Relationship between etiological factors and total motile sperm count in 350 infertile patients

Novel centrifugal technology for measuring sperm concentration in the home

OBJECTIVE

To evaluate the analytical performance and usability of the Trak Male Fertility Testing System, a semiquantitative (categorical) device recently US Food and Drug Administration (FDA)-cleared for measuring sperm concentration in the home by untrained users.

DESIGN

A three-site clinical trial comparing self-reported lay user results versus reference results obtained by computer-aided semen analysis (CASA).

SETTING

Simulated home use environments at fertility centers and urologist offices.

PATIENT(S)

A total of 239 untrained users.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

Sperm concentration results reported from self-testing lay users and laboratory reference method by CASA were evaluated semiquantitatively against the device's clinical cutoffs of 15 M/mL (current World Health Organization cutoff) and 55 M/mL (associated with faster time to pregnancy). Additional reported metrics include assay linearity, precision, limit of detection, and ease-of-use ratings from lay users.

RESULT(S)

Lay users achieved an accuracy (versus the reference) of 93.3% (95% confidence interval [CI] 84.1%-97.4%) for results categorized as ≤15 M/mL, 82.4% (95% CI 73.3%-88.9%) for results categorized as 15-55 M/mL, and 95.5% (95% CI 88.9%-98.2%) for results categorized as >55 M/mL. When measured quantitatively, Trak results had a strong linear correlation with CASA measurements (r = 0.99). The precision and limit of detection studies show that the device has adequate reproducibility and detection range for home use. Subjects generally rated the device as easy to use.

CONCLUSION(S)

The Trak System is an accurate tool for semiquantitatively measuring sperm concentration in the home. The system may enable screening and longitudinal assessment of sperm concentration at home.

CLINICAL TRIAL REGISTRATION NUMBER

ClinicalTrials.gov identifier: NCT02475395.

The Effect of Alcohol, Tobacco, and Aspirin Consumption on Seminal Quality among Healthy Young Men

In this study, the authors examined the effects of alcohol, tobacco, and drug use on plasma testosterone and seminal parameters (in accordance with the World Health Organization's standards) in healthy Argentine medical students (n = 34). Some alterations in seminal parameters were detected in 19 (56%) subjects. Alcohol and tobacco use were correlated significantly, p = 0.005; subjects who used these substances exhibited a nonsignificant reduction in sperm concentration, motility, viability, and normal morphology. There was a significant decrease in sperm motility among students who used moderate amounts of aspirin (i.e., > or = 500 mg/wk). The authors concluded that alcohol, tobacco, and aspirin use could have had detrimental effects on seminal parameters and that men who wish to procreate should be warned of such effects. Doses, exposure time, and interactions with other variables deserve additional study.

Immotile sperm and infertility in mice lacking mitochondrial voltage-dependent anion channel type 3

Voltage-dependent anion channels (VDACs), also known as mitochondrial porins, are small channel proteins involved in the translocation of metabolites across the mitochondrial outer membrane. A single channel-forming protein is found in yeast, whereas higher eukaryotes express multiple VDACs, with humans and mice each harboring three distinct channels (VDAC1-3) encoded by separate genes. To begin to assess the functions of each of the three isoforms, the VDAC3 gene was inactivated by targeted disruption in embryonic stem cells. Here we show that mice lacking VDAC3 are healthy, but males are infertile. Although there are normal sperm numbers, the sperm exhibit markedly reduced motility. Structural defects were found in two-thirds of epididymal axonemes, with the most common abnormality being loss of a single microtubule doublet at a conserved position within the axoneme. In testicular sperm, the defect was only rarely observed, suggesting that instability of a normally formed axoneme occurs with sperm maturation. In contrast, tracheal epithelial cilia showed no structural abnormalities. In addition, skeletal muscle mitochondria were abnormally shaped, and activities of the respiratory chain complexes were reduced. These results demonstrate that axonemal defects may be caused by associated nonaxonemal components such as mitochondrial channels and illustrate that normal mitochondrial function is required for stability of the axoneme.

Treatment of varicoceles in childhood and adolescence with Tauber's antegrade scrotal sclerotherapy

PURPOSE

The aim of this study was to evaluate surgical complications and the outcome of grade II and III varicoceles treated with Tauber's antegrade scrotal sclerotherapy.

METHODS

A total of 21 patients with a median age of 13 (range, 10 to 21) years and left-sided grade II and III varicoceles were treated with Tauber's antegrade scrotal sclerotherapy and underwent follow-up over a median period of 23 months (range, 9 to 35).

RESULTS

One grade II varicocele persisted after antegrade sclerotherapy for 6 months. After a second sclerotherapy 6 months later, no further recurrence was detected. One patient with a grade II to III varicocele had a grade I varicocele recurrence 14 months after operation. Three patients showed a slight hydrocele postoperatively.

CONCLUSION

This limited series indicates that Tauber's antegrade scrotal sclerotherapy is a safe and effective treatment for grade II and III varicoceles in children and adolescents.