Differences in the quality of semen in outdoor workers during summer and winter

Collecting semen samples at home for fertility assessment: time for a new standard?

BACKGROUND

In fertility clinics the standard approach to semen collection involves a private room close to the laboratory to avoid fluctuations in temperature and to control the time between collection and processing. There are still no firm conclusions whether collecting semen at home has any influence on sperm quality and reproductive competence. The purpose of this study was to assess whether the site of semen collection affects semen parameters.

METHODS

This retrospective cohort study performed at a tertiary level public fertility center included 8634 semen samples from 5880 men undergoing fertility assessment from 2015 to 2021. The impact of sample collection site was evaluated using a generalized linear mixed model. A subgroup analysis comparing clinic to home collection within the same patient was performed on 1260 samples from 428 men by paired t-test or Wilcoxon Signed Rank Test.

RESULTS

Samples collected at home (N.=3240) had significantly higher semen volume, sperm concentration and total sperm count respect to samples collected at clinic (N.=5530) (median (range): 2.9 (0.0-13.9) mL versus 2.9 (0.0-11.5) mL, P=0.016; 24.0 (0.0-252.0) million/mL versus 18.0 (0.0-390.0), P<0.0001; 64.6 (0.0-946.0) million versus 49.3 (0.0-1045.0), P<0.0001, respectively). There was no difference in abstinence period and sperm motility. Paired comparisons of semen characteristics in 428 patients with home-collected (N.=583) and clinic-collected (N.=677) samples confirmed a no negative effect on volume and total sperm count.

CONCLUSIONS

Our data provide evidence for a not disadvantage with collection at home.

Association of occupations with decreased semen quality in eastern China: a cross-sectional study of 12 301 semen donors

OBJECTIVES

This study aims to examine the association between occupational factors and semen quality in semen donors in eastern China.

METHODS

We recruited 12 301 semen donors from 2006 to 2020 as the studying population. A self-designed questionnaire was applied for collecting lifestyle and work style information. Semen samples were analysed according to WHO guidelines. A crude and adjusted linear regression model was used to analyse the association between occupational factors and semen quality.

RESULTS

College students accounted for 36.2% of all semen donors. The majority (81.3%) of semen donors were between 18 year and 30 years. Soldiers or the police had the highest semen volume (the median value=3.8 mL), however, they had the lowest sperm concentration (53.6×10⁶/ml) and sperm motility (45.5%). Workers in finance or insurance had an elevated risk of low semen volume, sperm concentration and total sperm count (OR=1.43, 1.57 and 1.98, respectively). Unemployed men had a high risk of low sperm concentration and low total sperm count (OR=1.84 and 1.58, respectively). Working in the information technology industry had a deleterious effect on the progressive motility of sperm (OR=1.27, 95% CI 1.03 to 1.57).

CONCLUSION

Our study indicated that sedentary work style and intensive sports in certain professions might be associated with decreased semen quality. We reported evidence of becoming unemployed on the damage to semen quality. Hence, we advocate a healthy work style to improve semen quality in eastern China.

Seasonal Influence on Assisted Reproductive Technology Outcomes: A Retrospective Analysis of 1409 Cycles

Background:

It is well known that seasonal variations influence natural conception and birth rates variably in different populations. It has been hypothesised that similar seasonal influences may affect treatment outcomes following assisted reproductive technology (ART). However, most studies report conflicting results.

Aim:

The aim of the study is to elucidate whether seasonality had any impact on the treatment success of the ART program.

Study Setting and Design:

We conducted a retrospective cohort study at a university-level tertiary care hospital in South India.

Materials and Methods:

All couples who underwent ART between January 2012 and December 2016 were included in the study. We divided the study population into three groups based on the seasonal differences experienced in our region. The primary outcome was live birth rate (LBR).

Statistical Analysis:

Univariate and multiple logistic regression models were used to compare outcomes and results reported as odds ratio (OR) and 95% confidence interval (CI).

Results:

Univariate analysis revealed no significant difference in LBR in monsoon season (174/651, 26.7% vs. 83/319, 26.0%; OR 1.04, 95% CI 0.77,1.41; P = 0.81) as compared to summer. However, LBR was significantly higher in winter season (114/341, 33.4% vs. 83/319, 26.0%; OR 1.43; 95% CI: 1.02, 2.00; P = 0.04). Further, multivariate analysis following adjustment for various confounding factors revealed no significant statistical difference in LBR in monsoon (adjusted odds ratio [aOR], 0.92; 95% CI: 0.66, 1.26; P = 0.59) or winter (aOR 1.32; 95% CI: 0.92, 1.88; P = 0.13) as compared to summer season.

Conclusion:

The current study found no significant effect of seasonal variation on LBR following ART.

Analysing the seasonality of births in mainland China

The seasonality of human births varies in different countries and regions. Explanations for this variation have been divided into biological and behavioural factors. This paper documents birth seasonality in mainland China using data for a large sample from China's Fifth National Population Census (FNPC) conducted in 2000. The main method used was the decomposition of monthly time series birth data into annual, seasonal and random trends. The results show large seasonal birth fluctuations, with a salient peak of October births. The study hypothesis is that this seasonal birth pattern is partially due to a home-bound wave of movement of people after the annual Spring Festival. Subsequent analysis of the calculated de-trended monthly births provided supportive evidence for this hypothesis. Further in-depth analysis showed that the magnitude of births varied with location and family characteristics. This result should inform researchers in the field of economics, where seasonality of births has been previously regarded as exogenous.

Ambient temperature, birth rate, and birth outcomes: evidence from South Korea

The effects from rising temperatures, a symptom of climate change, have become a significant concern. This study finds that one additional day with a maximum temperature of 30-32 °C (86-89.6 °F), relative to a day with a temperature of 28-30 °C (82.4-86 °F), decreases the birth rate 9 months later by 0.24%, or 92 babies per month in South Korea. This result is robust to various specifications and samples. This study also found that the impact of the temperature bin did not vary according to the mother's characteristics, including education and age. That is, high temperature has no differential effect on mothers of different backgrounds. Finally, we found no significant temperature effect on birth outcomes, but we cannot rule out that children born 9 months after summer heat are a selected (healthy) group.

Heat exposure induces oxidative stress and DNA damage in the male germ line

The reproductive consequences of global warming are not currently understood. In order to address this issue, we have examined the reproductive consequences of exposing male mice to a mild heat stress. For this purpose, adult male mice were exposed to an elevated ambient temperature of 35°C under two exposure models. The first involved acute exposure for 24 h, followed by recovery periods between 1 day and 6 weeks. The alternative heating regimen involved a daily exposure of 8 h for periods of 1 or 2 weeks. In our acute model, we identified elevated sperm mitochondrial ROS generation (P < 0.05), increased sperm membrane fluidity (P < 0.05), DNA damage in the form of single-strand breaks (P < 0.001), and oxidative DNA damage (P < 0.05), characteristic of an oxidative stress cascade. This DNA damage was detected in pachytene spermatocytes (P < 0.001) and round spermatids (P < 0.001) isolated from testes after 1 day heat recovery. Despite these lesions, the spermatozoa of heat-treated mice exhibited no differences in their ability to achieve hallmarks of capacitation or to fertilize the oocyte and support development of embryos to the blastocyst stage (all P > 0.05). Collectively, our acute heat stress model supports the existence of heat susceptible stages of germ cell development, with the round spermatids being most perturbed and spermatogonial stem cells exhibiting resistance to this insult. Such findings were complemented by our chronic heat stress model, which further supported the vulnerability of the round spermatid population.

Effect of exogenous melatonin treatment on the reproductive characteristics and progeny of male rats exposed to different periods from light and darkness

Light is an important environmental factor that controls the regulation of physiological functions of organisms. Melatonin is considered as one of the major hormones that play an important role in protecting body from many harmful effects and acts as a powerful anti-oxidant source to controlling the levels of antioxidant enzymes within the body. The main objectives of this work were to study the effect of 1) photoperiod changes and 2) exogenous melatonin hormone treatment on the sperm properties, body and testis weight, embryo characteristics, and concentration level of melatonin and testosterone in treated rat serum. This study has been conducted using thirty-six male rats and one hundred and twenty female rats. Animals were divided into six groups, each group containing six males and twenty female rats. Our results showed a significant influence of photoperiod changes on the melatonin and testosterone hormones concentration in rats serum, body weight only, while the other characteristics not affected. As for the effect of melatonin it has been found that the movement of sperm in GIII and IV, as well as embryos absorbed and newborns weight traits has been significantly affected, while the rest of the properties were not significantly affected by melatonin treatment.

Birth seasonality in rural areas of Iran, analysis of 5,536,262 births from 1992 to 2007

PURPOSE

We conducted this study to investigate birth seasonality in rural parts of Iran.

METHODS

In this study, patterns of 5,536,262 live births in rural parts of Iran between 1992 and 2007 were studied. Information about birth numbers, environmental factors, and sociocultural status of participants was obtained from previous works. Visually inspecting the seasonal variation of birth, studying its trend using autocorrelation analysis, examining the trend of birth seasonality using the seasonality coefficient, a newly introduced index, studying correlations between birth seasonality and possible associated factors, and analyzing associations between these variables and birth seasonality using multiple regression model were performed in this study.

RESULTS

In this study, we showed birth seasonality in rural parts of Iran, with the highest births in the first two seasons, winter and spring, mostly before the year of 2002. Latitude and mean temperature of districts, wealth status of families, education of women, and mothers' ages were associated with birth seasonality. However, latitude, temperature, and mothers' ages lost their associations after adjusting for sociocultural factors in the regression model.

CONCLUSIONS

Birth numbers in rural areas of Iran follow a rhythmic seasonal pattern; however, the ordering of seasons changes in the last years of the study period.

Human birth seasonality: latitudinal gradient and interplay with childhood disease dynamics

More than a century of ecological studies have demonstrated the importance of demography in shaping spatial and temporal variation in population dynamics. Surprisingly, the impact of seasonal recruitment on infectious disease systems has received much less attention. Here, we present data encompassing 78 years of monthly natality in the USA, and reveal pronounced seasonality in birth rates, with geographical and temporal variation in both the peak birth timing and amplitude. The timing of annual birth pulses followed a latitudinal gradient, with northern states exhibiting spring/summer peaks and southern states exhibiting autumn peaks, a pattern we also observed throughout the Northern Hemisphere. Additionally, the amplitude of United States birth seasonality was more than twofold greater in southern states versus those in the north. Next, we examined the dynamical impact of birth seasonality on childhood disease incidence, using a mechanistic model of measles. Birth seasonality was found to have the potential to alter the magnitude and periodicity of epidemics, with the effect dependent on both birth peak timing and amplitude. In a simulation study, we fitted an susceptible-exposed-infected-recovered model to simulated data, and demonstrated that ignoring birth seasonality can bias the estimation of critical epidemiological parameters. Finally, we carried out statistical inference using historical measles incidence data from New York City. Our analyses did not identify the predicted systematic biases in parameter estimates. This may be owing to the well-known frequency-locking between measles epidemics and seasonal transmission rates, or may arise from substantial uncertainty in multiple model parameters and estimation stochasticity.

Seasonal variations of human sperm cells among 6455 semen samples: a plausible explanation of a seasonal birth pattern

OBJECTIVE

To compare the different sperm parameters according to season of the year on sperm production day and the season 70 days prior (during spermatogenesis).

STUDY DESIGN

Retrospective Andrology Laboratory data comparison. A total of 6455 consecutive semen samples were collected as part of the basic fertility evaluation of 6447 couples. According to sperm concentration, the samples were classified as Normozoospermic or Oligozoospermic and analyzed in relation to the season.

RESULTS

The sperm concentration and percentage of fast motility showed a significant decrease from spring toward summer and fall (P < .001) with recovery noticed during the winter. As well, the highest percentage of normal sperm morphology was observed during the winter months.

CONCLUSION

Seasonal sperm pattern seems to be a circannual-rhythmic phenomenon. The winter and spring semen patterns are compatible with increased fecundability and may be a plausible explanation of the peak number of deliveries during the fall.

Vitamin D in human reproduction: a narrative review

BACKGROUND

Special attention has been given to the effect of vitamin D supplementation on fertility outcomes in both sexes.

AIMS

The purpose of this narrative review was to elucidate the role of vitamin D in male and female reproduction, providing current evidence from both animal and human studies.

MATERIALS AND METHODS

Using PubMed and Medline, we searched for publications during the last 30 years regarding the role of vitamin D in human reproduction.

RESULTS

Accumulating evidence from animal and human studies suggests that vitamin D is involved in many functions of the reproductive system in both genders. In women, vitamin D status has been associated with in vitro fertilization (IVF) outcome, features of polycystic ovarian syndrome (PCOS) and endometriosis. Although several data converge towards a beneficial effect of vitamin D supplementation in metabolic disturbances in women with PCOS, a significant knowledge gap precludes the establishment of a clear cause-effect relationship. In men, vitamin D status has been associated with semen quality and sperm count, motility and morphology. There is evidence for a favourable effect of vitamin D supplementation on semen quality, testosterone concentrations and fertility outcomes.

DISCUSSION

Studies with superior methodological characteristics are needed in order to establish a role for vitamin D on the treatment of female and male infertility.

CONCLUSIONS

Recent data on vitamin D provide new insights in the complex pathogenesis and treatment of infertility.

Male infertility and its causes in human

Infertility is one of the most serious social problems facing advanced nations. In general, approximate half of all cases of infertility are caused by factors related to the male partner. To date, various treatments have been developed for male infertility and are steadily producing results. However, there is no effective treatment for patients with nonobstructive azoospermia, in which there is an absence of mature sperm in the testes. Although evidence suggests that many patients with male infertility have a genetic predisposition to the condition, the cause has not been elucidated in the vast majority of cases. This paper discusses the environmental factors considered likely to be involved in male infertility and the genes that have been clearly shown to be involved in male infertility in humans, including our recent findings.

Association between urinary polycyclic aromatic hydrocarbon metabolites and sperm DNA damage: a population study in Chongqing, China

BACKGROUND

Polycyclic aromatic hydrocarbons (PAHs), a class of the most ubiquitous environmental contaminants, may reduce male reproductive functions, but the data from human population studies are very limited.

OBJECTIVES

We designed this study to determine whether environmental exposure to PAHs contributes to the alteration in semen quality, sperm DNA damage, and apoptosis in the general male human population.

METHODS

We measured urinary levels of four PAH metabolites and assessed semen quality, sperm apoptotic markers with Annexin V assay, and sperm DNA damage with comet assay in 232 men from Chongqing, China.

RESULTS

We found that increased urinary 2-hydroxynaphthalene (2-OHNa) levels were associated with increased comet parameters, including the percentage of DNA in the tail (tail%) [β coefficient = 13.26% per log unit 2-OHNa (micrograms per gram creatinine); 95% confidence interval (CI), 7.97-18.55]; tail length (12.25; 95% CI, 0.01-24.52), and tail distribution (7.55; 95% CI, 1.28-18.83). The urinary level of 1-hydroxypyrene was associated only with increased tail% (5.32; 95% CI, 0.47-10.17). Additionally, the increased levels of four urinary PAH metabolites were significantly associated with decreased vital Annexin V negative sperm counts. However, there was no significant association between urinary PAH metabolite levels and human semen parameters or morphology of the sperm samples.

CONCLUSIONS

Our data indicate that the environmental level of PAH exposure is associated with increased sperm DNA damage but not with semen quality. These findings suggest that exposure to PAHs may disrupt sperm DNA and thereby interfere with human male fertility.

Are serum levels of vitamin D associated with semen quality? Results from a cross-sectional study in young healthy men

OBJECTIVE

To examine the association between low serum vitamin D concentration and estimates of male reproductive function.

DESIGN

Cross-sectional study.

SETTING

University hospital.

PATIENT(S)

From a Danish pregnancy cohort established in 1984-1987, 347 sons were selected for a study conducted in 2005-2006.

INTERVENTION(S)

Semen parameters and reproductive hormones were related to vitamin D concentrations in 307 men.

MAIN OUTCOME MEASURE(S)

Semen characteristics and reproductive hormones.

RESULT(S)

A high vitamin D level was unexpectedly associated with lower crude median total sperm count and percentage of normal morphology sperm and a high level of crude median sex hormone-binding globulin and FSH. After adjustment, the associations attenuated to nonsignificant associations, except for sex hormone-binding globulin. Additionally, adjusted free androgen index was lower at higher vitamin D levels, and men with high vitamin D had 11% (95% confidence interval, 1%-20%) lower free androgen index compared with men with low vitamin D.

CONCLUSION(S)

These results do not indicate that low vitamin D is a risk factor for poor semen quality in a population of young healthy men, but we may not have enough men with low vitamin D levels to detect an effect. New studies should include a larger proportion of vitamin D-deficient men.

[Informations for the infertile couple]

The aim of the first consultation related to infertility is supposed to be the optimization of all factors that can increase the chances of pregnancy: more frequent sexual intercourse during the fertility windows; lifestyle modifications (better diet, decreased exposure to tobacco or other toxics); older couples can enjoy the same advice but should be proposed a quicker medical support. Maternal preconceptional advice must be transmitted. A testicular cancer must always be excluded in infertile men, while the risk of hormone-dependent cancers in infertile women remains undetermined. With the results of this first consultation, couples will generally be proposed the best solution to achieve their parental project: ovarian stimulation assisted reproductive technology (IUI, IVF or ICSI) or adoption.

Current concepts of human azoospermia and its causes

Infertility is a serious social problem in advanced nations today. One of the most important causes is the male factor. Striking progress has been achieved in recent years in elucidating the mechanisms of spermatogenesis in mice by experimental methods represented by the knockout mouse. Although many factors associated with male infertility are known in mice, the translation of this information to people has been slow. This is because the knockout mouse phenotype cannot necessarily be reproduced faithfully in humans. However, it is known that environmental factors, chromosomal defects and several specific gene mutations result in human male infertility. In this review, we first discuss the environmental factors considered likely to be involved in male infertility, and secondly we describe the Y chromosome and several important genes on the Y chromosome that play critical roles in spermatogenesis in humans. Then, we demonstrate the three critical genes identified in our laboratory in autosomes involved in human spermatogenesis, the SYCP3, MEI1 and PARP-2. Finally, we explain the future directionality and possibilities of research in this field.

Environmental factors and semen quality

OBJECTIVES

An increasing number of reports suggest that chemical and physical agents in the environment, introduced and spread by human activity, may affect male fertility in humans. This article aims at evaluating the impact of environmental exposures (pesticides, phthalates, PCBs, air pollution, trihalomethanes (THMs), mobile phones) on semen quality, by reviewing most recent published literature.

MATERIALS AND METHODS

Epidemiological studies focusing on exposure to environmental factors and semen quality for the last ten years were identified by a search of the Pubmed, Medline, Ebsco, Agricola and Toxnet literature bases.

RESULTS

The results from the presented studies suggest that there are strong and rather consistent indications that some pesticides besides DBCP (e.g. DDT/Dichlorodiphenyldichloroethylene [DDE], ethylenedibromide, organophosphates) affects sperm count. PCBs are detrimental to sperm motility. In case of air pollution, studies suggest a link between ambient air pollutants and various semen characteristics. Additional research is needed to corroborate this association and to establish the causal agents. Results of few studies on subfertile men demonstrate associations between phthalate levels commonly experienced by the public and impaired sperm quality (impact on sperm concentration, morphology, motility), but the findings have not been corroborated in studies of men from the general population. Mobile phones might adversely affect the quality of semen by decreasing mostly motility but also the sperm counts, viability and morphology. In spite of their consistent results, most of the studies are rather small. Association between exposure to THMs and poor semen quality was not observed.

CONCLUSIONS

Epidemiological studies suggest awareness of environmental factors which may affect semen quality. In case both of well proven and disputable reproductive and developmental hazards, it is necessary to prevent parental exposure to the agents associated with those hazards.

The effect of ambient air pollution on sperm quality

BACKGROUND

Research has suggested an association with ambient air pollution and sperm quality.

OBJECTIVES

We investigated the effect of exposure to ozone (O3) and particulate matter < 2.5 microm in aerodynamic diameter (PM2.5) on sperm quality.

METHODS

We reexamined a previous cohort study of water disinfection by-products to evaluate sperm quality in 228 presumed fertile men with different air pollution profiles. Outcomes included sperm concentration, total sperm per ejaculate (count), and morphology, as well as DNA integrity and chromatin maturity. Exposures to O3 and PM2.5 were evaluated for the 90-day period before sampling. We used multivariable linear regression, which included different levels of adjustment (i.e., without and with season and temperature) to assess the relationship between exposure to air pollutants during key periods of sperm development and adverse sperm outcomes.

RESULTS

Sperm concentration and count were not associated with exposure to PM2.5, but there was evidence of an association (but not statistically significant) with O3 concentration and decreased sperm concentration and count. Additionally, a significant increase in the percentage of sperm cells with cytoplasmic drop [beta = 2.64; 95% confidence interval (CI), 0.215.06] and abnormal head (beta = 0.47; 95% CI, 0.030.92) was associated with PM2.5 concentration in the base model. However, these associations, along with all other sperm outcomes, were not significantly associated with either pollutant after controlling for season and temperature. Overall, although we found both protective and adverse effects, there was generally no consistent pattern of increased abnormal sperm quality with elevated exposure to O3 or PM2.5.

CONCLUSIONS

Exposures to O3 or PM2.5 at levels below the current National Ambient Air Quality Standards were not associated with statistically significant decrements in sperm outcomes in this cohort of fertile men. However, some results suggested effects on sperm concentration, count, and morphology.

Male germ cell-specific protein Trs4 binds to multiple proteins

Temperature-related sequence 4 (Trs4) has been identified as a testis-specific gene with expression sensitive to the abdominal temperature changes induced by artificial cryptorchidism. In murine testes, Trs4 mRNA was detected in round spermatids and its protein was localized mainly in the elongating spermatids as well as in the acrosomes and tails of mature spermatozoa. Using a yeast two-hybrid screening system, we identified Rshl-2, Gstmu1, and Ddc8 as putative binding partners of the Trs4 protein in mouse testes. Their interactions were confirmed by in vivo and in vitro binding assays. Further studies demonstrated that Ddc8, a newly identified gene with unknown functions, displayed a similar expression pattern with Trs4 in mouse testes. In particular, Trs4, Ddc8, and Rshl-2 proteins were co-localized to the tails of mature spermatozoa. These results suggested that Trs4 might be involved in diverse processes of spermiogenesis and/or fertilization through interactions with its multiple binding partners.

Potential factors affecting semen quality in the Asian elephant (Elephas maximus)

BACKGROUND

One of the major obstacles in using artificial insemination to manage genetics of elephant population in captivity is the large variations in semen quality among ejaculates within the same and among individuals. The objectives of this study were to determine the influences of (1) age (2) seasonality (3) and circulating testosterone (SrTest), triiodothyronine (SrT3) and tetraiodothyronine (SrT4), as well as seminal (4) testosterone (SpTest), zinc (SpZn) and protein (SpTP) on semen quality in the Asian elephant

METHODS

Analyses, including motility, viability and morphology were performed in semen samples collected twice monthly from 13 elephant bulls (age range, 10-to 72-years) by manual stimulation between July 2004 and June 2005. Serum samples obtained monthly were assessed for SrTest, SrT3, SrT4, and seminal plasma samples were evaluated for, SpTest, SpZn and SpTP.

RESULTS

The highest semen quality was observed at age 23 to 43 years. Percentages of progressive motility and viable sperm were lowest at age 51 to 70 years (P < 0.05); on the other hand, sperm concentration was lowest at age 10 to 19 years (P < 0.05). Percentage of sperm with normal morphology was highest at age 23 to 43 years. The levels of SrT3, SrTest, SpTest and SpZn were lowest at age 51 to 70 years, whereas SrT4 was lowest at age 23 to 43 years. Seasonality significantly affected semen characteristics in which percentage of viable sperm and cell concentration were highest during rainy season and lowest during summer months (P < 0.05). However, percentage of sperm with normal morphology was highest in summer and lowest in rainy season (P < 0.05). Seasonality significantly influenced SrTest with elevated concentrations observed in rainy season and winter (P < 0.05).

CONCLUSION

This study indicates that age and seasonality had influence on semen characteristics in the Asian elephant. The knowledge obtained in this study will improve our understanding of the reproductive biology of this species.

Decline and loss of birth seasonality in Spain: analysis of 33,421,731 births over 60 years

BACKGROUND AND AIM

Several seasonal variations have been found in birth rates in different countries at different periods. The characteristics of the rhythmic patterns vary according to geographical location and chronological changes. This study presents data on spanish birth seasonality over six decades.

METHODS

A time series composed of 33,421,731 births in Spain in the period 1941-2000 was analysed. The series comes from the National Institute of Statistics and was processed according to the following norms: (1) normalisation of the duration of months and years; (2) clinical analysis of temporal series (isolation of seasonal component); (3) Fourier's spectral analysis; and (4) cosinor analysis (adjustment to the cosine curve of two harmonics).

RESULTS

Significant seasonal rhythm was found in the set of births, both for a 12-month period and a 6-month period. The rhythm shows bimodal morphology, with a pronounced birth peak in April and a smaller one in September. These peaks correspond to July and December conceptions, respectively. The major birth peak shifted to March-May between the 1940s and the 1980s. Birth rhythm changed after the 1960s, with a decrease in amplitude and later loss of seasonality in the 1990s.

CONCLUSIONS

In Spain, seasonal birth rhythm shows a decline from 1970, and, finally, lack of birth seasonality in 1991-2000. This trend is similar to other European countries, although Spain shows a more intense loss of seasonality.

Seasonal variation in serum concentrations of reproductive hormones and urinary excretion of 6-sulfatoxymelatonin in men living north and south of the Arctic Circle: a longitudinal study

OBJECTIVE

Seasonal variation in photoperiod or temperature may influence human reproductive biology. The present study evaluated whether seasonal changes occurred in the levels of reproductive hormones and the major melatonin metabolite, 6-sulfatoxymelatonin (aMT6s), in populations exposed to extreme variation in photoperiod and temperature.

DESIGN

Two separate cohorts of Norwegian men were recruited from the general population in either of two locations: Tromsø (69.5 degrees N, n = 92) or Oslo (60 degrees N, n = 112), located north and south of the Arctic Circle (66.5 degrees N), respectively.

MEASUREMENTS

Four blood and 12-h overnight urine samples were obtained on separate occasions over a 12-month period, including during the photoperiod maximum and minimum. Serum concentrations of FSH, LH, testosterone (T), oestradiol (E(2)), SHBG and the urinary excretion of aMT6s were assessed.

RESULTS

Statistical analysis using generalized estimating equations indicated that LH levels were lowest during early winter in both locations (both P = 0.01). In Tromsø, free T and E(2) concentrations peaked during early winter (P = 0.02 and 0.003, respectively). In Oslo, free T levels were lowest during early winter (P = 0.06) whereas E(2) levels were lowest during late summer (P < 0.001). Urinary aMT6s concentrations were lowest during early summer in Tromsø and Oslo. Concentrations peaked during early winter in Tromsø (P < 0.001) and during late winter in Oslo (P < 0.001).

CONCLUSIONS

LH levels exhibited similar changes in both locations, whereas the patterns of changes of the sex steroid concentrations differed, possibly indicating different underlying mechanisms. Excretion of aMT6s was lowest during early summer in both locations, indicating that the long natural photoperiod was sufficient to cause suppression of melatonin secretion. Whether these changes have any biological significance remains uncertain.

Within-subject variation of seminal parameters in men with infertile marriages

As little information exists on the semen variability in infertile men, this study aimed at analysing the within-subject variability of semen from men with infertile marriages included in an intrauterine insemination (IUI) programme. Five ejaculates from each of 436 men (2180 specimens) were analysed. The within-subject coefficients of variation (CV(w)) were high for all parameters (semen volume, sperm concentration, forward motility and combined parameters), ranging from 0.73 for the total motile sperm count to 0.27 for the semen volume. Nevertheless, within-subject fluctuations were smaller than the between-subject variability, as indicated by high Intraclass Correlation Coefficient (ICC) values, which, however, significantly lowered when <or=3 samples were analysed against five samples. Neither seasonality nor the length of abstinence between 3 and 7 days significantly affected within-subject semen variability, whereas total motile sperm count was significantly and negatively affected at 2 days of abstinence. In 253 cycles of double IUI, performed in two consecutive days, semen volume and parameters including volume decreased in the second sample, but semen quality improved in most cases of oligo- and/or asthenozoospermia. Useful information for clinical purposes is provided.

Genetic and environmental correlates of semen quality: a twin study

BACKGROUND

The influences of environmental factors on the male reproductive system have been much debated over the last 3 decades. We studied the impact of genes and environment on semen quality, sex hormone levels, and sperm chromatin stability by using a twin design.

METHODS

The study population consisted of monozygotic and dizygotic twins from the population-based Danish Twin Registry and a random selection of pairs of singleton brothers from the Danish Civil Registration System. All men were 20 to 45 years of age. The study population comprised 100 monozygotic twin brothers (50 pairs), 102 dizygotic twins (51 pairs), and 102 single-born brothers (51 pairs). A semen sample and blood sample were collected from all participants.

RESULTS

Heritability was estimated to account for 20% (95% confidence interval = 0% to 68%) of the variation in sperm density. A higher heritability was found for the hormones reflecting Sertoli cell function (inhibin B, 76% [36% to 84%] and follicle-stimulating hormone, 81% [40% to 88%]) and for percent morphologic normal cells (41% [0% to 60%] and sperm chromatin parameters (mean alphaT, 68% [34% to 81%] and COMP alphaT, 72% [25% to 82%], respectively).

CONCLUSION

Our study indicates a substantial hereditary component in plasma levels of hormones reflecting Sertoli cell function and in sperm cell chromatin stability and morphology. The environmental contribution (including the prenatal environment) appeared to be largest for sperm count.

Fecundability according to male serum inhibin B—a prospective study among first pregnancy planners

BACKGROUND

New biological markers of male fecundity are needed for use in large-scale epidemiological studies. We studied the association between male inhibin B and fecundability.

METHODS

Four hundred and thirty Danish couples without previous reproductive experience were followed from termination of contraception until pregnancy or for a maximum of six menstrual cycles. At enrolment we obtained semen samples (n = 418) and blood samples to measure reproductive hormones, including inhibin B (n = 343).

RESULTS

The fecundability odds ratio for an increment of male inhibin B by 1 log pg/ml was 1.428 (95% confidence interval 1.022-1.994), adjusted for factors influencing the crude estimate. Only inhibin B values below 100 pg/ml were strongly related to fecundability. We designed a receiver operating characteristic curve based on the 29 males with serum inhibin B #100 pg/ml. The area under the curve (AUC) for inhibin B was 0.787 and the corresponding AUCs for sperm density and FSH were 0.913 and 0.800, respectively.

CONCLUSION

Serum inhibin B may be a reliable marker of male fecundity for epidemiological research and may have some advantages over sperm density. Our findings do not support the replacement of sperm density by male inhibin B when obtaining sperm data is an option.

Lack of seasonal variations in fertilization, pregnancy and implantation rates in women undergoing IVF

BACKGROUND

Several studies have investigated seasonal variations during IVF. Their results are contradictory, especially concerning fertilization and pregnancy rates. The aim of the present study was to re-evaluate these parameters using a large number of IVF cycles.

METHODS

A total of 7368 IVF cycles conducted in Switzerland between 1995 and 2003 were retrospectively analysed. To avoid a bias in the evaluation of the fertilization rate, only IVF cycles without ICSI were considered for analysis. Cycles were assigned to seasons according to the date of the beginning of stimulation.

RESULTS

There were no statistically significant differences between the seasons concerning the fertilization, the pregnancy and the implantation rates. However, statistically significant variables deciding on the outcome of an IVF cycle are age, centre, aetiology of infertility and day of transfer.

CONCLUSIONS

There were no statistically significant seasonal differences in central Europe (Switzerland) that influenced the outcome of IVF treatment. The only statistically significant variables of IVF outcome were age, centre, aetiology of infertility and day of transfer. A change to routine fertility treatment concerning the different seasons should therefore not be taken into account.

Longitudinal changes in semen parameters in young Danish men from the Copenhagen area

BACKGROUND

Several recent studies have reported low sperm concentration in young men recruited from the general population, but it is unknown whether the semen quality of these young men reflects that of more mature men or is reduced due to relative immaturity. We conducted a longitudinal follow-up study to address this question.

METHODS

We followed 158 young men (median age = 19.1 years at entry) for up to 4 years and requested quarterly semen samples (total 1838 semen samples) and yearly genital examinations. We examined longitudinal changes in sperm concentration, semen volume, percentage of immotile sperm and percentage of morphologically normal sperm. We used general linear models in which each man served as his own control which also controlled for age, smoking, urogenital infections or disorders, fever and abstinence time.

RESULTS

We found no evidence that sperm concentration, total sperm count or percentage of morphologically normal sperm changed appreciably during the 4 years of follow-up. Semen volume appeared to increase slightly with age, perhaps due to greater acceptance of the study protocol by participants. Sperm motility also improved somewhat, although this may, at least in part, reflect a trend in motility measurement.

CONCLUSIONS

In this analysis of 1838 semen samples from 158 young men from the Copenhagen area, sperm concentration, total sperm count and sperm morphology did not change significantly during 4 years of follow-up, suggesting that previously reported low sperm concentration and poor sperm morphology among young Danish men are unlikely to be the result of immaturity.

Does seasonality alter intrauterine insemination outcomes: a 5-year study

PURPOSE

To determine if seasonal changes alter pregnancy rate in intrauterine insemination (IUI) patients.

METHODS

One-thousand and eighty semen analyses prepared for IUI were evaluated in this retrospective cohort study of 496 patients.

RESULTS

Volume, pH, sperm concentration, and pregnancy rates were not altered by season. However, the percent motility, the total motile spermatozoa in the ejaculate, the straight-line velocity (VSL) of spermatozoa, as well as the morphology of sperm were altered by season. In a subset of these patients that were defined as normal, only the VSL and the morphology of the spermatozoa were altered by seasonal changes.

CONCLUSIONS

Seasonality alters sperm motility parameters as well as morphology, but these changes are not significant enough to alter pregnancy rates.

Reproductive function during summer and winter in Norwegian men living north and south of the Arctic circle

Seasonal, daylight-dependent variation in human spermatozoa counts, with lowest values during summer, has been suggested. To test this hypothesis, we performed a longitudinal study of semen quality and reproductive hormone levels in Norwegian men living north and south of the Arctic Circle. An ejaculate and a serum specimen were obtained both in summer and in winter from 92 volunteers in Tromsoe (69 degrees north latitude) and 112 in Oslo (60 degrees north latitude). Semen analyses were performed, and serum was assayed for FSH and inhibin B. The median spermatozoa concentration in Tromsoe after adjustment for abstinence period length was 49 x 10(6)/ml in summer and 54 x 10(6)/ml in winter. Corresponding values for Oslo were 59 x 10(6)/ml and 54 x 10(6)/ml. The seasonal differences in spermatozoa concentration were not statistically significant, nor were significant differences observed in median total spermatozoa count, semen volume, percentage progressive motile spermatozoa, or FSH. In Tromsoe, but not Oslo, inhibin B concentration was slightly, but significantly (P = 0.02) higher in winter than summer (229 ng/liter vs. 223 ng/liter). The length of the daylight period may have a slight impact on hormonal markers of spermatogenesis but does not cause substantial changes in spermatozoa numbers and motility.

Effects of ejaculatory frequency and season on variations in semen quality

OBJECTIVE

To describe the intraindividual variation in semen parameters.

DESIGN

Prospective, longitudinal study.

SETTING

Academic research environment.

PATIENT(S)

Twenty-seven healthy men, followed monthly for 16 months.

INTERVENTION(S)

Monthly semen samples were collected, as well as information regarding duration of abstinence, febrile episodes, and ejaculatory frequency.

MAIN OUTCOME MEASURE(S)

Sperm concentration, percentage immotile spermatozoa, and percentage morphologically normal spermatozoa.

RESULT(S)

There were no significant seasonal variations in sperm concentration, motility, or morphology. The ejaculatory frequency was significantly higher during spring compared with winter months. There was a significant difference in sperm concentration with respect to having one, two, or more than two ejaculations during a 7-day period before the abstinence period. Sperm motility and morphology were not affected by ejaculatory frequency. Duration of abstinence, ejaculatory frequency, and fever accounted only little for the high intraindividual variation in individual semen parameters. Three semen samples compared with two reduced the intraindividual variations as follows: sperm concentration from 41% to 33.5%, percentage normal spermatozoa from 6.9% to 5.7%, and percentage immotile spermatozoa from 19% to 15.5%.

CONCLUSION(S)

Ejaculatory frequency but not season significantly affected sperm concentration. Most of the intraindividual variations in semen parameters could not be explained by duration of abstinence, fever, or ejaculatory frequency.

Timing of birth after spontaneous onset of labor

OBJECTIVE

To describe naturally occurring birth patterns in low-risk women with singleton gestations and spontaneous onset of labor at term.

MATERIALS AND METHODS

The timing of birth of women who delivered in the low-risk labor unit at Parkland Hospital, Dallas, Texas, between January 1, 2000, to December 31, 2000, was analyzed. Women admitted to this unit were between 36(0/7) and 41(6/7) weeks of gestation, were in spontaneous labor, and had a singleton gestation. Women with contraindications to labor, significant medical problems, a known fetal anomaly, and stillbirths were excluded from analysis. The frequency of birth was analyzed in relation to the time of day, day of week, and month of the year.

RESULTS

Low-risk women (n = 6608) met the study criteria and were included in the analysis. No association was found between the day of the week and the frequency of births (P =.31). Births were most common between the hours of 1 to 2 pm and least common between the hours of 10:00 to 12:00 hours (Central Standard Time, P =.04). Births were more common in the fall, September through November, and least common in the winter, December through February. Daylight Saving Time did not affect these results.

CONCLUSION

Birth after the spontaneous onset of labor is most common in the early afternoon, and most births occur in the fall. There is no natural association between spontaneous birth in low-risk women and the day of the week.

LEVEL OF EVIDENCE

II-2

Bcl-2 and Bax are involved in experimental cryptorchidism-induced testicular germ cell apoptosis in rhesus monkey

Apoptosis occurs spontaneously during spermatogenesis. However, little is known about its regulation in primate. Using an experimental cryptorchidism model in rhesus monkey, we have investigated the relationship between apoptosis and the Bcl-2 family members, Bcl-2 and Bax. Apoptotic cells were identified by in situ end labeling of fragmented DNA. The expressions of Bcl-2 and Bax in the testes during the heat stress-induced testicular germ cell apoptosis were detected by immunohistochemistry and Western blot techniques. The results showed that the apoptotic signals increased after heat treatment and the most susceptible cell types were spermatocytes and spermatids. A redistribution of Bax from the cytoplasmic to nuclear localization in some germ cells was observed. However, its total expression levels in the cells remained unchanged in the cryptorchid testes as determined by Western blot analysis; on the other hand, Bcl-2 levels increased significantly in response to heat stress. The subcellular redistribution of Bax and the increase in Bcl-2 expression in the cryptorchid testis suggest an involvement of Bcl-2 family members in heat stress-induced germ-cell apoptosis.

The relationship of long term global temperature change and human fertility

According to the United Nations, global fertility has declined in the last century as reflected by a decline in birth rates. The earth's surface air temperature has increased considerably and is referred to as global warming. Since changes in temperature are well known to influence fertility we sought to determine if a statistical relationship exists between long-term changes in global air temperatures and birth rates. The most complete and reliable birth rate data in the 20th century was available in 19 industrialized countries. Using bivariate and multiple regression analysis, we compared yearly birth rates from these countries to global air temperatures from 1900 to 1994.A common pattern of change in birth rates was noted for the 19 industrialized countries studied. In general, birth rates declined markedly throughout the century except during the baby boom period of approximately 1940 to 1964. An inverse relationship was found between changes in global temperatures and birth rates in all 19 countries. Controlling for the linear yearly decline in birth rates over time, this relationship remained statistically significant for all the 19 countries in aggregate and in seven countries individually (p<0.05).

CONCLUSIONS

The results of our analyses are consistent with the underlying premise that temperature change affects fertility and suggests that human fertility may have been influenced by change in environmental temperatures.

Quality control, quality assurance, and proficiency testing in the andrology laboratory

The primary goal of any andrology laboratory should be the performance of accurate, reproducible, high-quality, and clinically relevant laboratory testing. An underlining objective of such a goal is to better serve the ordering physician, and the patient, by continually improving laboratory performance. Quality control (QC) is the procedure that determines accurate and reproducible testing. Proficiency testing (PT) is the process allowing physicians to compare results from one laboratory to another. Quality assurance (QA) is the mechanism ensuring high-quality, clinically relevant testing. Together, QC, QA, and PT serve as the foundation responsible for a program that continually improves the overall quality of the testing, allowing the physician ordering the test to be more effective in treating the patient. Several examples are presented to assist the implementation of effective QC and QA programs aimed at continually improving performance in the andrology laboratory.

Long-term (6-wk) hindlimb suspension inhibits spermatogenesis in adult male rats

The International Space Station will allow extended habitation in space and long-term exposure to microgravity (microG). A concern is the impact of long-term microG exposure on the ability of species to reproduce. The model often used to simulate microG is rat hindlimb suspension (HLS), where the hindlimbs are elevated above the cage floor with a tail harness. Experiments described here are the first to examine the effect of long-term HLS on testicular function in adult male rats. Free-roaming (controls), animals with only the tail harnessed but hindlimbs in contact with the cage floor (TO), and HLS animals were tested for 6 wk. Cryptorchidism was prevented in TO and HLS animals by partial constriction of the inguinal canal with sutures. All parameters were compared at the end of the 6-wk experiment. Testicular weights and spermatogenesis were significantly reduced by HLS, such that no spermatogenic cells beyond round spermatids were present and epididymides were devoid of mature sperm. In many tubules, loss of all germ cells, except a few spermatogonia, resulting in histopathology similar to the Sertoli cell, was observed. Spermatogenesis appeared unaffected in control and TO animals. Sertoli and Leydig cell appearance, testosterone, luteinizing hormone, and follicle-stimulating hormone levels, and epididymal and seminal vesicle weight were unchanged by HLS. Cortisone was not elevated by HLS; thus stress may not be a factor. These results demonstrate that spermatogenesis is severely inhibited by long-term HLS, whereas testicular androgen production is not. These results have significant implications regarding serious effects of long-term exposure to microG on the reproductive capability of scrotal mammals, including humans.

Descriptive studies: what they can and cannot do

Descriptive studies often represent the first scientific toe in the water in new areas of inquiry. A fundamental element of descriptive reporting is a clear, specific, and measurable definition of the disease or condition in question. Like newspapers, good descriptive reporting answers the five basic W questions: who, what, why, when, where. and a sixth: so what? Case reports, case-series reports, cross-sectional studies, and surveillance studies deal with individuals, whereas ecological correlational studies examine populations. The case report is the least-publishable unit in medical literature. Case-series reports aggregate individual cases in one publication. Clustering of unusual cases in a short period often heralds a new epidemic, as happened with AIDS. Cross-sectional (prevalence) studies describe the health of populations. Surveillance can be thought of as watchfulness over a community; feedback to those who need to know is an integral component of surveillance. Ecological correlational studies look for associations between exposures and outcomes in populations-eg, per capita cigarette sales and rates of coronary artery disease-rather than in individuals. Three important uses of descriptive studies include trend analysis, health-care planning, and hypothesis generation. A frequent error in reports of descriptive studies is overstepping the data: studies without a comparison group allow no inferences to be drawn about associations, causal or otherwise. Hypotheses about causation from descriptive studies are often tested in rigorous analytical studies.

Seasonal influences on in vitro fertilization and embryo transfer

PURPOSE

The study was aimed to investigate the influence of time factors (day, week, month) on pregnancy rates and in vitro fertilization (IVF) and embryo transfer (ET) parameters.

METHODS

8,184 IVF-ET cycles, taking place in two IVF centers from 1992 to 1999, were analyzed. Multiple logistic and linear regression methods were performed as statistical analyses.

RESULTS

Oocyte pickup on Tuesdays achieved a significantly higher mean number of oocytes (median: 7) and the highest pregnancy rate (PR) (33.4%) per ET There was a significant variation over the year, with the lowest PR/ET in July (25.71%) and the highest in December (35.5%). Concerning outcomes, the age factor and the number of embryos transferred had the highest significant (p < 0.0001) influence.

CONCLUSIONS

The observed weekly rhythm for oocyte pick-ups is certainly due to preprogrammed ovarian stimulation used in our IVF programs. Age as well as the number of embryos transferred are the main influencing factors on a positive outcome and more predictive than seasonal aspects.

Circannual variation in human semen parameters

The aim of the present study was to determine whether there were significant monthly variations in the semen parameters (i.e. volume, sperm count, total sperm count, motile and normal sperm count) of men living in a Mediterranean climate area. A total of 10 877 semen analysis results were included. Semen samples were obtained as a part of an initial screening of male partners from couples with infertility problems who were attending our laboratory from 1970 to 2000. Log transformation and cubic root transformation were used to test the sample distribution. Statistical significance was adjusted by year of examination, patient's age and sexual abstinence period by performing covariance analyses. Differences between months were assessed with the Bonferroni post-hoc test. There was an increase in March and a decrease in September in the adjusted mean sperm count (p < 0.0005), total sperm count (p < 0.0005), motile sperm count (p=0.01) and normal sperm count (p=0.002). There were no variations in semen volume in the study period. Monthly changes in semen quality are confirmed in this population.

Seasonal changes in human sperm chromatin condensation

PURPOSE

The aim of this study was to investigate possible seasonal changes in human sperm parameters, especially chromatin condensation.

METHOD

In a first run, 3155 patients attending the andrological outpatient clinic at the Centre of Dermatology and Andrology at Justus Liebig University, Giessen, Germany, from January 1992 to October 1995 were examined for sperm count, motility, vitality, and chromatin condensation.

RESULTS

The respective results were correlated according to season. Significant seasonal changes were observed in chromatin condensation and sperm count, with mean maximum values (for chromatin condensation and sperm count) of 86.24% aniline blue-negative spermatozoa in January and 68.75 x 10(6) mL-1 in April. To confirm the observation of seasonal changes in sperm chromatin condensation in Germany on the Southern Hemisphere, 179 patients attending the Reproductive Biology Unit at Tygerberg Hospital, Tygerberg, South Africa, were examined by means of the aniline blue stain from April 1999 to April 2000. For chromatin condensation, a significant seasonal change shifted by 4-5 months was observed on the Southern Hemisphere. However, no seasonal variations could be found for the sperm count.

CONCLUSIONS

Our results clearly demonstrate seasonal changes in sperm count and chromatin condensation. In contrast, no circannual relation was observed for motility and vitality.

The possible effects of environmental estrogen disrupters on reproductive health

The term environmental estrogen refers to chemical substances that exhibit some degree of estrogen-like activity. The primary emphasis for potential adverse effects resulting from exposure to environmental estrogens is on in utero exposure because such exposures can occur during critical periods of organogenesis. Assessment of biological plausibility can be based, in part, on the extensive data on the effects of diethylstilbestrol (DES). The available evidence is too limited to judge with any confidence whether sperm counts have declined during the past 50 years. Based on both animal and human data with DES, it is biologically plausible that in utero exposures to exogenous estrogenic compounds are capable of reducing sperm production in adult men. However, the apparent existence of a maternal dose threshold for DES-induced effects on sperm count undermines the likelihood that environmental estrogens, which are substantially less potent, are capable of causing similar effects.

Environment, lifestyle and male infertility

Our understanding of the importance of environmental and lifestyle factors on sperm count and fertility is constrained by the extreme variation in sperm count between men and between ejaculates. The factors responsible for this variation provide a key to understanding what factors actually affect the sperm count. The relative importance of the various factors and the pathways via which they affect sperm count are discussed. The most important are Sertoli cell number, ejaculatory frequency, season, factors affecting scrotal heating (e.g. the time spent seated), a past history of reproductive tract disorders and ageing. The possible role of other environmental factors commonly supposed to affect sperm count (exposure to pesticides or endocrine disruptors) is discussed, although the evidence for a major influence of such factors is lacking. It is suggested that lifestyle changes, especially in the time spent seated, will exert an adverse effect on sperm production in a progressively larger group of men over the next decade.

Seasonal variability in fertilization and embryo quality rates in women undergoing IVF

OBJECTIVE

IVF-ET provides unique controlled conditions for the study of seasonal influences on the human reproductive process. This study was designed to evaluate the effects of seasonality on fertilization rate, embryo quality, and conception rates.

DESIGN

A retrospective observational cohort study. A chart review of all individuals undergoing IVF-ET from 1988 to 1991 at our institution was performed.

SETTING

An assisted reproduction unit at a university-based tertiary medical center.

PATIENT(S)

657 women, for a total of 1074 IVF-ET treatment cycles, were evaluated. From this population, we chose 305 women undergoing their first IVF-ET cycle for reasons of pure mechanical infertility.

INTERVENTION(S)

IVF-ET cycles.

MAIN OUTCOME MEASURE(S)

Seasonal variability in fertilization rates and quality-A embryo rates, and the correlation with the absolute number of light hours, as well as the influence of temperature, humidity, and other environmental parameters.

RESULT(S)

A significant seasonal variability in the fertilization rate and the quality-A embryo rate was demonstrated. The highest fertilization and quality-A embryo rates were observed during the spring and the lowest in the autumn. These changes correlated with the absolute number of light hours and its increment over time, but not with the temperature, humidity, or other environmental parameters.

CONCLUSION(S)

Seasonality seems to have a significant influence on the fertilization process and on the quality of the human embryos that are obtained in vitro, possibly because of the light/dark variations over time. If this finding is confirmed, these seasonal changes should be taken into account when evaluating infertility data and in everyday clinical practice.

The p53/retinoblastoma-mediated repression of testicular orphan receptor-2 in the rhesus monkey with cryptorchidism

Whereas the linkage of infertility to cryptorchidism, the failure of the testis to descend into the scrotum at birth, has been well documented, the detailed molecular mechanism remains unclear. Here we report that the testicular orphan receptor-2 (TR2) expression, which modulates many signal pathways, was completely repressed in the surgery-induced cryptorchidism of the rhesus monkey. Further studies link TR2 repression to the induction of p53 and results suggest that induced p53 could repress TR2 expression via the p53-->p21-->CDK-->Rb-->E2F signal pathway. In return, TR2 could also control the expression of p53 and Rb through the regulation of human papillomavirus 16 E6/E7 genes. Together, our data suggest a feedback control mechanism between TR2 and p53/Rb tumor suppressors, which might play important roles in male infertility associated with cryptorchidism.

Birthweight and semen characteristics

A correlation between birthweight and sperm counts in adult life was anticipated because impaired fetal growth could impair replication of Sertoli cells produced in fetal life. Furthermore, it was expected that males born with a high birthweight might have impaired sperm production as they are expected to have been exposed to higher levels of oestrogen in fetal life. We examined these predictions by including midwives records for 296 Danish males that had taken part in studies on male fecundity for other reasons. The study provided no support for these expectations. If anything, males born with a birthweight of 3000-3999 g had slightly lower sperm counts and more abnormal spermatozoa.