy problems.
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Affiliation(s)
- J R Schlehofer
- Department of Tumor Virology (F010), German Cancer Research Center, Im Neuenheimer Feld 242, Heidelberg 69120, Germany.
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Are Chlamydial Lipopolysaccachide-directed Antibodies in Seminal Plasma or Serum Clinically Significant During Investigation of Male Infertility? Urology 2011; 77:1101-6. [DOI: 10.1016/j.urology.2010.11.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2010] [Revised: 11/11/2010] [Accepted: 11/11/2010] [Indexed: 11/23/2022]
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12
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Tremellen K, Tunc O. Macrophage activity in semen is significantly correlated with sperm quality in infertile men. ACTA ACUST UNITED AC 2010; 33:823-31. [DOI: 10.1111/j.1365-2605.2009.01037.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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13
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Eggert-Kruse W, Zimmermann K, Geißler W, Ehrmann A, Boit R, Strowitzki T. Clinical relevance of polymorphonuclear (PMN-) elastase determination in semen and serum during infertility investigation. ACTA ACUST UNITED AC 2009; 32:317-29. [DOI: 10.1111/j.1365-2605.2007.00852.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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14
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Proceedings of the 3rd Dies Andrologicus ‘Immunoreactions of the Human Testis and Spermatozoa’. Andrologia 2009. [DOI: 10.1111/j.1439-0272.1999.tb01431.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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15
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Cumming JA, Carrell DT. Utility of reflexive semen cultures for detecting bacterial infections in patients with infertility and leukocytospermia. Fertil Steril 2009; 91:1486-8. [DOI: 10.1016/j.fertnstert.2008.07.1756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2008] [Revised: 06/30/2008] [Accepted: 07/02/2008] [Indexed: 10/21/2022]
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16
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Cytomegalovirus (CMV) infection—related to male and/or female infertility factors? Fertil Steril 2009; 91:67-82. [DOI: 10.1016/j.fertnstert.2007.11.014] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2007] [Revised: 11/11/2007] [Accepted: 11/11/2007] [Indexed: 11/18/2022]
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17
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Pelliccione F, D’Angeli A, Cordeschi G, Mihalca R, Ciociola F, Necozione S, Francavilla F, Francavilla S. Seminal macrophages in ejaculates from men with couple infertility. ACTA ACUST UNITED AC 2008; 32:623-8. [DOI: 10.1111/j.1365-2605.2008.00909.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Role for tumor necrosis factor alpha (TNF-alpha) and interleukin 1-beta (IL-1beta) determination in seminal plasma during infertility investigation. Fertil Steril 2007; 87:810-23. [PMID: 17430733 DOI: 10.1016/j.fertnstert.2006.08.103] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2005] [Revised: 08/31/2006] [Accepted: 08/31/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate the clinical relevance of tumor necrosis factor alpha (TNF-alpha) and interleukin 1-beta (IL-1beta) determination in seminal plasma during infertility investigation. DESIGN Prospective study. SETTING Outpatient infertility clinic of a university-based hospital. PATIENT(S) Randomly chosen asymptomatic males (n = 148) from subfertile couples. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Determination of TNF-alpha and IL-1beta in seminal plasma (SP) by enzyme-linked immunosorbent assay (ELISA). In aliquots of the same ejaculates: 1) evaluation of semen quality with sperm analysis and sperm function testing; 2) determination of antisperm antibodies (ASA) of the immunoglobulin (Ig) G and IgA class; 3) microbial screening; and 4) immunocytochemical round cell differentiation to determine leukocyte counts and ratios. Medical history, clinical examination, and determination of subsequent fertility (after control for female infertility factors). RESULT(S) The concentrations of TNF-alpha and IL-1beta in SP correlated significantly (r = 0.65; P<.0001), and these parameters were significantly related to the leukocyte ratio (%LC) of the seminal round cells (r = 0.36; P<.001) and the leukocyte counts per ejaculate (r = 0.34; P<.001). There was no relationship of TNF-alpha and IL-1beta levels in SP with semen quality or parameters of sperm functional capacity, and there was no association with local ASA of the IgG or IgA class. The concentration of both cytokines was also not related to the outcome of the microbial screening and did not affect subsequent fertility. No correlation of TNF-alpha and IL-1beta levels in SP with the concentration of C-reactive protein in same-day serum samples was found. CONCLUSION(S) The levels of TNF-alpha and IL-1beta in seminal fluid correlate significantly with leukocyte counts and ratios in the same ejaculates, as indicators of silent male genital tract infection/inflammation. However, this is not related to semen cultures in asymptomatic individuals and not associated with clinically relevant parameters of semen quality, including sperm fertilizing capacity.
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Bezold G, Politch JA, Kiviat NB, Kuypers JM, Wolff H, Anderson DJ. Prevalence of sexually transmissible pathogens in semen from asymptomatic male infertility patients with and without leukocytospermia. Fertil Steril 2007; 87:1087-97. [PMID: 17433312 PMCID: PMC2697906 DOI: 10.1016/j.fertnstert.2006.08.109] [Citation(s) in RCA: 147] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2006] [Revised: 08/08/2006] [Accepted: 08/08/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the prevalence of pathogens that cause sexually transmitted infections (STIs) in semen from asymptomatic male infertility patients with and without leukocytospermia (LCS), and associations between STIs, inflammatory markers, and other semen variables. DESIGN Retrospective, controlled study. SETTING Academic Medical Center. PATIENT(S) Two hundred and forty-one male infertility patients undergoing routine semen analysis: 132 with LCS, and 109 without LCS. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The DNA from STI pathogens (human papillomavirus [HPV], cytomegalovirus [CMV], herpes simplex virus [HSV], human herpesvirus type 6 [HHV-6], Epstein-Barr virus [EBV], hepatitis B virus [HBV], and Chlamydia trachomatis [CT]), routine semen parameters, and markers of accessory gland and epididymal function and inflammation. RESULT(S) The DNA from STI pathogens was detected in 45/241 (18.7%) of the samples (CMV, 8.7%; HPV, 4.5%; HHV-6, 3.7%; HSV, 3.7%; CT, 2.5%; EBV, 0.4%; and HBV, 0%), with no difference in prevalence between the LCS and non-LCS groups. The DNA of STI pathogens in semen was associated with a decrease in sperm concentration, motile sperm concentration, total sperm count, and neutral alpha-glucosidase concentration, whereas LCS was associated with a decrease in total sperm count, percent normal forms, and fructose concentration. CONCLUSION(S) The DNA of STI pathogens was detected in semen from a high percentage of asymptomatic male infertility patients, and was associated with poor semen quality. Efforts to diagnose and treat subclinical genital-tract infections should be intensified.
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Affiliation(s)
- Guntram Bezold
- Fearing Research Laboratory, Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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20
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Jedrzejczak P, Fraczek M, Szumała-Kakol A, Taszarek-Hauke G, Pawelczyk L, Kurpisz M. Consequences of semen inflammation and lipid peroxidation on fertilization capacity of spermatozoa in in vitro conditions. ACTA ACUST UNITED AC 2005; 28:275-83. [PMID: 16128987 DOI: 10.1111/j.1365-2605.2005.00547.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A body of data exists on reactive oxygen species (ROS) release, however, no direct correlation was found between the oxidative stress and infertility. The aim of the study was to measure semen oxidative stress and its correlation with classical in vitro fertilization (IVF) rate. A prospective study in academic non-profit institution where 79 infertile couples were subjected to IVF programme was conducted. Two infertile groups were discriminated according to the pronuclei presence in IVF. The main outcome measure (pronuclei presence) was then correlated with lipid peroxidation product in semen (ROS effect). Although the average IL-8 levels and malondialdehyde (MDA) content in semen did not differ between the studied subgroups (successful vs. non-successful fertilization), a statistically significant negative correlation was found between MDA level and fertilization rate in performed regression analysis. Thus we may suggest that MDA levels in seminal plasma may have prognostic value for IVF success.
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Affiliation(s)
- Piotr Jedrzejczak
- Clinic of Infertility and Reproductive Endocrinology, School of Medicine, Poznań, Poland
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Aziz N, Agarwal A, Lewis-Jones I, Sharma RK, Thomas AJ. Novel associations between specific sperm morphological defects and leukocytospermia. Fertil Steril 2004; 82:621-7. [PMID: 15374705 DOI: 10.1016/j.fertnstert.2004.02.112] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2003] [Revised: 02/09/2004] [Accepted: 02/09/2004] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine the relationship between leukocyte concentrations in semen and sperm morphology in a group of infertile men and healthy fertile donors. DESIGN A prospective clinical study. SETTING Male infertility clinic at a tertiary care teaching hospital and a reproductive medicine unit at a Women's Hospital in the United Kingdom. PATIENT(S) Fifty-six infertile men and 13 healthy fertile sperm donors (control). INTERVENTION(S) Standard semen analysis, seminal leukocyte concentration, and the assessment of sperm morphology and sperm deformity index (SDI), applying Tygerberg's strict criteria. MAIN OUTCOME MEASURE(S) Granulocyte concentrations in semen, percentages of different sperm morphological abnormalities, and SDI scores. RESULT(S) Leukocyte concentrations were statistically significantly and negatively correlated with the proportion of sperm with damaged acrosomes, cytoplasmic droplet, tail defects, and SDI scores with normal and borderline morphology. The percentage sperm motility was significantly and negatively correlated with leukocytic concentration in semen. However, the leukocytic concentration was not significantly correlated with sperm concentration. CONCLUSION(S) This is the first study to report a significant positive correlation between leukocytospermia and sperm tail defects, acrosomal damage, and high SDI scores. These observations suggest that leukocytospermia is associated with compromised sperm structural integrity.
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Affiliation(s)
- Nabil Aziz
- Reproduction Medicine Unit, Liverpool Women's Hospital, University of Liverpool, Liverpool, United Kingdom
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23
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Boit R, Petzoldt D, Klinga K, Eggert-Kruse W. C3 in seminal plasma has no additional informative value in the diagnosis of infection/inflammation of the male genital tract. Andrologia 2003; 35:93-9. [PMID: 12653782 DOI: 10.1046/j.1439-0272.2003.00545.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to determine the clinical significance of complement fraction C3 (C3c) in seminal plasma. Therefore 120 samples from randomly chosen subfertile males without signs of genital tract infection were screened for C3 and for seminal leucocytes as markers for subclinical infection/inflammation. A comprehensive semen evaluation included sperm analysis, sperm migration testing, immunocytochemical round cell differentiation to determine seminal leucocyte counts and the leucocyte ratio and semen cultures, in aliquots of the same ejaculates. C3 concentrations were significantly correlated with leucocyte counts per ml (P < 0.002) and per ejaculate (P < 0.001), and with the leucocyte ratio (P < 0.001). No association of C3 concentrations with semen quality or with the bacterial colonization of semen samples was found. The significant association with seminal leucocytes suggests that C3 might be used as an additional marker for silent male genital tract infection. In comparison with semen leucocytes, C3 screening does not reveal any further information about semen quality or infection/inflammation pathogenesis of the male genital tract.
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Affiliation(s)
- R Boit
- Department of Dermatology, Division of Andrology and STD, University of Heidelberg, Vossstrasse 2, 69115 Heidelberg, Germany.
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Saleh RA, Agarwal A, Kandirali E, Sharma RK, Thomas AJ, Nada EA, Evenson DP, Alvarez JG. Leukocytospermia is associated with increased reactive oxygen species production by human spermatozoa. Fertil Steril 2002; 78:1215-24. [PMID: 12477515 DOI: 10.1016/s0015-0282(02)04237-1] [Citation(s) in RCA: 177] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
To investigate the role of increased seminal leukocytes in enhancing reactive oxygen species (ROS) production by human spermatozoa.A prospective study. Male infertility clinic.Forty-eight infertile men. Standard semen analysis. Assessment of sperm nuclear DNA damage by sperm chromatin structure assay. Incubation of spermatozoa from nonleukocytospermic samples with blood neutrophils. Spontaneous and phorbol 12-myristate 13-acetate (PMA)-induced ROS production in pure-sperm suspensions (after removal of leukocytes) as measured by a chemiluminescence assay. Levels of spontaneous and PMA-induced ROS production in pure-sperm suspensions from the infertile men with a diagnosis of leukocytospermia (n = 16) were significantly higher compared with the case of infertile men without leukocytospermia (n = 32) and with the case of a control group of healthy volunteers (n = 13). A similar pattern of increased ROS was observed when spermatozoa were incubated with blood neutrophils. Leukocytospermia was associated with a significant decrease in sperm motility and increase in DNA damage. Increased seminal leukocytes may play a role in stimulating ROS production by human spermatozoa. Such stimulation may be mediated via direct cell-cell contact or by soluble products released by leukocytes. Poor sperm quality in leukocytospermic samples may be due to leukocyte-mediated oxidative stress.
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Affiliation(s)
- Ramadan A Saleh
- Center for Advanced Research in Human Reproduction, Infertility, and Sexual Function, Urological Institute, The Cleveland Clinic Foundation., Cleveland, Ohio 44195, USA
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25
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Alvarez JG, Sharma RK, Ollero M, Saleh RA, Lopez MC, Thomas AJ, Evenson DP, Agarwal A. Increased DNA damage in sperm from leukocytospermic semen samples as determined by the sperm chromatin structure assay. Fertil Steril 2002; 78:319-29. [PMID: 12137869 DOI: 10.1016/s0015-0282(02)03201-6] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine DNA damage as measured by the sperm chromatin structure assay (SCSA) in subsets of human spermatozoa at different stages of maturation in patients who are undergoing infertility evaluation. DESIGN Prospective study. SETTING Andrology laboratory at a tertiary care hospital. PATIENT(S) Fifty-six patients undergoing infertility evaluation. Patients with normal semen parameters (n = 17), abnormal semen parameters (n = 29), leukocytospermia (n = 10), and a group of healthy fertile men (n = 18) were included in the study. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The shift of green (native DNA) to red (denatured, single-stranded DNA) fluorescence was measured and quantified using the expression alpha(t) (red fluorescence/[red + green fluorescence] per cell). Sperm DNA damage was examined in subsets of spermatozoa isolated by a three-step density gradient. The DNA damage was correlated with classic semen characteristics. RESULT(S) Leukocyte concentration in semen was directly correlated with chromatin alterations in immature and mature sperm. Leukocyte concentration in semen was also directly correlated with immature germ cell concentration and the percentage of abnormal forms in semen. CONCLUSION(S) The increase in chromatin alterations and DNA damage in sperm, as defined by the sperm chromatin structure assay from leukocytospermic samples may be related to alterations in the regulation of spermatogenesis.
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Affiliation(s)
- Juan G Alvarez
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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26
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Eggert-Kruse W, Neuer A, Clussmann C, Boit R, Geissler W, Rohr G, Strowitzki T. Seminal antibodies to human 60kd heat shock protein (HSP 60) in male partners of subfertile couples. Hum Reprod 2002; 17:726-35. [PMID: 11870127 DOI: 10.1093/humrep/17.3.726] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Heat shock proteins (HSP) are essential mammalian and bacterial stress proteins. At the cellular level, they act as chaperones, have important regulatory functions, and are considered to be an essential factor for reproduction. Scarce information exists on the role of sensitization to HSP and the potential role in the aetiology of male infertility. METHODS The potential association of immunoglobulin (Ig)A antibodies (Ab) to the human 60 kDa heat shock protein (HSP 60) with several parameters of subclinical male genital tract infection/inflammation and with semen quality and sperm fertilizing capacity was analysed in a prospective study. IgA Ab to human HSP 60 were determined in seminal plasma of 202 randomly chosen male partners of subfertile couples with a median duration of infertility of 4 years (range 1-15 years), who were asymptomatic for genital tract infection. After medical history and clinical examination, a comprehensive evaluation of semen quality, in aliquots of the same ejaculates used for HSP Ab determination, included: sperm analysis; local antisperm antibody (ASA) screening; standardized sperm-cervical mucus (CM) penetration testing; immunocytochemical round cell differentiation to determine seminal leukocyte counts; evaluation of complement fraction C(3) and of some pro-inflammatory cytokines; and microbial screening. Subsequent fertility was recorded after 6 months. RESULTS The presence of HSP 60 IgA Ab in seminal fluid (total positive 6.9%) was significantly associated with leukocytospermia, the presence of C(3), and also with high interleukin (IL) levels in seminal plasma. HSP 60 Ab were not related to the bacterial colonization of ejaculates. There was no association of seminal IgA Ab to human HSP 60 with semen quality, determined with microscopical semen analysis, nor with local IgG- or IgA-class ASA. There was no relationship with sperm intrinsic motility and duration of motility in the sperm CM-penetration test, nor with sperm fertilizing capacity. CONCLUSIONS The combined presence of IgA Ab to human 60 kDa HSP, leukocytes and other established infection/inflammation markers in semen might suggest a potential role of the immune response to heat shock proteins (HSP) in cases of silent male genital tract infection, but the results do not indicate a marked relationship of HSP 60 Ab in seminal fluid with standard parameters of semen quality.
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Affiliation(s)
- Waltraud Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, University of Heidelberg, Vosstrasse 9, 69115 Heidelberg, Germany
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27
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Eggert-Kruse W, Zwick EM, Batschulat K, Rohr G, Armbruster FP, Petzoldt D, Strowitzki T. Are zinc levels in seminal plasma associated with seminal leukocytes and other determinants of semen quality? Fertil Steril 2002; 77:260-9. [PMID: 11821081 DOI: 10.1016/s0015-0282(01)02974-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To evaluate a potential association of zinc levels with seminal leukocytes, the outcome of semen cultures; and semen quality and sperm fertilizing capacity. DESIGN Prospective study. SETTING Outpatient infertility clinic of a university hospital. PATIENT(S) Two hundred fifty-six randomly chosen asymptomatic males from subfertile couples. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Determination of zinc in seminal plasma by flame atomic absorption spectroscopy. In aliquots of the same ejaculates the following tests were performed: immunocytochemical round cell differentiation to determine leukocyte counts and ratios, microbial screening, and comprehensive evaluation of semen quality (sperm analysis, biochemical parameters, antisperm antibody testing, and in vitro examination of sperm ability to penetrate cervical mucus). The patients underwent medical history, clinical examination, and postcoital testing. Subsequent fertility was determined (controlled for female infertility factors). RESULT(S) The concentration of zinc in seminal plasma did not correlate in a statistically significant way with leukocytes in semen, nor was it associated with bacterial colonization. There was no statistically significant relationship of zinc in seminal plasma or serum with semen quality parameters nor with local antisperm antibody testing of the IgG or IgA class. Zinc levels did not influence sperm capacity to penetrate cervical mucus in vitro or in vivo, and did not affect subsequent fertility. CONCLUSION(S) The zinc level in seminal fluid and serum is not associated with silent male genital tract infection (indicated by seminal leukocytes); nor is it related to semen cultures in asymptomatic individuals. The lack of association with other semen quality parameters indicates that the routine determination of zinc levels during infertility investigation is not recommended.
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Affiliation(s)
- Waltraud Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital, University of Heidelberg, Vossstrasse 9, 69115 Heidelberg, Germany
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28
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Eggert-Kruse W, Boit R, Rohr G, Aufenanger J, Hund M, Strowitzki T. Relationship of seminal plasma interleukin (IL) -8 and IL-6 with semen quality. Hum Reprod 2001; 16:517-28. [PMID: 11228223 DOI: 10.1093/humrep/16.3.517] [Citation(s) in RCA: 89] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The concentration of interleukin (IL) -8 and IL-6 was determined in seminal plasma (SP) samples from 137 randomly chosen subfertile males to evaluate the relationship with other potential parameters of subclinical infection/inflammation such as seminal leukocytes, and with semen quality in a prospective study. All patients were asymptomatic for genital tract infection. A comprehensive semen evaluation included sperm analysis, sperm migration testing, antisperm antibody screening, immunocytochemical round cell differentiation to determine seminal leukocytes counts and the leukocyte ratio, complement fraction C(3) (C(3c)) determination, and semen cultures, in aliquots of the same ejaculates. The SP concentration of IL-8 was inversely related to semen quality, e.g. to the total number of motile spermatozoa or to the outcome of the sperm migration test (motile sperm harvested after a swim-up procedure). IL-8 concentrations were significantly correlated with leukocyte counts per ml (P < 0.0001) and per ejaculate (P < 0.0001), and with the leukocyte ratio (P < 0.001). All leukocytospermic samples had high IL-8 concentrations (< or =2 ng/ml). The SP concentration of IL-6 was much lower, but was significantly correlated with IL-8 (P < 0.0001). Both IL-8 and IL-6 were significantly related with the C(3c). No association of interleukin concentrations with the bacterial colonization of semen samples was found. The results indicate a marked relationship of some pro-inflammatory cytokines with semen quality. The significant association with seminal leukocytes and other potential inflammation markers suggests that IL-8 might be used as sensitive marker for silent male genital tract infection.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynaecological Endocrinology and Reproductive Medicine, Women's University Hospital, Heidelberg, Germany
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29
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Ricci G, Presani G, Guaschino S, Simeone R, Perticarari S. Leukocyte detection in human semen using flow cytometry. Hum Reprod 2000; 15:1329-37. [PMID: 10831564 DOI: 10.1093/humrep/15.6.1329] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study set out to establish a new method, using flow cytometry, to evaluate leukocytes in semen. Ejaculates of 59 males, asymptomatic for genitourinary infections, were examined. Routine semen analyses were carried out as well as peroxidase and polymorphonuclear granulocyte-elastase detection. Leukocytes were detected combining flow cytometry and monoclonal antibodies (anti-CD45, anti-CD53). This technique reliably assessed the total number of leukocytes and differentiated subpopulations even at low concentrations. The peroxidase test and elastase determination showed good specificity, but only moderate sensitivity versus flow cytometry combined with monoclonal antibodies. No significant association was observed between semen parameters and leukocytospermia whether evaluated by conventional methods or flow cytometry except for a moderate correlation between spermatozoa and CD53-positive cell concentrations. A first comparison of data from patients grouped on the basis of leukocytospermia (>10(6) white blood cells, WBC/ml) or non-leukocytospermia revealed no significant differences in semen parameters; lowering the threshold value for leukocytospermia to 2x10(5) WBC/ml, sperm concentration was reduced in the group with a low number of WBC identified by monoclonal antibodies. Flow cytometry using monoclonal antibodies was seen to be a simple, reproducible method that enables leukocytes in semen to be accurately detected and to identify WBC subpopulations without preliminary purification procedures.
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Affiliation(s)
- G Ricci
- Department of Obstetrics and Gynaecology, University of Trieste, Istituto per l'Infanzia 'Burlo Garofolo', IRCCS, Trieste, Italy.
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Caşkurlu T, Tasci AI, Samasti M, Bayraktar Z, Cek M, Sevin G. Immature germ cells in semen and their correlations with other semen parameters. Int Urol Nephrol 2000; 31:389-93. [PMID: 10672959 DOI: 10.1023/a:1007186405678] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE The significance of the presence of leukocytes and immature germ cells in semen and other parameters of semen is currently a subject of controversy. MATERIALS AND METHODS Semen from 572 subfertile patients was analyzed according to WHO criteria and leukocytes as well as immature germ cells were assessed by identifying the round cells in semen by peroxidase staining. Microbiological investigation was carried out in cases with leukocyte counts of >1,000,000/ml. RESULTS It was found that as the concentration of spermatozoa decreased the rate of immature germ cells increased and this increase was accompanied by a decrease in motility and in the number of spermatozoa with normal morphology. As the sperm count increased, motility, number of spermatozoa with normal morphology and of immature germ cells also increased whereas an increase in sperm motility was accompanied by an increase in the percentage of spermatozoa with normal morphology. Microbiological investigations were negative in patients with semen leukocyte counts of >l,000,000/ml. CONCLUSIONS Although it is possible to establish that the leukocyte and immature germ cell counts correlate with other parameters of semen, these correlations are not statistically significant. The most significant finding is that as the number of sperms decreases, the ratio of immature germ cells to total germ cells increases. While assessing immature germ cells instead of giving special attention to the number of immature germ cells in semen, the ratio of immature germ cells to total germ cells should be considered. The increase of leukocyte count in the semen of oligospermic patients may not always mean leukospermia.
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Affiliation(s)
- T Caşkurlu
- Department of Urology, Vakif Gureba Hospital, Istanbul, Turkey
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Liljedal S, Folstad I, Skarstein F. Secondary sex traits, parasites, immunity and ejaculate quality in the Arctic charr. Proc Biol Sci 1999. [DOI: 10.1098/rspb.1999.0863] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ståle Liljedal
- Department of Ecology, Faculty of Science, University of Tromso, N–9037 TromsB, Norway
| | - Ivar Folstad
- Department of Ecology, Faculty of Science, University of Tromso, N–9037 TromsB, Norway
| | - Frode Skarstein
- Department of Ecology, Faculty of Science, University of Tromso, N–9037 TromsB, Norway
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Abstract
Male genital tract inflammation is reflected by increased numbers of white blood cells (WBC) in semen. An ejaculate containing more than 10(6) WBC ml-1 semen is termed leukocytospermic. Among male infertility patients, the frequency of leukocytospermia is between 10% and 20%. By conventional light microscopy or sperm staining techniques, it is not possible to reliably differentiate WBC from immature germ cells in semen. In contrast, the cytochemical peroxidase method reliably identifies granulocytes, the most prevalent WBC type in semen. The method is cheap, fast and easy to perform. The gold standard for the detection of all WBC populations in semen is immunocytology using monoclonal antibodies. However, it is expensive and time-consuming, thus remaining a research tool at present. The measurement of granulocyte elastase in semen provides information on the number of granulocytes and their inflammatory activation. However, commercial granulocyte elastase enzyme immunoassays are expensive and due to logistical reasons often delay the results for more than 1 week. Leukocyte esterase dipstick tests lack both sensitivity and specificity for the detection of inflammatory changes in semen. For clinical purposes, the peroxidase method is ideally suited to detect inflammatory changes in semen.
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Affiliation(s)
- H Wolff
- Department of Dermatology, Ludwig-Maximilians-University, Munich, Germany
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Abstract
The aim of this study was to investigate the influence of urogenital infections as indicated by leukocytospermia on human sperm morphology, diagnosed cytologically and by means of a leukocyte peroxidase test. A basic semen analysis, including a leukocyte peroxidase test, was prospectively performed on 150 consecutive semen samples. Cytology smears were microscopically investigated for the presence of WBC and the results expressed on a 4 point scale as +/- to +3 WBCs/high power field (HPF). ROC curve analysis indicated that for cases with more than +/- WBC/HPF the peroxidase determined WBC count cut-off value was > 0.25 x 10(6) WBC ml-1 with a sensitivity of 75% and specificity of 90%. The presence of more than +/- WBC/HPF was negatively correlated with sperm morphology characteristics studied. The mean (+/- SD) percentage of morphological normal spermatozoa was 7.0% (SD 4.4) in the WBC negative group (n = 134) compared to 4.3% (SD 3.5) in the WBC positive (n = 16) group (P < 0.0001). There was also an associated increase, 15.3% (SD 13.3) to 23.6% (SD 13.8), in the percentage of spermatozoa with elongated head forms in the WBC positive group (P = 0.0218). No other effect on sperm and acrosome morphology could be found. With the peroxidase determinations there was also a tendency in the WBC positive group (n = 10) towards poorer sperm morphology characteristics, but these changes were not statistically significant. The presence of urogenital infections as diagnosed cytologically was associated with statistically poorer sperm morphology characteristics. This statistical relationship was not found in the peroxidase diagnosed leukocytospermia positive groups.
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Affiliation(s)
- R Menkveld
- Department of Obstetrics and Gynaecology, Tygerberg Hospital, South Africa.
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Eggert-Kruse W, Rohr G, Probst S, Rusu R, Hund M, Demirakca T, Aufenanger J, Runnebaum B, Petzoldt D. Antisperm antibodies and microorganisms in genital secretions--a clinically significant relationship? Andrologia 1998; 30 Suppl 1:61-71. [PMID: 9629445 DOI: 10.1111/j.1439-0272.1998.tb02828.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
In asymptomatic infertility patients, no significant relationship was found between the presence of antisperm antibodies (ASA) in serum and in semen samples (IgG and/or IgA ASA), differentiated with the mixed antiglobulin reaction (MAR), and the microbial colonization of ejaculates covering a broad spectrum of microorganisms. Likewise, there was no significant association of ASA with microbial findings in patients' female partners, who also presented without symptoms of genital tract infection and were screened at the same time. Furthermore, ASA in semen (IgG and IgA) were not significantly related to several potential markers of subclinical male sexual gland infection or inflammation (leukocytes, PMN elastase, albumin, C3c) evaluated in aliquots of the same ejaculates used for immunological testing.
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Affiliation(s)
- W Eggert-Kruse
- Department of Gynecological Endocrinology and Reproductive Medicine, Women's Hospital Heidelberg, Germany
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Eggert-Kruse W, Probst S, Rohr G, Tilgen W, Runnebaum B. Induction of immunoresponse by subclinical male genital tract infection?**Presented in part at the 11th International Meeting of the European Society of Human Reproduction and Embryology, Hamburg, Germany, June 28 to July 1, 1995. Fertil Steril 1996. [DOI: 10.1016/s0015-0282(16)58339-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Conte RA, Luke S, Verma RS. Enumeration of semen leucocytes by fluorescence in situ hybridisation technique. Mol Pathol 1995; 48:M319-21. [PMID: 16696031 PMCID: PMC407998 DOI: 10.1136/mp.48.6.m319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim-To determine whether the fluorescent in situ hybridisation technique (FISH) using a total human DNA genomic probe can be used to enumerate semen leucocytes.Methods-Semen samples from five donors were subjected to a mild KC1 solution. These samples were then biotin labelled under FISH conditions using a total human DNA genomic probe and the leucocyte counts were determined. To check the accuracy of the technique a monoclonal antibody against the common leucocyte antigen CD45 [KC56(T-200)] served as a control. An isotypic control for [KC56(T-200)], the immunoglobulin [MsIgG1], served as a secondary control.Results-Semen leucocytes stained by the FISH technique were easily detected because of their distinct bright yellow colour, while the sperm cells were red. The leucocyte count ranged from 0.5 to 4.9 x 10(6) per ml of semen. KC56(T-200) and its isotypic control MsIgG1, which served as control for the FISH technique, accurately identified 94% and 97% of the semen leucocytes of a control donor, respectively.Conclusions-The FISH technique using a total human DNA probe can accurately and effectively enumerate the overall leucocyte population in semen.
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Affiliation(s)
- R A Conte
- Division of Genetics, Long Island College Hospital-SUNY Health Science Center at Brooklyn, New York, USA
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Eggert-Kruse W, Probst S, Rohr G, Aufenanger J, Runnebaum B. Screening for subclinical inflammation in ejaculates**Presented in part at the 10th International Meeting of the European Society of Human Reproduction and Embryology (ESHRE), Brussels, Belgium, June 25 to 29, 1994. Fertil Steril 1995. [DOI: 10.1016/s0015-0282(16)57921-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
OBJECTIVE To analyze the data available on the biologic significance of white blood cells (WBC) in semen of infertility patients. DATA RESOURCES The relevant literature was reviewed. RESULTS It is not possible to identify reliably WBC by conventional sperm staining techniques. The peroxidase method is sufficient for quantification of granulocytes, but immunocytology is the gold standard for the detection of all WBC populations in semen. Granulocytes are the most prevalent WBC type in semen (50% to 60%), followed by macrophages (20% to 30%) and T-lymphocytes (2% to 5%). The prevalence of leukocytospermia (> 10(6) WBC/mL semen) among male infertility patients is approximately 10% to 20%. There is controversy on the significance of WBC in semen. Whereas some authors did not observe sperm damage in the presence of leukocytospermia, others have found evidence that WBC are significant cofactors of male infertility: [1] seminal WBC numbers were higher in infertility patients than among fertile men; [2] leukocytospermia was associated with decreased sperm numbers and impaired sperm motility; [3] WBC damaged sperm function and hamster ovum penetration in vitro and were important prognostic factors for IVF-ET failure. Because of absence of clinical symptoms, the origin of WBC is difficult to determine. Normally, most WBC appear to originate from the epididymis because vasectomized men show very few WBC in semen. On the other hand, leukocytospermic samples show low citric acid levels, pointing to asymptomatic prostatitis as a source of WBC in semen. Surprisingly, approximately 80% of leukocytospermic samples are microbiologically negative. In some cases Chlamydia trachomatis might have triggered a persistent inflammatory reaction leading to leukocytospermia. Sperm damage by WBC can be mediated by reactive oxygen species, proteases and cytokines. Furthermore, genital tract inflammation facilitates the formation of sperm antibodies. As seminal plasma has strong anti-inflammatory properties and because there is only short contact between sperm and WBC in prostatitis and seminal vesiculitis, inflammations of the epididymis and testis are likely to have the largest impact on sperm. CONCLUSIONS There is ample evidence that WBC can affect sperm function. Further studies are needed to define cofactors that increase or decrease the risk of sperm damage by WBC.
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Affiliation(s)
- H Wolff
- Department of Dermatology, Ludwig-Maximilians-University, Munich, Germany
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De Geyter C, De Geyter M, Behre HM, Schneider HP, Nieschlag E. Peroxidase-positive round cells and microorganisms in human semen together with antibiotic treatment adversely influence the outcome of in-vitro fertilization and embryo transfer. INTERNATIONAL JOURNAL OF ANDROLOGY 1994; 17:127-34. [PMID: 7960186 DOI: 10.1111/j.1365-2605.1994.tb01231.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Human semen contains not only spermatozoa but also other cells routinely differentiated as being peroxidase-positive (e.g. leucocytes) and peroxidase-negative (e.g. immature germ cells and lymphocytes) cells. Considerable uncertainty exists about their role in male fertility. To assess the clinical value of both parameters, and of microorganisms in semen, 391 treatments with in-vitro fertilization and embryo transfer were analysed retrospectively, and the concentrations of both peroxidase-positive and -negative cells, together with the presence of microorganisms in semen, were compared with both the fertilization and pregnancy rates. The data indicate that the results of treatment were affected only by excessively elevated concentrations of peroxidase-positive cells (> 6 x 10(6)/ml) and only marginally by the presence of microorganisms in the semen. The pregnancy rate after in-vitro fertilization and embryo transfer was not improved by antibiotic treatments preceding gamete recovery by several weeks. The increased presence of peroxidase-negative cells (e.g. germ cells) in semen was not associated with a significant change in the pregnancy rate. However, the concentration of peroxidase-negative cells in semen correlated significantly with sperm numbers (p < 0.01), sperm concentration (p < 0.01), and normal morphology rates (p < 0.01). It is concluded that short-term antibiotic treatment of asymptomatic patients before assisted reproduction should be handled with caution. The widespread view that peroxidase-negative cells in semen are harmful is rejected.
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Affiliation(s)
- C De Geyter
- Woman's Hospital of the University, Münster, Germany
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Abstract
Infections of the male genitourinary tract may contribute to infertility by adversely affecting sperm function, causing anatomical obstruction or initiating a leukocyte response. The majority of infertile males are asymptomatic, and the significance and the criteria for the diagnosis of a genital tract infection are controversial. The evaluation for a genital tract infection focuses on urine and semen cultures as well as on the accurate quantitation of seminal leukocytes. An elevated seminal leukocyte count, pyospermia, can be associated with male infertility and may reflect an infectious or inflammatory disorder. In addition, the role of specific genital tract infections such as chlamydiosis, gonorrhea, ureaplasma and trichomoniasis and their possible association with male infertility is addressed.
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Affiliation(s)
- N Bar-Chama
- Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, N.Y
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