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Schifano N, Chiappini S, Mosca A, Miuli A, Santovito MC, Pettorruso M, Capogrosso P, Dehò F, Martinotti G, Schifano F. Recreational Drug Misuse and Its Potential Contribution to Male Fertility Levels' Decline: A Narrative Review. Brain Sci 2022; 12:1582. [PMID: 36421906 PMCID: PMC9688450 DOI: 10.3390/brainsci12111582] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 10/14/2023] Open
Abstract
Recreational drug intake may be associated with a range of medical untoward consequences, including male infertility. However, as the related evidence is still limited, the main outcome of this review is to provide a better understanding of the existence of any association between recreational drug misuse and male fertility levels' decline. Whilst searching the MEDLINE/PubMed, a comprehensive overview of the literature regarding male infertility and substances of abuse (e.g., phytocannabinoids, opiates/opioids, stimulants, 'herbal highs', psychedelics, and 'novel psychoactive substances) was here undertaken. Due to the paucity of robust, high-quality, empirical, human studies, a narrative strategy was here preferred over a systematic approach. Relevant data are qualitatively analyzed and presented in a table. Although most available evidence is in support of a detrimental role of cannabis on human spermatogenesis, a few remaining studies failed to document any effect of this drug on seminal quality, and it is not clear to which extent this drug impacts fertility rates/time to pregnancy. The current understanding of the impact of opiate-, cocaine- and amphetamine/stimulant-misuse on human reproduction is widely unknown, and most studies dealing with this matter represent only an extrapolation of data derived from specific clinical circumstances. Although the message of 'no smoking, no alcohol and no street drugs' should always be offered as good health advice to all patients seeking medical help for fertility issues, robust scientific clinical evidence in support of a direct detrimental impact of recreational drugs on spermatogenesis is scant to date.
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Affiliation(s)
- Nicolò Schifano
- Department of Urology, ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Maria Chiara Santovito
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Paolo Capogrosso
- Department of Urology, ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Federico Dehò
- Department of Urology, ASST Sette Laghi–Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9EU, UK
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Chanal C, Mazurier E, Doray B. Use of Psychoactive Substances during the Perinatal Period: Guidelines for Interventions during the Perinatal Period from the French National College of Midwives. J Midwifery Womens Health 2022; 67 Suppl 1:S17-S37. [PMID: 36480661 DOI: 10.1111/jmwh.13419] [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: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 12/13/2022]
Abstract
Based on their clinical practice and an extensive review of the literature, the authors propose a framework of procedures to be followed to provide services to all women of childbearing age who use psychoactive substances (alcohol, cannabis, cocaine, amphetamines, and opioids), especially during pregnancy or during the postpartum and breastfeeding periods, in view of their individual situations and environmental contexts.
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Affiliation(s)
- Corinne Chanal
- Hôpital Arnaud de Villeneuve, CHU Montpellier, 371 avenue du Doyen Gaston Giraud cedex 5, Montpellier, 34295, France.,Réseau de Périnatalité Occitanie Espace Henri BERTIN SANS, Bat A, 59 avenue de Fès-34080, Montpellier, France
| | - Evelyne Mazurier
- Hôpital Arnaud de Villeneuve, CHU Montpellier, 371 avenue du Doyen Gaston Giraud cedex 5, Montpellier, 34295, France
| | - Bérénice Doray
- Service de génétique, CHU de La Réunion, allée des Topazes, cedex, 97405, SAINT-DENIS.,Centre Ressource Troubles du Spectre de l'Alcoolisation Fœtale (TSAF) - Fondation Père Favron - 43 rue du Four à Chaux, Saint-Pierre, 97410, Réunion
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Alghobary M, Mostafa T. Addiction and human male fertility: A systematic review and a critical appraisal. Andrology 2022; 10:1073-1095. [PMID: 35588397 DOI: 10.1111/andr.13196] [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: 09/21/2021] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Addiction is a global problem that has many negative consequences on human health as well as the quality of life. OBJECTIVES This review aimed to assess the effect of addiction on human male fertility. METHODS A systematic review was conducted on various electronic sites. RESULTS The initial literature search identified a total of 5239 articles in all searched databases. After removing duplicates and application of inclusion/exclusion criteria,177 were potential articles, 112 were omitted because no direct relevance was encountered. Finally, 65 studies were retained for review. They were classified according to the type of addiction into; opioids and cannabinoids (18 articles), alcohol (7 articles), cocaine (2 articles), Androgenic Anabolic steroids AAS (15 articles), tobacco (10 articles) and caffeine (13 articles). Most of these recruited articles demonstrated a negative impact of the addressed substance on male fertility with variable levels of evidence. CONCLUSIONS It was concluded that addiction harms human male fertility that should be put into consideration. More future studies are needed after a proper methodological and statistical approach, including logistic regression analysis, to predict the effect of a specific substance on human male fertility. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Moheiddin Alghobary
- Department of Dermatology, Andrology & STIs, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt
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Nazmara Z, Ebrahimi B, Makhdoumi P, Noori L, Mahdavi SA, Hassanzadeh G. Effects of illicit drugs on structural and functional impairment of testis, endocrinal disorders, and molecular alterations of the semen. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2021; 24:856-867. [PMID: 34712415 PMCID: PMC8528244 DOI: 10.22038/ijbms.2021.53326.12002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 01/24/2021] [Indexed: 12/03/2022]
Abstract
Illicit drug use is growing among young people, which is one of the major problems in today's society that can be associated with many medical issues, including infertility. Amphetamines, cocaine, opioids, and marijuana are the most common and the most used illicit drugs worldwide. The purpose of this review was to collect as much literature as possible about the impact of illicit drugs on male fertility and summarize their valuable data. Original studies and reviews were collected by searching the keywords "illicit drugs (all kinds of that) and male infertility". The obtained information was also categorized based on the content of the "Infertility in the Male" book. Almost all studies suggested that taking all kinds of illicit drugs with the effects on different parts of the male reproductive system can result in subfertility or complete infertility in the consumers. Although the data in this field are not decisive and there are some confounding factors in human studies, it can be inferred that the use of any illicit drug with an effect on male sexual health reduces fertility potency. Therefore, it is recommended that couples, who are planning to conceive, avoid taking any illicit drugs before and during treatment.
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Affiliation(s)
- Zohreh Nazmara
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Babak Ebrahimi
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Pouran Makhdoumi
- Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Leila Noori
- Department of Biomedicine, Neurosciences and Advanced Diagnostic, University of Palermo, Palermo, Italy
- Department of Anatomical Sciences, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | | | - Gholamreza Hassanzadeh
- Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Anatomy, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Nassan FL, Arvizu M, Mínguez-Alarcón L, Gaskins AJ, Williams PL, Petrozza JC, Hauser R, Chavarro JE. Marijuana smoking and outcomes of infertility treatment with assisted reproductive technologies. Hum Reprod 2020; 34:1818-1829. [PMID: 31505640 PMCID: PMC6736415 DOI: 10.1093/humrep/dez098] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/10/2019] [Indexed: 12/15/2022] Open
Abstract
STUDY QUESTION What is the association of female and male partner marijuana smoking with infertility treatment outcomes with ART? SUMMARY ANSWER Women who were marijuana smokers at enrollment had a significantly higher adjusted probability of pregnancy loss during infertility treatment with ART whereas, unexpectedly, there was a suggestion of more favorable treatment outcomes in couples where the man was a marijuana smoker at enrollment. WHAT IS KNOWN ALREADY Data on the relation of female and male partner marijuana use with outcomes of infertility treatment is scarce despite increased use and legalization worldwide. STUDY DESIGN, SIZE, DURATION We followed 421 women who underwent 730 ART cycles while participating in a prospective cohort (the Environment and Reproductive Health Study) at a fertility center between 2004 and 2017. Among them, 200 women (368 cycles) were part of a couple in which their male partner also enrolled in the study. PARTICIPANTS/MATERIALS, SETTING, METHODS Participants self-reported marijuana smoking at baseline. Clinical endpoints were abstracted from electronic medical records. We used generalized linear mixed models with empirical standard errors to evaluate the association of baseline marijuana smoking with ART outcomes adjusting for participants' age, race, BMI, tobacco smoking, coffee and alcohol consumption, and cocaine use. We estimated the adjusted probability of implantation, clinical pregnancy, and live birth per ART cycle, as well as the probability of pregnancy loss among those with a positive B-hCG. MAIN RESULTS AND THE ROLE OF CHANCE The 44% of the women and 61% of the men had ever smoked marijuana; 3% and 12% were marijuana smokers at enrollment, respectively. Among 317 women (395 cycles) with a positive B-hCG, those who were marijuana smokers at enrollment (N = 9, cycles = 16) had more than double the adjusted probability of pregnancy loss than those who were past marijuana smokers or had never smoked marijuana (N = 308, 379 cycles) (54% vs 26%; P = 0.0003). This estimate was based on sparse data. However, couples in which the male partner was a marijuana smoker at enrollment (N = 23, 41 cycles) had a significantly higher adjusted probability of live birth than couples in which the male partner was a past marijuana smoker or had never smoked marijuana (N= 177, 327 cycles) (48% vs 29%; P = 0.04), independently of the women's marijuana smoking status. Treatment outcomes of past marijuana smokers, male and female, did not differ significantly from those who had never smoked marijuana. LIMITATIONS, REASONS FOR CAUTION Marijuana smoking was self-reported with possible exposure misclassification. Chance findings cannot be excluded due to the small number of exposed cases. The results may not be generalizable to couples from the general population. WIDER IMPLICATIONS OF THE FINDINGS Even though marijuana smoking has not been found in past studies to impact the ability to become pregnant among pregnancy planners in the general population, it may increase the risk of pregnancy loss among couples undergoing infertility treatment. Marijuana smoking by females and males may have opposing effects on outcomes of infertility treatment with ART. STUDY FUNDING/COMPETING INTEREST(S) The project was financed by grants R01ES009718, P30ES000002, and K99ES026648 from the National Institute of Environmental Health Sciences (NIEHS). None of the authors has any conflicts of interest to declare.
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Affiliation(s)
- Feiby L Nassan
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Mariel Arvizu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Lidia Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Audrey J Gaskins
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Paige L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - John C Petrozza
- Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Russ Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Vincent Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jorge E Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Verstegen RHJ, Wang G, Langenberg-Ververgaert KPS, Ren LY, Nulman I. Paternal exposure to recreational drugs before conception and its effect on live-born offspring: A scoping review. Birth Defects Res 2020; 112:970-988. [PMID: 32431075 DOI: 10.1002/bdr2.1702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/03/2020] [Accepted: 04/21/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND Men of reproductive age increasingly use recreational drugs. While many of these substances may reduce the quantity and quality of sperm, less is known about the effects of these exposures on their offspring. We performed a scoping review to summarize the available literature and identify areas for future research on the outcome of live-born offspring of fathers who were exposed to recreational drugs before conception. METHODS A systematic search was conducted of the Medline, EMBASE, and Web of Science databases, which included keywords for the following substances: cannabis-related products, cocaine, heroin, hallucinogens, ecstasy and amphetamines. In total, 2,983 records were screened, and 129 publications were selected for full-text assessment. Publications were included if (a) the timing of exposure included the preconceptional period, and (b) if outcomes in live-born offspring were compared with an unexposed group. RESULTS We included 30 publications, of which 15 animal studies and 15 human studies. Animal studies showed neurocognitive abnormalities, in particular in male offspring. Interestingly, these outcomes depend significantly on the method of exposure (i.e., fixed-dose administration vs. variable self-administration, which mimics addiction). Human studies were limited to specific congenital malformations and childhood cancers, which showed small increased odds ratios. CONCLUSIONS While animal studies describe impaired neurocognitive outcomes following paternal exposure to recreational drugs, data in humans is currently lacking. Human studies require sound methodology in order to confirm findings on congenital malformations and childhood cancers. In addition, future neurocognitive studies require parental neurocognitive assessments to correct for confounding effects (i.e., role of genetics).
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Affiliation(s)
- Ruud H J Verstegen
- Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Guo Wang
- Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Lily Yuxi Ren
- Hospital Library, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Irena Nulman
- Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
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Duca Y, Aversa A, Condorelli RA, Calogero AE, La Vignera S. Substance Abuse and Male Hypogonadism. J Clin Med 2019; 8:E732. [PMID: 31121993 PMCID: PMC6571549 DOI: 10.3390/jcm8050732] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 05/18/2019] [Accepted: 05/18/2019] [Indexed: 12/27/2022] Open
Abstract
Progressive deterioration of male reproductive function is occurring in Western countries. Environmental factors and unhealthy lifestyles have been implicated in the decline of testosterone levels and sperm production observed in the last fifty years. Among unhealthy lifestyles, substance and drug abuse is a recognized cause of possible alterations of steroidogenesis and spermatogenesis. Alcohol, opioids and anabolic-androgenic steroids are capable to reduce testosterone production in male interfering with testicular and/or hypothalamic-pituitary function. Other substances such as nicotine, cannabis, and amphetamines alter spermatogenesis inducing oxidative stress and subsequent apoptosis in testicular tissue. Substance and drug abuse is a potentially reversible cause of hypogonadism, defined as the failure of the testis to produce physiological concentrations of testosterone and/or a normal number of spermatozoa. The identification of the abuse is important because the withdrawal of substance intake can reverse the clinical syndrome. This review summarizes the most important clinical and experimental evidence on the effect of substance abuse on testosterone and sperm production.
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Affiliation(s)
- Ylenia Duca
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Antonio Aversa
- Department of Experimental and Clinical Medicine, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy.
| | | | - Aldo Eugenio Calogero
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy.
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Durairajanayagam D. Lifestyle causes of male infertility. Arab J Urol 2018; 16:10-20. [PMID: 29713532 PMCID: PMC5922227 DOI: 10.1016/j.aju.2017.12.004] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/05/2017] [Accepted: 12/12/2017] [Indexed: 01/08/2023] Open
Abstract
Objective To examine the potential effects of lifestyle factors on male reproductive health. Evidence of a global decline in human sperm quality over recent decades has been accumulating. Environmental, occupational, and modifiable lifestyle factors may contribute to this decline. This review focuses on key lifestyle factors that are associated with male infertility such as smoking cigarettes, alcohol intake, use of illicit drugs, obesity, psychological stress, advanced paternal age, dietary practices, and coffee consumption. Other factors such as testicular heat stress, intense cycling training, lack of sleep and exposure to electromagnetic radiation from mobile phone use are briefly discussed. Materials and method A comprehensive literature search was performed to identify and synthesise all relevant information, mainly from within the last decade, on the major lifestyle factors associated with male infertility and semen quality. Database searches were limited to reports published in English only. A manual search of bibliographies of the reports retrieved was conducted to identify additional relevant articles. Results In all, 1012 articles were identified from the database search and after reviewing the titles and abstract of the reports, 104 articles met the inclusion criteria. Of these, 30 reports were excluded as the full-text could not be retrieved and the abstract did not have relevant data. The remaining 74 reports were reviewed for data on association between a particular lifestyle factor and male infertility and were included in the present review. Conclusion The major lifestyle factors discussed in the present review are amongst the multiple potential risk factors that could impair male fertility. However, their negative impact may well be mostly overcome by behaviour modification and better lifestyle choices. Greater awareness and recognition of the possible impact of these lifestyle factors are important amongst couples seeking conception.
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Key Words
- AAS, anabolic–androgenic steroids
- APA, advanced paternal age
- ART, assisted reproductive technology
- ASIH, anabolic steroid-induced hypogonadism
- BMI, body mass index
- Chk1, checkpoint kinase 1
- ECS, endogenous cannabinoid system
- GnIH, gonadotropin-inhibitory hormone
- HADS, Hospital Anxiety and Depression Score
- HPA, hypothalamus–pituitary–adrenal
- HPG, hypothalamus–pituitary–gonadal
- ICSI, intracytoplasmic sperm injection
- IUI, intrauterine insemination
- IVF, in vitro fertilisation
- Lifestyle
- MMP, mitochondrial membrane potential
- Male infertility
- ROS, reactive oxygen species
- Risk factors
- SOD, superoxide dismutase
- Semen quality
- Sperm DNA fragmentation
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Affiliation(s)
- Damayanthi Durairajanayagam
- Address: Discipline of Physiology, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia. Fax: +60 3 6126 5224.
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Sansone A, Di Dato C, de Angelis C, Menafra D, Pozza C, Pivonello R, Isidori A, Gianfrilli D. Smoke, alcohol and drug addiction and male fertility. Reprod Biol Endocrinol 2018; 16:3. [PMID: 29334961 PMCID: PMC5769315 DOI: 10.1186/s12958-018-0320-7] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 01/02/2018] [Indexed: 01/17/2023] Open
Abstract
In recent decades, the decline in human fertility has become increasingly more worrying: while therapeutic interventions might help, they are vexing for the couple and often burdened with high failure rates and costs. Prevention is the most successful approach to fertility disorders in males and females alike. We performed a literature review on three of the most common unhealthy habits - tobacco, alcohol and drug addiction - and their reported effects on male fertility. Tobacco smoking is remarkably common in most first-world countries; despite a progressive decline in the US, recent reports suggest a prevalence of more than 30% in subjects of reproductive age - a disturbing perspective, given the well-known ill-effects on reproductive and sexual function as well as general health. Alcohol consumption is often considered socially acceptable, but its negative effects on gonadal function have been consistently reported in the last 30 years. Several studies have reported a variety of negative effects on male fertility following drug abuse - a worrying phenomenon, as illicit drug consumption is on the rise, most notably in younger subjects. While evidence in these regards is still far from solid, mostly as a result of several confounding factors, it is safe to assume that cessation of tobacco smoking, alcohol consumption and recreational drug addiction might represent the best course of action for any couple trying to achieve pregnancy.
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Affiliation(s)
- Andrea Sansone
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy.
| | - Carla Di Dato
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Cristina de Angelis
- I.O.S.& COLEMAN Srl, Naples, Italy
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Naples, Italy
| | - Davide Menafra
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Naples, Italy
| | - Carlotta Pozza
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Rosario Pivonello
- Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università "Federico II" di Napoli, Naples, Italy
| | - Andrea Isidori
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
| | - Daniele Gianfrilli
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza - University of Rome, Viale Regina Elena 324, 00161, Rome, Italy
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Tournaye H, Krausz C, Oates RD. Concepts in diagnosis and therapy for male reproductive impairment. Lancet Diabetes Endocrinol 2017; 5:554-564. [PMID: 27395770 DOI: 10.1016/s2213-8587(16)30043-2] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Accepted: 04/08/2016] [Indexed: 12/13/2022]
Abstract
An accurate medical history and directed physical examination are essential in diagnosis of male infertility. We review the hormonal assessments and specific genetic analyses that are useful additional tests, and detail other evidence-based examinations that are available to help guide therapeutic strategies. By contrast with female infertility treatments-especially hormonal manipulations to stimulate or enhance oocyte production-spermatogenesis and sperm quality abnormalities are much more difficult to affect positively. In general, a healthy lifestyle can improve sperm quality. A few men have conditions in which evidence-based therapies can increase their chances for natural conception. In this second of two papers in The Lancet Diabetes and Endocrinology Series on male reproductive impairment, we examine the agreements and controversies that surround several of these conditions. When we are not able to cure, correct, or mitigate the cause of conditions such as severe oligozoospermia, non-remedial ductal obstruction, and absence of sperm fertilising ability, assisted reproductive technologies, such as in-vitro fertilisation (IVF) with intracytoplasmic sperm injection (ICSI), can be used as an adjunctive measure to allow for biological paternity. Not considered possible just two decades ago, azoospermia due to testicular failure, including 47,XXY (Klinefelter syndrome), is now treatable in approximately 50% of cases when combining surgical harvesting of testicular sperm and ICSI. Although genetic fatherhood is now possible for many men previously considered sterile, it is crucial to discover and abrogate causes as best possible, provide reliable and evidenced-based therapy, consider seriously the health and wellness of any offspring conceived, and always view infertility as a possible symptom of a more general or constitutional disease.
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Affiliation(s)
- Herman Tournaye
- Centre for Reproductive Medicine, University Hospital of the Free University Brussels, Brussels, Belgium.
| | - Csilla Krausz
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Robert D Oates
- Department of Urology, Boston University School of Medicine, Boston, MA, USA
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11
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Drobnis EZ, Nangia AK. Introduction to Medication Effects on Male Reproduction. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1034:1-4. [DOI: 10.1007/978-3-319-69535-8_1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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