1
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Graziani A, Scafa R, Grande G, Ferlin A. Diabetes and male fertility disorders. Mol Aspects Med 2024; 99:101303. [PMID: 39084095 DOI: 10.1016/j.mam.2024.101303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 07/25/2024] [Accepted: 07/26/2024] [Indexed: 08/02/2024]
Abstract
Couple infertility is a common condition, defined as being unable to conceive after 12 months of regular unprotected sexual intercourse. Male Factor Infertility (MFI) is responsible, alone or in combination with female factors, for about half of the overall cases of couple infertility. MFI is gradually increasing in prevalence, with a notable decline in semen parameters over the last decades. The aetiologies behind the finding of decreasing sperm counts are difficult to pinpoint but might be due in part to increasing rates of overweight and obesity in men of childbearing age. Diabetes mellitus (DM) is a common and chronic metabolic disease, whose prevalence is also gradually increasing, rising up to 10% of the population. The International Diabetes Federation estimates that there are currently more than 500 million people living with DM worldwide, the vast majority of whom suffering from type 2 DM (T2DM). There is growing awareness of the relationship between unhealthy lifestyle, in particular unhealthy diet, and MFI. Starting from all these premises, the aim of this narrative review is to describe the current evidence on the link between DM and MFI, both in terms of DM as a cause of/a risk factor for MFI and of MFI as a possible predictive marker for T2DM. Finally, we will discuss the risk of DM as a consequence of the therapy of MFI or assisted reproductive techniques.
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Affiliation(s)
| | - Raffaele Scafa
- University of Padova, Department of Medicine, Padova, Italy
| | - Giuseppe Grande
- University Hospital of Padova, Department of Systems Medicine, Unit of Andrology and Reproductive Medicine, Padova, Italy
| | - Alberto Ferlin
- University of Padova, Department of Medicine, Padova, Italy; University Hospital of Padova, Department of Systems Medicine, Unit of Andrology and Reproductive Medicine, Padova, Italy.
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2
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Zhao CC, Scott M, Eisenberg ML. Male Fertility as a Proxy for Health. J Clin Med 2024; 13:5559. [PMID: 39337044 PMCID: PMC11432267 DOI: 10.3390/jcm13185559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 08/30/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
Male fertility is affected by a wide range of medical conditions that directly and indirectly affect spermatogenesis. As such, it can be useful as both an indicator of current health and a predictive factor for future health outcomes. Herein, we discuss the current literature regarding the association between male fertility and systemic health conditions and exposures. We review the connection between male fertility and genetics, medications, diet, and environmental pollutants, as well as its effects on future oncologic, cardiovascular, and autoimmune conditions. Understanding this interplay will allow more health care providers to engage in health counseling that will not only improve men's reproductive outcomes but also their overall health.
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Affiliation(s)
- Calvin C Zhao
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael Scott
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA 94305, USA
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3
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Xi Y, Cao YL, Tao LY, Gao SZ, Jin ZR, Cheng JX, Jiang H, Zhang Z. A global perspective: characteristics of infertility-related randomized clinical trials. Andrology 2024; 12:1324-1335. [PMID: 38231194 DOI: 10.1111/andr.13596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/09/2023] [Accepted: 01/01/2024] [Indexed: 01/18/2024]
Abstract
BACKGROUND Infertility is a prevalent global condition, and emerging reproductive technologies may enhance its evaluation and treatment. Understanding the current features of randomized clinical trials in infertility is crucial for improving study design and ensuring the translation of results for patient benefits. OBJECTIVES To investigate the primary characteristics of randomized clinical trials related to infertility and areas where require improvement. MATERIALS AND METHODS We conducted a search on the International Clinical Trials Registry platform for eligible infertility trials between 2003 and 2022. The distribution ratio of various characteristics uploaded by infertility-related studies on the platform was analyzed and compared according to sex and registration year. RESULTS Out of the total trials, 85.3% (1,906) included only women, 8.6% (192) included only men, and 6.1% (136) included couples. The majority of retrieved trials followed a parallel arm design (91.0%) and were non-industry-funded (92.2%), with a median planned sample size of 131 patients (interquartile range 75-270). Among these trials, 54.5% (1,217) were conducted in Asia. The most common primary purpose of infertility-related trials was treatment (88.8%), with over half of the investigated interventions focusing on medication (57.9%). DISCUSSION Asia is the leading region for research, and the drug therapy is still widely used and updated. However, support care for infertile couples has also received some preference. Areas that require improvement and promotion include addressing male infertility and focusing on underserved regions like Africa. The results also highlight deficiencies in trial registration and masking methods, emphasizing the need for better regulation and facilitation of infertility trials in the post-COVID-19 era. CONCLUSION Based on the current status of infertility RCT studies, greater attention should be paid to infertile men and populations in underdeveloped regions like Africa in future studies, together with a standardized registration and implementation procedures.
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Affiliation(s)
- Yu Xi
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Ya-Lei Cao
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Li-Yuan Tao
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Song-Zhan Gao
- Department of Andrology, Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zi-Run Jin
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Jian-Xing Cheng
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
| | - Hui Jiang
- Department of Urology, Peking University First Hospital, Beijing, China
- Institute of Urology, Peking University, Beijing, China
| | - Zhe Zhang
- Department of Urology, Peking University Third Hospital, Beijing, China
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, China
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4
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Saffati G, Thompson LN, Starke N, Khera M, Muthigi A. Can semen analysis be utilized as a screening tool for overall health in young men? Int J Impot Res 2024:10.1038/s41443-024-00949-9. [PMID: 38951639 DOI: 10.1038/s41443-024-00949-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 06/18/2024] [Accepted: 06/25/2024] [Indexed: 07/03/2024]
Abstract
Traditionally, semen analysis has been viewed solely as a tool for assessing male fertility. However, emerging research suggests that abnormal semen parameters may serve as indicators of broader health issues beyond reproductive function. Studies have revealed significant associations between abnormal semen parameters and an increased risk of chronic diseases such as prostate cancer, diabetes, ischemic heart disease, and metabolic disorders. These findings challenge the conventional understanding and position semen analysis as a potential screening tool for overall male health. The correlation between abnormal semen parameters and conditions like erectile dysfunction further underscores the multifaceted implications of semen quality. This suggests that abnormal semen parameters may be a risk factor for poorer overall health and a higher likelihood of developing comorbidities over time. Given these compelling associations, there is a growing call to integrate semen analysis into routine health assessments for young men, particularly in conjunction with established general health screenings. This proactive approach aligns with a preventative healthcare paradigm, facilitating early detection of underlying health concerns and timely interventions. However, overcoming cultural, logistical, and cost-related barriers is crucial for the successful implementation of this shift in reproductive health.
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Affiliation(s)
- Gal Saffati
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA.
| | - Laura N Thompson
- Department of Urology, Houston Methodist Hospital, Houston, TX, USA
| | - Nathan Starke
- Department of Urology, Houston Methodist Hospital, Houston, TX, USA
| | - Mohit Khera
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Akhil Muthigi
- Department of Urology, Houston Methodist Hospital, Houston, TX, USA
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5
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Kitlinski M, Giwercman A, Christensson A, Nilsson PM, Elenkov A. Prevalence of impaired renal function among childless men as compared to fathers: a population-based study. Sci Rep 2024; 14:7720. [PMID: 38565688 PMCID: PMC10987536 DOI: 10.1038/s41598-024-58479-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 03/29/2024] [Indexed: 04/04/2024] Open
Abstract
Male reproductive impairment has been linked with an increased risk of numerous non-communicable diseases. Yet, epidemiological data on renal disease among subfertile men is scarce. Therefore, by using male childlessness as a proxy for male infertility, we aimed to investigate its association with renal function. Data was sourced from a population-based cohort including 22,444 men. After exclusion of men aged < 45 years (n = 10,842), the remaining men were divided into two groups: these being childless (n = 5494) and fathers (n = 6108). Logistic regression was applied to explore the association between male childlessness and renal impairment. Childless men as compared to fathers, were more likely to have an estimated-glomerular filtration rate < 60 ml/min/1.73m2 (OR 1.36, 95 CI 1.08-1.70; p = 0.008). After adjustment for age, marital status, smoking habits, diabetes, hypertension and other components of metabolic syndrome, childless men were also more likely to have dipstick proteinuria (OR 1.85, 95 CI 1.16-2.95; p = 0.01). With the growing panorama of disease associated with male reproductive impairment, men with fertility issues may constitute a target population with potential benefit from closer follow-up of their renal function.
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Affiliation(s)
- Michael Kitlinski
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden.
- Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland.
| | - Aleksander Giwercman
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden
- Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
| | - Anders Christensson
- Department of Nephrology, Skåne University Hospital, Malmö, Sweden
- Department of Clinical Sciences, Lunds University, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences, Lunds University, Malmö, Sweden
| | - Angel Elenkov
- Department of Translational Medicine, Clinical Research Centre, Lund University, Malmö, Sweden
- Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
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6
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Mu Y, Luo LB, Wu SJ, Gao Y, Qin XL, Zhao J, Liu Q, Yang J. Bezafibrate alleviates diabetes-induced spermatogenesis dysfunction by inhibiting inflammation and oxidative stress. Heliyon 2024; 10:e28284. [PMID: 38533024 PMCID: PMC10963653 DOI: 10.1016/j.heliyon.2024.e28284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
The metabolic disorders caused by diabetes can lead to various complications, including male spermatogenesis dysfunction. Exploring effective therapeutics that attenuate diabetes mellitus (DM)-induced male subfertility is of great importance. Pharmaceuticals targeting PPARα activation such as bezafibrate have been regarded as an important strategy for patients with diabetes. In this study, we use streptozocin (STZ) injection to establish a type 1 DM mice model and use bezafibrate to treat DM mice and evaluate the effects of bezafibrate on the spermatogenic function of the DM male mice. Bezafibrate treatment exhibited protective effects on DM-induced spermatogenesis deficiency, as reflected by increased testis weight, improved histological morphology of testis, elevated sperm parameters, increased serum testosterone concentration as well as increased mRNA levels of steroidogenesis enzymes. Meanwhile, testicular cell apoptosis, inflammation accumulation and oxidative stress status were also shown to be alleviated by bezafibrate compared with the DM group. In vivo and in vitro studies, PPARα specific inhibitor and PPARα knockout mice were further used to investigate the role of PPARα in the protective effects of bezafibrate on DM-induced spermatogenesis dysfunction. Our results indicated that the protection of bezafibrate on DM-induced spermatogenesis deficiency was abrogated by PPARα inhibition or deletion. Our study suggested that bezafibrate administration could ameliorate DM-induced spermatogenesis dysfunction and may represent a novel practical strategy for male infertility.
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Affiliation(s)
- Yang Mu
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ling-Bo Luo
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Shu-juan Wu
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yue Gao
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xiao-lin Qin
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jing Zhao
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Qian Liu
- Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jing Yang
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China
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7
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Szałabska-Rąpała K, Zych M, Borymska W, Londzin P, Dudek S, Kaczmarczyk-Żebrowska I. Beneficial effect of honokiol and magnolol on polyol pathway and oxidative stress parameters in the testes of diabetic rats. Biomed Pharmacother 2024; 172:116265. [PMID: 38364735 DOI: 10.1016/j.biopha.2024.116265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/18/2024] Open
Abstract
In diabetes hyperglycemia, excessive production of free radicals and present oxidative stress lead to many complications in the body, including male reproductive system disorders. To prevent the development of diabetic complications in the testes resulting from them, it seems beneficial to include compounds considered as natural antioxidants. Honokiol and magnolol are neolignans obtained from magnolia bark, which possess proven antioxidant properties. The aim of this study was to evaluate the effect of honokiol and magnolol on the parameters of oxidative stress, polyol pathway and glycation products in the testes as well as on selected biochemical parameters in the blood serum of rats with type 2 diabetes. The study was conducted on mature male Wistar rats with high fat diet and streptozotocin-induced type 2 diabetes. Neolignans-treated rats received honokiol or magnolol orally at the doses of 5 or 25 mg/kg, respectively, for 4 weeks. Parameters related to glucose and lipid homeostasis, basic serological parameters and sex hormones level in the serum as well as polyol pathway parameters, antioxidant enzyme activity, endogenous antioxidants level, sumaric parameters for oxidative stress and oxidative damage in the testes were estimated. Oral administration of honokiol and magnolol turned out to be beneficial in combating the effects of oxidative stess in the testes, but showed no favorable effects on serum biochemical parameters. Additionally, magnolol compared to honokiol revealed more advantageous impact indicating the reversal of the effects of diabetic complications in the male reproductive system and counteracted oxidative stress damages and polyol pathway disorders in the testes.
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Affiliation(s)
- Katarzyna Szałabska-Rąpała
- Doctoral School of the Medical University of Silesia in Katowice, Discipline of Pharmaceutical Sciences, Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, Sosnowiec 41-200, Poland.
| | - Maria Zych
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, Sosnowiec 41-200, Poland
| | - Weronika Borymska
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, Sosnowiec 41-200, Poland
| | - Piotr Londzin
- Department of Pharmacology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, Sosnowiec 41-200, Poland
| | - Sławomir Dudek
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, Sosnowiec 41-200, Poland
| | - Ilona Kaczmarczyk-Żebrowska
- Department of Pharmacognosy and Phytochemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Jagiellońska 4, Sosnowiec 41-200, Poland
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8
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Kimmins S, Anderson RA, Barratt CLR, Behre HM, Catford SR, De Jonge CJ, Delbes G, Eisenberg ML, Garrido N, Houston BJ, Jørgensen N, Krausz C, Lismer A, McLachlan RI, Minhas S, Moss T, Pacey A, Priskorn L, Schlatt S, Trasler J, Trasande L, Tüttelmann F, Vazquez-Levin MH, Veltman JA, Zhang F, O'Bryan MK. Frequency, morbidity and equity - the case for increased research on male fertility. Nat Rev Urol 2024; 21:102-124. [PMID: 37828407 DOI: 10.1038/s41585-023-00820-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2023] [Indexed: 10/14/2023]
Abstract
Currently, most men with infertility cannot be given an aetiology, which reflects a lack of knowledge around gamete production and how it is affected by genetics and the environment. A failure to recognize the burden of male infertility and its potential as a biomarker for systemic illness exists. The absence of such knowledge results in patients generally being treated as a uniform group, for whom the strategy is to bypass the causality using medically assisted reproduction (MAR) techniques. In doing so, opportunities to prevent co-morbidity are missed and the burden of MAR is shifted to the woman. To advance understanding of men's reproductive health, longitudinal and multi-national centres for data and sample collection are essential. Such programmes must enable an integrated view of the consequences of genetics, epigenetics and environmental factors on fertility and offspring health. Definition and possible amelioration of the consequences of MAR for conceived children are needed. Inherent in this statement is the necessity to promote fertility restoration and/or use the least invasive MAR strategy available. To achieve this aim, protocols must be rigorously tested and the move towards personalized medicine encouraged. Equally, education of the public, governments and clinicians on the frequency and consequences of infertility is needed. Health options, including male contraceptives, must be expanded, and the opportunities encompassed in such investment understood. The pressing questions related to male reproductive health, spanning the spectrum of andrology are identified in the Expert Recommendation.
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Affiliation(s)
- Sarah Kimmins
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- The Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
- The Département de Pathologie et Biologie Cellulaire, Université de Montréal, Montreal, Quebec, Canada
| | - Richard A Anderson
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Christopher L R Barratt
- Division of Systems Medicine, School of Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - Hermann M Behre
- Center for Reproductive Medicine and Andrology, University Hospital, Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Sarah R Catford
- Hudson Institute of Medical Research, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, The Royal Women's Hospital, Melbourne, Victoria, Australia
| | | | - Geraldine Delbes
- Institut National de la Recherche Scientifique, Centre Armand-Frappier Sante Biotechnologie, Laval, Quebec, Canada
| | - Michael L Eisenberg
- Department of Urology and Obstetrics and Gynecology, Stanford University, Stanford, CA, USA
| | - Nicolas Garrido
- IVI Foundation, Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - Brendan J Houston
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Melbourne, Australia
| | - Niels Jørgensen
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Csilla Krausz
- Department of Experimental and Clinical Biomedical Sciences, 'Mario Serio', University of Florence, University Hospital of Careggi Florence, Florence, Italy
| | - Ariane Lismer
- Department of Pharmacology and Therapeutics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Robert I McLachlan
- Hudson Institute of Medical Research and the Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
- Monash IVF Group, Richmond, Victoria, Australia
| | - Suks Minhas
- Department of Surgery and Cancer Imperial, London, UK
| | - Tim Moss
- Healthy Male and the Department of Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia
| | - Allan Pacey
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Lærke Priskorn
- Department of Growth and Reproduction, International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Stefan Schlatt
- Centre for Reproductive Medicine and Andrology, University of Münster, Münster, Germany
| | - Jacquetta Trasler
- Departments of Paediatrics, Human Genetics and Pharmacology & Therapeutics, McGill University and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Leonardo Trasande
- Center for the Investigation of Environmental Hazards, Department of Paediatrics, NYU Grossman School of Medicine, New York, NY, USA
| | - Frank Tüttelmann
- Institute of Reproductive Genetics, University of Münster, Münster, Germany
| | - Mónica Hebe Vazquez-Levin
- Instituto de Biología y Medicina Experimental, Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina, Fundación IBYME, Buenos Aires, Argentina
| | - Joris A Veltman
- Biosciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Feng Zhang
- Obstetrics and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai, China
| | - Moira K O'Bryan
- School of BioSciences and Bio21 Institute, The University of Melbourne, Parkville, Melbourne, Australia.
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Fallara G, Pozzi E, Belladelli F, Boeri L, Capogrosso P, Corona G, D'Arma A, Alfano M, Montorsi F, Salonia A. A Systematic Review and Meta-analysis on the Impact of Infertility on Men's General Health. Eur Urol Focus 2024; 10:98-106. [PMID: 37573151 DOI: 10.1016/j.euf.2023.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/10/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023]
Abstract
CONTEXT Male infertility has been associated with increased morbidity and mortality. OBJECTIVE To perform a systematic review and meta-analysis to provide the most critical evidence on the association between infertility and the risk of incident comorbidities in males. EVIDENCE ACQUISITION A systematic review and meta-analysis was performed according to the Meta-analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and registered on PROSPERO. All published studies on infertile versus fertile men regarding overall mortality and risks of cancer, diabetes, and cardiovascular events were selected from a database search on PubMed, EMBASE, Google Scholar, and Cochrane. Forest plot and quasi-individual patient data meta-analysis were used for pooled analyses. A risk of bias was assessed using the ROBINS-E tool. EVIDENCE SYNTHESIS Overall, an increased risk of death from any cause was found for infertile men (hazard risk [HR] 1.37, [95% confidence interval {CI} 1.04-1.81], p = 0.027), and a 30-yr survival probability of 91.0% (95% CI 89.6-92.4%) was found for infertile versus 95.9% (95% CI 95.3-96.4%) for fertile men (p < 0.001). An increased risk emerged of being diagnosed with testis cancer (relative risk [RR] 1.86 [95% CI 1.41-2.45], p < 0.001), melanoma (RR 1.30 [95% CI 1.08-1.56], p = 0.006), and prostate cancer (RR 1.66 [95% CI 1.06-2.61], p < 0.001). As well, an increased risk of diabetes (HR 1.39 [95% CI 1.09-1.71], p = 0.008), with a 30-yr probability of diabetes of 25.0% (95% CI 21.1-26.9%) for infertile versus 17.1% (95% CI 16.1-18.1%) for fertile men (p < 0.001), and an increased risk of cardiovascular events (HR 1.20 [95% CI 1.00-1.44], p = 0.049), with a probability of major cardiovascular events of 13.9% (95% CI 13.3-14.6%) for fertile versus 15.7% (95% CI 14.3-16.9%) for infertile men (p = 0.008), emerged. CONCLUSIONS There is statistical evidence that a diagnosis of male infertility is associated with increased risks of death and incident comorbidities. Owing to the overall high risk of bias, results should be interpreted carefully. PATIENT SUMMARY Male fertility is a proxy of general men's health and as such should be seen as an opportunity to improve preventive strategies for overall men's health beyond the immediate reproductive goals.
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Affiliation(s)
- Giuseppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy; Department of Urology, IRCCS European Institute of Oncology (IEO), Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Luca Boeri
- Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation, Varese, Italy
| | - Giovanni Corona
- Medical Department, Endocrinology Unit, Azienda Usl, Maggiore-Bellaria Hospital, Bologna, Italy
| | - Alessia D'Arma
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy.
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10
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Kaltsas A, Dimitriadis F, Zachariou D, Zikopoulos A, Symeonidis EN, Markou E, Tien DMB, Takenaka A, Sofikitis N, Zachariou A. From Diagnosis to Treatment: Comprehensive Care by Reproductive Urologists in Assisted Reproductive Technology. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1835. [PMID: 37893553 PMCID: PMC10608107 DOI: 10.3390/medicina59101835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
Infertility is a global health concern, with male factors playing an especially large role. Unfortunately, however, the contributions made by reproductive urologists in managing male infertility under assisted reproductive technology (ART) often go undervalued. This narrative review highlights the important role played by reproductive urologists in diagnosing and treating male infertility as well as any barriers they face when providing services. This manuscript presents a comprehensive review of reproductive urologists' role in managing male infertility, outlining their expertise in diagnosing and managing male infertility as well as reversible causes and performing surgical techniques such as sperm retrieval. This manuscript investigates the barriers limiting urologist involvement such as limited availability, awareness among healthcare professionals, and financial constraints. This study highlights a decrease in male fertility due to lifestyle factors like sedentary behavior, obesity, and substance abuse. It stresses the significance of conducting an evaluation process involving both male and female partners to identify any underlying factors contributing to infertility and to identify patients who do not require any interventions beyond ART. We conclude that engaging urologists more effectively in infertility management is key to optimizing fertility outcomes among couples undergoing assisted reproductive technology treatments and requires greater education among healthcare providers regarding the role urologists and lifestyle factors that could have an effect on male fertility.
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Affiliation(s)
- Aris Kaltsas
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (N.S.)
| | - Fotios Dimitriadis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (F.D.); (E.N.S.)
| | - Dimitrios Zachariou
- Third Orthopaedic Department, National and Kapodestrian University of Athens, KAT General Hospital, 14561 Athens, Greece;
| | - Athanasios Zikopoulos
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (N.S.)
| | - Evangelos N. Symeonidis
- Department of Urology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (F.D.); (E.N.S.)
| | - Eleftheria Markou
- Department of Microbiology, University Hospital of Ioannina, 45500 Ioannina, Greece;
| | - Dung Mai Ba Tien
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City 70000, Vietnam;
| | - Atsushi Takenaka
- Division of Urology, Department of Surgery, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan;
| | - Nikolaos Sofikitis
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (N.S.)
| | - Athanasios Zachariou
- Department of Urology, Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece; (A.K.); (A.Z.); (N.S.)
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11
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Belladelli F, Muncey W, Eisenberg ML. Reproduction as a window for health in men. Fertil Steril 2023; 120:429-437. [PMID: 36642302 DOI: 10.1016/j.fertnstert.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/29/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023]
Abstract
Male factor infertility is widely considered a harbinger for a man's general health. Failure of reproduction often accompanies other underlying processes, with growing evidence suggesting that a diagnosis of infertility increases the likelihood of developing future cardiac, metabolic, and oncologic diseases. The goal of this review is to provide a comprehensive overview of the research on male fertility as a marker for current and future health. A multidisciplinary approach is essential, and there is growing consensus that the male fertility evaluation offers an opportunity to better men's wellness beyond their immediate reproductive ambitions.
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Affiliation(s)
- Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy; Department of Urology, School of Medicine, Stanford University, Stanford, California
| | - Wade Muncey
- Department of Urology, School of Medicine, Stanford University, Stanford, California
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, California.
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12
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The Association Between Lipid Serum and Semen Parameters: a Systematic Review. Reprod Sci 2023; 30:761-771. [PMID: 35902546 DOI: 10.1007/s43032-022-01040-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/12/2022] [Indexed: 10/16/2022]
Abstract
Increased lipid levels sometimes not only affect sexual function but also are considered to harm semen quality. It is often a suspicion that elevated lipids are a factor in infertility. We conduct a systematic review. Articles that met the criteria were identified according to The Preferred Reporting Items for Systematic Review and Meta-analysis of recommendations in the PubMed, ProQuest, EBSCO, Web of Science Wiley Online, Springer Link, Scopus, and Science Direct databases with no time restriction for publication. Seven studies are eligible for qualitative analysis from nine studies that have the potential to be assessed. These studies measure the correlation of serum lipids (VLDL, HDL, LDL, triglycerides, total cholesterol, free cholesterol, phospholipids, free fatty acids) with semen parameters (concentration, motility, morphology, DNA fragmentation index). Although not all studies consistently report that lipids impact semen quality, this review suspects that lipids have a significant impact on sperm quality. This study implies that it is necessary to maintain lipid levels to maintain sperm quality and quality of life. However, further investigation with an observational cohort study design needs to be carried out to assess the effect of lipids on semen quality more precisely for the promotion of reproductive health care.
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13
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Hansen LS, Priskorn L, Holmboe SA, Jensen TK, Hansen AH, Andersson AM, Jørgensen N. Testicular function is associated with cardiometabolic health markers: A cross-sectional study of 2289 young men. Andrology 2023; 11:561-574. [PMID: 36520458 DOI: 10.1111/andr.13365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/26/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Testicular function, including compensated Leydig cell function, has been indicated to be an early marker of morbidity. OBJECTIVE To study the association of testicular function and markers of metabolic and cardiovascular health in a population of young men. MATERIALS AND METHODS A cross-sectional study of 2289 men (median age 19 years, 5-95 percentile 18.4-22.2) from the general population examined between 2012 and 2019. Participants answered a questionnaire, had a blood sample drawn for assessment of reproductive hormone levels and health markers (lipids, glycosylated hemoglobin), delivered a semen sample, underwent physical examination including blood pressure measurements, and dual-energy X-ray absorptiometry scan for assessment of body composition. Associations were assessed in both crude and adjusted linear regression analyses. RESULTS The men were within the normal reference intervals of their age for reproductive and health biomarkers. Compared to the lowest quartile, having luteinizing hormone levels in the highest quartile was associated with higher mean arterial pressure (1.6 [95% confidence interval: 0.8; 2.5] mmHg), cholesterol (0.1 [95% confidence interval: 0.02; 0.18] mmol/L), and total body fat percentage (1.1 [95% confidence interval: 0.4; 1.8] %-points). Higher serum testosterone levels were associated with more advantageous cardiometabolic health markers and higher total sperm count with a healthier body composition and lower glycosylated hemoglobin. DISCUSSION AND CONCLUSION In this study of young men, unselected regarding reproductive hormones and semen quality, higher luteinizing hormone was associated with cardiovascular risk factors. Higher testosterone and total sperm count were associated with more favorable cardiometabolic indices. Thus, serum reproductive hormones and semen quality may be early appearing biomarkers of cardiovascular health even among young healthy men, which could potentially be useful for preventive initiatives to reduce the excess mortality and morbidity risk among infertile men. However, our study was cross-sectional and cannot determine causation. Future longitudinal studies of reproductive health in young men are warranted.
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Affiliation(s)
- Laura Smidt Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Laerke Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Stine A Holmboe
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Tina Kold Jensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Ann Holm Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,International Center for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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14
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Lotti F, Maggi M. Effects of diabetes mellitus on sperm quality and fertility outcomes: Clinical evidence. Andrology 2023; 11:399-416. [PMID: 36416060 DOI: 10.1111/andr.13342] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Diabetes mellitus is a global epidemic characterized by high morbidity and mortality. Diabetes mellitus can lead to acute and chronic systemic complications. Among them, a negative effect of diabetes mellitus on sperm quality and male/couple fertility has been suggested. However, available studies in diabetes mellitus men evaluated relatively small cohorts with discordant results. OBJECTIVES To evaluate the clinical evidences of the effects of diabetes mellitus on sperm quality and fertility outcomes. METHODS An extensive Medline search was performed identifying studies in the English language. RESULTS The prevalence of diabetes mellitus in infertile men ranges from 0.7% to 1.4%, while the prevalence of infertility in diabetes mellitus men, evaluated in a few studies, ranges from 35% to 51%. Male diabetes mellitus seems to play a negative effect on couple fecundity, while being childless or subfertile men might increase the risk of diabetes mellitus. Available cross-sectional studies investigating semen parameters and male sexual hormones in men with diabetes mellitus are heterogeneous, assessed relatively small cohorts, show often discordant results and frequently are not directly comparable to derive robust conclusions. Two meta-analyses support a negative effect of diabetes mellitus on sperm normal morphology and no effect on sperm total count, with contradictory results regarding other semen parameters. Considering only studies on type 1 diabetes mellitus men, meta-analyses support a negative effect of diabetes mellitus on sperm motility and no effect on sperm total count, with contradictory results regarding other semen parameters. The rate of children observed among type 1 diabetes mellitus men was lower than controls, especially in subjects with a longer diabetes mellitus duration. Couples with a diabetes mellitus male partner undergoing assisted reproduction techniques showed lower pregnancy rates than controls. No study evaluated the impact of diabetes mellitus treatment on semen quality and male fertility. CONCLUSIONS Overall, available data show that diabetes mellitus might impair male reproductive health and couple fertility. However, further larger and full of details studies are needed.
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Affiliation(s)
- Francesco Lotti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Andrology, Female Endocrinology, and Gender Incongruence Unit, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", Endocrinology Unit, Univesity of Florence, Florence, Italy
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15
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Burke ND, Nixon B, Roman SD, Schjenken JE, Walters JLH, Aitken RJ, Bromfield EG. Male infertility and somatic health - insights into lipid damage as a mechanistic link. Nat Rev Urol 2022; 19:727-750. [PMID: 36100661 DOI: 10.1038/s41585-022-00640-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2022] [Indexed: 11/08/2022]
Abstract
Over the past decade, mounting evidence has shown an alarming association between male subfertility and poor somatic health, with substantial evidence supporting the increased incidence of oncological disease, cardiovascular disease, metabolic disorders and autoimmune diseases in men who have previously received a subfertility diagnosis. This paradigm is concerning, but might also provide a novel window for a crucial health reform in which the infertile phenotype could serve as an indication of potential pathological conditions. One of the major limiting factors in this association is the poor understanding of the molecular features that link infertility with comorbidities across the life course. Enzymes involved in the lipid oxidation process might provide novel clues to reconcile the mechanistic basis of infertility with incident pathological conditions. Building research capacity in this area is essential to enhance the early detection of disease states and provide crucial information about the disease risk of offspring conceived through assisted reproduction.
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Affiliation(s)
- Nathan D Burke
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Brett Nixon
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Shaun D Roman
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
- Priority Research Centre for Drug Development, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
| | - John E Schjenken
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Jessica L H Walters
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - R John Aitken
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia
| | - Elizabeth G Bromfield
- Priority Research Centre for Reproductive Science, School of Environmental and Life Sciences, Discipline of Biological Sciences, University of Newcastle, Callaghan, New South Wales, Australia.
- Hunter Medical Research Institute, Infertility and Reproduction Research Program, New Lambton Heights, New South Wales, Australia.
- Department of Biomolecular Health Sciences, Utrecht University, Utrecht, Netherlands.
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16
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Mascarenhas M, Jeve Y, Polanski L, Sharpe A, Yasmin E, Bhandari HM. Management of recurrent implantation failure: British Fertility Society policy and practice guideline. HUM FERTIL 2022; 25:813-837. [PMID: 33820476 DOI: 10.1080/14647273.2021.1905886] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Recurrent implantation failure (RIF) is defined as the absence of a positive pregnancy test after three consecutive transfers of good quality embryos. There remains significant variation in clinical practice in the management of RIF. This British Fertility Society (BFS) Policy and Practice guideline analyses the evidence for investigations and therapies that are employed in RIF and provides recommendations for clinical practice and for further research. Evidence for investigations of sperm and egg quality, uterine and adnexal factors, immunological factors and thrombophilia, endocrine conditions and genetic factors and for associated therapies have been evaluated. This guideline has been devised to assist reproductive medicine specialists and patients in making shared decisions concerning management of RIF. Finally, suggestions for research towards improving understanding and management of RIF have also been provided.
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Affiliation(s)
- Mariano Mascarenhas
- Leeds Fertility, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Glasgow Centre for Reproductive Medicine, The Fertility Partnership, Glasgow, UK
| | - Yadava Jeve
- Birmingham Women's Fertility Centre, Birmingham Women's Hospital, Birmingham, UK
| | - Lukasz Polanski
- Assisted Conception Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Abigail Sharpe
- Leeds Fertility, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ephia Yasmin
- Department of Women's Health, University College London Hospitals, London, UK
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17
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Wei J, Lu X, Bao X, Zhang C, Li J, Ren C, Zhu Z, Ma B, Zhang N, Jin X, Ma B. Aucubin supplementation alleviate diabetes induced-disruption of blood-testis barrier and testicular damage via stabilizing cell junction integrity. Eur J Pharmacol 2022; 938:175430. [PMID: 36460131 DOI: 10.1016/j.ejphar.2022.175430] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/30/2022]
Abstract
Disruption of blood-testis barrier (BTB) was a crucial pathological feature of diabetes induced-testicular injury at early phase. Aucubin (AU), a main active component in Eucommiae Cortex, has drawn attention for its benefits against male reproductive system disease. The current study was aimed at investigating the protective role of AU and exploring the underlying mechanism in diabetic model. A murine model of type 2 diabetes mellitus (T2DM) was induced by high-fat diet (HFD) combined with streptozocin (STZ). Testicular weight index and morphology, sperm quality, integrity of BTB and protein levels were analyzed. The underlying mechanism of the protective effect of AU was further explored in Sertoli cells (SCs) cultured with high glucose (HG). Our results showed AU inhibited testicular structural destruction, restored disruption of BTB and improved abnormal spermatogenic function in diabetic mice. Consistent with in vivo results, HG induced decreased transcellular resistance and increased permeability in SCs monolayers, while AU exposure reverses this trend. Meanwhile, reduced expression of Zonula occludin-1(ZO-1) and Connexin43(Cx43) in testicular tissue diabetic mice and HG-induced SCs was prominently reversed via AU treatment. Mechanistic studies suggested a high affinity interaction between AU and c-Src protein was identified based on molecular docking, and the activation of c-Src was significantly inhibited in AU treatment. Furthermore, AU significantly increased the expression of Cx43 and ZO-1 proteins HG-induced SCs, which can be further enhanced in gene-silenced c-Src cells to some extent. Our results suggested that AU ameliorated disruption of BTB and spermatogenesis dysfunction in diabetic mice via inactivating c-Src to stabilize cell junction integrity.
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Affiliation(s)
- Jingxun Wei
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Xuanzhao Lu
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Xiaowen Bao
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Chi Zhang
- Nanjing Tech University School of Economics & Management. Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Jiaqi Li
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Chaoxing Ren
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Zhiming Zhu
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Beiting Ma
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Nan Zhang
- School of Chemical and Molecular Engineering, Nanjing Tech University, Nanjing, People's Republic of China
| | - Xin Jin
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China
| | - Bo Ma
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, 210009, People's Republic of China.
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18
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Elenkov A, Zarén P, Sundell B, Lundin L, Giwercman A. Testosterone deficiency and metabolic disturbances in men who fathered a child by use of donated spermatozoa. Sci Rep 2022; 12:14458. [PMID: 36002478 PMCID: PMC9402707 DOI: 10.1038/s41598-022-17864-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 08/02/2022] [Indexed: 11/18/2022] Open
Abstract
Dose–response association between level of impairment of semen quality and risk of morbidity or premature death has been reported. Therefore, it can be presumed that men utilizing donated spermatozoa, i.e. patients with non-obstructive azoospermia, are at highest risk for adverse health outcomes. To evaluate the risks of prescription of medications for common metabolic disturbances and testosterone replacement therapy (TRT) among men who father children with donated spermatozoa—who presumably do it due to severe impairment of fertility. We used Swedish nationwide register data on all fathers who had a live-born child between 2007 and 2014 in order to compare men who fathered children with donated spermatozoa to the ones who became fathers by using own gametes. Cox regression analysis was used in order to estimate the post-conception incidence of prescription of medicines for hypertension (HT), diabetes (type 1 and 2), dyslipidaemia (DLE) or TRT. Starting the follow up at time of conception, models were adjusted for age, educational level, and previous cancer treatment. In total 410,119 childbirths were included in the analysis. Among them, for 390 fathers donated spermatozoa were utilized. Fathers to children conceived with donated spermatozoa had higher risk for having TRT prescribed (HR: 18.14; 95%CI: 11.71–28.10; p ≪ 0.001). Same was true for DLE (HR: 2.08; 95%CI: 1.27–3.39; p = 0.003) but not diabetes. Fathers to children conceived by use of donated spermatozoa are at significantly increased risk for testosterone treatment and dyslipidaemia, necessitating stringent follow up and inclusion in prevention programs.
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Affiliation(s)
- Angel Elenkov
- Reproductive Medicine Centre, Skane University Hospital Malmo, Malmö, Sweden. .,Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden.
| | - Peter Zarén
- Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden
| | - Bianca Sundell
- Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden
| | - Lovisa Lundin
- Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine Centre, Skane University Hospital Malmo, Malmö, Sweden.,Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden
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19
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Hao Y, Feng Y, Yan X, Chen L, Zhong R, Tang X, Shen W, Sun Q, Sun Z, Ren Y, Zhang H, Zhao Y. Gut microbiota-testis axis: FMT improves systemic and testicular micro-environment to increase semen quality in type 1 diabetes. Mol Med 2022; 28:45. [PMID: 35468731 PMCID: PMC9036783 DOI: 10.1186/s10020-022-00473-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/11/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Clinical data suggest that male reproductive dysfunction especially infertility is a critical issue for type 1 diabetic patient (T1D) because most of them are at the reproductive age. Gut dysbiosis is involved in T1D related male infertility. However, the improved gut microbiota can be used to boost spermatogenesis and male fertility in T1D remains incompletely understood. METHODS T1D was established in ICR (CD1) mice with streptozotocin. Alginate oligosaccharide (AOS) improved gut microbiota (fecal microbiota transplantation (FMT) from AOS improved gut microbiota; A10-FMT) was transplanted into the T1D mice by oral administration. Semen quality, gut microbiota, blood metabolism, liver, and spleen tissues were determined to investigate the beneficial effects of A10-FMT on spermatogenesis and underlying mechanisms. RESULTS We found that A10-FMT significantly decreased blood glucose and glycogen, and increased semen quality in streptozotocin-induced T1D subjects. A10-FMT improved T1D-disturbed gut microbiota, especially the increase in small intestinal lactobacillus, and blood and testicular metabolome to produce n-3 polyunsaturated fatty acid (PUFA) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) to ameliorate spermatogenesis and semen quality. Moreover, A10-FMT can improve spleen and liver functions to strengthen the systemic environment for sperm development. FMT from gut microbiota of control animals (Con-FMT) produced some beneficial effects; however, to a smaller extent. CONCLUSIONS AOS-improved gut microbiota (specific microbes) may serve as a novel, promising therapeutic approach for the improvement of semen quality and male fertility in T1D patients via gut microbiota-testis axis.
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Affiliation(s)
- Yanan Hao
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China ,grid.412608.90000 0000 9526 6338College of Life Sciences, Qingdao Agricultural University, Qingdao, 266109 People’s Republic of China ,grid.1025.60000 0004 0436 6763College of Science, Health, Engineering and Education, Murdoch University, Perth, 6150 Australia
| | - Yanni Feng
- grid.412608.90000 0000 9526 6338College of Veterinary Medicine, Qingdao Agricultural University, Qingdao, 266109 People’s Republic of China
| | - Xiaowei Yan
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China ,grid.412608.90000 0000 9526 6338College of Life Sciences, Qingdao Agricultural University, Qingdao, 266109 People’s Republic of China
| | - Liang Chen
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China
| | - Ruqing Zhong
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China
| | - Xiangfang Tang
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China
| | - Wei Shen
- grid.412608.90000 0000 9526 6338College of Life Sciences, Qingdao Agricultural University, Qingdao, 266109 People’s Republic of China
| | - Qingyuan Sun
- grid.413405.70000 0004 1808 0686Fertility Preservation Lab, Reproductive Medicine Center, Guangdong Second Provincial General Hospital, Guangzhou, 510317 People’s Republic of China
| | - Zhongyi Sun
- grid.263488.30000 0001 0472 9649Urology Department, Shenzhen University General Hospital, Shenzhen, 518055 People’s Republic of China
| | - Yonglin Ren
- grid.1025.60000 0004 0436 6763College of Science, Health, Engineering and Education, Murdoch University, Perth, 6150 Australia
| | - Hongfu Zhang
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China ,grid.1025.60000 0004 0436 6763College of Science, Health, Engineering and Education, Murdoch University, Perth, 6150 Australia
| | - Yong Zhao
- grid.410727.70000 0001 0526 1937State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, 100193 People’s Republic of China ,grid.1025.60000 0004 0436 6763College of Science, Health, Engineering and Education, Murdoch University, Perth, 6150 Australia
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20
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Lei X, Huo P, Xie Y, Wang Y, Liu G, Tu H, Shi Q, Mo Z, Zhang S. Dendrobium nobile Lindl polysaccharides improve testicular spermatogenic function in streptozotocin‐induced diabetic rats. Mol Reprod Dev 2022; 89:202-213. [DOI: 10.1002/mrd.23556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/27/2021] [Accepted: 12/01/2021] [Indexed: 11/06/2022]
Affiliation(s)
- Xiaocan Lei
- Department of Histology and Embryology, Clinical Anatomy & Reproductive Medicine Application Institute University of South China Hengyang China
| | - Peng Huo
- School of Public and Health Guilin Medical University Guilin China
| | - Yuan‐jie Xie
- Department of Histology and Embryology, Clinical Anatomy & Reproductive Medicine Application Institute University of South China Hengyang China
| | - Yaohui Wang
- School of Basic Medical Sciences Zunyi Medical University Zunyi China
| | - Guanghai Liu
- School of Basic Medical Sciences Zunyi Medical University Zunyi China
| | - Haoyan Tu
- Department of Reproductive Medical Center The Affiliated Hospital of Guilin Medical University Guilin China
| | - Qingxiang Shi
- School of Basic Medical Sciences Zunyi Medical University Zunyi China
| | - Zhong‐cheng Mo
- Department of Histology and Embryology, Clinical Anatomy & Reproductive Medicine Application Institute University of South China Hengyang China
| | - Shun Zhang
- Department of Reproductive Medical Center The Affiliated Hospital of Guilin Medical University Guilin China
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21
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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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22
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23
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Fajri M, Ahmadi A, Sadrkhanlou R. Protective effects of Equisetum arvense methanolic extract on testicular tissue disorders in streptozotocin-induced diabetic murine model. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2021; 12:497-503. [PMID: 35529823 PMCID: PMC9010846 DOI: 10.30466/vrf.2020.108502.2576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 06/14/2021] [Indexed: 11/30/2022]
Abstract
Diabetes in a long period can damage the testicular tissue and impair the male fertility potential. Recently, different herbal treatments have been used for the prevention of type I diabetes and its pathological effects. Methanolic extract of Equisetum arvense has anti-oxidant and hypoglycemic properties. Thus, the current study aimed to evaluate the protective effects of Equisetum arvense methanolic extract (EE) on diabetes-induced detrimental effects in mice testicular tissue. Thirty-two adult male mice were randomly divided into four groups including control-sham, diabetic (induced by streptozotocin, 50.00 mg kg-1 for five days), diabetic + EE 250 (250 mg kg-1) and diabetic + EE 500 (500 mg kg-1). After 45 days, all animals were euthanized and their testicles were dissected out and undergone histological analyses. Moreover, the serum level of testosterone was evaluated. Analyses showed that seminiferous tubules diameter, Leydig cells number per mm2 of the connective tissue, Sertoli cells number per tubule, serum level of testosterone and percentage of seminiferous tubules with positive tubular differentiation, repopulation and spermiogenesis indices were significantly decreased in the diabetic group in comparison with control-sham group. The administration of EE in test groups significantly decreased the adverse effects of diabetes (especially 500 mg kg-1). The results of this study revealed that diabetes disturbs spermatogenesis and spermiogenesis processes in mice. Meanwhile, the EE prevents diabetes-induced damages in mice testicular tissue, which may be associated with its hypoglycemic and antioxidative activities.
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Affiliation(s)
- Mehrsa Fajri
- DVM Graduate, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Abbas Ahmadi
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran.,Correspondence Abbas Ahmadi. DVM, PhD, Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran . E-mail:
| | - Rajabali Sadrkhanlou
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
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24
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Koroglu Aydın P, Karabulut-Bulan O, Bugan I, Turkyilmaz IB, Altun S, Yanardag R. The protective effect of metformin against testicular damage in diabetes and prostate cancer model. Cell Biochem Funct 2021; 40:60-70. [PMID: 34845738 DOI: 10.1002/cbf.3674] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 12/18/2022]
Abstract
Individuals with diabetes have an increased risk of breast, colorectal, pancreatic and prostate cancer. Metformin, an oral biguanide used to treat diabetes, has anti-hyperglycaemic, anti-hyperinsulinemic and antioxidant activities. The effects of metformin on testicular tissue damage in cancer and diabetic + cancer rat models were evaluated histologically, immunohistochemically and biochemically. The diabetic model was produced in Copenhagen rats using a single dose of streptozotocin (65 mg/kg), while prostate cancer was induced through subcutaneous inoculation of 2 × 104 Mat-LyLu cells into the animals. At the end of the experimental period, testicular tissues with a close functional relationship to the prostate were collected. Histological evaluation found moderate to severe damage to testes following the diabetes and cancer process. Histopathological and biochemical impairments were observed in the early stage of prostate cancer, which were increased in the diabetic animals. Metformin administration reversed these injuries and provided substantial protection of the testes. In particular, metformin had protective effects on tissue damage, apoptosis, oxidative stress and antioxidant capacity. This suggests that metformin should be further investigated as a targeted protective drug against prostate cancer-related damage to the testes.
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Affiliation(s)
- Pınar Koroglu Aydın
- Department of Histology and Embryology, Faculty of Medicine, Halic University, Istanbul, Turkey
| | - Omur Karabulut-Bulan
- Department of Biology, Faculty of Science, Istanbul University, Istanbul, Turkey
| | - Ilknur Bugan
- Department of Biology, Faculty of Science, Istanbul University, Istanbul, Turkey
| | - Ismet Burcu Turkyilmaz
- Department of Chemistry, Faculty of Engineering, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Seyhan Altun
- Department of Molecular Biology and Genetics, Faculty of Science and Letters, Istanbul Kultur University, Istanbul, Turkey
| | - Refiye Yanardag
- Department of Chemistry, Faculty of Engineering, Istanbul University-Cerrahpasa, Istanbul, Turkey
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25
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Priskorn L, Tøttenborg SS, Almstrup K, Andersson AM, Axelsson J, Bräuner EV, Elenkov A, Freiesleben NLC, Giwercman YL, Grøndahl ML, Hansen AH, Hansen LS, Henic E, Kitlinski ML, Landersoe SK, Lindh C, Løkkegaard EL, Malm J, Olsen KW, Petersen KU, Schmidt L, Stormlund S, Svendsen PF, Vassard D, Wang NF, Zedeler A, Bhasin S, Chavarro J, Eisenberg ML, Hauser R, Huhtaniemi I, Krawetz SA, Marko-Varga G, Salonia A, Toppari J, Juul A, Jørgensen N, Nielsen HS, Pinborg A, Rylander L, Giwercman A. RUBIC (ReproUnion Biobank and Infertility Cohort): A binational clinical foundation to study risk factors, life course, and treatment of infertility and infertility-related morbidity. Andrology 2021; 9:1828-1842. [PMID: 34114375 PMCID: PMC10015988 DOI: 10.1111/andr.13063] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/03/2021] [Accepted: 06/03/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Infertility affects 15%-25% of all couples during their reproductive life span. It is a significant societal and public health problem with potential psychological, social, and economic consequences. Furthermore, infertility has been linked to adverse long-term health outcomes. Despite the advanced diagnostic and therapeutic techniques available, approximately 30% of infertile couples do not obtain a live birth after fertility treatment. For these couples, there are no further options to increase their chances of a successful pregnancy and live birth. OBJECTIVES Three overall questions will be studied: (1) What are the risk factors and natural life courses of infertility, early embryonic loss, and adverse pregnancy outcomes? (2) Can we develop new diagnostic and prognostic biomarkers for fecundity and treatment success? And (3) what are the health characteristics of women and men in infertile couples at the time of fertility treatment and during long-term follow-up? MATERIAL AND METHODS ReproUnion Biobank and Infertility Cohort (RUBIC) is established as an add-on to the routine fertility management at Copenhagen University Hospital Departments in the Capital Region of Denmark and Reproductive Medicine Centre at Skåne University Hospital in Sweden. The aim is to include a total of 5000 couples equally distributed between Denmark and Sweden. The first patients were enrolled in June 2020. All eligible infertile couples are prospectively asked to participate in the project. Participants complete an extensive questionnaire and undergo a physical examination and collection of biospecimens (blood, urine, hair, saliva, rectal swabs, feces, semen, endometrial biopsies, and vaginal swabs). After the cohort is established, the couples will be linked to the Danish and Swedish national registers to obtain information on parental, perinatal, childhood, and adult life histories, including disease and medication history. This will enable us to understand the causes of infertility and identify novel therapeutic options for this important societal problem.
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Affiliation(s)
- Laerke Priskorn
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Health, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Kristian Almstrup
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna-Maria Andersson
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Jonatan Axelsson
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | - Elvira Vaclavik Bräuner
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Angel Elenkov
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | - Nina la Cour Freiesleben
- The Fertility Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Marie Louise Grøndahl
- Fertility Clinic, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Ann Holm Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Laura Smidt Hansen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Emir Henic
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden
| | | | - Selma Kloeve Landersoe
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Ellen Leth Løkkegaard
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Obstetrics and Gynecology, Copenhagen University Hospital - North Zealand, Copenhagen, Denmark
| | - Johan Malm
- Department of Translational Medicine, Lund University, Malmö, Sweden
| | | | - Kajsa Uglevig Petersen
- Department of Occupational and Environmental Health, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sacha Stormlund
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Pernille Fog Svendsen
- Fertility Clinic, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - Ditte Vassard
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Nathalie Friis Wang
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anne Zedeler
- Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jorge Chavarro
- Departments of Nutrition and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael L Eisenberg
- Department of Urology and Obstetrics & Gynecology, Stanford University School of Medicine, Stanford, California, USA
| | - Russ Hauser
- Departments of Environmental Health and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ilpo Huhtaniemi
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | | | - Andrea Salonia
- Graduate School of Urology, University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Jorma Toppari
- Institute of Biomedicine, Research Centre for Integrated Physiology and Pharmacology, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku, Turku, Finland.,Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Anders Juul
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Niels Jørgensen
- Department of Growth and Reproduction, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Henriette Svarre Nielsen
- The Fertility Clinic, Copenhagen University Hospital - Amager and Hvidovre, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Fertility Department, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Lars Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine Center, Skåne University Hospital, Malmö, Sweden.,Department of Translational Medicine, Lund University, Malmö, Sweden
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26
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Akomolafe SF, Olasehinde TA, Oladapo IF, Oyeleye SI. Diet Supplemented with Chrysophyllum albidum G. Don (Sapotaceae) Fruit Pulp Improves Reproductive Function in Hypertensive Male Rats. Reprod Sci 2021; 29:540-556. [PMID: 34591290 DOI: 10.1007/s43032-021-00746-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 09/17/2021] [Indexed: 12/12/2022]
Abstract
Hypertension has been implicated as a risk factor of reproductive disorders. High blood pressure may trigger impaired sperm quality and biomarkers of reproductive disorders. This study aims to investigate the effect of diet supplemented with Chrysophyllum albidum fruit pulp (FP) on sperm parameters, reproductive hormones, and antioxidant markers in testes and epididymis of hypertensive rats. Male Wistar rats were divided into seven groups (n = 10): normotensive control rats [NC], cyclosporine (25 mg/kg)-induced hypertensive rats [Hypert], hypertensive rats treated with captopril (10 mg/kg/day) [Hypert + Capt], hypertensive [Hypert + 2%FP and Hypert + 4%FP], and normotensive [2%FP and 4%FP] rats treated with 2% and 4% of diet supplemented with African star apple fruit's pulp [FP]. Hemodynamic parameters (arterial pressure, diastolic, and systolic pressure), sperm count, sperm motility, reproductive hormones, reactive oxygen species, and malondialdehyde levels were assessed. Diet supplemented with FP fed to hypertensive rats reduced mean arterial pressure, diastolic and systolic blood pressure, and heart rate. Furthermore, FP improved sperm quality in hypertensive rats by increasing sperm count, sperm motility with a concomitant reduction in sperm abnormality. FP also increased 3β and 17β-hydroxysteroid hydrogenase (3β-HSD and 17β -HSD) activities, as well as testosterone, luteinizing hormone, and follicle-stimulating hormone levels. Besides, FP triggered a significant increase in 3β-HSD, 17β -HSD, and STAR expression in rats' testicular tissues. Diet supplemented with FP also reduced ROS and malondialdehyde levels and triggered an increase in thiol levels, catalase, and glutathione-S-transferase activities. This study revealed that FP supplemented diet improved sexual function in cyclosporine-induced hypertensive rats by reducing blood pressure and modulation of sperm parameters, steroidogenic enzymes, and reproductive hormones.
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Affiliation(s)
- Seun F Akomolafe
- Department of Biochemistry, Ekiti State University, Private Mail Bag 5363, Ado-Ekiti, Nigeria.
| | - Tosin A Olasehinde
- Department of Biochemistry and Microbiology, University of Fort Hare, Alice Eastern Cape, South Africa
- Nutrition and Toxicology Division, Food Technology Department, Federal Institute of Industrial Research Oshodi, Lagos, Nigeria
| | - Iyabo F Oladapo
- Department of Basic Medical Science, College of Health Science and Technology, Ijero Ekiti, Nigeria
| | - Sunday I Oyeleye
- Biomedical Technology Department, Federal University of Technology, Akure, Nigeria
- Functional Foods and Nutraceuticals Unit, Department of Biochemistry, Federal University of Technology Akure, Akure, Ondo State, Nigeria
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27
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Elenkov A, Melander O, Nilsson PM, Zhang H, Giwercman A. Impact of genetic risk score on the association between male childlessness and cardiovascular disease and mortality. Sci Rep 2021; 11:18526. [PMID: 34535694 PMCID: PMC8448891 DOI: 10.1038/s41598-021-97733-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 08/26/2021] [Indexed: 11/09/2022] Open
Abstract
Childless men are reported to have a higher risk of cardiovascular disease (CVD) and mortality. Information on inherited genetic risk for CVD has improved the predictive models. Presuming that childlessness is a proxy of infertility we aimed to investigate if childless men inherit more often genetic traits for CVD and if combining genetic and parenthood information improves predictive models for CVD morbidity and mortality. Data was sourced from a large prospective population-based cohort where genetic risk score (GRS) was calculated using two sets of either 27 (GRS 27) or 50 (GRS 50) single nucleotide polymorphisms (SNPs) previously found to be associated with CVD. Part of the participants (n = 2572 men) were randomly assigned to a sub-cohort with focus on CVD which served as an exploratory cohort. The obtained statistically significant results were tested in the remaining (confirmatory) part of the cohort (n = 9548 men). GRS distribution did not differ between childless men and fathers (p-values for interaction between 0.29 and 0.76). However, when using fathers with low GRS as reference high GRS was a strong predictor for CVD mortality, the HR (95% CI) increasing from 1.92 (1.10-3.36) for GRS 50 and 1.54 (0.87-2.75) for GRS 27 in fathers to 3.12 (1.39-7.04) for GRS50 and 3.73 (1.75-7.99) for GRS27 in childless men. The confirmatory analysis showed similar trend. Algorithms including paternal information and GRS were more predictive for CVD mortality at 5 and 10 years follow-ups when compared to algorithms including GRS only (AUC 0.88 (95% CI 0.84-0.92) and 0.86 (95% CI 0.84-0.90), and, AUC 0.81 (95% CI 0.75-0.87) and 0.78 (95% CI 0.73-0.82), respectively). Combining information on parental status and GRS for CVD may improve the predictive power of risk algorithms in middle-aged men. Childless men and those with severe infertility problem may be an important target group for prevention of CVD.
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Affiliation(s)
- Angel Elenkov
- Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.
- Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden.
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Department of Emergency and Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - He Zhang
- Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
- Department of Translational Medicine, Clinical Research Centre, Lund University, Jan Waldenströms gata 35, Building 60, Plan 9, 20502, Malmö, Sweden
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28
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Boeri L, Ventimiglia E, Cazzaniga W, Pederzoli F, Fallara G, Pozzi E, Belladelli F, Baudo A, Frego N, Capogrosso P, Alfano M, Montorsi F, Salonia A. Risk of health status worsening in primary infertile men: a prospective 10-year follow-up study. Andrology 2021; 10:128-136. [PMID: 34369670 DOI: 10.1111/andr.13090] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/13/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND A severe male infertility factor has been associated with both lower health status and increased mortality in infertile men. OBJECTIVES To investigate reproductive factors associated with health status impairment in infertile men over a 10-year time frame since first clinical evaluation. MATERIALS AND METHODS Data from 899 infertile men were analysed at baseline between 2003 and 2010. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients were followed-up yearly recording any worsening in their health status until 2019. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of CCI score increase. RESULTS At a median follow-up of 136 months (IQR 121, 156), 85 men (9.5%) depicted an increase of their baseline CCI score of at least 1 point. The most frequent reason for CCI upgrade was cancer (34%), cardio-vascular diseases (29%) and diabetes mellitus (22%). Compared to patients without a CCI increase, patients with a CCI increase presented with higher BMI and FSH values, a higher rate of baseline CCI ≥ 1 (all p < 0.01) and a greater proportion of non-obstructive azoospermia (p < 0.001). In the Cox regression model, patient's BMI (p < 0.001), baseline CCI ≥ 1 (p < 0.01) and azoospermia status (p = 0.001) were found to be independently associated with CCI increases. CONCLUSIONS Almost 10% of men presenting for primary infertility had a decrease of the overall health status already in the relatively short 10-year time frame after first presentation. Non-obstructive azoospermic men showed the worst health status impairment and should be strictly followed-up regardless of their fertility status. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Foundation IRCCS Ca' Granda - Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Filippo Pederzoli
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Giueppe Fallara
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Baudo
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Nicola Frego
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,Department of Urology, Istituto Clinico Humanitas IRCCS-Clinical and Research Hospital, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy.,Department of Urology, Circolo & Fondazione Macchi Hospital - ASST Sette Laghi, Varese, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.,University Vita-Salute San Raffaele, Milan, Italy
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29
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Nasiri K, Akbari A, Nimrouzi M, Ruyvaran M, Mohamadian A. Safflower seed oil improves steroidogenesis and spermatogenesis in rats with type II diabetes mellitus by modulating the genes expression involved in steroidogenesis, inflammation and oxidative stress. JOURNAL OF ETHNOPHARMACOLOGY 2021; 275:114139. [PMID: 33894286 DOI: 10.1016/j.jep.2021.114139] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 04/02/2021] [Accepted: 04/18/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Diabetes mellitus (DM), as a multiorgan syndrome, is an endocrine and metabolic disorder that is associated with male reproductive system dysfunction and infertility. Safflower (Carthamus tinctorius L.) as an herbal remedy improves DM and infertility-related disorders. The anti-hypercholesterolemic, anti-inflammatory, and antioxidative properties of this herb have been well documented, but its role in testosterone production, male reproductive system and zinc homeostasis has not been fully illustrated. AIM OF THE STUDY This study aimed to investigate the preventive and therapeutic properties of different doses of safflower seed oil against reproductive damage caused by type II DM by investigating zinc element homeostasis, inflammation and oxidative damage in testis tissue and their relationship with testosterone production and sperm parameters. MATERIALS AND METHODS Eighty adult male Sprague-Dawley rats were randomly divided into eight groups and treated daily for 12 and 24 weeks in protective and therapeutic studies, respectively. Type II DM was induced by a High Fat Diet (HFD) in normoglycemic rats for three months. At the end of each study, serum level of glucose, testosterone, gonadotropins, TNF-α, insulin, and leptin were measured. Moreover, antioxidant enzymes activity, lipid peroxidation, zinc and testosterone along with the expression of Nrf-2, NF-κB, TNF-α, StAR, P450scc, and 17βHSD3 genes in the testis were detected. RESULTS After the intervention, the activity of antioxidant enzymes and the level of testosterone and gonadotropins significantly decreased in the rats with DM in comparison to the others. However, lipid peroxidation and serum level of insulin, leptin and TNF-α increased and the testicular level of zinc significantly changed in the rats with DM compared to the control groups (p < 0.05). The gene expression of NF-κB and TNF-α were also significantly increased and the gene expression of Nrf2, StAR, P450scc and 17βHSD3 were decreased in the testis of diabetic rats (p < 0.05). The results showed that pretreatment and treatment with safflower seed oil could improve these parameters in diabetic rats compared with untreated diabetic rats (p < 0.05). CONCLUSION HFD could impair the production of testosterone and sperm, and reduce gonadotropin by increasing the serum level of leptin and inducing insulin resistance, oxidative stress and inflammation. However, safflower oil in a dose-dependent manner could improve testosterone level and sperm parameters by improving the level of leptin, zinc and insulin resistance, and the genes expression involved in testosterone synthesis, inflammation and oxidative stress.
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Affiliation(s)
- Khadijeh Nasiri
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran.
| | - Abolfazl Akbari
- Department of Physiology, School of Veterinary Medicine, Shiraz University, Shiraz, Iran.
| | - Majid Nimrouzi
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Maede Ruyvaran
- Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Alireza Mohamadian
- Department of Radiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
IMPORTANCE In the US, approximately 12.7% of reproductive age women seek treatment for infertility each year. This review summarizes current evidence regarding diagnosis and treatment of infertility. OBSERVATIONS Infertility is defined as the failure to achieve pregnancy after 12 months of regular unprotected sexual intercourse. Approximately 85% of infertile couples have an identifiable cause. The most common causes of infertility are ovulatory dysfunction, male factor infertility, and tubal disease. The remaining 15% of infertile couples have "unexplained infertility." Lifestyle and environmental factors, such as smoking and obesity, can adversely affect fertility. Ovulatory disorders account for approximately 25% of infertility diagnoses; 70% of women with anovulation have polycystic ovary syndrome. Infertility can also be a marker of an underlying chronic disease associated with infertility. Clomiphene citrate, aromatase inhibitors such as letrozole, and gonadotropins are used to induce ovulation or for ovarian stimulation during in vitro fertilization (IVF) cycles. Adverse effects of gonadotropins include multiple pregnancy (up to 36% of cycles, depending on specific therapy) and ovarian hyperstimulation syndrome (1%-5% of cycles), consisting of ascites, electrolyte imbalance, and hypercoagulability. For individuals presenting with anovulation, ovulation induction with timed intercourse is often the appropriate initial treatment choice. For couples with unexplained infertility, endometriosis, or mild male factor infertility, an initial 3 to 4 cycles of ovarian stimulation may be pursued; IVF should be considered if these approaches do not result in pregnancy. Because female fecundity declines with age, this factor should guide decision-making. Immediate IVF may be considered as a first-line treatment strategy in women older than 38 to 40 years. IVF is also indicated in cases of severe male factor infertility or untreated bilateral tubal factor. CONCLUSIONS AND RELEVANCE Approximately 1 in 8 women aged 15 to 49 years receive infertility services. Although success rates vary by age and diagnosis, accurate diagnosis and effective therapy along with shared decision-making can facilitate achievement of fertility goals in many couples treated for infertility.
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Affiliation(s)
- Sandra Ann Carson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
| | - Amanda N Kallen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
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31
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Greer C, Bhakta H, Ghanem L, Refai F, Linn E, Avella M. Deleterious variants in genes regulating mammalian reproduction in Neanderthals, Denisovans and extant humans. Hum Reprod 2021; 36:734-755. [PMID: 33417716 DOI: 10.1093/humrep/deaa347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 11/12/2020] [Indexed: 02/06/2023] Open
Abstract
STUDY QUESTION Were Neanderthals and Denisovans (referred here also as extinct hominidae) carrying deleterious variants in genes regulating reproduction? SUMMARY ANSWER The majority of extinct hominidae analyzed here, presented a considerable number of deleterious variants per individual in proteins regulating different aspects of reproduction, including gonad and uterine function, and gametogenesis. WHAT IS KNOWN ALREADY Neanderthals, Denisovans and extant humans were interfertile and hybridized while occupying geographically overlapping areas in Europe and Asia. This is evidenced by the small archaic genome component (average ∼2%) present in non-African extant humans. STUDY DESIGN, SIZE, DURATION The genome of eight extinct hominidae, together with five human genome databases, plus 44 mothers and 48 fathers (fertile controls), were screened to look for deleterious variants in 1734 protein-coding genes regulating reproduction. PARTICIPANTS/MATERIALS, SETTING, METHODS Ancient DNA from six Neanderthals and two Denisovans dated between ∼82 000 and 43 000 calibrated years was retrieved from the public European Nucleotide Archive. The hominins analyzed include Altai, Vindija 33.15, 33.19, 33.25 and 33.26, El Sidron 1253, Denisova 3 and 11. Their DNA was analyzed using the CLC Genomics Workbench 12, by mapping overlapping paired-end reads (Illumina, FASTQ files) to the human genome assembly GRCh37 (hg19) (Vindija 33.19, 33.25, 33.26, Denisova 3 and Denisova 11) or by analyzing BAM files (Altai, El Sidron 1253 and Vindija 33.15) (human genome reference, GRCh37 (hg19)). Non-synonymous reproductive variants were classified as deleterious or tolerated (PolyPhen-2 and SIFT analyses) and were compared to deleterious variants obtained from extant human genome databases (Genome Aggregation Database (GnomAD), 1000 Genomes, the Haplotype Map (HapMap), Single Nucleotide Polymorphism Database (dbSNPs)) across different populations. A genetic intersection between extant or extinct DNA variants and other genetic disorders was evaluated by annotating the obtained variants with the Clinical Variant (ClinVar) database. MAIN RESULTS AND THE ROLE OF CHANCE Among the eight extinct hominidae analyzed, a total of 9650 non-synonymous variants (only coverage ≥20 reads included; frameshift mutations were excluded) in 1734 reproductive protein-coding genes were found, 24% of which were classified as deleterious. The majority (73%) of the deleterious alleles present in extant humans that are shared between extant humans and extinct hominidae were found to be rare (<1%) in extant human populations. A set of 8044 variants were found uniquely in extinct hominidae. At the single-gene level, no extinct individual was found to be homozygous for deleterious variants in genes necessary for gamete recognition and fusion, and no higher chance of embryo-lethality (calculated by Mendelian Genetics) was found upon simulated mating between extant human and extinct hominidae compared to extant human-extant human. However, three of the eight extinct hominidae were found to be homozygous for 48-69 deleterious variants in 55 genes controlling ovarian and uterine functions, or oogenesis (AKAP1, BUB1B, CCDC141, CDC73, DUSP6, ESR1, ESR2, PATL2, PSMC3IP, SEMA3A, WT1 and WNT4). Moreover, we report the distribution of nine Neanderthal variants in genes associated with a human fertility phenotype found in extant human populations, one of which has been associated with polycystic ovarian syndrome and primary congenital glaucoma. LIMITATIONS, REASONS FOR CAUTION While analyzing archaic DNA, stringent filtering criteria were adopted to screen for deleterious variants in Neanderthals and Denisovans, which could result in missing a number of variants. Such restraints preserve the potential for detection of additional deleterious variants in reproductive proteins in extinct hominidae. WIDER IMPLICATIONS OF THE FINDINGS This study provides a comprehensive overview of putatively deleterious variants in extant human populations and extinct individuals occurring in 1734 protein-coding genes controlling reproduction and provides the fundaments for future functional studies of extinct variants in human reproduction. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by the Department of Biological Science and by the Office of Research and Sponsored Programs at the University of Tulsa (Faculty Research Grant and Faculty Research Summer Fellowship) to M.A. and the University of Tulsa, Tulsa Undergraduate Research Challenge (TURC) program to E.L.; no conflict of interest to declare. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Cory Greer
- Department of Biological Science, College of Engineering and Natural Sciences, University of Tulsa, Tulsa, OK 74104, USA
| | - Hanisha Bhakta
- Department of Biological Science, College of Engineering and Natural Sciences, University of Tulsa, Tulsa, OK 74104, USA
| | - Lillian Ghanem
- Department of Biological Science, College of Engineering and Natural Sciences, University of Tulsa, Tulsa, OK 74104, USA
| | - Fares Refai
- Department of Biological Science, College of Engineering and Natural Sciences, University of Tulsa, Tulsa, OK 74104, USA
| | - Emma Linn
- Department of Biological Science, College of Engineering and Natural Sciences, University of Tulsa, Tulsa, OK 74104, USA
| | - Matteo Avella
- Department of Biological Science, College of Engineering and Natural Sciences, University of Tulsa, Tulsa, OK 74104, USA
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Aljahdali GL, Alkhaldi FA, Almujarri SF, Alsadhan HF, Yaqoub AS, Alsahabi JA, Masud N, Felemban AA. Live Birth Rate Comparison Between Single vs. Double Ovary Women With Assisted Reproduction: A Single Tertiary Center Study. Cureus 2021; 13:e14876. [PMID: 34104604 PMCID: PMC8179779 DOI: 10.7759/cureus.14876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction
One of the major hardships faced by married couples is the inability to conceive a child. This issue is becoming more prevalent given the increasing rate of infertility worldwide. Assisted reproductive technology (ART) has brought hope to infertile couples. We aim to estimate the live birth rate (LBR) and pregnancy rate in women with one ovary compared with those with two ovaries. Methods A retrospective cohort study of women who underwent ART at King Abdulaziz Medical City (Jan 2000 - Dec 2018) was conducted. Five cycles of patient data were collected. The LBR (both conditional and cumulative) was compared between women with one and two ovaries. Results The final analysis included 403 women. Of these, 9% (n = 37) had one ovary. The majority (59%, n = 233) had primary infertility. A male-associated factor accounted for 52% (n = 208) of the infertility cases. The total number of live births was 164; and the overall LBR from five cycles was estimated as 9%, 16%, 18%, 18%, and 15%, respectively. In the double ovary group, the highest rate was in the fourth cycle [19% (12-26)], while in the single ovary group peaked in the third cycle [27% (9-46)]. Pregnancy was at its highest in the first cycle, accounting for 88 pregnancies. Conclusion The outcomes of ART varied between study groups. LBR was lower in single ovary women. The average of five cycles in the single and double ovary groups was 13% and 15%, respectively. Nevertheless, there was no significant difference in LBR between single or double ovary women.
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Affiliation(s)
- Ghadeer L Aljahdali
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Fatimah A Alkhaldi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Sarah F Almujarri
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Haifa F Alsadhan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Amirah S Yaqoub
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Jawaher A Alsahabi
- Department of Obstetrics and Gynecology, King Abdulaziz Medical City, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Nazish Masud
- Research Unit, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Afaf A Felemban
- Department of In-Vitro Fertilization, King Abdulaziz Medical City, Riyadh, SAU.,Research, King Abdullah International Medical Research Center, Riyadh, SAU
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Del Giudice F, Kasman AM, Chen T, De Berardinis E, Busetto GM, Sciarra A, Ferro M, Lucarelli G, Belladelli F, Salonia A, Eisenberg ML. The Association between Mortality and Male Infertility: Systematic Review and Meta-analysis. Urology 2021; 154:148-157. [PMID: 33819517 DOI: 10.1016/j.urology.2021.02.041] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To summarize the current body of evidence on the relationship between impaired male fertility and the risk of early death through a systematic review and meta-analysis of population-based retrospective cohort studies. METHODS PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases were searched from inception to August 2020 according to the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Pooled Risk Ratio (RR), Risk Difference (Δr), Hazard Ratio (HR) and Standardized Mortality Ratio (SMR) differences among male factor infertility cohorts were compared to fertile/normospermic control populations or to national mortality data. RESULTS Six studies from 2006 to 2020 met inclusion criteria. Three studies examined male infertility and mortality (ntot = 202,456; ndeaths = 1396), while four studies examined survival in relation to semen parameters (ntot = 59,291; ndeaths = 643). Comparing infertile to fertile men, pooled HR for the risk of death was 1.26 (95%CI:1.01-1.59). Pooled RR and Δr of death for combined oligo- and azoospermic men vs normospermic men was 1.67 (95%CI:1.26-2.21) and 0.37% (95%CI:0.18-0.55%) respectively. When comparing oligo- and normospermic men to azoospermic men, the cumulative HR was 1.31 (95%CI:1.11-1.54) and 2.17 (95%CI:1.55-3.04) respectively. Infertile men had a lower overall risk of death compared to the overall population (SMR, 0.38, 95%CI:0.31-0.45). CONCLUSION Compared to fertile men, infertile men had a higher risk of death. Moreover, the risk of death increased with increasing severity of semen quality impairment. However, compared to men from the general population, infertile men have a lower risk of death suggesting that social determinants of health are also important.
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Affiliation(s)
- Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy; Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Alex M Kasman
- Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Tony Chen
- Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Gian Maria Busetto
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), Milan, Italy
| | | | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA.
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Jølving LR, Erb K, Nørgård BM, Fedder J, Larsen MD. The Danish National Register of assisted reproductive technology: content and research potentials. Eur J Epidemiol 2021; 36:445-452. [PMID: 33796977 DOI: 10.1007/s10654-021-00742-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/18/2021] [Indexed: 01/25/2023]
Abstract
The Danish National Register of assisted reproductive technology (ART) was initially established in 1994. The register comprises complete information on all ART procedures in public and private clinics in Denmark from 2013 and onwards, including baseline information on the cause of infertility and a number of health-related patient characteristics. The register enables monitoring and research on infertility treatment and reproductive topics in single women or couples seeking assisted reproduction, and the register is thus a key component of the Danish health information system within human reproduction. We aimed to provide an updated description of the register including advantages and pitfalls when using the register for reproductive epidemiological research, and a description of the accessibility for researchers. The Danish ART register is a valuable tool for epidemiological research. However, the inherent strengths and limitations ought to be in perspective when designing studies and interpreting the study results. Reports with annually aggregated data on ART treatments, can be accessed on the Danish Health Data Authority web page and researchers may obtain access to individual pseudonomized data via secure servers at the Danish Health Data Authority and Statistics Denmark.
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Affiliation(s)
- Line Riis Jølving
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, Entrance 216, 5000, Odense C, Denmark. .,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | | | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, Entrance 216, 5000, Odense C, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Jens Fedder
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,, Svendborg, Denmark.,Department D, Center of Andrology and Fertility Clinic, Odense University Hospital, Odense, Denmark
| | - Michael Due Larsen
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, Entrance 216, 5000, Odense C, Denmark.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Behboudi-Gandevani S, Bidhendi Yarandi R, Rostami Dovom M, Azizi F, Ramezani Tehrani F. The Association Between Male Infertility and Cardiometabolic Disturbances: A Population-Based Study. Int J Endocrinol Metab 2021; 19:e107418. [PMID: 34149845 PMCID: PMC8198602 DOI: 10.5812/ijem.107418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/13/2021] [Accepted: 02/17/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Further studies are needed to extend our knowledge about the association between male infertility and cardio-metabolic disorders. OBJECTIVES We aimed to assess the association between male infertility and cardiometabolic disturbances using a population-based design. METHODS In total, 1611 participants of the Tehran-Lipid and Glucose-Study (phase III) were categorized into two groups of men with documented male infertility (n = 88) and those with at least one live birth and no history of primary infertility (n = 1523). Logistic regression was applied to explore the association between male infertility and cardiometabolic disturbances, including diabetes mellitus, pre-diabetes, hypertension, metabolic syndrome, dyslipidemia, obesity, central obesity, and chronic kidney disease, following adjustment for age and body mass index (BMI). RESULTS The unadjusted model revealed a significant association between infertility and hypertension and CKD (OR = 1.8; 95% CI: 1.2, 2.9, P-value = 0.006 and OR = 1.9; 95% CI: 1.1, 3.6, P-value = 0.033), respectively. However, after adjusting for age and BMI, as potential confounders, this association was not significant. Moreover, there was no association between infertility and other cardiometabolic disturbances, including diabetes and pre-diabetes, metabolic syndrome, dyslipidemia, obesity, and central obesity in both unadjusted and adjusted models. CONCLUSIONS Our study revealed no association between male infertility and cardiometabolic disturbances. The findings can pave the way for further studies to extend our knowledge in this field. More population-based studies with a large sample size are warranted to confirm these findings.
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Affiliation(s)
| | - Razieh Bidhendi Yarandi
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Rostami Dovom
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrin Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fahimeh Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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36
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Pourheydar M, Hasanzadeh S, Razi M, Pourheydar B, Najafi G. Effects of liraglutide on sperm characteristics and fertilization potential following experimentally induced diabetes in mice. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2021; 12:109-116. [PMID: 33953881 PMCID: PMC8094147 DOI: 10.30466/vrf.2019.96822.2315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/01/2019] [Indexed: 11/18/2022]
Abstract
The current study was conducted to analyze the dose-dependent effects of liraglutide against the diabetes-induced detrimental impact on sperm parameters and fertilization potential. For this purpose, 42 adult male mice were randomly divided into control (with no intervention) and experimental groups. Next, the experimental group was subdivided into diabetic, 1.20 mg kg-1 liraglutide-received diabetic, 1.80 mg kg-1 liraglutide-received diabetic, 1.20 mg kg-1 liraglutide-received non-diabetic and 1.80 mg kg-1 liraglutide-received non-diabetic groups. All chemicals were administrated subcutaneously. Following 42 days, the animals were euthanized, and sperm samples were collected. The sperm count, motility, viability, DNA integrity, and maturity were analyzed and compared between groups. Moreover, the sperm fertilization potential was investigated by in vitro fertilization (IVF). For this purpose, the preimplantation embryo development at 2-cell, 4-cell, morula, and blastocyst stages was investigated and compared. Observations revealed that diabetes significantly diminished sperm count, motility, viability, chromatin condensation, and DNA integrity percentages versus a control group. On the other hand, 1.20 mg kg-1 and 1.80 mg kg-1 of liraglutide did not improve sperm motility and viability, while ameliorated sperm count and chromatin condensation and DNA integrity in diabetic animals. The diabetic animals represented diminished preimplantation embryo development, which was not altered in liraglutide-received groups. In conclusion, at least in administrated doses, liraglutide could not improve the sperm viability and motility and, via this mechanism, could not induce an appropriate/beneficial effect on IVF outcome.
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Affiliation(s)
- Maryam Pourheydar
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Shapour Hasanzadeh
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Mazdak Razi
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Bagher Pourheydar
- Department of Anatomical Sciences, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Gholamreza Najafi
- Department of Basic Sciences, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
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The Seminiferous Epithelial Cycle of Spermatogenesis: Role of Non-receptor Tyrosine Kinases. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1288:1-20. [PMID: 34453729 DOI: 10.1007/978-3-030-77779-1_1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Non-receptor tyrosine kinases (NRTKs) are implicated in various biological processes including cell proliferation, differentiation, survival, and apoptosis, as well as cell adhesion and movement. NRTKs are expressed in all mammals and in different cell types, with extraordinarily high expression in the testis. Their association with the plasma membrane and dynamic subcellular localization are crucial parameters in their activation and function. Many NRTKs are found in endosomal protein trafficking pathways, which suggests a novel mechanism to regulate the timely junction restructuring in the mammalian testis to facilitate spermiation and germ cell transport across the seminiferous epithelium.
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38
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Salas-Huetos A, Tüttelmann F, Wyrwoll MJ, Kliesch S, Lopes AM, Goncalves J, Boyden SE, Wöste M, Hotaling JM, Nagirnaja L, Conrad DF, Carrell DT, Aston KI. Disruption of human meiotic telomere complex genes TERB1, TERB2 and MAJIN in men with non-obstructive azoospermia. Hum Genet 2020; 140:217-227. [PMID: 33211200 DOI: 10.1007/s00439-020-02236-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/03/2020] [Indexed: 12/14/2022]
Abstract
Non-obstructive azoospermia (NOA), the lack of spermatozoa in semen due to impaired spermatogenesis affects nearly 1% of men. In about half of cases, an underlying cause for NOA cannot be identified. This study aimed to identify novel variants associated with idiopathic NOA. We identified a nonconsanguineous family in which multiple sons displayed the NOA phenotype. We performed whole-exome sequencing in three affected brothers with NOA, their two unaffected brothers and their father, and identified compound heterozygous frameshift variants (one novel and one extremely rare) in Telomere Repeat Binding Bouquet Formation Protein 2 (TERB2) that segregated perfectly with NOA. TERB2 interacts with TERB1 and Membrane Anchored Junction Protein (MAJIN) to form the tripartite meiotic telomere complex (MTC), which has been shown in mouse models to be necessary for the completion of meiosis and both male and female fertility. Given our novel findings of TERB2 variants in NOA men, along with the integral role of the three MTC proteins in spermatogenesis, we subsequently explored exome sequence data from 1495 NOA men to investigate the role of MTC gene variants in spermatogenic impairment. Remarkably, we identified two NOA patients with likely damaging rare homozygous stop and missense variants in TERB1 and one NOA patient with a rare homozygous missense variant in MAJIN. Available testis histology data from three of the NOA patients indicate germ cell maturation arrest, consistent with mouse phenotypes. These findings suggest that variants in MTC genes may be an important cause of NOA in both consanguineous and outbred populations.
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Affiliation(s)
- Albert Salas-Huetos
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | - Frank Tüttelmann
- Institute of Reproductive Genetics, University of Münster, 48149, Münster, Germany
| | - Margot J Wyrwoll
- Institute of Reproductive Genetics, University of Münster, 48149, Münster, Germany.,Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital Münster, 48149, Münster, Germany
| | - Sabine Kliesch
- Centre of Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital Münster, 48149, Münster, Germany
| | - Alexandra M Lopes
- i3S-Instituto de Investigação e Inovação em Saúde, University of Porto, 4200-135, Porto, Portugal.,IPATIMUP-Instituto de Patologia e Imunologia Molecular da Universidade do Porto, 4200-135, Porto, Portugal
| | - João Goncalves
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr Ricardo Jorge, 1649-016, Lisbon, Portugal.,ToxOmics-Centro de Toxicogenómica e Saúde Humana, Nova Medical School, 1169-056, Lisbon, Portugal
| | - Steven E Boyden
- Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA.,Utah Center for Genetic Discovery, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
| | - Marius Wöste
- Institute of Medical Informatics, University of Münster, 48149, Munster, Germany
| | - James M Hotaling
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.,Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA
| | | | - Liina Nagirnaja
- Division of Genetics, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, 97006, USA
| | - Donald F Conrad
- Division of Genetics, Oregon National Primate Research Center, Oregon Health and Science University, Beaverton, OR, 97006, USA.,Department of Genetics, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Douglas T Carrell
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.,Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, UT, 84112, USA
| | - Kenneth I Aston
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.
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Stair S, Persily J, Siev M, Thakker S, Najari BB. Men Who Have Undergone Vasectomy are Healthier Than Non-sterilized Fertile Men: An Analysis of the Nation Survey for Family Growth. Urology 2020; 146:107-112. [PMID: 33011182 DOI: 10.1016/j.urology.2020.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/07/2020] [Accepted: 09/21/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the health status of men who have undergone vasectomy versus nonsterilized fertile men. METHODS Using the National Survey for Family Growth from 2002 to 2017, univariate and multivariate analyses were performed on demographic and health data, including health status and health care utilization. RESULTS Men who have undergone vasectomy are more likely to be older, healthier, have more children, identify as non-Hispanic white, be married, have a higher level of education, earn a higher mean household income, and were more likely to be privately insured than non-sterilized fertile men. On multivariate analysis, men who underwent vasectomy had a better health status despite being older. CONCLUSION There are significant socioeconomic and health differences between men who elect vasectomy and non-sterilized fertile men. These differences should be considered when considering using sterilized men as a proxy for proven fertile men in epidemiological studies.
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Affiliation(s)
- Sabrina Stair
- Departments of Urology, New York University School of Medicine, New York, NY
| | - Jesse Persily
- Departments of Urology, New York University School of Medicine, New York, NY
| | - Michael Siev
- Departments of Urology, New York University School of Medicine, New York, NY
| | - Sameer Thakker
- Departments of Urology, New York University School of Medicine, New York, NY
| | - Bobby B Najari
- Departments of Urology, New York University School of Medicine, New York, NY; Department of Population Health, New York University School of Medicine, New York, NY.
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Del Giudice F, Kasman AM, Li S, Belladelli F, Ferro M, de Cobelli O, De Berardinis E, Busetto GM, Eisenberg ML. Increased Mortality Among Men Diagnosed With Impaired Fertility: Analysis of US Claims Data. Urology 2020; 147:143-149. [PMID: 33017614 DOI: 10.1016/j.urology.2020.07.087] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/14/2020] [Accepted: 07/30/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine whether male infertility or impaired spermatogenesis is associated with mortality. METHODS The Optum de-identified Clinformatics Data Mart database was queried from 2003 to 2017. Infertile men were compared to subjects undergoing semen analysis (ie, infertility testing). Infertile men with oligozoospermia or azoospermia were included. Mortality was determined by data linkage to the Social Security Administration Death Master File. Results were adjusted for age, smoking, obesity, year of evaluation, and health care visits as well as for most prevalent comorbidities. We separately examined men with prevalent or incident cardiovascular disease and cancer diagnoses to determine associations with mortality. RESULTS A total of 134,796 infertile men and 242,282 controls were followed for a mean of 3.6 and 3.1 years respectively. Overall, infertile men had a higher risk of death (Hazard Ratio [HR]= 1.42, 95% CI: 1.27-1.60) The diagnosis of azoospermia was associated with a significantly increased risk of death (HR= 2.01, 95% CI: 1.60-2.53) with a higher trend among men with oligospermia (HR: 1.17, 95% CI: 0.92-1.49) compared to controls. Subanalysis was done excluding prevalent cardiovascular and malignant disease (alone and combined) showing similar hazard ratios. CONCLUSION Male infertility is associated with a higher risk of mortality especially among azoospermic men. Prevalent disease (which is known to be higher among infertile men) did not explain the higher risk of death among infertile men. The implications for treatment and surveillance of infertile men require further study.
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Affiliation(s)
- Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy; Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Alex M Kasman
- Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Shufeng Li
- Department of Urology, Stanford University School of Medicine, Stanford, CA
| | - Federico Belladelli
- University Vita-Salute San Raffaele, Milan, Italy; Division of Experimental Oncology/Unit of Urology; URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology (IEO), Milan, Italy
| | | | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Gian Maria Busetto
- Department of Maternal-Infant and Urological Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA; Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA.
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Glazer CH, Eisenberg ML, Tøttenborg SS, Giwercman A, Flachs EM, Bräuner EV, Vassard D, Pinborg A, Schmidt L, Bonde JP. Male factor infertility and risk of death: a nationwide record-linkage study. Hum Reprod 2020; 34:2266-2273. [PMID: 31725880 DOI: 10.1093/humrep/dez189] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/05/2019] [Indexed: 12/20/2022] Open
Abstract
STUDY QUESTION What is the risk of death among men with oligospermia, unspecified male factor and azoospermia in the years following fertility treatment? SUMMARY ANSWER No significantly elevated risk was observed among men with oligospermia and unspecified male factor, while an increased risk was found among men with azoospermia. WHAT IS KNOWN ALREADY Previous studies have shown associations between male factor infertility and risk of death, but these studies have relied on internal reference groups and the risk of death according to type of male infertility is not well characterized. STUDY DESIGN, SIZE, DURATION In this prospective record-linkage cohort study, we identified men who had undergone medically assisted reproduction (MAR) between 1994 and 2015. Data was linked to the Danish causes of death register and sociodemographic registers through personal identification numbers assigned to all Danish citizens at birth. PARTICIPANTS/MATERIALS, SETTING, METHODS Men that had undergone MAR in Denmark (MAR Cohort; n = 64 563) were identified from the Danish IVF register, which includes data on whether infertility was due to male factor. For each man in the MAR cohort, five age-matched men who became fathers without fertility treatment were selected from the general population (non-MAR fathers; n = 322 108). Men that could not adequately be tracked in the Danish CPR register (n = 1259) and those that were censored prior to study entry (n = 993) were excluded, leaving a final population of 384 419 men. Risk of death was calculated by Cox regression analysis with age as an underlying timeline and adjustments for educational attainment, civil status and year of study entry. The risk of death was compared among men with and without male factor infertility identified from the IVF register (internal comparisons) as well as to the non-MAR fathers (external comparison). MAIN RESULTS AND THE ROLE OF CHANCE The risk of death between the MAR cohort (all men, regardless of infertility) and the non-MAR fathers was comparable [hazard ratio (HR), 1.07; 95% CI, 0.98-1.15]. When the MAR cohort was limited to infertile men, these men were at increased risk of death [HR, 1.27; 95% CI, 1.12-1.44]. However, when stratified by type of male factor infertility, men with azoospermia had the highest risk of death, which persisted when in both the internal [HR, 2.30; 95% CI, 1.54-3.41] and external comparison [HR, 3.32; 95% CI, 2.02-5.40]. No significantly elevated risk of death was observed among men with oligospermia [HR, 1.14; 95% CI, 0.87-1.50] and unspecified male factor [HR, 1.10; 95% CI, 0.75-1.61] compared with the non-MAR fathers. The same trends were observed for the internal comparison. LIMITATIONS, REASONS FOR CAUTION Duration of the follow-up was limited and there is limited generalizability to infertile men who do not seek fertility treatment. WIDER IMPLICATIONS OF THE FINDINGS Using national health registers, we found an increased risk of death among azoospermic men while no increased risk was found among men with other types of infertility. For the azoospermic men, further insight into causal pathways is needed to identify options for monitoring and prevention. STUDY FUNDING/COMPETING INTEREST(S) This study is part of the ReproUnion collaborative study, co-financed by the European Union, Interreg V ÖKS. C.G.'s research stay at Stanford was funded by grants from the University of Copenhagen, Kong Christian den Tiendes Fond, Torben og Alice Frimodt Fond and Julie Von Müllen Fond. M.E. is an advisor for Sandstone and Dadi. All other authors declare no conflict of interests. TRIAL REGISTRATION NUMBER Not relevant.
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Affiliation(s)
- Clara Helene Glazer
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark.,Department of Urology, Stanford University, Palo Alto, CA, USA
| | | | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Esben Meulengracht Flachs
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
| | - Elvira Vaclavik Bräuner
- Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.,The International Research and Research Training Centre in Endocrine Disruption of Male Reproduction and Child Health (EDMaRC), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ditte Vassard
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Anja Pinborg
- Fertility Clinic, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lone Schmidt
- Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Copenhagen, Denmark
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Elenkov A, Giwercman A, Søgaard Tøttenborg S, Bonde JPE, Glazer CH, Haervig KK, Bungum AB, Nilsson PM. Male childlessness as independent predictor of risk of cardiovascular and all-cause mortality: A population-based cohort study with more than 30 years follow-up. PLoS One 2020; 15:e0237422. [PMID: 32881896 PMCID: PMC7470262 DOI: 10.1371/journal.pone.0237422] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/14/2020] [Indexed: 01/19/2023] Open
Abstract
In a recent population-based study, an elevated risk of the Metabolic syndrome (MetS) and type 2 diabetes was found in childless men compared to those who have fathered one or more children. Therefore, by using a larger cohort of more than 22 000 men from the Malmo Preventive Project (MPP) we aimed to expand our observations in order to evaluate the metabolic profile of childless men and to evaluate if childlessness is an additional and independent predictor of major adverse cardiovascular events (MACE), mortality and incident diabetes when accounting for well-known biochemical, anthropometric, socio-economic and lifestyle related known risk factors. Logistic regression was used to assess risk of MACE, diabetes and MetS at baseline. Multivariate Cox regression was used to evaluate the risks of MACE and mortality following the men from baseline screening until first episode of MACE, death from other causes, emigration, or end of follow-up (31st December 2016) adjusting for age, family history, marital status, smoking, alcohol consumption, educational status, body mass index, prevalent diabetes, high blood lipids, increased fasting glucose and hypertension. Childless men presented with a worse metabolic profile than fathers at the baseline examination, with elevated risk of high triglycerides, odds ratio (OR) 1.24 (95%CI: 1.10–1.42), high fasting glucose OR 1.23 (95%CI: 1.05–1.43) and high blood pressure, OR 1.28 (95%CI: 1.14–1.45), respectively. In the fully adjusted prospective analysis, childless men presented with elevated risk of cardiovascular mortality, HR: 1.33 (95% CI: 1.18–1.49) and all-cause mortality, HR 1.23 (95%CI: 1.14–1.33), respectively. In conclusion, these results add to previous studies showing associations between male reproductive health, morbidity and mortality. Male childlessness, independently of well-known socio-economic, behavioral and metabolic risk factors, predicts risk of cardiovascular disease and mortality. Consequently, this group of men should be considered as target population for preventive measures.
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Affiliation(s)
- Angel Elenkov
- Department of Translational Medicine, Molecular Reproductive Medicine, Lund University, Malmoe, Sweden
- Reproductive Medicine Center, Skåne University Hospital, Malmoe, Sweden
- * E-mail:
| | - Aleksander Giwercman
- Department of Translational Medicine, Molecular Reproductive Medicine, Lund University, Malmoe, Sweden
- Reproductive Medicine Center, Skåne University Hospital, Malmoe, Sweden
| | | | - Jens Peter Ellekilde Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
- Department of Public Health, The Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Katia Keglberg Haervig
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Ane Berger Bungum
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Peter M. Nilsson
- Department of Clinical Sciences, Internal Medicine Research Group, Skåne University Hospital, Malmoe, Sweden
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Sun C, Rong X, Cai Y, Qiu S, Farzaneh M. Mini review: The FDA-approved prescription drugs that induce ovulation in women with ovulatory problems. Drug Dev Res 2020; 81:815-822. [PMID: 32428356 DOI: 10.1002/ddr.21687] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 04/11/2020] [Accepted: 05/04/2020] [Indexed: 01/26/2023]
Abstract
Infertility is defined as not being able to become pregnant after 12 months or more of unprotected sexual intercourse. Female infertility as a serious health issue can result from ovulation disorders, menstrual cycle problems, structural problems, and environmental factors. Ovulation occurs once a month between the time of menarche and menopause. The release of a mature egg from the ovary is controlled with the hypothalamic-pituitary-ovarian axis. Several hormones such as gonadotropin-releasing hormone (GnRH), FSH (follicle-stimulating hormone), LH (luteinizing hormone), estrogen, and progesterone play fundamental roles in the ovulation process. Both FSH and LH are the main treatment for women with ovulation disorders. Depending on the reasons for infertility, several different types of treatment are available for infertile women. Fertility drugs as an important part of treatment work like the natural hormones to treat infertility. Several fertility drugs can regulate ovulation and the release of an egg from the ovary in women with polycystic ovary syndrome (PCOS) or undergoing in vitro fertilization (IVF) treatment. This mini-review is about the FDA-approved prescription drugs that induce ovulation in women with ovulatory problems.
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Affiliation(s)
- Chunlei Sun
- Pediatrics Department, Yidu Central Hospital of Weifang, Weifang, China
| | - Xi Rong
- Pharmacy Department, Yidu Central Hospital of Weifang, Weifang, China
| | - Yongqin Cai
- Gynaecology Department, Yidu Central Hospital of Weifang, Weifang, China
| | - Song Qiu
- Imaging Department of Brain Hospital, Weifang Peoples Hospital, Weifang, China
| | - Maryam Farzaneh
- Physiology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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44
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Gum Arabic improves the reproductive capacity through upregulation of testicular glucose transporters (GLUTs) mRNA expression in Alloxan induced diabetic rat. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.bcdf.2020.100218] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Abstract
PURPOSE OF REVIEW Many aspects of reproduction have been associated with increased blood pressure and impaired glucose metabolism that reveals a subsequent increased risk of cardiovascular disease. The aim of this review is to assess reproductive life factors associated with an increased risk of hypertension and cardiovascular disease, e.g., early life programming, sexual, and reproductive health in men and women. RECENT FINDINGS Impaired fetal growth, with low birth weight adjusted for gestational age, has been found associated with hypertension in adulthood. Erectile dysfunction, currently considered an early diagnostic marker of cardiovascular disease preceding the manifestation of coronary artery disease by several years, frequently coexisting with hypertension, could also be exacerbated by some antihypertensive drugs. Male hypogonadism or subfertility are associated with increased cardiovascular risk. Hypertensive disorders in pregnancy including preeclampsia represent a major cause of maternal, fetal and neonatal morbidity, and mortality. The risk of developing preeclampsia can be substantially reduced in women at its high or moderate risk with a low dose of acetylsalicylic acid initiated from 12 weeks of gestation. An increased risk of hypertension in women following invasive-assisted reproductive technologies has been newly observed. Blood pressure elevation has been noticed following contraceptive pill use, around the menopause and in postmenopausal age. Furthermore, drug treatment of hypertension has to be considered as a factor with a potential impact on reproduction (e.g., due to teratogenic drug effects). In summary, a deeper understanding of reproductive life effects on hypertension and metabolic abnormalities may improve prediction of future cardiovascular disease.
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Affiliation(s)
- Peter M Nilsson
- Department of Clinical Sciences, Lund University, Lund, Sweden.
- Skåne University Hospital, Malmö, Sweden.
| | - Margus Viigimaa
- Heart Health Centre of North Estonia Medical Centre, and Centre for Cardiovascular Medicine, Tallinn University of Technology, Tallinn, Estonia
| | - Aleksander Giwercman
- Department of Translational Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Renata Cifkova
- Center for Cardiovascular Prevention, First Faculty of Medicine and Thomayer Hospital, Charles University in Prague, Prague, Czech Republic
- Department of Medicine II, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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46
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Kasman AM, Del Giudice F, Eisenberg ML. New insights to guide patient care: the bidirectional relationship between male infertility and male health. Fertil Steril 2020; 113:469-477. [PMID: 32089256 DOI: 10.1016/j.fertnstert.2020.01.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 01/02/2020] [Indexed: 12/21/2022]
Abstract
Male reproduction is a complex process, and numerous medical conditions have the potential to alter spermatogenesis. In addition, male factor infertility may be a biomarker for future health. In the present review, we discuss the current literature regarding the association between systemic diseases and fertility, which may impact clinical outcomes or semen parameters. A number of conditions that have systemic consequences were identified, including genetic (e.g., cystic fibrosis, DNA mismatch repair alterations), obesity, psychological stress, exogenous testosterone, and a variety of common medications. As such, the infertility evaluation may offer an opportunity for health counseling beyond the discussion of reproductive goals. Moreover, male infertility has been suggested as a marker of future health, given that poor semen parameters and a diagnosis of male infertility are associated with an increased risk of hypogonadism, cardiometabolic disease, cancer, and even mortality. Therefore, male fertility requires multidisciplinary expertise for evaluation, treatment, and counseling.
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Affiliation(s)
- Alex M Kasman
- Department of Urology, School of Medicine, Stanford University, Stanford, California
| | - Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Michael L Eisenberg
- Department of Urology, School of Medicine, Stanford University, Stanford, California; Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, California.
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Zhou J, Xi Y, Zhang J, Tang J, Zhou X, Chen J, Nie C, Zhu Z, Ma B. Protective effect of Dioscorea zingiberensis ethanol extract on the disruption of blood-testes barrier in high-fat diet/streptozotocin-induced diabetic mice by upregulating ZO-1 and Nrf2. Andrologia 2020; 52:e13508. [PMID: 31957918 DOI: 10.1111/and.13508] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 11/19/2019] [Accepted: 12/02/2019] [Indexed: 12/15/2022] Open
Abstract
Testicular injury is the primary pathogenesis of diabetes-induced male infertility. Dioscorea zingiberensis (DZ), a traditional Chinese medicine (TCM) including saponins, flavonoids and cellulose, is used to treat diseases in the reproductive system. But the protective effects of DZ on diabetes-induced testicular injury remain poorly understood. In this study, the therapeutic effects of chronic oral DZ treatment on testis impairment in a diabetic mouse model were explored by assessing sperm morphology, blood-testes barrier (BTB) integrity and testicular histological examination. Our results showed that DZ significantly reversed BTB disruption, testicular tissue injury and abnormal sperm morphology in diabetic mice. Interestingly, diabetes-induced disruption of the BTB was associated with a decrease in the tight junction (TJ) protein zonula occludens-1 (ZO-1). Dioscorea zingiberensis effectively increased ZO-1 expression in testis tissue to restore the integrity of the BTB. Moreover, DZ treatment significantly reduced hyperglycaemia-induced increases in malondialdehyde (MDA) and 8-hydroxy-2'-deoxyguanosine (8-OHdG) levels. Further mechanistic studies revealed that DZ substantially enhanced the expression of Nrf2, NOQ1 and HO-1, which indicated that DZ exerts potential antioxidant effects against testicular tissue damage via the activation of Nrf2. In conclusion, the protective effects of DZ rely on repairing the integrity of the BTB and on reducing oxidative stress damage by mediating ZO-1 and Nrf2. The study contributes to discovering the DZ possible mechanism of action.
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Affiliation(s)
- Jie Zhou
- School of Pharmaceutical Sciences, Jiangsu Health Vocational College, Nanjing, China
| | - Youli Xi
- Department of Pharmacy, Nanjing Drum Tower Hospital, Nanjing, China
| | - Jie Zhang
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
| | - Jun Tang
- Jiangsu Huanghe Pharmaceutical Co., Ltd, Yancheng, China
| | - Xiaowei Zhou
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
| | - Jiayi Chen
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
| | - Chao Nie
- School of Pharmaceutical Sciences, Jiangsu Health Vocational College, Nanjing, China
| | - Zhengbiao Zhu
- Jiangsu Huanghe Pharmaceutical Co., Ltd, Yancheng, China
| | - Bo Ma
- School of Pharmaceutical Sciences, Nanjing Tech University, Nanjing, China
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48
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The current status and future of andrology: A consensus report from the Cairo workshop group. Andrology 2019; 8:27-52. [PMID: 31692249 DOI: 10.1111/andr.12720] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND In attempting to formulate potential WHO guidelines for the diagnosis of male infertility, the Evidence Synthesis Group noted a paucity of high-quality data on which to base key recommendations. As a result, a number of authors suggested that key areas of research/evidence gaps should be identified, so that appropriate funding and policy actions could be undertaken to help address key questions. OBJECTIVES The overall objective of this Consensus workshop was to clarify current knowledge and deficits in clinical laboratory andrology, so that clear paths for future development could be navigated. MATERIALS AND METHODS Following a detailed literature review, each author, prior to the face-to-face meeting, prepared a summary of their topic and submitted a PowerPoint presentation. The topics covered were (a) Diagnostic testing in male fertility and infertility, (b) Male fertility/infertility in the modern world, (c) Clinical management of male infertility, and (d) The overuse of ICSI. At the meeting in Cairo on February 18, 2019, the evidence was presented and discussed and a series of consensus points agreed. RESULTS The paper presents a background and summary of the evidence relating to these four topics and addresses key points of significance. Following discussion of the evidence, a total of 36 consensus points were agreed. DISCUSSION The Discussion section presents areas where there was further debate and key areas that were highlighted during the day. CONCLUSION The consensus points provide clear statements of evidence gaps and/or potential future research areas/topics. Appropriate funding streams addressing these can be prioritized and consequently, in the short and medium term, answers provided. By using this strategic approach, andrology can make the rapid progress necessary to address key scientific, clinical, and societal challenges that face our discipline now and in the near future.
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Male Sexual and Reproductive Health-Does the Urologist Have a Role in Addressing Gender Inequality in Life Expectancy? Eur Urol Focus 2019; 6:791-800. [PMID: 31711931 DOI: 10.1016/j.euf.2019.10.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 09/09/2019] [Accepted: 10/17/2019] [Indexed: 12/21/2022]
Abstract
Despite considerable public health initiatives in the past century, there remains a significant gender inequality in life expectancy. The Global Burden of Diseases study has highlighted that the life expectancy for men is 70.5years, compared with 75.6years for women. This discrepancy in mortality appears to be related to a disproportionately higher number of preventable and premature male deaths. Whilst there has been an increased focus on men's health, as evidenced by the establishment of men's health charities and governmental legislation promoting equality, a recent World Health Organization report has highlighted that there is still a prevailing misconception that the higher rate of premature mortality amongst men is a natural phenomenon. We explore the association of male sexual and reproductive health-related diseases and the potential role of a urologist in addressing gender inequality in life expectancy. PATIENT SUMMARY: In this report, we discuss the causes for the gender gap in life expectancy and highlight that men continue to have a higher rate of premature death than women, which is associated with diseases of the male reproductive system. Furthermore, this not only appears to be related to a number of metabolic and lifestyle factors, but may also be the result of the increased risk of cancer in men with sexual and reproductive health-related diseases.
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Manirafasha C, Rebecca Oyenihi O, Lisa Brooks N, S. du Plessis S, Guillaume Aboua Y. Potential Antioxidative Effects of Kolaviron on Reproductive Function in Streptozotocin-Induced Diabetic Wistar Rats. Antioxidants (Basel) 2019. [DOI: 10.5772/intechopen.84822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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