Effect of paracetamol on semen quality

Several published studies, both direct and indirect, have connected paracetamol, also named acetaminophen, a commonly used over‐the‐counter analgesic and antipyretic medication, with semen quality and male infertility, although as yet this connection is unclear. This review addresses the effect of paracetamol on semen quality and hence on male factor infertility. We searched the MEDLINE database from January 1980 through January 2017 for English‐language articles using the key words “paracetamol” and “acetaminophen” versus “sperm.” References from articles were used only if relevant. In summary, paracetamol, when used at high doses, appears to change semen quality, particularly sperm morphology, and hence its fertilising ability. Such effect of paracetamol on semen quality may occur by suppressing testosterone synthesis, inducing oxidative stress, provoking apoptosis of spermatocytes, reducing nitric oxide production and inhibiting prostaglandin synthesis. Further research, particularly clinical research, will be very important to confirm these effects.     

Effect of diclofenac on semen quality: A review

Diclofenac is an effective nonsteroidal anti-inflammatory drug and one of the most prescribed medicines worldwide. So far, there are many published articles that directly link between diclofenac and semen quality; however, hitherto, there is no collective review or comprehensive discussion that reveal such imperative link. Therefore, this work reviews and judges the association between diclofenac administration and semen quality, henceforth male infertility. As a tool to accomplish this scientific input, Scopus, Embase and PubMed databases have been searched for all original articles using the keywords “diclofenac” versus “semen” and “sperm” since August 1987 through November 2020. In summary, diclofenac appears to induce negative effects on both qualitative and quantitative measures of sperm; however, this conclusion requires confirmation by human studies. The detected negative effects of diclofenac on semen quality measures may be owed to reduced levels of gonadal hormones, decreased antioxidant defence mechanism, increased oxidative stress, altered concentrations of nitric oxide that are required to maintain normal sperm physiology and reduced synthesis of prostaglandins.     

Effect of ginger (Zingiber officinale) on semen quality

To date, according to the Scopus database, the biological effects of ginger (binominal name: Zingiber officinale), or ginger extracts, and its derived compounds on semen quality and sperm parameters have been revealed in more than 35 original articles. Though, still, there are no collective systematic or narrative discussion and conclusion of this specific research streak. Here, we systematically review and summarise the current link between ginger and its bioactive compounds with semen quality. To achieve this, we searched the central databases (Scopus and PubMed) for original studies, published in English language from August 2004 through February 2019 using the keywords “ginger” versus “sperm” and “semen.” In summary, there is solid evidence that ginger enhances semen quality and improves the main sperm parameters such as concentration, viability, motility and morphology. Such beneficial effects of ginger on semen quality are attributable, at least in part, to increased levels of gonadal hormones, in particular, testosterone and luteinising hormone, decreased oxidative damage to cells, increased production of nitric oxide, hypoglycaemic response of ginger and the presence of valued nutrients in ginger such as manganese. Still, the positive effects of ginger on semen quality require additional approval in men.     

Effect of ibuprofen on semen quality

Ibuprofen is a widely used analgesic/antipyretic medication belongs to the nonsteroidal anti‐inflammatory class. Even though the influence of ibuprofen on semen quality has been investigated in various occasions, the comprehensive understanding and discussion of its impact on semen quality is still yet to be determined. In this work, we systematically review and reveal the effect of ibuprofen on semen quality, and thus on fertilising capability. To achieve this goal, we searched the main research databases (Scopus and PubMed) from 1 June 1986 through 13 October 2018 for English‐language articles and abstracts using the keywords “ibuprofen” versus “semen” and “sperm”. In addition, related published articles or abstracts were also discussed if relevant. Altogether, the main stream of research, from both in vitro and in vivo studies, presents an adverse effect of ibuprofen on different sperm parameters such as motility, viability, count and DNA integrity; however, such effect is not yet confirmed in humans. Mechanisms by which ibuprofen affects semen quality may be by reducing testosterone and prostaglandin synthesis, chelating zinc ions and inhibiting nitric oxide synthesis. However, further research studies, mainly clinical, are still of great importance to confirm the effects of ibuprofen on semen quality.     

Effect of captopril on semen quality

Various studies (direct and indirect) have presented the effect of captopril, a universally used antihypertensive medication, on semen quality; yet, this effect is still collectively unreviewed. This review systematically discusses and summarises the effect of captopril on semen quality. We searched all published articles in the MEDLINE electronic database since June 1985 until January 2016 using the keywords “captopril” and “sperm,” and certain supporting articles were reviewed and considered, if relevant. In conclusion, up to the present time, captopril does not appear to induce a striking change in semen quality, and hence on male infertility, while it may affect the rate of spermatozoa–egg fusion as it inhibits the activity of angiotensin‐converting enzyme that is released during capacitation and the acrosome reaction. Further research, mainly clinical, is still desired to prove these effects.     

Semen parameters are unaffected by statin use in men evaluated for infertility

The effects of statin use on conventional semen parameters in humans are largely unknown and have not been previously studied in subfertile men. We retrospectively reviewed data from 10,140 patients seen at our fertility clinic between 2002 and 2013 to assess the effects of statin use on semen parameters. Men who used any statins for >3 months before semen sample collection were included as cases. Data were gathered on patient age, medication use and conventional semen parameters. A total of 118 patients (126 samples) used statins for at least 3 months before semen sample collection. Data from 7698 patients (8,760 samples), who were not using any medications, were used as controls. In age‐adjusted regression models, statin use was not associated with statistically significant changes in semen parameters. When used in combination with other nonspermatotoxic medications, it was associated with 0.3 ml decrease in semen volume (95% confidence interval: 0.02 to 0.58 ml, p‐value = .04). In conclusion, statin use was not adversely associated with semen parameters other than semen volume in subfertile patients. These findings from our large‐scale retrospective study suggest that there are no clinically relevant deleterious effects from statin use on conventional semen parameters.     

Effect of antidepressant medications on semen parameters and male fertility

Antidepressant medications are commonly used in males of reproductive age for long-term treatment of depression, as well as other disorders. Although antidepressants are known to be associated with sexual side-effects, their effects on semen parameters and other markers of male fertility have been less thoroughly described. The majority of available studies have focused on selective serotonin reuptake inhibitors, which have been shown to negatively impact semen quality in in vitro, animal and human studies. Fluoxetine, in particular, has been the subject of multiple studies and has been associated with gonadotoxic effects, including decreased sperm concentration and motility, increased deoxyribonucleic acid fragmentation, and decreased reproductive organ weights. Studies of several other selective serotonin reuptake inhibitors have yielded similar results. Reassuringly, this effect does seem to be reversible. The data regarding serotonin–norepinephrine reuptake inhibitors, norepinephrine–dopamine reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors and atypical antidepressants are sparse, varied and conflicting. Given the widespread and often long-term use of antidepressant medications, there is a clear need for further data regarding their impact on semen quality and male fertility.     

Semen quality in sub-fertile range for a significant proportion of young men from the general German population: a co-ordinated, controlled study of 791 men from Hamburg and Leipzig

Population studies have shown that a high proportion of Nordic men may have so poor semen quality that they can be classified as sub-fertile according to international standards. A question is whether the Nordic data are specific for the Nordic countries or they should be seen as an expression of a general trend in Europe. We therefore carried out a prospective study of semen quality of young men raised in the former East Germany (Leipzig) and West Germany (Hamburg). To enable inter-regional comparisons, we utilized a common European research protocol previously used in studies in the Nordic-Baltic region. Three hundred and thirty-four young men representative of the general population from Hamburg, and 457 from Leipzig delivered semen samples, underwent physical examinations and provided information on life-style and reproductive health parameters. The study period in Hamburg was February 2003--July 2004, and in Leipzig July 2003--April 2005. No significant differences were observed in sperm concentration (median 46, 42, and 44 million/mL for men from Hamburg, Leipzig and the combined Hamburg-Leipzig group respectively) or total sperm count (154,141 and 149 million), whereas the differences for morphologically normal spermatozoa (9.4 and 8.4%) and motile spermatozoa (67 and 81%) were significantly different. Previously published studies have shown reduced fertility with decreasing sperm concentrations below 40-55 millions/mL and normal sperm morphology below 9-19%. Thus, a large fraction of young German men seem to have impaired semen quality that may reduce their natural fertility. However, it remains to be investigated to what extent poor semen quality contributes to the low German fertility rates.     

Regional differences in semen qualities in the Baltic region

Recent prospective studies of male reproductive health have shown differences between several European countries. Our objective was to evaluate the current situation in the two Baltic States Estonia and Lithuania. In 1997-99 we investigated semen parameters, levels of reproductive hormones and general health factors of 196 men from the general population in Lithuania; from Estonia, 79 men from the general population and 118 soldiers were investigated. Adjusted for interlaboratory differences and abstinence period, sperm concentration of Lithuanian and Estonian men from the general populations were shown to be 55 and 67 million/mL, respectively. The Estonian soldiers had the highest sperm concentration, 82 million/mL. The frequencies of morphologically normal spermatozoa were 6.2, 7.7 and 9.6%, respectively. In contrast to the semen qualities, highest Inhibin B levels were detected in the Lithuanians (233 pg/mL) followed by Estonian men from the general population (220 pg/mL) and Estonian soldiers (185 pg/mL). The soldiers had also the lowest level of testosterone and oestradiol. The sperm counts of the Estonian and Lithuanian men investigated here are higher than recently shown for Norwegian, Danish, Estonian and Finnish men. Comparisons should be cautiously drawn as the groups are not completely comparable. Still, even within the Baltic region, geographically close and sharing common recent social history, differences in semen quality and levels of reproductive hormones are apparent.     

Relationships between serum hormone levels and semen quality among men from an infertility clinic

Participation rates in epidemiologic studies on semen quality are generally very low, raising concerns as to the potential for selection bias. Since hormones both initiate and maintain spermatogenesis, they may serve as surrogates of semen quality in epidemiologic studies. For this reason, in the present study, we explored the influence and predictive ability of reproductive and thyroid hormones on semen quality among men who were partners in an infertile couple. Between 1999 and 2003, 388 men were recruited from Massachusetts General Hospital Andrology Laboratory for clinical evaluation of fertility status. Fresh semen samples were assessed for quality (concentration, motility and morphology) and the serum levels of hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, sex hormone-binding globulin (SHBG), testosterone, free androgen index, free T4, total T3, and thyroid-stimulating hormone (TSH), were measured. Multiple logistic regression revealed increased odds for below-reference sperm concentration and morphology in men with increased FSH, and decreased odds for below-reference sperm concentration and motility in men with increased inhibin B. When FSH and inhibin B were divided into quintiles, the relationships with sperm concentration showed evidence of a threshold value. However, the ability of specific FSH (10 IU/L) and/or inhibin B (80 pg/mL) cutoff values to predict semen quality was lower than in previous reports. In multiple linear regression analysis, FSH and LH were inversely associated with sperm concentration, motility, and morphology. Inhibin B and free T4 were positively associated with sperm concentration, while there was a suggestive positive association between testosterone and sperm motility. In conclusion, we have found that FSH, LH, inhibin B, testosterone and free T4 levels are associated with human semen parameters. Additional consideration should be given to the utility of serum hormone levels as a surrogate for semen quality in epidemiologic studies in which the collection of semen is difficult due to logistical and/or volunteer rate constraints.     

Semen banking in patients with cancer: 20-year experience

Modern techniques of banking sperm provide an effective way to preserve the option of future fertility for most teenagers and young men diagnosed with a variety of malignancies that will necessitate treatment with chemotherapy, pelvic surgery, or significant radiation doses to the testes. Results of cumulative data collected at the Cleveland Clinic Foundation from patients with testicular cancer, lymphoma, leukemia, sarcoma, carcinoma and other kinds of malignancy have revealed that: (1) pretreatment semen quality (pre-freeze and post-thaw) in patients with cancer is poorer compared with healthy donors; (2) the percentage decline in semen quality (from pre-freeze to post-thaw) in patients with cancer is similar to that of normal donors. This suggested that the effect of cryodamage on spermatozoa from patients with cancer is similar to that of normal donors. (3) The stage of cancer in patients with testicular cancer and Hodgkin's disease shows no relationship to their semen quality. Based on studies conducted at the Cleveland Clinic Foundation, we recommend that sperm cryopreservation be offered to all men of reproductive age who have malignancies. Cryopreservation is safe and inexpensive, and gives patients a chance to establish pregnancies in the future with an assisted reproductive technique.     

Effects of spinal cord injury on semen parameters

OBJECTIVE/BACKGROUND: Neurogenic reproductive dysfunction in men with spinal cord injury (SCI) is common and the result of a combination of impotence, ejaculatory failure, and abnormal semen characteristics. It is well established that the semen quality of men with SCI is poor and that changes are seen as early as 2 weeks after injury. The distinguishing characters of poor quality are abnormal sperm motility and viability. In the majority of the men with SCI, the sperm count is not abnormal. We elaborate on the effects of the SCI on semen parameters that may contribute to poor motility and poor viability. METHODS: Review. DESIGN: PubMed and MEDLINE databases were searched using the following key words: spinal cord injuries, fertility, sexual dysfunction, and spermatogenesis. All literature was reviewed by the team of authors according to the various stages of sperm development and transport in the male reproductive cycle. FINDINGS: The cause of asthenozoospermia appears to be multifactorial. CONCLUSION: Current literature does not support the preeminence of a single factor relating to neurogenic reproductive dysfunction in men with SCI. After SCI, there is ample evidence of disturbance of sperm production, maturation and storage, and transport due to an abnormal neuroendocrine milieu. Semen quality seems to be primarily affected by changes to the seminal plasma constituents, type of bladder management, and the neurogenic impairment to the ejaculatory function. Further focused and structured studies are required.     

Aspirin decreases human sperm motility and vitality,chelates seminal calcium,but insignificantly reduces seminal nitric oxide production

Lately, there is a systematic research consensus that reveals adverse effects of aspirin on semen quality characteristics; however, such consensus is lacking further confirmation by human studies. Therefore, here, we asked whether sperm motility and vitality are affected in the presence of aspirin at 0.1 and 1 mM in the ejaculated semen, and whether such effect may be due to an alteration in seminal calcium ions or seminal nitric oxide production. Forty-three semen samples from different normozoospermic men were recruited in this study. Sperm motility was measured by Makler counting chamber, and sperm vitality was measured by Eosin test. Calcium chelating effect of aspirin and seminal nitric oxide production was measured spectrophotometrically. Aspirin at both tested concentrations significantly (p < .05) reduced progressive grade-a motility and vitality of spermatozoa. Additionally, aspirin was found to have significant ability (p < .05) to bind seminal calcium ions, but insignificantly reduced the amount of seminal nitric oxide. In conclusion, sperm motility and vitality were reduced in the presence of aspirin at 0.1 and 1 mM in semen. Such reduction may be attributable to the ability of aspirin to chelate seminal calcium ions, but not to an alteration in the amount of nitric oxide produced.     

Effect of freeze–thawing procedure on chromatin stability, morphological alteration and membrane integrity of human spermatozoa in fertile and subfertile men

Cryopreservation is known to impair sperm motility and decrease the fertilization rate by detrimental effects on acrosomal structure and acrosin activity. However, the consequences of cryopreservation on the integrity of the sperm nucleus, chromatin stability and centrosome are less clear. The present study was designed to determine the effect of the freeze-thawing procedure on chromatin condensation (aniline blue staining) and the morphology (strict criteria) and membrane integrity of human spermatozoa. The structural and functional characteristics of the sperm plasma membrane were measured by the eosin-test and hypo-osmotic swelling test which were done separately. Sperm cryopreservation was performed on semen samples from two groups of men classified as fertile (n = 20) and subfertile (n = 72), based on their reproductive history and semen analysis according to WHO guidelines. The mean percentage of condensed chromatin, morphologically normal spermatozoa and membrane integrity in all semen samples investigated (n = 92) decreased significantly (p = 0.0001) after freeze-thawing, in comparison to the value observed prior to freezing. By comparing the semen samples between fertile and subfertile patients, significantly (p = 0.0009) greater damage was demonstrated in the subfertile than in the fertile group. Furthermore, no significant difference was observed between the two groups with regard to the morphological alteration and structural as well as functional damage of the sperm membrane. In conclusion, the freeze-thawing procedure significantly affects chromatin structure and sperm morphology, especially in the head and the tail regions, and this may explain the lower fertilization rate and IVF/ICSI outcome when frozen-thawed spermatozoa are used. In addition, this study demonstrates that chromatin condensation is a sensitive parameter for the evaluation of cryodamage of semen samples from fertile and subfertile patients, though subfertile patients with very poor semen characteristics have yet to be studied. It is therefore recommended that chromatin condensation be used as an additional parameter for the assessment of sperm quality after freeze-thawing.     

The role of statin drugs in the management of the peripheral vascular patient

The impact of statin therapy on established vascular conditions and recurrent disease is most relevant for long-term care. Patients receiving statin therapy have been shown to experience less recurrent stenosis following carotid endarterectomy and stent angioplasty, reduced cardiac events following cardiac and noncardiac vascular surgery, and reduction in aneurysm development. In patients with peripheral arterial disease, claudication distance is increased, as well as patency rates following infrainguinal arterial bypass grafting. Of note, statins drugs may also prove beneficial in the prevention of certain cancers, Alzheimer's disease, and osteoporosis (all diseases frequently seen concurrently in the patient with peripheral arterial disease). As such, it is becoming all the more necessary that vascular surgeons remain informed about clinical research initiatives related to statin use and lipid management in general. The following is a review of lipid metabolism as it applies to statins as well as a review of the beneficial effects of statins.     

辅酶Q_(10)的生物学功能及其对精子质量的影响

过氧化损伤是导致精子质量下降的重要原因之一,辅酶Q10是一种存在于线粒体中的脂溶性抗氧化剂,其在精浆和精子中的水平对男性生殖系统的抗氧化损伤能力具有重要影响。外源性补充辅酶Q10有利于改善精子质量,提高不育患者生育能力,对男性不育具有一定的辅助治疗作用。现就辅酶Q10的生物学功能及其对精子质量的影响,以及对男性不育的辅助治疗作用等方面作一综述。     

Sperm cryopreservation for men with nonmalignant, systemic diseases: a descriptive study.

Cytotoxic drugs and immunosuppressive therapies are used to treat patients with nonmalignant, nontesticular systemic diseases. These therapies can permanently suppress spermatogenesis. Sperm cryopreservation before treatment theoretically could give these men the opportunity to achieve a pregnancy with a woman later in life when the couple decides to do so. However, it is not known whether pretreatment sperm quality in these men is good enough to be used for assisted reproductive techniques. The main objective of this study was to determine the usefulness of cryopreservation in this patient population by: 1) assessing their pretreatment semen quality (eg, count, motility, and motion kinetics) and comparing it with that of healthy donors before and after cryopreservation; 2) comparing patients' pretreatment semen characteristics with World Health Organization reference values for normal sperm; and 3) examining the differences in semen parameters among patient groups. Semen specimens were obtained from 25 healthy donors and from 23 patients with a variety of disorders (12 had autoimmune disorders, 4 had kidney disorders, 3 had diabetes, 2 had ulcerative colitis, and 2 had heart transplants). All patients, except those with diabetes, required immunosuppressive or cytotoxic therapy. Although the pretreatment quality of the semen of these patients was not as good as that of donors, semen samples were within the normal reference range of the World Health Organization. No statistically significant differences in sperm parameters were found within the 4 patient groups except for those with diabetes (n = 3), who showed poorer sperm counts (P < .04). However, no conclusive evidence can be reached due to the small sample size. Our results indicate that pretreatment semen quality in these patients is adequate for reproductive techniques. We believe that cryopreservation should be offered to patients of reproductive age with disease or treatment regimens that may cause infertility.     

Semen analysis from an epidemiologic perspective

The fifth edition of the World Health Organization （WHO） manual for semen analysis includes for the first time reference values for human semen characteristics. This paper considers whether such values will help to resolve the intensely debated data indicating temporal and geographical shifts in sperm counts and hypotheses that anthropogenic activities that result in the release of chemicals into the environment are detrimental to male reproductive health. The reasons that these reference values will not fulfil these purposes are also explained. Although established reference values for semen characteristics are of limited value in analytical epidemiologic research, the WHO guidelines are of utmost importance for supporting the development of appropriate research protocols. Moreover, in spite of its limitations, semen analysis is still a useful research tool in epidemiological research, and no superior alternatives are on the horizon.