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Kaur M, Ghosal A, Kaur R, Chhabra K, Kapoor HS, Khetarpal P. Exposure to potentially toxic elements (PTEs) and the risk of male infertility- A Systematic review and meta-analysis. J Gynecol Obstet Hum Reprod 2024; 53:102782. [PMID: 38554943 DOI: 10.1016/j.jogoh.2024.102782] [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: 11/06/2023] [Revised: 02/23/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Infertility has been defined as a failure to conceive for at least 12 months of regular unprotected sexual intercourse. The male factors are responsible for about 50 % of cases. Various factors such as endocrine, immunological, genetic, exposure to toxicants, and idiopathic factors are involved in male infertility. Recently, the role of PTEs in reproductive performance has been explored by various studies. OBJECTIVES Current systematic review and meta-analysis have been carried out to compile and statistically analyze the findings of relevant studies and reach some conclusion. METHODOLOGY A literature search was done according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines in three scientific literature databases; PubMed, Google Scholar, and Science Direct. Meta-analysis was performed using Review Manager 5.4 software. The study's protocol was registered in PROSPERO (CRD42023465776). RESULTS Meta-analysis of lead in the blood of infertile cases and healthy controls indicated a significant association with male infertility, observed standard mean difference (SMD) was 0.67 at 95 % confidence interval (CI) (0.07, 1.28), and p = 0.03. In the case of lead analysis in semen, the values are as follows: SMD = 1.19 at 95 % CI (0.42, 1.96) with p = 0.002. Significant association appears for cadmium in semen with SMD 0.92 at 95 % CI (0.54, 1.29) and p < 0.00001. No significant association was observed for arsenic, barium, and mercury in blood. CONCLUSION Most of the studies focus on the detection of PTE in semen samples followed by blood as sample type. Lead and cadmium exposure is significantly associated with male infertility. However, non-significant results for arsenic, barium, and mercury are observed.
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Affiliation(s)
- Mandeep Kaur
- Department of Human Genetics, Punjabi University Patiala, 147002, India
| | - Ahelee Ghosal
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151001, India
| | - Rajinder Kaur
- Department of Human Genetics, Punjabi University Patiala, 147002, India
| | - Kiran Chhabra
- Chhabra Hospital & Test Tube Baby Centre, Bathinda, 151001, India
| | | | - Preeti Khetarpal
- Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, 151001, India.
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Counteracting effects of heavy metals and antioxidants on male fertility. Biometals 2021; 34:439-491. [PMID: 33761043 DOI: 10.1007/s10534-021-00297-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/04/2021] [Indexed: 01/06/2023]
Abstract
Infertility is regarded as a global health problem affecting 8-12% of couples. Male factors are regarded as the main cause of infertility in 40% of infertile couples and contribute to this condition in combination with female factors in another 20% of cases. Abnormal sperm parameters such as oligospermia, asthenospermia, and teratozoospermia result in male factor infertility. Several studies have shown the deteriorative impact of heavy metals on sperm parameters and fertility in human subjects or animal models. Other studies have pointed to the role of antioxidants in counteracting the detrimental effects of heavy metals. In the currents study, we summarize the main outcomes of studies that assessed the counteracting impacts of heavy metal and antioxidants on male fertility. Based on the provided data from animal studies, it seems rational to administrate appropriate antioxidants in persons who suffer from abnormal sperm parameters and infertility due to exposure to toxic elements. Yet, further human studies are needed to approve the beneficial effects of these antioxidants.
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Selvaraju V, Baskaran S, Agarwal A, Henkel R. Environmental contaminants and male infertility: Effects and mechanisms. Andrologia 2020; 53:e13646. [PMID: 32447772 DOI: 10.1111/and.13646] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022] Open
Abstract
The escalating prevalence of male infertility and decreasing trend in sperm quality have been correlated with rapid industrialisation and the associated discharge of an excess of synthetic substances into the environment. Humans are inevitably exposed to these ubiquitously distributed environmental contaminants, which possess the ability to intervene with the growth and function of male reproductive organs. Several epidemiological reports have correlated the blood and seminal levels of environmental contaminants with poor sperm quality. Numerous in vivo and in vitro studies have been conducted to investigate the effect of various environmental contaminants on spermatogenesis, steroidogenesis, Sertoli cells, blood-testis barrier, epididymis and sperm functions. The reported reprotoxic effects include alterations in the spermatogenic cycle, increased germ cell apoptosis, inhibition of steroidogenesis, decreased Leydig cell viability, impairment of Sertoli cell structure and function, altered expression of steroid receptors, increased permeability of blood-testis barrier, induction of peroxidative and epigenetic alterations in spermatozoa resulting in poor sperm quality and function. In light of recent scientific reports, this review discusses the effects of environmental contaminants on the male reproductive function and the possible mechanisms of action.
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Affiliation(s)
- Vaithinathan Selvaraju
- Department of Nutrition, Dietetics and Hospitality Management, Auburn University, Auburn, AL, USA
| | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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Abarikwu SO. Lead, Arsenic, Cadmium, Mercury: Occurrence, Toxicity and Diseases. ENVIRONMENTAL CHEMISTRY FOR A SUSTAINABLE WORLD 2013. [DOI: 10.1007/978-3-319-02387-8_7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Bloom MS, Fujimoto VY, Steuerwald AJ, Cheng G, Browne RW, Parsons PJ. Background exposure to toxic metals in women adversely influences pregnancy during in vitro fertilization (IVF). Reprod Toxicol 2012; 34:471-81. [DOI: 10.1016/j.reprotox.2012.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 05/31/2012] [Accepted: 06/15/2012] [Indexed: 10/28/2022]
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Pillai P, Pandya C, Bhatt N, Gupta SS. Biochemical and reproductive effects of gestational/lactational exposure to lead and cadmium with respect to testicular steroidogenesis, antioxidant system, endogenous sex steroid and cauda-epididymal functions. Andrologia 2011; 44:92-101. [DOI: 10.1111/j.1439-0272.2010.01109.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Kim K, Steuerwald AJ, Parsons PJ, Fujimoto VY, Browne RW, Bloom MS. Biomonitoring for exposure to multiple trace elements via analysis of urine from participants in the study of metals and assisted reproductive technologies (SMART). ACTA ACUST UNITED AC 2011; 13:2413-9. [PMID: 21773592 DOI: 10.1039/c1em10341e] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Humans are exposed to concentrations of multiple trace elements through a variety of background sources; many are suspected reproductive toxicants. Prior to investigating associations between trace elements and human reproductive health, potential biomarkers of exposure should be characterized by sources of variability in the population at risk. Factors influencing elemental exposure should also be identified to ensure their consideration as potential confounding variables. The principal aim of this study is to characterize sources of variability for 19 trace elements measured in urine specimens collected from 55 women and 36 male partners completing a 1st cycle of in vitro fertilization (IVF). Urine specimens were analyzed using a biomonitoring method based on inductively coupled plasma-mass spectrometry (ICP-MS). Randomly selected urine specimens (∼6%) were analyzed in duplicate, and these data were used to characterize sources of variability. Nine trace elements including As, Ba, Cd, Cs, Co, Cu, Mn, Mo, and Zn, were quantified in most specimens, indicating their utility in future epidemiologic studies of trace elements exposure and IVF outcomes. With few exceptions, normalizing urine using the traditional creatinine-correction procedure, or an alternative approach based on a linear regression model, increased residual variability only slightly. Sex and race appear to be important factors to consider in epidemiologic studies conducted in this population. Urine concentrations for most elements are similar to those reported in the 2005-2006 National Health and Nutrition Examination Survey (NHANES); however, differences in others may indicate regional trends or a unique exposure history for this infertile study population.
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Affiliation(s)
- Keewan Kim
- Department of Environmental Health Sciences, University at Albany, State University of New York, Rensselaer, NY, USA.
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Wirth JJ, Mijal RS. Adverse Effects of Low Level Heavy Metal Exposure on Male Reproductive Function. Syst Biol Reprod Med 2010; 56:147-67. [DOI: 10.3109/19396360903582216] [Citation(s) in RCA: 163] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Toxic trace metals and human oocytes during in vitro fertilization (IVF). Reprod Toxicol 2010; 29:298-305. [PMID: 20096775 DOI: 10.1016/j.reprotox.2010.01.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Revised: 12/29/2009] [Accepted: 01/14/2010] [Indexed: 11/22/2022]
Abstract
Trace exposures to the toxic metals mercury (Hg), cadmium (Cd) and lead (Pb) may threaten human reproductive health. The aim of this study is to generate biologically-plausible hypotheses concerning associations between Hg, Cd, and Pb and in vitro fertilization (IVF) endpoints. For 15 female IVF patients, a multivariable log-binomial model suggests a 75% reduction in the probability for a retrieved oocyte to be in metaphase-II arrest for each microg/dL increase in blood Pb concentration (relative risk (RR)=0.25, 95% confidence interval (CI) 0.03-2.50, P=0.240). For 15 male IVF partners, each microg/L increase in urine Cd concentration is associated with an 81% decrease in the probability for oocyte fertilization (RR=0.19, 95% CI 0.03-1.35, P=0.097). Because of the magnitude of the effects, these results warrant a comprehensive study with sufficient statistical power to further evaluate these hypotheses.
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Exposure to heavy metals (lead, cadmium and mercury) and its effect on the outcome of in-vitro fertilization treatment. Int J Hyg Environ Health 2007; 211:560-79. [PMID: 18160343 DOI: 10.1016/j.ijheh.2007.09.005] [Citation(s) in RCA: 80] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2006] [Revised: 07/18/2007] [Accepted: 09/11/2007] [Indexed: 11/23/2022]
Abstract
We investigated the effect of lead, cadmium and mercury exposure on pregnancy and fertilization rate outcome among 619 Saudi women (age 19-50 years) who sought in-vitro fertilization (IVF) treatment between 2002 and 2003. The concentrations of lead, cadmium and mercury were measured in both blood and follicular fluids. At levels well below the current US occupational exposure limit guidelines (40microg/dL) and even less than the current Centers for Disease Control and Prevention level of concern for preventing lead poisoning in children (10microg/dL), blood lead level was negatively associated with fertilization outcome in both adjusted and unadjusted logistic regression models. We found that among various demographic, socioeconomic and environmental factors, fish consumption was positively associated with blood lead levels. These results support the hypothesis that a raised blood lead level affects infertility and intervention to reduce the lead exposure might be needed for women of reproductive age. The present results also revealed unexpected finding - the positive relationship between follicular cadmium levels and fertilization outcome, which points to the necessity for further investigation. Though adverse effect of mercury on pregnancy outcome or fertilization rate was not evident in this study, mercury5.8microg/L (EPA safety limit) was found in the blood and follicular fluid of 18.7% and 8.3% of the women, respectively. Concerns about its possible adverse effects on the physiology of reproduction or fetal development cannot be ruled out. It should be noted that skin-lightening creams and dental amalgam were important contributors to mercury exposure. Such finding is alarming and priority for further studies are, urgently, needed.
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Mendiola J, Ten J, Araico F, Martín-Ondarza C, Torres-Cantero AM, Moreno-Grau JM, Moreno-Grau S, Bernabeu R. Metales pesados y calidad seminal en humanos. Rev Int Androl 2007. [DOI: 10.1016/s1698-031x(07)74051-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Lu JC, Xu HR, Huang YF, Lu NQ. Preliminary investigations on the standardization and quality control for the determination of acid phosphatase activity in seminal plasma. Clin Chim Acta 2007; 375:76-81. [PMID: 16857182 DOI: 10.1016/j.cca.2006.06.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2006] [Revised: 06/05/2006] [Accepted: 06/05/2006] [Indexed: 10/24/2022]
Abstract
BACKGROUND The determination of ACP in seminal plasma was considered as an appropriate biochemical marker to evaluate prostate function, as recommended by the WHO manual. However, few reports on the standardization and quality control for the determination of biochemical markers in seminal plasma have been documented. METHODS Two frozen samples of seminal plasma with or without phenylmethylsulfonyl fluoride were determined for their acid phosphatase (ACP) levels. The ACP level and sperm concentration of each of 72 samples of seminal plasma obtained at 1000xg for 10 min or 3000xg for 15 min centrifugation were assayed. ACP activity in 10 samples of seminal plasma was measured immediately or standing for 30 min after dilution. The ACP levels in seminal plasma with or without chymotrypsin were also assayed. RESULTS There was no significant difference of ACP levels (P=0.166) but of sperm concentrations (P=0.000) in seminal plasma obtained by centrifugation at different velocity. ACP activities in seminal plasma measured when standing for 30 min after dilution were significantly lower than those measured immediately after dilution (P=0.001). Both chymotrypsin and freezing-thawing had no apparent effect on the determination of ACP in seminal plasma. CONCLUSION The results indicated that standing time after dilution and centrifugation velocity should be standardized, and frozen seminal plasma could serve as the quality control products for the determination of ACP activity among different laboratories.
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Affiliation(s)
- Jin-Chun Lu
- Department of Reproduction and Genetics, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210002, China.
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Saradha B, Mathur PP. Effect of environmental contaminants on male reproduction. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2006; 21:34-41. [PMID: 21783636 DOI: 10.1016/j.etap.2005.06.004] [Citation(s) in RCA: 86] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Accepted: 06/18/2005] [Indexed: 05/31/2023]
Abstract
A substantial body of evidence has accumulated in recent years that consistently indicate various adverse effects of environmental contaminants on human health. Decreasing trend of male fertility in terms of sperm counts and sperm quality, along with other changes in male reproductive health, including congenital malformations and testicular cancer in humans, and similar problems in wildlife has been correlated to the exposure to environmental contaminants. Many environmental chemicals have been reported to cause these reproductive abnormalities by eliciting changes in endocrine control of reproduction; however the specific underlying mechanisms are poorly understood. The present review summarizes recent studies on environmental contaminants and associated possible mechanism leading to adverse effects on male reproduction. Numerous studies demonstrate the interaction of environmental toxicants with steroid receptors and thereby causing interference with developmental and functional aspects of testis, epididymis and accessory sex organs. Induction of reactive oxygen species (ROS) by environmental contaminants and associated oxidative stress also have role in defective sperm function and male infertility.
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Affiliation(s)
- B Saradha
- Department of Biochemistry and Molecular Biology, School of Life Sciences, Pondicherry University, Pondicherry 605 014, India
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Pant N, Mathur N, Banerjee AK, Srivastava SP, Saxena DK. Correlation of chlorinated pesticides concentration in semen with seminal vesicle and prostatic markers. Reprod Toxicol 2004; 19:209-14. [PMID: 15501386 DOI: 10.1016/j.reprotox.2004.08.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2003] [Revised: 07/26/2004] [Accepted: 08/02/2004] [Indexed: 10/26/2022]
Abstract
Semen samples of fertile and infertile men were analysed by gas liquid chromatography (GLC) for the presence of dichlorodiphenyltrichloroethane (DDT) and its metabolites (1,1-dichloro-2,2-bis(p-chlorophenyl) ethylene) (pp'-DDE); (1,1,1-trichloro-2,2-bis(p-chlorophenyl ethane) (pp'-DDT); (1,1-dichloro-2,2 bis(p-chlorophenyl) ethane) (pp'-DDD); (1,1,1-trichloro-2-(o-chlorophenyl)-2-(p-chlorophenyl) ethane) (op'-DDT), hexachlorocyclohexane (HCH) and its isomers alpha (alpha), beta (beta), gamma (gamma), delta (delta) and aldrin. The biochemical analysis of seminal vesicle and prostatic marker was done by spectrophotometer. The concentrations of alpha-, beta-, gamma-HCH, pp'-DDE and pp'-DDD were higher in the semen of infertile than in that of fertile men. An elevation in the fructose level along with decrease in the gamma-glutamyl transpeptidase and acid phosphatase activity was noticed in infertile men as compared to fertile subjects. The data showed correlation between alpha-, beta-, gamma-HCH, pp'-DDE, pp'-DDD and seminal vesicle marker fructose and prostatic marker gamma-gluatamyl transpeptidase and acid phosphatase in infertile men. The study suggests that the chlorinated pesticides may influence the semen quality by affecting the seminal and prostatic functions in infertile men.
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Affiliation(s)
- Niraj Pant
- Industrial Toxicology Research Centre, Post Box no. 80, M.G. Marg, Lucknow 226001, India
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