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Henkel R. Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility. J Clin Med 2024; 13:2841. [PMID: 38792382 PMCID: PMC11122306 DOI: 10.3390/jcm13102841] [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: 04/05/2024] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the prevalence of male factor infertility is about 7%. Among numerous other causes, the prevalence of male genital tract infections reportedly ranges between 10% and 35%. Leukocytospermia is found in 30% of infertile men and up to 20% in fertile men. Bacterial infections cause an inflammatory response attracting leukocytes, which produce reactive oxygen species (ROS) and release cytokines, both of which can cause damage to sperm, rendering them dysfunctional. Although leukocytospermia and bacteriospermia are both clinical conditions that can negatively affect male fertility, there is still debate about their impact on assisted reproduction outcomes and management. According to World Health Organization (WHO) guidelines, leukocytes should be determined by means of the Endtz test or with monoclonal antibodies against CD15, CD68 or CD22. The cut-off value proposed by the WHO is 1 × 106 peroxidase-positive cells/mL. For bacteria, Gram staining and semen culture are regarded as the "gold standard", while modern techniques such as PCR and next-generation sequencing (NGS) are allowing clinicians to detect a wider range of pathogens. Whereas the WHO manual does not specify a specific value as a cut-off for bacterial contamination, several studies consider semen samples with more than 103 colony-forming units (cfu)/mL as bacteriospermic. The pathogenic mechanisms leading to sperm dysfunction include direct interaction of bacteria with the male germ cells, bacterial release of spermatotoxic substances, induction of pro-inflammatory cytokines and ROS, all of which lead to oxidative stress. Clinically, bacterial infections, including "silent" infections, are treatable, with antibiotics being the treatment of choice. Yet, non-steroidal antiphlogistics or antioxidants should also be considered to alleviate inflammatory lesions and improve semen quality. In an assisted reproduction set up, sperm separation techniques significantly reduce the bacterial load in the semen. Nonetheless, contamination of the semen sample with skin commensals should be prevented by applying relevant hygiene techniques. In patients where leukocytospermia is detected, the causes (e.g. infection, inflammation, varicocele, smoking, etc.) of the leukocyte infiltration have to be identified and addressed with antibiotics, anti-inflammatories or antioxidants in cases where high oxidative stress levels are detected. However, no specific strategy is available for the management of leukocytospermia. Therefore, the relationship between bacteriospermia and leukocytospermia as well as their specific impact on functional sperm parameters and reproductive outcome variables such as fertilization or clinical pregnancy must be further investigated. The aim of this narrative review is to provide an update on the current knowledge on leukocytospermia and bacteriospermia and their impact on male fertility.
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Affiliation(s)
- Ralf Henkel
- LogixX Pharma Ltd., Merlin House, Brunel Road, Theale, Reading RG7 4AB, UK;
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0HS, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville 7535, South Africa
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Gill P, Puchalt NG, Molinaro T, Werner M, Seli E, Hotaling J, Cheng P. Leukocytospermia does not negatively impact outcomes in in vitro fertilization cycles with intracytoplasmic sperm injection and preimplantation genetic testing for aneuploidy: findings from 5435 cycles. J Assist Reprod Genet 2024; 41:1213-1219. [PMID: 38642270 PMCID: PMC11143111 DOI: 10.1007/s10815-024-03085-x] [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: 11/20/2023] [Accepted: 03/01/2024] [Indexed: 04/22/2024] Open
Abstract
PURPOSE To investigate whether leukocytospermia (defined as the presence of ≥ 1 × 106 white blood cells/mL) affects clinical and embryologic outcomes in in vitro fertilization (IVF) cycles with intracytoplasmic sperm injection (ICSI) and preimplantation genetic testing for aneuploidy (PGT-A). METHODS This was a retrospective cohort study including 5425 cycles between January 2012 to December 2021 at a single large university-affiliated fertility clinic. The primary outcome was live birth rate (LBR). RESULTS The prevalence of leukocytospermia was 33.9% (n = 1843). Baseline characteristics including female age, BMI, AMH, Day 3 FSH, and male partner's age were similar in cycles with and without leukocytospermia. The LBR after the first euploid embryo transfer was similar in those with and without leukocytospermia (62.3% vs. 63% p = 0.625). Secondary outcomes including clinical pregnancy rate (CPR), sustained implantation rate (SIR), fertilization (2PN) rate, blastulation rate, and aneuploidy rate were also evaluated. The CPR (73.3% vs 74.9%, p = 0.213) and SIR (64.6% vs. 66%, p = 0.305) were similar in both groups. The 2PN rate was also similar in both groups (85.7% vs. 85.8%, p = 0.791), as was the blastulation rate per 2PN (56.7% vs. 57.5%, p = 0.116). The aneuploidy rate was not significantly different between groups (25.7% vs 24.4%, p = 0.053). A generalized estimation equation with logistic regression demonstrated that the presence leukocytospermia did not influence the LBR (adjusted OR 0.878; 95% CI, 0.680-1.138). CONCLUSION Leukocytospermia diagnosed just prior to an IVF cycle with PGT-A does not negatively impact clinical or embryologic outcomes.
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Affiliation(s)
- Pavan Gill
- IVI-RMA New Jersey, Basking Ridge, NJ, USA.
| | | | | | | | - Emre Seli
- IVI-RMA New Jersey, Basking Ridge, NJ, USA
| | - James Hotaling
- School of Medicine Andrology and IVF Laboratories, University of Utah, Salt Lake City, UT, USA
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Davies R, Minhas S, Jayasena CN. Next-Generation Sequencing to Elucidate the Semen Microbiome in Male Reproductive Disorders. MEDICINA (KAUNAS, LITHUANIA) 2023; 60:25. [PMID: 38256286 PMCID: PMC10819355 DOI: 10.3390/medicina60010025] [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: 11/12/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 01/24/2024]
Abstract
Mean sperm counts are declining at an accelerated rate and infertility is increasingly becoming a public health concern. It is now understood that human semen, previously considered to be sterile, harbours its own specific microbiome. Via activated leucocytes and the generation of reactive oxygen species, bacteria have the capability of evoking an immune response which may lead to sperm damage. Men with infertility have higher rates of both reactive oxygen species and sperm DNA damage. Due to the lack of sensitivity of routine culture and PCR-based methods, next-generation sequencing technology is being employed to characterise the seminal microbiome. There is a mounting body of studies that share a number of similarities but also a great range of conflicting findings. A lack of stringent decontamination procedures, small sample sizes and heterogeneity in other aspects of methodology makes it difficult to draw firm conclusions from these studies. However, various themes have emerged and evidence of highly conserved clusters of common bacteria can be seen. Depletion or over-representation of specific bacteria may be associated with aberrations in traditional and functional seminal parameters. Currently, the evidence is too limited to inform clinical practice and larger studies are needed.
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Affiliation(s)
- Rhianna Davies
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0HS, UK;
| | - Suks Minhas
- Department of Urology, Charing Cross Hospital, Imperial College NHS Trust, London W6 8RF, UK;
| | - Channa N. Jayasena
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0HS, UK;
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Fan S, Zhao Y, Zhang Z, Wang H, Hou Y, Bai S, Liu R, Xu B. Effect of leukocytes on semen quality in men from primary and secondary infertile couples: A cross-sectional study. Health Sci Rep 2023; 6:e1683. [PMID: 38028702 PMCID: PMC10630749 DOI: 10.1002/hsr2.1683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 10/06/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aims Leukocytospermia (LCS) is a known cause of male infertility. However, the relationship between seminal leukocytes and semen quality among infertile couples remains controversial. This study aims to investigate the association between semen quality and LCS in male partners of infertile couples. Methods Semen samples were collected from 512 men who asked for a fertility evaluation in a reproductive center in China. Seminal leukocytes were counted following peroxidase staining with benzidine. Other semen parameters were compared in subfertile men with and without LCS. Results Poor semen quality (e.g., low semen volume, sperm concentration, and sperm progressive/total motility) was observed among men with LCS compared to those without LCS. Men with LCS had a higher risk of low sperm progressive motility (OR = 0.99, 95% CI = 0.98-0.99, p = 0.02) and total motility (OR = 0.99, 95% CI = 0.98-0.99, p = 0.02), even after adjustment for potential confounders (both OR = 0.99, 95% CI = 0.98-0.99, p = 0.03). Lower sperm viability was observed in LCS from male partners of secondary couples, while no significant difference in semen parameters was found between men with and without LCS in male partners of primary infertile couples. Low sperm motility and viability were associated with LCS in men from secondary infertile couples after adjusting for confounders (OR = 0.97, 95% CI = 0.95-0.99, p = 0.04; OR = 0.94, 95% CI = 0.89-0.99, p = 0.04, respectively). Conclusions Our findings indicate that a higher risk of abnormal semen parameters was correlated with an increased number of leukocytes in men from secondary infertile couples.
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Affiliation(s)
- Shiwei Fan
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
| | - Yuanqi Zhao
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
- Wannan Medical CollegeWuhuAnhuiChina
| | - Zeling Zhang
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
| | - Huiru Wang
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
| | - Yifu Hou
- Center for Reproductive MedicineTraditional Chinese Hospital of LuAnLu'anAnhuiChina
| | - Shun Bai
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
| | - Ran Liu
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
| | - Bo Xu
- Reproductive and Genetic Hospital, The First Affiliated Hospital of USTC, Division of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefeiAnhuiChina
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Rivero MJ, Kulkarni N, Thirumavalavan N, Ramasamy R. Evaluation and management of male genital tract infections in the setting of male infertility: an updated review. Curr Opin Urol 2023; 33:180-186. [PMID: 36861760 PMCID: PMC10073322 DOI: 10.1097/mou.0000000000001081] [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] [Indexed: 03/03/2023]
Abstract
PURPOSE OF REVIEW Male infertility may be secondary to male genital tract infection (MGTI) in an estimated 15% of cases. In the absence of overt clinical signs, evaluation for MGTI beyond semen analysis is not well established. Therefore, we review the literature on the evaluation and management of MGTI in the setting of male infertility. RECENT FINDINGS A set of international guidelines recommends semen culture and PCR testing, but the significance of positive results remains unclear. Clinical trials evaluating anti-inflammatory or antibiotic treatment report improvements in sperm parameters and leukocytospermia, but data on the effect on conception rates are lacking. Human papillomavirus (HPV) and the novel coronavirus (SARS-CoV-2) have been associated with poor semen parameters and decreased conception rates. SUMMARY The finding of leukocytospermia on semen analysis prompts further evaluation for MGTI, including focused physical examination. The role of routine semen culture is controversial. Treatment options include anti-inflammatories; frequent ejaculation; and antibiotics, which should not be used in the absence of symptoms or microbiological infection. SARS-CoV-2 represents a subacute threat to fertility that should be screened for in the reproductive history along with HPV and other viruses.
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Affiliation(s)
- Marco-Jose Rivero
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL
- Case Western Reserve University School of Medicine, Cleveland, OH
| | - Nikhil Kulkarni
- Herbert Wertheim College of Medicine, Florida International University, Miami, FL
| | - Nannan Thirumavalavan
- Case Western Reserve University School of Medicine, Cleveland, OH
- Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL
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Gill K, Machalowski T, Harasny P, Kups M, Grabowska M, Duchnik E, Sipak O, Fraczek M, Kurpisz M, Kurzawa R, Piasecka M. Male Infertility Coexists with Decreased Sperm Genomic Integrity and Oxidative Stress in Semen Irrespective of Leukocytospermia. Antioxidants (Basel) 2022; 11:1987. [PMID: 36290709 PMCID: PMC9598546 DOI: 10.3390/antiox11101987] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/30/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
Our research was designed to verify the relationship between male infertility, basic semen characteristics (with respect to detailed sperm morphology), sperm DNA fragmentation (SDF), oxidation-reduction potential in semen (ORP), and leukocytospermia. The obtained results showed that infertile groups (with or without leukocytospermia) had significantly lower basic semen characteristics and higher SDF, raw ORP, and static ORP (sORP) than fertile controls. The thresholds of 13% SDF (AUC = 0.733) and 1.40 sORP (AUC = 0.857) were predictive values for discriminating infertile from fertile men. In infertile groups, a higher prevalence and risk for >13% SDF and >1.40 sORP were revealed. Unexpectedly, leukocytospermic subjects had lower sORP, prevalence, and risk for >1.40 sORP than leukocytospermic-negative men. These groups did not differ in SDF and raw ORP. Both SDF and sORP negatively correlated with basic semen parameters but positively correlated with sperm head and midpiece defects. sORP positively correlated with sperm tail defects, immature sperm cells with excess residual cytoplasm, and SDF. In turn, raw ORP negatively correlated with sperm count but positively correlated with SDF and sORP. These findings indicate that (1) there is a relationship between male infertility, SDF, and OS in semen; (2) in infertile men, there is a clinically significant risk of SDF and OS irrespective of leukocytospermia; and (3) the assessment of SDF and oxidative stress should be independent of leukocytospermia.
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Affiliation(s)
- Kamil Gill
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Tomasz Machalowski
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland
- Department of Perinatology, Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Pomeranian Medical University, 72-010 Police, Poland
| | - Patryk Harasny
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland
- Department of Urology and Urological Oncology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Michal Kups
- Department of Urology and Oncological Urology, Regional Specialist Hospital in Szczecin, 71-455 Szczecin, Poland
- The Fertility Partnership Vitrolive in Szczecin, 70-483 Szczecin, Poland
| | - Marta Grabowska
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Ewa Duchnik
- Department of Aesthetic Dermatology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
| | - Olimpia Sipak
- Department of Obstetrics and Pathology of Pregnancy, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Monika Fraczek
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznan, Poland
| | - Maciej Kurpisz
- Institute of Human Genetics, Polish Academy of Sciences, 60-479 Poznan, Poland
| | - Rafal Kurzawa
- The Fertility Partnership Vitrolive in Szczecin, 70-483 Szczecin, Poland
- Department of Gynecology and Reproductive Health, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Malgorzata Piasecka
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University, 71-210 Szczecin, Poland
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Noweir HA, Modgil V, Pearce I. Male accessory gland inflammation (MAGI): an evolving entity. JOURNAL OF CLINICAL UROLOGY 2022. [DOI: 10.1177/2051415820987687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Male accessory gland infection (MAGI) is a generic acronym indicating inflammatory conditions affecting the prostate gland, seminal vesicles, the ductus deferens and the epididymis. It is a frequent disease, mostly with a chronic course. Majority of the MAGIs remain asymptomatic, thereby leading to a debate whether to treat these patients or not. The primary criterion for MAGI was suggested by Comhaire and colleagues in 1980. The role of MAGI in causing infertility and sexual dysfunctions has long been a matter of debate. The most recent studies show that MAGI could alter, with various mechanisms, both conventional and biofunctional sperm parameters, and determine worst reproductive outcome. This article provides an overview of up-to-date research findings about MAGI with special focus on data published on its impact on fertility; and diagnostic criteria including cellular and seminal biomarkers along with the promising results of emerging proteomic platforms for the identification of MAGI.
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Affiliation(s)
- Hosam A. Noweir
- Manchester Royal Infirmary, Manchester University Foundation Trust, UK
| | - Vaibhav Modgil
- Manchester Royal Infirmary, Manchester University Foundation Trust, UK
| | - Ian Pearce
- Manchester Royal Infirmary, Manchester University Foundation Trust, UK
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Bacteriospermia and Male Infertility: Role of Oxidative Stress. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1358:141-163. [PMID: 35641869 DOI: 10.1007/978-3-030-89340-8_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Male infertility is one of the major challenging and prevalent diseases having diverse etiologies of which bacteriospermia play a significant role. It has been estimated that approximately 15% of all infertility cases are due to infections caused by uropathogens and in most of the cases bacteria are involved in infection and inflammation leading to the development of bacteriospermia. In response to bacterial load, excess infiltration of leukocytes in the urogenital tract occurs and concomitantly generates oxidative stress (OS). Bacteria may induce infertility either by directly interacting with sperm or by generating reactive oxygen species (ROS) and impair sperm parameters such as motility, volume, capacitation, hyperactivation. They may also induce apoptosis leading to sperm death. Acute bacteriospermia is related with another clinical condition called leukocytospermia and both compromise male fertility potential by OS-mediated damage to sperm leading to male infertility. However, bacteriospermia as a clinical condition as well as the mechanism of action remains poorly understood, necessitating further research in order to understand the role of individual bacterial species and their impact in male infertility.
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Gholami M, Moosazadeh M, Haghshenash MR, Jafarpour H, Mousavi T. Evaluation of the Presence of Bacterial and Viral Agents in the Semen of Infertile Men: A Systematic and Meta-Analysis Review Study. Front Med (Lausanne) 2022; 9:835254. [PMID: 35602502 PMCID: PMC9116196 DOI: 10.3389/fmed.2022.835254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/05/2022] [Indexed: 02/02/2023] Open
Abstract
Objectives Infections in the male genitourinary system with bacterial and viral agents may play a significant role in male infertility. These agents usually infect the urethra, seminal vesicles, prostate, epididymis, vas deferens, and testes retrograde through the reproductive system. A meta-analysis review study was performed to evaluate the presence of bacterial and viral agents in the semen of infertile men and its correlation with infertility. Methods Relevant cross-sectional and/or case-control studies were found by an online review of national and international databases (Web of Science, PubMed, Scopus, Science Direct, and Google scholar), and suitable studies were selected. A checklist determined the qualities of all studies. Heterogeneity assay among the primary studies was evaluated by Cochran’s Q test and I2 index (significance level 50%). A statistical analysis was conducted using the Comprehensive Stata ver. 14 package (StataCorp, College Station, TX, United States). Results Seventy-two studies were included in this meta-analysis. Publication bias was compared with Egger’s test, and the impact of each research on overall estimate was evaluated by sensitivity analysis. In 56 studies, the rate of bacterial infections in the semen of infertile men was 12% [95% confidence interval (CI): 10–13]. Also, in 26 case-control studies, the association of infertility in men with bacterial infections was evaluated. The results show that the odds ratio of infertility in men exposed to bacterial infections is 3.31 times higher than that in non-infected men (95% CI: 2.60–4.23). Besides, in 9 studies that examined the prevalence of human papillomavirus (HPV), herpes simplex virus 1 (HSV1), herpes simplex virus 2 (HSV2), and herpes simplex virus 1-2 (HSV1-2) in infertile men, the frequency of these viruses was 15% (95% CI: 9–21). In 6 case-control studies, the association between human cytomegalovirus (HCMV), Cytomegalovirus (CMV), and HPV and male infertility was evaluated. The chance of male infertility due to exposure to these viruses was 2.24 times higher than those without exposure to these viruses (CI 95%: 1.9–4.52). The results show that the chance of infertility in men exposed to bacteria was significantly higher than that in the uninfected population. Conclusion This meta-analysis showed that viral and bacterial infections are a risk factor and could impair male fertility potential. Moreover, our study supports the hypothesis that bacterial and viral infections of the genital tract correlate positively with impairment of sperm quality in the male population.
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Affiliation(s)
- Mehrdad Gholami
- Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Molecular and Cell Biology Research Center (MCBRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Haghshenash
- Department of Microbiology and Virology, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Hamed Jafarpour
- Faculty of Medicine, University of Medical Sciences, Sari, Iran
| | - Tahoora Mousavi
- Molecular and Cell Biology Research Center (MCBRC), Hemoglobinopathy Institute, Mazandaran University of Medical Sciences, Sari, Iran.,Medical Sciences Technologies, Molecular and Cell Biology Research Center (MCBRC), Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Assidi M. Infertility in Men: Advances towards a Comprehensive and Integrative Strategy for Precision Theranostics. Cells 2022; 11:cells11101711. [PMID: 35626747 PMCID: PMC9139678 DOI: 10.3390/cells11101711] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/20/2022] [Indexed: 02/05/2023] Open
Abstract
Male infertility is an increasing and serious medical concern, though the mechanism remains poorly understood. Impaired male reproductive function affects approximately half of infertile couples worldwide. Multiple factors related to the environment, genetics, age, and comorbidities have been associated with impaired sperm function. Present-day clinicians rely primarily on standard semen analysis to diagnose male reproductive potential and develop treatment strategies. To address sperm quality assessment bias and enhance analysis accuracy, the World Health Organization (WHO) has recommended standardized sperm testing; however, conventional diagnostic and therapeutic options for male infertility, including physical examination and semen standard analysis, remain ineffective in relieving the associated social burden. Instead, assisted reproductive techniques are becoming the primary therapeutic approach. In the post-genomic era, multiomics technologies that deeply interrogate the genome, transcriptome, proteome, and/or the epigenome, even at single-cell level, besides the breakthroughs in robotic surgery, stem cell therapy, and big data, offer promises towards solving semen quality deterioration and male factor infertility. This review highlights the complex etiology of male infertility, especially the roles of lifestyle and environmental factors, and discusses advanced technologies/methodologies used in characterizing its pathophysiology. A comprehensive combination of these innovative approaches in a global and multi-centric setting and fulfilling the suitable ethical consent could ensure optimal reproductive and developmental outcomes. These combinatorial approaches should allow for the development of diagnostic markers, molecular stratification classes, and personalized treatment strategies. Since lifestyle choices and environmental factors influence male fertility, their integration in any comprehensive approach is required for safe, proactive, cost-effective, and noninvasive precision male infertility theranostics that are affordable, accessible, and facilitate couples realizing their procreation dream.
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Affiliation(s)
- Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia; ; Tel.: +966-(012)-6402000 (ext. 69267)
- Medical Laboratory Department, Faculty of Applied Medical Sciences, King Abdulaziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia
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Ferlin A, Calogero AE, Krausz C, Lombardo F, Paoli D, Rago R, Scarica C, Simoni M, Foresta C, Rochira V, Sbardella E, Francavilla S, Corona G. Management of male factor infertility: position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS) : Endorsing Organization: Italian Society of Embryology, Reproduction, and Research (SIERR). J Endocrinol Invest 2022; 45:1085-1113. [PMID: 35075609 DOI: 10.1007/s40618-022-01741-6] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/05/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE Infertility affects 15-20% of couples and male factors are present in about half of the cases. For many aspects related to the diagnostic and therapeutic approach of male factor infertility, there is no general consensus, and the clinical approach is not uniform. METHODS In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), endorsed by the Italian Society of Embryology, Reproduction, and Research (SIERR), we propose evidence-based recommendations for the diagnosis, treatment, and management of male factor infertility to improve patient and couple care. RESULTS Components of the initial evaluation should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, and imaging are suggested in most men and recommended when specific risk factors for infertility exist or first-step analyses showed abnormalities. Full examination including genetic tests, testicular cytology/histology, or additional tests on sperm is clinically oriented and based on the results of previous investigations. For treatment purposes, the identification of the specific cause and the pathogenetic mechanism is advisable. At least, distinguishing pre-testicular, testicular, and post-testicular forms is essential. Treatment should be couple-oriented, including lifestyle modifications, etiologic therapies, empirical treatments, and ART on the basis of best evidence and with a gradual approach. CONCLUSION These Guidelines are based on two principal aspects: they are couple-oriented and place high value in assessing, preventing, and treating risk factors for infertility. These Guidelines also highlighted that male infertility and in particular testicular function might be a mirror of general health of a man.
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Affiliation(s)
- A Ferlin
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35121, Padua, Italy.
| | - A E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - C Krausz
- Department of Experimental and Clinical Biomedical Sciences 'Mario Serio', University of Florence, Florence, Italy
| | - F Lombardo
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank "Loredana Gandini", University of Rome "La Sapienza", Rome, Italy
| | - D Paoli
- Department of Experimental Medicine, Laboratory of Seminology-Sperm Bank "Loredana Gandini", University of Rome "La Sapienza", Rome, Italy
| | - R Rago
- Department of Gender, Parenting, Child and Adolescent Medicine, Physiopathology of Reproduction and Andrology Unit, Sandro Pertini Hospital, Rome, Italy
| | - C Scarica
- European Hospital, Centre for Reproductive Medicine, Rome, Italy
| | - M Simoni
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - C Foresta
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Via Giustiniani 2, 35121, Padua, Italy
| | - V Rochira
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - E Sbardella
- Department of Experimental Medicine, University of Rome "La Sapienza", Rome, Italy
| | - S Francavilla
- Department of Life, Health and Environmental Sciences, Unit of Andrology, University of L'Aquila, L'Aquila, Italy
| | - G Corona
- Medical Department, Endocrinology Unit, Maggiore-Bellaria Hospital, Azienda Usl, Bologna, Italy
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12
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Sharma R, Gupta S, Agarwal A, Henkel R, Finelli R, Parekh N, Saleh R, Arafa M, Ko E, Zini A, Tadros N, Shah R, Ambar RF, Elbardisi H, Sengupta P, Martinez M, Boitrelle F, Simopoulou M, Vogiatzi P, Gosalvez J, Kavoussi P, Kandil H, Palani A, Rodriguez Peña M, Rajmil O, Busetto GM, Anagnostopoulou C, Micic S, Alves MG, Rocco L, Mostafa T, Alvarez JG, Jindal S, Sallam HN, Maldonado Rosas I, Lewis SEM, AlSaid S, Altan M, Park HJ, Ramsay J, Parekattil S, Sabbaghian M, Tremellen K, Khalafalla K, Durairajanayagam D, Colpi GM. Relevance of Leukocytospermia and Semen Culture and Its True Place in Diagnosing and Treating Male Infertility. World J Mens Health 2022; 40:191-207. [PMID: 34169683 PMCID: PMC8987138 DOI: 10.5534/wjmh.210063] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/17/2021] [Accepted: 04/21/2021] [Indexed: 02/05/2023] Open
Abstract
The current WHO 2010 manual for human semen analysis defines leukocytospermia as the presence of peroxidase-positive leukocytes at a concentration >1×106/mL of semen. Granular leukocytes when activated are capable of generating high levels of reactive oxygen species in semen resulting in oxidative stress. Oxidative stress has been correlated with poor sperm quality, increased level of sperm DNA fragmentation and low fertility potential. The presence of leukocytes and pathogens in the semen may be a sign of infection and/or localized inflammatory response in the male genital tract and the accessory glands. Common uro-pathogens including Chlamydia trachomatis, Ureaplasma urealyticum, Neisseria gonorrhoeae, Mycoplasma hominis, and Escherichia coli can cause epididymitis, epididymo-orchitis, or prostatitis. The relationship between leukocytospermia and infection is unclear. Therefore, we describe the pathogens responsible for male genital tract infections and their association with leukocytospermia. The review also examines the diagnostic tests available to identify seminal leukocytes. The role of leukocytospermia in male infertility and its management is also discussed.
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Affiliation(s)
- Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Sajal Gupta
- 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 Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Neel Parekh
- Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, Canada
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Rafael F Ambar
- Department of Urology, Centro Universitario em Saude do ABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Selangor, Malaysia
| | - Marlon Martinez
- Section of Urology, University of Santo Tomas Hospital, Manila, Philippines
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Mara Simopoulou
- Department of Physiology, School of Medicine, National & Kapodistrian University of Athens, Maroussi, Athens, Greece
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Greece
| | - Jaime Gosalvez
- Departamento de Biología, Universidad Autónoma de Madrid, Madrid, Spain
| | - Parviz Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Ayad Palani
- Department of Biochemistry, College of Medicine, University of Garmian, Kalar, Iraq
| | - Marcelo Rodriguez Peña
- Departamento Docencia e Investigación, Hospital Militar Campo de Mayo, Universidad Barcelo, Buenos Aires, Argentina
| | - Osvaldo Rajmil
- Clinical and training Centre of the European Academy of Andrology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
| | | | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Marco G Alves
- Department of Anatomy & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies (DiSTABiF), University of Campania Luigi Vanvitelli, Caserta, Italy
| | - Taymour Mostafa
- Department of Andrology, Sexology & STIs, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Juan G Alvarez
- Centro ANDROGEN, La Coruña, Spain
- Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, USA
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Hassan N Sallam
- Department of Obstetrics and Gynaecology, Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Israel Maldonado Rosas
- Centerf Technological Innovation, and Reproductive Medicine (CITMER), Mexico City, Mexico
| | - Sheena E M Lewis
- Examenlab Ltd., Weavers Court Business Park, Linfield Road, Belfast, Northern Ireland, UK
| | - Sami AlSaid
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Mesut Altan
- Department of Urology, Haceppete University, Ankara, Turkey
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | | | - Sijo Parekattil
- Avant Concierge Urology & University of Central Florida, Winter Garden, FL, USA
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Kelton Tremellen
- Department of Obstetrics Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
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13
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Qiao X, Zeng R, Yang Z, Xu L, Ma Q, Yang Y, Bai Y, Yang Y, Bai P. Effects of leukocytospermia on the outcomes of assisted reproductive technology. Andrologia 2022; 54:e14403. [PMID: 35233797 PMCID: PMC9542176 DOI: 10.1111/and.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Leukocytospermia is one of the common causes of male infertility, and its effects on the clinical outcomes of assisted reproduction are controversial. There are no recommendations for the management of leukocytospermia in cases of assisted reproductive technology (ART). To investigate the impact of leukocytospermia on ART, we retrospectively compared the clinical outcomes in ART couples with or without leukocytospermia and further analysed the impact of the insemination method itself by split insemination treatment in ART couples with leukocytospermia. In this study, leukocytospermia was detected in 133 patients, namely 63 in the conventional in vitro fertilization (IVF) group, 38 in the intracytoplasmic sperm injection (ICSI) group and 32 in the split insemination group. Leukocytospermia has a negative influence on the parameters of semen samples; however, leukocytospermia did not affect the clinical outcomes of IVF or ICSI. Different insemination methods did not affect the fertilization, clinical pregnancy or live birth rates. In the split insemination study, no significant differences in clinical pregnancy and live birth rates between the IVF and ICSI groups were found; however, the numbers of two pronuclei (2PN), available embryos and good‐quality embryos in the ICSI group were higher than those in the IVF group. Leukocytospermia may be a risk factor affecting semen parameters, and more attention should be given to IVF insemination. Leukocytospermia has no significant negative effect on the outcomes of ART. ICSI may obtain better embryos than IVF, but it cannot improve the clinical pregnancy and live birth rates.
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Affiliation(s)
- Xiaoyong Qiao
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.,The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Rujun Zeng
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.,The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Zhilan Yang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.,The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Liangzhi Xu
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Reproductive Endocrinology and Regulation Laboratory, West China Second University Hospital, Sichuan University, Chengdu, China.,The Joint Laboratory for Reproductive Medicine of Sichuan University, The Chinese University of Hong Kong, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Qianhong Ma
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yezhou Yang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yu Bai
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Yihong Yang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Peng Bai
- Department of Forensic Genetics, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
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14
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Long S, Kenworthy S. Round Cells in Diagnostic Semen Analysis: A Guide for Laboratories and Clinicians. Br J Biomed Sci 2022; 79:10129. [PMID: 35996519 PMCID: PMC8915675 DOI: 10.3389/bjbs.2021.10129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/23/2021] [Indexed: 11/21/2022]
Abstract
Round cells in seminal fluid are defined as either leucocytes or immature germ cells. Laboratories undertaking semen analysis often report these combined as a concentration, with no further review, comment or direction for clinician action or review. Although numerous publications discuss the possible clinical relevance of these cells (particularly leucocytes) in infertility, the methods employed to differentiate them are often beyond the scope of most diagnostic laboratories. This paper aims to support healthcare scientists in understanding the clinical significance of round cells and aid their identification, differentiation and interpretation. This will support the quality of care the patient receives and direct clinicians to further considerations that may be appropriate for their patient and should consequently reduce indiscriminate and unnecessary use of antibiotics.
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Affiliation(s)
- S. Long
- University Hospitals Birmingham, Birmingham, United Kingdom
- *Correspondence: S. Long,
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15
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Das S, Roychoudhury S, Roychoudhury S, Agarwal A, Henkel R. Role of Infection and Leukocytes in Male Infertility. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1358:115-140. [DOI: 10.1007/978-3-030-89340-8_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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Pourmirzaei F, Ranjbaran M, Kadkhodaee M, Kianian F, Lorian K, Abdi A, Hajiaghaei M, Seifi B. Sperm and testicular dysfunction during cecal ligation and puncture-induced sepsis in male rats and effects of tannic acid through reducing testicular oxidative stress and inflammation. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2021; 24:1554-1560. [PMID: 35317115 PMCID: PMC8917847 DOI: 10.22038/ijbms.2021.59375.13183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 10/19/2021] [Indexed: 11/06/2022]
Abstract
Objective(s): One of the problems caused by infectious diseases is the decrease in sperm count and motility. Tannic acid is known as an anti-oxidant and anti-inflammatory agent. In this study, Cecal Ligation and Puncture (CLP) sepsis model was induced to investigate the effect of tannic acid on oxidative stress and inflammation in testicular and sperm structure and function. Materials and Methods: Twenty-four male Wistar rats (250–300 g) were randomly divided into 3 groups of 8: 1) sham, 2) sepsis, and 3) sepsis + tannic acid (20 mg/kg at 6, 12, and 24 hr after sepsis induction). Thirty hours after induction of sepsis, testicular samples were collected to measure SOD activity and MDA, IL-6, and TNF-α levels. Another part of the testis was fixed in 10% formalin for histological examinations. Results: In the sepsis group, testicular MDA, TNF-α, and IL-6 levels increased and SOD activity decreased compared with the sham group. In addition, the percentage of motile sperm and the survival rate of sperm decreased significantly in the sepsis group. Administration of tannic acid significantly decreased inflammatory markers (TNF-α and IL-6) and MDA levels and increased SOD activity. Furthermore tannic acid significantly improved sperm parameters and increased sperm and animal survival rates. Conclusion: The results of this study showed that the reproductive system may be strongly affected by the conditions created during sepsis. Tannic acid improved reproductive dysfunction in sepsis by reducing oxidative stress and inflammation.
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Affiliation(s)
- Fatemeh Pourmirzaei
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Ranjbaran
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehri Kadkhodaee
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Kianian
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Keivan Lorian
- Department of Reproductive Biology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arash Abdi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Hajiaghaei
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Behjat Seifi
- Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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17
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Drury RH, King B, Herzog B, Hellstrom WJG. Hematospermia Etiology, Diagnosis, Treatment, and Sexual Ramifications: A Narrative Review. Sex Med Rev 2021; 10:669-680. [PMID: 37051970 DOI: 10.1016/j.sxmr.2021.07.004] [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: 06/04/2021] [Revised: 07/21/2021] [Accepted: 07/24/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Hematospermia (HS) is the presence of blood in ejaculatory fluid. It is a rare condition that is historically idiopathic or associated with sexual behavior. Technological advances have identified many of the etiologies behind HS, improving treatment. Though often benign, HS remains a source of considerable sexual anxiety for patients. Few papers have outlined a diagnostic and therapeutic approach to HS, and none have explicitly addressed its sexual consequences. OBJECTIVES To provide a comprehensive overview of HS, emphasizing its sexual ramifications. METHODS A PubMed literature search was performed through May 2021 to identify all relevant publications related to etiology, diagnosis, treatment, and sexual effects of HS. Original research and reviews were analyzed, and pertinent studies were included in this review. RESULTS Iatrogenic interventions (eg, transrectal ultrasound-guided prostate biopsies) are the most common cause of HS. Infection and/or nonspecific inflammation is the most common non-iatrogenic etiology. Malignancies, including prostate, testicular, and other genitourinary cancers, are rarely the cause of HS. Diagnostic approaches to HS can be organized according to patient age (less than or greater than 40 years old), persistence of bleeding, and the presence/absence of concerning symptoms. Though HS often spontaneously resolves, treatment may require various medications (eg, antibiotics, anti-inflammatories) or surgical interventions. HS has several sexual ramifications, including libido-affecting anxiety, social repercussions from sexual partners and non-sexual affiliates, increased risk of erectile dysfunction or transmission of sexual infections, and compromised fertility, especially when cryopreservation is utilized. CONCLUSION HS may significantly affect sexual health through several mechanisms, though there is a paucity of formal data on this subject. Further research is needed to fully understand the severity and extent of HS's effect on sexual well-being, especially in those with refractory bleeding. Drury RH, King B, Herzog B, et al. Hematospermia Etiology, Diagnosis, Treatment, and Sexual Ramifications: A Narrative Review. Sex Med Rev. 2021;XX:XXX-XXX.
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Affiliation(s)
- Robert H Drury
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Brendan King
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Bryan Herzog
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA
| | - Wayne J G Hellstrom
- Tulane University School of Medicine, Department of Urology, New Orleans, LA, USA.
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18
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Adamyan L, Elagin V, Vechorko V, Stepanian A, Dashko A, Doroshenko D, Aznaurova Y, Sorokin M, Suntsova M, Garazha A, Buzdin A. COVID-19 - associated inhibition of energy accumulation pathways in human semen samples. ACTA ACUST UNITED AC 2021; 2:355-364. [PMID: 34377996 PMCID: PMC8339600 DOI: 10.1016/j.xfss.2021.07.004] [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: 05/28/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022]
Abstract
Objective To investigate transcriptional alterations in human semen samples associated with COVID-19 infection. Design Retrospective observational cohort study. Setting City hospital. Patient(s) Ten patients who had recovered from mild COVID-19 infection. Eight of these patients had different sperm abnormalities that were diagnosed before infection. The control group consisted of 5 healthy donors without known abnormalities and no history of COVID-19 infection. Intervention(s) We used RNA sequencing to determine gene expression profiles in all studied biosamples. Original standard bioinformatic instruments were used to analyze activation of intracellular molecular pathways. Main Outcome Measure(s) Routine semen analysis, gene expression levels, and molecular pathway activation levels in semen samples. Result(s) We found statistically significant inhibition of genes associated with energy production pathways in the mitochondria, including genes involved in the electron transfer chain and genes involved in toll-like receptor signaling. All protein-coding genes encoded by the mitochondrial genome were significantly down-regulated in semen samples collected from patients after recovery from COVID-19. Conclusion(s) Our results may provide a molecular basis for the previously observed phenomenon of decreased sperm motility associated with COVID-19 infection. Moreover, the data will be beneficial for the optimization of preconception care for men who have recently recovered from COVID-19 infection.
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Affiliation(s)
- Leila Adamyan
- A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20b1 Delegatskaya St., Moscow, 127473, Russian Federation
| | - Vladimir Elagin
- A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20b1 Delegatskaya St., Moscow, 127473, Russian Federation.,O.M. Filatov City clinical hospital №15, 23 Veshnjakovskaja St., Moscow, 111539, Russian Federation
| | - Valeriy Vechorko
- O.M. Filatov City clinical hospital №15, 23 Veshnjakovskaja St., Moscow, 111539, Russian Federation
| | - Assia Stepanian
- Academia of Women's Health and Endoscopic Surgery, 755 Mount Vernon Hwy, Atlanta, GA, 30328, USA
| | - Anton Dashko
- O.M. Filatov City clinical hospital №15, 23 Veshnjakovskaja St., Moscow, 111539, Russian Federation
| | - Dmitriy Doroshenko
- O.M. Filatov City clinical hospital №15, 23 Veshnjakovskaja St., Moscow, 111539, Russian Federation
| | - Yana Aznaurova
- A.I. Evdokimov Moscow State University of Medicine and Dentistry, 20b1 Delegatskaya St., Moscow, 127473, Russian Federation
| | - Maxim Sorokin
- Moscow Institute of Physics and Technology (National Research University), 9 Institutskij pereulok, Dolgoprudnyj city, Moscow region, 141700, Russian Federation.,OmicsWay Corp., 340 S Lemon Ave, Walnut, CA, 91789, USA.,World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, 2-4 Bolshaya Pirogovskaya St., Moscow, 119435, Russian Federation
| | - Maria Suntsova
- World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, 2-4 Bolshaya Pirogovskaya St., Moscow, 119435, Russian Federation
| | | | - Anton Buzdin
- Moscow Institute of Physics and Technology (National Research University), 9 Institutskij pereulok, Dolgoprudnyj city, Moscow region, 141700, Russian Federation.,OmicsWay Corp., 340 S Lemon Ave, Walnut, CA, 91789, USA.,World-Class Research Center "Digital biodesign and personalized healthcare", Sechenov First Moscow State Medical University, 2-4 Bolshaya Pirogovskaya St., Moscow, 119435, Russian Federation
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19
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Bonyadi F, Hasanzadeh S, Malekinejad H. Cyclopiazonic acid induced p53-dependent apoptosis in the testis of mice: Another male related risk factor of infertility. ENVIRONMENTAL TOXICOLOGY 2021; 36:903-913. [PMID: 33400354 DOI: 10.1002/tox.23092] [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: 11/17/2020] [Accepted: 12/19/2020] [Indexed: 06/12/2023]
Abstract
Cyclopiazonic acid (CPA) is an indole tetrameric acid mycotoxin. This study carried out to investigate the potential effects of CPA on male reproductive system. In the current study, 40 adult male mice were divided into five groups (n = 8). The control group did not expose to CPA, while animals in vehicle-received group; received the CPA-solvent (0.05% dimethyl sulfoxide) and the animals of third, fourth, and fifth groups received CPA 0.03, 0.06, and 0.12 mg/kg, body weight, respectively for 28 days. Morphometric and morphological deviations, spermatogenesis indices, malondialdehyde (MDA) content, total thiol molecules (TTM) concentration, total antioxidant capacity (TAC), protein carbonylation rate (CO), and nitric oxide (NO) concentration were examined. The expression changes of apoptotic genes (P53, Bcl-2, and Caspase III) at mRNA level were also evaluated by qPCR technique. Reduction in the Leydig and Sertoli cells population, diameter of seminiferous tubules, and spermatogenesis parameters was significant only in the group that received the highest dose of CPA. An increase in the level of MDA, NO, and CO in testicular tissue and reduction of TAC and TTM were observed in the CPA-exposed groups. Significant up-regulation (p < .05) in the expression of P53 and Caspase III genes and down-regulation of Bcl-2 gene were found in the CPA-received groups. These results are indicating the detrimental effects of CPA on the testicles, which may attribute to the CPA-induced oxidative stress and apoptosis. Moreover, results also help to understand a serious concern about the presence of CPA in foods as a potential risk factor in male-related infertility.
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Affiliation(s)
- Farzaneh Bonyadi
- Department of Basic Science, Histology section, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Shapor Hasanzadeh
- Department of Basic Science, Histology section, Faculty of Veterinary Medicine, Urmia University, Urmia, Iran
| | - Hassan Malekinejad
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Urmia University of Medical Sciences, Urmia, Iran
- Experimental and Applied Pharmaceutical Research Center, Urmia University of Medical Sciences, Urmia, Iran
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20
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Vasilescu SA, Khorsandi S, Ding L, Bazaz SR, Nosrati R, Gook D, Warkiani ME. A microfluidic approach to rapid sperm recovery from heterogeneous cell suspensions. Sci Rep 2021; 11:7917. [PMID: 33846481 PMCID: PMC8042033 DOI: 10.1038/s41598-021-87046-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/18/2021] [Indexed: 12/11/2022] Open
Abstract
The isolation of sperm cells from background cell populations and debris is an essential step in all assisted reproductive technologies. Conventional techniques for sperm recovery from testicular sperm extractions stagnate at the sample processing stage, where it can take several hours to identify viable sperm from a background of collateral cells such as white bloods cells (WBCs), red blood cells (RBCs), epithelial cells (ECs) and in some cases cancer cells. Manual identification of sperm from contaminating cells and debris is a tedious and time-consuming operation that can be suitably addressed through inertial microfluidics. Microfluidics has proven an effective technology for high-quality sperm selection based on motility. However, motility-based selection methods cannot cater for viable, non-motile sperm often present in testicular or epididymal sperm extractions and aspirations. This study demonstrates the use of a 3D printed inertial microfluidic device for the separation of sperm cells from a mixed suspension of WBCs, RBCs, ECs, and leukemic cancer cells. This technology presents a 36-fold time improvement for the recovery of sperm cells (> 96%) by separating sperm, RBCS, WBCs, ECs and cancer cells into tight bands in less than 5 min. Furthermore, microfluidic processing of sperm has no impact on sperm parameters; vitality, motility, morphology, or DNA fragmentation of sperm. Applying inertial microfluidics for non-motile sperm recovery can greatly improve the current processing procedure of testicular sperm extractions, simplifying the fertility outcomes for severe forms of male infertility that warrant the surgery.
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Affiliation(s)
- Steven A Vasilescu
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Shayan Khorsandi
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Lin Ding
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Sajad Razavi Bazaz
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, 2007, Australia
| | - Reza Nosrati
- Department of Mechanical and Aerospace Engineering, Monash University, Clayton, VIC, 3800, Australia
| | - Debra Gook
- Reproductive Services, Royal Women's Hospital/Melbourne IVF, Melbourne, Australia
- Department of Obstetrics and Gynaecology, University of Melbourne Victoria, Melbourne, Australia
| | - Majid Ebrahimi Warkiani
- School of Biomedical Engineering, University of Technology Sydney, Sydney, NSW, 2007, Australia.
- Institute for Biomedical Materials and Devices (IBMD), Faculty of Science, University of Technology Sydney, Sydney, NSW, 2007, Australia.
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21
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Velez D, Ohlander S, Niederberger C. Pyospermia: background and controversies. F S Rep 2021; 2:2-6. [PMID: 34223265 PMCID: PMC8244362 DOI: 10.1016/j.xfre.2021.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 11/28/2022] Open
Abstract
Pyospermia (or leukocytospermia) is suspected based on the presence of >1 × 106 round cells/mL of ejaculate and diagnosed using peroxidase stain revealing >1 × 106 white blood cells/mL. The presence of white blood cells is a concern for overt infections or excessive inflammation, both of which have been postulated to negatively impact bulk semen parameters and fertilization capability. The threshold for pyospermia has been debated upon in the literature, as has the optimal treatment method. In the absence of clinical infectious symptoms, it appears that antibiotics, anti-inflammatory agents, and/or frequent ejaculation may improve bulk semen parameters in men with pyospermia. Further research is needed to adequately assess the effect of these methods on pregnancy and live birth outcomes, especially among couples attempting natural conception compared to those attempting intrauterine insemination or in vitro fertilization.
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Affiliation(s)
- Danielle Velez
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - Samuel Ohlander
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois
| | - Craig Niederberger
- Department of Urology, University of Illinois at Chicago, Chicago, Illinois.,Department of Bioengineering, University of Illinois at Chicago College of Engineering, Chicago, Illinois
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22
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Abstract
PURPOSE OF REVIEW Contrary to historic dogma, many tissues and organs in the human body contain a resident population of bacteria, fungi, and viruses collectively known as the microbiome. The microbiome plays a role in both homeostatic symbiosis and also pathogenic dysbiosis in a wide array of diseases. Our understanding of the relationship between the microbiome and male factor infertility is in its infancy but is slowly evolving. RECENT FINDINGS Recent literature indicates that semen (and likely the testis) is not sterile and contains a distinct microbiome, and these changes in its composition are associated with alterations in semen quality and fertility status. Preliminary investigation indicates that manipulating the human microbiome may have implications in improving semen parameters and fertility. SUMMARY In this review, we describe relationships between the microbiome and the genitourinary system, discuss the prior work on the relationship among bacteriospermia, leukocytospermia and male factor infertility, and summarize the current literature utilizing 16s rRNA-based next-generation sequencing on the seminal and testicular microbiome. We explore the specific microbial taxa implicated in various aspects of spermatic dysfunction and introduce preliminary evidence for therapeutic approaches to alter the microbiome and improve fertility status.
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23
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Myeloperoxidase and lactoferrin expression in semen fluid: Novel markers of male infertility risk? Immunobiology 2020; 225:151999. [PMID: 32962819 DOI: 10.1016/j.imbio.2020.151999] [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: 04/24/2020] [Revised: 07/26/2020] [Accepted: 08/02/2020] [Indexed: 01/01/2023]
Abstract
RESEARCH QUESTION Infections and/or inflammation processes of male genital tract are highly prevalent and often associated with risk of infertility. These conditions represent a possible cause of leukocytospermia, which is still under debate. Leukocytes are key-factors to reactive oxygen species (ROS) production and the increase of ROS in semen fluid is associated with the worsening of semen parameters. At present, there are not appropriate andrological tests to identify asymptomatic inflammatory conditions when the amount of leukocytes is in the normal range. DESIGN We studied the innate immunity profile of myeloperoxidase and lactoferrin (MPO/LAC) proteins expressed in the semen fluid of 39 men evaluated for couple infertility, in the absence of leukocytospermia. RESULTS The presence of both MPO and LAC proteins was associated with a decrease of sperm concentration and of progressive/total motility, whereas the increase of MPO-/LAC + indicated a worse sperm morphology. It is worth to report the predictive potential of MPO+/LAC + pattern (above 4.36 %) as a biological marker to distinguish normozoospermic from pathological patients. CONCLUSION Our findings indicate MPO/LAC analysis as a potential diagnostic tool to identify asymptomatic conditions eventually related to male infertility, even when the number of leukocytes in semen fluid is below 1 million/mL.
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24
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Henkel R, Offor U, Fisher D. The role of infections and leukocytes in male infertility. Andrologia 2020; 53:e13743. [PMID: 32693434 DOI: 10.1111/and.13743] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 12/16/2022] Open
Abstract
Declining birth rates are one of the problems facing society today. Male counterparts are responsible for about half of the infertility cases, and genitourinary tract infections may play a contributing role in approximately 15% of male infertility cases. Leukocytospermia is an established indicator of infection in the male urogenital tract, although other microorganisms such as bacteria and virus may also be contributors to the etiology of male infertility. The pathophysiology of these infectious agents may be initiated by a local inflammatory reaction resulting in an increase in reactive oxygen species (ROS). This results in testicular injury, thereby affecting sperm morphology, sperm motility, sperm viability and elevation of the seminal leukocyte as a result of the genital tract infection. The infectious and inflammatory changes can result in male infertility. It is proposed that high concentrations of seminal leukocyte and infectious agents may affect sperm function resulting in clumping of motile spermatozoa, decreasing acrosomal functionality and also causing alterations in sperm morphology. However, the literature has poorly clarified the role of infection in male infertility, provoking further debate and research on this topic.
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Affiliation(s)
- Ralf Henkel
- Department of Medical Bioscience, Faculty of Natural Science, University of Western Cape, Bellville, South Africa.,American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ugochukwu Offor
- Department of Pre-Clinical Sciences, Faculty of Health Sciences, University of Limpopo, Polokwane, South Africa
| | - David Fisher
- Department of Medical Bioscience, Faculty of Natural Science, University of Western Cape, Bellville, South Africa
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25
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Khodamoradi K, Kuchakulla M, Narasimman M, Khosravizadeh Z, Ali A, Brackett N, Ibrahim E, Ramasamy R. Laboratory and clinical management of leukocytospermia and hematospermia: a review. Ther Adv Reprod Health 2020; 14:2633494120922511. [PMID: 32577619 PMCID: PMC7290265 DOI: 10.1177/2633494120922511] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/08/2020] [Indexed: 12/23/2022] Open
Abstract
Leukocytospermia and hematospermia are defined as the presence of abnormally high white blood cell and red blood cell concentration in the semen, respectively. Numerous etiologies and various implications on fertility have been identified. In a small proportion of men, the presence of white blood cells or red blood cells can adversely affect sperm quality by the production of reactive oxygen species. Several methods have been used to assess the presence of white blood cells and red blood cells in samples, such as identification of round cells, immunohistochemical staining using monoclonal antibodies, the Endtz test, the peroxidase test, and flow cytometry or microscopy. In addition, techniques have been identified to separate sperm samples from white blood cells and red blood cells for cryopreservation to improve outcomes in assisted reproductive technology. In this review, laboratory and clinical management of leukocytospermia and hematospermia are discussed. Currently available diagnostic methods and treatment options are outlined, and available optimal cryopreservation techniques for samples with white blood cells or red blood cells are summarized.
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Affiliation(s)
- Kajal Khodamoradi
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Manish Kuchakulla
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Manish Narasimman
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Zahra Khosravizadeh
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Aleena Ali
- Des Moines University, Des Moines, IA, USA
| | - Nancy Brackett
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Emad Ibrahim
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1563, Miami, FL 33136, USA
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26
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Baskaran S, Finelli R, Agarwal A, Henkel R. Diagnostic value of routine semen analysis in clinical andrology. Andrologia 2020; 53:e13614. [PMID: 32400107 DOI: 10.1111/and.13614] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/01/2020] [Indexed: 01/11/2023] Open
Abstract
Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.
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Affiliation(s)
- Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- 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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27
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Determination of 27 amino acids’ levels in seminal plasma of asthenospermia and oligospermia patients and diagnostic value analysis. J Pharm Biomed Anal 2020; 184:113211. [DOI: 10.1016/j.jpba.2020.113211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/24/2020] [Accepted: 02/24/2020] [Indexed: 11/22/2022]
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28
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Ogunwole E, Kunle-Alabi OT, Akindele OO, Raji Y. Saccharum officinarum juice alters reproductive functions in male Wistar rats. J Basic Clin Physiol Pharmacol 2020; 31:/j/jbcpp.2020.31.issue-4/jbcpp-2019-0235/jbcpp-2019-0235.xml. [PMID: 32755099 DOI: 10.1515/jbcpp-2019-0235] [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: 08/29/2019] [Accepted: 02/29/2020] [Indexed: 11/15/2022]
Abstract
Infertility is a problem across almost all cultures and societies. Problems in the male partner, especially as a result of unhealthy dietary habits, are the commonest single group of course. Many populations, therefore, tend more toward the use of natural dietary substitutes opined to proffer less risk to reproductive functions and more health benefits. Saccharum officinarum juice (SOJ) is a widely consumed, energy-rich, nutritious substance that has many minerals and enzymes. Saccharum officinarum plant was reported to have anti-thrombosis, anti-inflammatory and immune-stimulatory activities. This study evaluated the reproductive effects of S. officinarum juice in male Wistar rats. A sugarcane press juicer was used to extract S. officinarum juice. Twenty male Wistar rats (100-120 g) grouped into four (n = 5) received 1.0 mL/kg/day distilled water (control), and 1.0, 3.2 and 10.0 mL/kg/day of fresh S. officinarum juice once daily for 8 weeks via gavage. Sperm analysis, histology of testes and epididymides were evaluated by microscopy. Enzyme-linked immunosorbent assay (ELISA) was used in assessing the serum levels of luteinizing hormone, follicle-stimulating hormone and testosterone. Data were analyzed using the analysis of variance at a significance of p < 0.05. SOJ increased fasting blood glucose levels in 3.2 and 10.0 mL/kg groups. The 10.0 mL/kg juice caused a significant increase in testosterone level and sperm count, and it also increased the percentage of aberrant sperm and decreased sperm viability. Saccharum officinarum juice impaired the histological integrity of the testes and epididymides. Thus, S. officinarum juice adversely altered the reproductive functions of male Wistar rats by reducing sperm quality and disrupting testicular architecture.
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Affiliation(s)
- Eunice Ogunwole
- Laboratory for Reproductive Physiology and Developmental Programming, Department of Physiology, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Physiology, College of Health Sciences, Bingham University, New Karu, Nasarawa, Nigeria, Phone: +23408060771728
| | - Olufadekemi T Kunle-Alabi
- Laboratory for Reproductive Physiology and Developmental Programming, Department of Physiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Opeyemi O Akindele
- Laboratory for Reproductive Physiology and Developmental Programming, Department of Physiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Yinusa Raji
- Laboratory for Reproductive Physiology and Developmental Programming, Department of Physiology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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29
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Farber NJ, Madhusoodanan VK, Gerkowicz SA, Patel P, Ramasamy R. Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist. ACTA ACUST UNITED AC 2019; 2. [PMID: 31723937 DOI: 10.21037/gpm.2019.09.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Obstetricians and gynecologists, and in particular reproductive endocrinologists (REIs), are typically the gatekeepers and first-line providers for couples initially seeking an infertility evaluation. A timely referral to a reproductive urologist may improve pregnancy outcomes in certain clinical scenarios. This review examines the evidence behind circumstances requiring referral and delivers practice-based recommendations on commonly encountered scenarios in the clinic. Scenarios that should prompt referral to a reproductive urologist include semen analysis (SA) abnormalities (e.g., asthenozoospermia, azoospermia, globozoospermia, leukocytospermia, necrozoospermia, oligospermia), recurrent intrauterine insemination (IUI)/in vitro fertilization (IVF) failure, and idiopathic recurrent pregnancy loss (RPL). Conversely, deferment is appropriate in the cases of isolated teratozoospermia and subclinical varicocele. Men with infertility are also at higher risk for other comorbid conditions and should have at least a baseline evaluation by a primary care physician. Coordination of care between a REI and reproductive urologist is critical in several clinical scenarios and expedient referral can improve reproductive outcomes.
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Affiliation(s)
- Nicholas J Farber
- Department of Urology, Cleveland Clinic Foundation, The Glickman Urological & Kidney Institute, Cleveland, OH, USA
| | | | | | - Premal Patel
- Department of Urology, University of Miami, Miami, FL, USA
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