Relationships between total testicular volume,reproductive parameters and surrogate measures of adiposity in men presenting for couple's infertility

The objective of this study was to investigate the relationships between total testicular volume (TTV), reproductive parameters and adiposity measures: body mass index, waist circumference and waist‐to‐height ratio. Semen analysis was performed, and reproductive hormone levels were measured in 2,672 male patients (mean age 32.6) due to couple's infertility. Significant, positive correlations between semen parameters and the TTV were found. Gonadotrophins were negatively related to the TTV, and testosterone was not related to the TTV. Three anthropometric parameters were negatively correlated to the total sperm count, and sperm concentration seen in men with a TTV of ≤46 ml. In the case of a TTV >46 ml, only the semen volume was inversely correlated with WC and WHtR. These changes occurred from a WHtR ≥0.56, WC ≥102 cm and BMI ≥29 and were more pronounced between WHtR and the TTV. Adiposity was associated with a significant testosterone level decline but did not have a major impact on the gonadotrophin levels. This study shows the divergent results in sperm parameters in different TTV groups in the presence of central adiposity.     

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 quality and reproductive endocrinal function related to blood lead levels in infertile painters

Lead causes male reproductive impairment among painters, but information is still limited. Therefore, the effect of lead on semen quality and reproductive endocrinal function in those patients was investigated. A case series of 27 infertile painters were subjected to semen analysis, measuring of blood lead level (PbB) and serum levels of endocrinal parameters including follicle‐stimulating hormone (FSH), luteinising hormone (LH), testosterone (T) and prolactin (PRL). Significantly lower sperm count and motility were found in those with duration of exposure (≥15 years), but no significant difference was found for PbB and serum levels of FSH, LH, PRL and T. A significant negative correlation between PbB and spermatic count and motility was observed, while there was no significant correlation between PbB and all endocrinal parameters. Patients with PbB ≥ 20 μg dl^?1 showed a significant decrease in sperm motility and increase in testosterone alone among all measured hormones. But the observed decrease in sperm count did not reach a significant level. It is concluded that infertile painters are at risk of lead‐related influence on semen quality, especially sperm motility and increased testosterone level without significant affection of other reproductive endocrinal parameters.     

利用腰围身高比预测有雄激素缺乏症的老年男性体内血清睾酮水平

老年男性血清睾酮的下降可能部分是由肥胖引起的,但是,还不能确定哪些肥胖相关的参数与睾酮水平最密切相关。我们研究过伴有雄激素缺乏症但健康状况良好的老年男性的年龄、肥胖和睾酮水平的关系。本研究中,我们从社区中募集了54岁以上无痛症或其他严重疾病的非吸烟男性做横向研究分析,测定身高,体重和腰围,并计算体质指数（BMI）和腰围身高比（WHt）。收集两个早上的血液样本,测量总睾酮,性激素结合球蛋白和促黄体激素。计算游离睾酮（cFT）。并对上述指标与肥胖参数之间的关系进行多元线性凹归分析。207名54-86岁之间的男性参与了此次研究。单因素分析结果表明腰围身高比与睾酮和游离睾酮的相关性明显高于体重和腰吲或体质指数。另外,对总睾酮和游离睾酮来说,体重和腰围以及身高都有重要意义（所有的P均小于0．05）,身高值中加入体重和腰围值后,导致体重和腰用以及身高的回归系数都增加了,其中腰围呈负相关,身高呈正相关。总之,腰围身高比是预测健康但有雄激素缺乏症的老年男性的睾酮和游离睾酮最好的体质指标。     

Sperm concentration and normal sperm morphology decrease and follicle-stimulating hormone level increases with age

OBJECTIVE: To assess hormone levels, testicular volume, and semen characteristics of fertile men of various age groups. PATIENTS AND METHODS: The records of 889 men who sought a vasectomy between September 1999 and March 2003 were reviewed. Patients were divided into five groups by age; we evaluated semen volume, sperm concentration, motility, morphology and complex sperm motion variables. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone levels and both testicular volumes were compared. RESULTS: There were no differences among the groups in the levels of LH, testosterone, or right and left testicular volumes. There were differences among the five groups in FSH levels, semen volume, sperm concentration and motility. Normal morphology according to the World Health Organisation criteria was significantly lower in patients aged > 45 years. From a linear regression analysis, semen volume, sperm concentration and motility decreased by 0.01 mL, 2.1%, and 0.27%, respectively, per year, and the FSH level increased by 0.27%. CONCLUSIONS: Sperm concentration and motility decrease and FSH levels increase with age. Normal sperm morphology decreases from 45 years old. Thus, the ageing effect should be considered when proposing standard values for semen characteristics in routine semen analysis.     

Gonadotropins,testosterone and prolactin in men with abnormal semen findings and an evaluation of the hormone profile

Over a 4-year period, 259 men were investigated regarding primary (86.5%) or secondary (13.5%) infertility. Men with azoospermia had significantly higher concentrations of FSH and LH and lower concentrations of testosterone than those with spermatozoa. High concentrations of FSH and LH in serum were found in case of low sperm density. Men with low testicular voluem had high concentrations of FSH and LH and low concentrations of testosterone. FSH was closely correlated with LH and also with total testicular volume. A negative correlation was found between both gonadotropins and testosterone. The correlation between LH and testosterone was stronger in azoospermic men than in those with spermatozoa in semen. Serum concentrations of prolactin were higher in men with high sperm motility than among men with low motility of spermatozoa. Otherwise, prolactin concentrations were not correlated either with sperm density or with the morphology of spermatozoa or total testicular volume. A ‘hormone profile’ of FSH, LH and testosterone concentrations is suggested useful in the routine investigation of the infertile man, as more information is given by this profile than by FSH concentrations alone.     

Teratospermic and normospermic domestic cats: ejaculate traits, pituitary-gonadal hormones, and improvement of spermatozoal motility and morphology after swim-up processing

Electroejaculate traits, testicular volume, and circulating FSH, LH, and testosterone concentrations were compared between two populations of domestic cats consistently producing either a high (greater than 60%, normospermic) or low (less than 40%, teratospermic) incidence of structurally normal spermatozoa/ejaculate. The effects of semen dilution in Biggers, Whitten and Whittingham (BWW) or modified Krebs Ringer bicarbonate (mKRB) medium and swim-up processing on sperm viability and duration of motility in vitro also were assessed. Ejaculate volume, percent sperm motility, sperm progressive motility, motile spermatozoa/ejaculate, testes volume, and mean serum FSH and LH concentrations were similar (P greater than 0.05) between normospermic and teratospermic cats. However, sperm concentration/ml of ejaculate was greater and circulating testosterone levels were lower in teratospermic males. Swim-up processing increased (P less than 0.05) percent sperm motility, progressive motility, and the number of structurally normal sperm cells recovered and also prolonged the duration of sperm motility in both cat populations. In teratospermic ejaculates, swim-up separation increased the proportion of morphologically normal spermatozoa recovered by more than two-fold. Diluting cat semen with either BWW or mKRB increased flagellar bending in both normospermic and teratospermic cats. The sperm motility characteristics of only the teratospermic ejaculates were influenced by medium type; mKRB increased percent sperm motility and progressive motility whereas BWW had no effect. Compared with undiluted raw ejaculates, the duration of sperm motility was improved 18- to 24-fold by diluting semen in either BWW or mKRB medium followed by swim-up processing. This study demonstrates that the electroejaculate characteristics of domestic cats vary markedly and that some males consistently produce high proportions of morphologically abnormal spermatozoa. Diminished serum testosterone concentrations and normal pituitary secretion of FSH and LH in teratospermic males suggest that there is an inverse relationship between gonadal androgen production and pleiomorphic spermatozoa in the domestic cat. The swim-up procedure is effective for recovering motile, structurally normal spermatozoa from teratospermic cats.     

Body mass index has no impact on sperm quality but on reproductive hormones levels

The influence of overweight and obesity on sperm quality and reproductive hormone levels is under discussion. The aim of the present retrospective study was to evaluate the influence of body mass index (BMI) on sperm quality and reproductive hormones. We analysed semen samples and serum levels of FSH, LH, T and PRL of a total of 2110 men attending our andrology unit from 1994 to 2010 due to infertility work‐up. Patients were stratified according to their BMI in four groups. Main outcome measures were sperm motility, morphology and concentration. Serum levels of FSH, LH, T and PRL were evaluated as well. No statistically significant difference was found for sperm quality and BMI between patients categorised according to the four BMI levels. T (P < 0.001) and LH (P = 0.006) significantly differed between the four groups. In multivariable analysis, BMI did not have significantly independent influence on all assessed sperm quality parameters, whereas BMI significantly influenced hormone values for LH (P = 0.001), T (P = <0.001) and PRL (P = 0.044). We therefore conclude that BMI has no significant impact on sperm quality parameters. However, serum levels of LH, T and PRL were significantly influenced by BMI.     

Predictive factors associated with successful varicocele repair a study of 139 infertile men with valicocele

PURPOSE: To determine pretreatment parameters which predict improvements following varicocele repaire in semen quality. MATERIALS AND METHODS: We retrospectively evaluated a total of 139 infertile patients who underwent varicocelectomy from February 1995 to March 2000. A logistic regression analysis was performed to identify parameters associated with improvements in semen quality. Parameters evaluated included varicocele grade, age, testicular volume, serum testosterone, liteinizing hormone (LH), follicle-stimulating hormone (FSH), preoperative sperm density and sperm motility. RESULTS: Of 139 patients 71 (51.0%) improved sperm concentration and 59 (42.4%) improved sperm motility postoperatively. Overall, median sperm density significantly increased from 10 x 10(6)/ml preoperatively to 30 x 10(6)/ml postoperatively. Sperm motility also significantly increased 33% to 45%. In logistic regression analysis, varicocele grade (odds ratio [OR] = 5.7; 95% confidential interval [CI : 1.9-17), FSH level ([OR] = 0.76; [CI]: 0.60-0.96) and sperm motility ([OR] = 1.03; [CI]: 1.0-1.1) were independent predictive factors for improvement in sperm concentration. CONCLUSION: Varicocelectomy improves sperm concentration and motility. Our data suggest that patients with grade 3 varicocele, low serum FSH level and high sperm motility are more likely to benefit from varicocele repair in sperm concentration.     

它莫西芬对促性腺激素、睾酮及精液参数影响的研究

本文报告它莫西芬治疗特发性少精症对卵泡刺激素_(ESH)、黄体生成素_(LH)、睾酮(T)以及对精子数量、活力、精浆果糖等参数的影响。采用的双盲法对39例受试者分为实验组、实验对照组、安慰组。结果表明服用它莫西芬20mg/日3个月,可以明显增加血中FSH、LH、T水平,对精子活力,精浆果糖浓度无明显影响。对精子密度在3个月服药期间个体差异较大,均数无明显增加。从临床角度而言,它莫西治疗特发性少精症不育可能对配偶妊娠是有益的。     

Is semen quality affected by male body fat distribution?

The aim of this study was to examine the relationship of semen parameters, sexual function-related hormones and waist/hip ratio. Eighty-one selected patients presenting with infertility were examined. Weight, height, waist circumference and hip circumference were measured, and reproduction-related hormone levels were determined. Semen was analysed by conventional methods. Semen volume, sperm concentration, motility, total sperm count, total motile sperm cell number, rapid progressive motile sperm count and reproduction-related hormone levels [follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone, 17beta-oestradiol and sexual hormone-binding globulin (SHBG)]. Significant correlations were found: (i) weight, waist circumference and hip circumference versus testosterone level, SHBG level, and testosterone/17beta-oestradiol ratio; (ii) hip circumference versus sperm concentration; (iii) waist circumference and hip circumference versus sperm count, total motile sperm cell number and rapid progressive motile sperm count; (iv) weight versus total sperm count and total motile sperm cell number; (v) waist circumference and hip circumference versus prolactin level (positively) and SHBG (negatively); (vi) waist circumference and waist/hip ratio versus semen volume. It can be concluded that the waist/hip ratio is correlated with the reproductive hormone levels. Although both the waist circumference and hip circumference correlated with the semen characteristics, the waist/hip ratio did not.     

Association between leptin,obesity, hormonal interplay and male infertility

Male infertility is a major health problem worldwide. We investigated a possible association between leptin, obesity, hormonal interplay and male infertility. This cross‐sectional study of 313 males (178 infertile and 135 fertile) was carried out in 2017. The subjects were categorised by body mass index (BMI) and body fat percentage (BF%) into normal weight, overweight and obese. Significantly higher levels of BMI and BF% (p‐value < 0.001) and lower levels of FSH, LH, testosterone, and SHBG (p‐value < 0.001) were found in infertile males. However, no significant difference was observed in leptin levels (p‐value = 0.35). Leptin levels were significantly higher, and all the sex hormones were significantly lower (p‐value < 0.001) in obese subjects, whereas according to BF% only leptin, FSH and SHBG were significantly different. Leptin showed a significant positive correlation with BMI and BF% (p < 0.001). A strong positive link to serum testosterone was found with age, FSH, and LH (p < 0.001) and a negative one with BMI and BF% (p < 0.001). In mutivariable anlaysis, after adjusting for the other covariates, a significant association between FSH and testosterone (p‐value <0.001) was found. Serum leptin levels did not differ significantly in fertile and infertile groups, and no association was found with infertility. Furthermore, male obesity was found to be associated with infertility with the decrease in levels of sex hormones.     

Effect of psychological stress on fertility hormones and seminal quality in male partners of infertile couples

The present study evaluated the effect of psychological stress on male fertility hormones and seminal quality in male partner of infertile couples. Seventy male partners of infertile couples were evaluated for level of psychological stress using Hospital Anxiety and Depression Score (HADS) questionnaire, serum total testosterone, luteinising hormone (LH) and follicle‐stimulating hormone (FSH) by electrochemiluminescence assay and serum GnRH by ELISA. Seminal analysis was performed as per WHO guideline. Nineteen (27%) of them had HADS anxiety and depression score ≥8 (abnormal HADS score). The persons having abnormal HADS had lower serum total testosterone, higher serum FSH and LH than those of persons having normal HADS. Serum total testosterone correlated negatively with HADS, but LH and FSH correlated positively. There was no change in GnRH with the change in stress or testosterone levels. Sperm count, motility and morphologically normal spermatozoa were lower in persons having abnormal HADS. Sperm count correlated positively with total testosterone and negatively with FSH and LH. Abnormal sperm motility and morphology were related to lower testosterone and higher LH and FSH levels. Psychological stress primarily lowers serum total testosterone level with secondary rise in serum LH and FSH levels altering seminal quality. Stress management is warranted for male infertility cases.     

Relationship between body mass index,waist circumference and waist to hip ratio and the steroid hormone receptor status in breast carcinoma of pre- and postmenopausal women

ObjectiveTo assess whether body mass index (BMI), waist circumference (WC) and waist to hip ratio (WRH) are associated to the steroid receptor status in breast carcinomas.MethodsFour hundred and seventy three women with breast malignancies stage I–III were included. Weight, height, the waist and hip circumferences (WC), body mass index (BMI), and the waist to hip ratio (WHR) were determined. The expression of estrogen (ER) and progesterone (PR) receptors was determined with immunohistochemistry.ResultsMost women had central obesity (WC ≥ 88 and WHR ≥ 0.85 in 64.3 and 73.4%, respectively). The majority (78.1%) of the women had tumors that expressed at least one of the HR. BMI, WC and WHP were not related to the HR status in neither the pre- or postmenopausal women. Multivariate analysis confirmed these findings.ConclusionsBMI, WC or WHR may not be good predictors of HR status in breast malignancies in either pre- or postmenopausal women.     

Effect of abamectin exposure on semen parameters indicative of reduced sperm maturity: a study on farmworkers in Antalya (Turkey)

Environmental exposure to pesticides may cause serious health risks including fertility and reproductive function. The aim of this study was to highlight whether there is a relationship between exposure to abamectin and male fertility parameters of farmworkers. Twenty male farmworkers who were using abamectin and 20 men not exposed to pesticides were recruited as experimental and control groups, respectively. Semen analysis, molecular markers of sperm maturity and serum reproductive hormone levels were evaluated. In experimental group, high plasma abamectin levels were detected. These men have decreased sperm motility. Moreover, diminished molecular markers of sperm maturity, such as decreased hyaluronic acid (HA) binding of sperm, increased numbers of aniline blue positive sperm and increased percentage of creatine kinase (CK) positive sperm, were observed in abamectin‐exposed men. Their serum testosterone, LH and FSH levels did not change significantly. We conclude that exposure to abamectin may impair male fertility by effecting semen quality.     

50例正常生育力男子精液和血液激素的一年动态观察

作者对南京市50名正常男子,每月1次、连续12个月测定了精液常规、某些精液生化和血清激素水平。结果表明:精子密度每次之间波动范围较大,冬季数值比夏季显著为高(P<0.01)。其它指标包括正常形态精子、活动精子、前向运动级别、精液果糖、硷性磷酸酶、酸性磷酸酶及血清,FSH LH T 则变动不显著。精液常规中除精子密度和各参数关系不明显外,所有其它参数之间呈正相关;但精液常规、精液生化和血清激素三者互不相关。从本组研究结果,作者提出了南京市正常男子这些指标的参考正常值。     

Predictors of improved seminal characteristics by varicocele repair

The aim of this study was to investigate predictors of the improvement of semen characteristics after low ligation for patients with varicoceles. The records of 97 oligozoospermic patients who underwent microsurgical left or bilateral inguinal varicocele repair were retrospectively evaluated. We assessed factors that could be predictors of the improvement of semen characteristics using logistic regression analysis. We evaluated age, testicular volume, varicocele grade, serum follicle-stimulating hormone (FSH), luteinising hormone, testosterone, sperm concentration and motility before low ligation. Among the 97 patients, sperm concentration improved from 6.4 ± 5.8 to 24.2 ± 35.1 million ml⁻¹ and sperm motility increased from 32.8 ± 24.9% to 41.0 ± 14.6% in 55 patients (57%). In logistic regression analysis, pre-operative serum FSH and testosterone concentration were predictors of sperm concentration improvement. Varicocele repair improved sperm concentration and motility. Low serum FSH and high testosterone are significant factors predicting the improvement of semen characteristics before low ligation.     

Testicular function in men treated in childhood for undescended testes

PURPOSE: The aim of the study was to evaluate testicular hormones and sperm counts of young men treated in childhood for cryptorchidism METHODS: Testicular volume, serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone as well as semen specimens were evaluated in 57 men (mean age, 19 years; range, 18 to 27 years) treated in childhood for unilateral (n = 47) and bilateral (n = 10) cryptorchidism. In 3 unilateral cases monorchidism was found. Thirty-seven patients underwent orchiopexy after hormonal treatment (luteinizing hormone releasing factor, 1.2 mg/d for 28 days followed by human chorionic gonadotropin, 500 IU intramuscularly 3 times a week for 3 weeks). The remainder underwent surgery. Mean age at surgical treatment was 5.4 years (range, 2 to 12 years). These patients were examinated again after a mean period of 13.3 years (range, 10 to 19 years). RESULTS: Reduced testicular volume (<12 mL) was found in 6 of 64 testes (9.3%). LH, FSH, and testosterone levels were found within the normal range in all patients. With linear regression, inverse relations were found between FSH and, respectively, testicular volume (P =.002), sperm concentration (P =.013), sperm motility (P =.023), and normally shaped sperms (P =.019). There were direct relations between testicular volume and sperm concentration (P =.02), sperm motility (P =.000), and normally shaped sperms (P =.001). We did not find any statistical correlation between age at surgery and semen quality. Significantly better results in terms of sperm counts were found in patients directly operated on in comparison to those treated with hormones before orchiopexy. CONCLUSIONS: Presented data indicate tubular impairment in young men operated on in childhood for cryptorchidism; FSH values increase and testicular volume decrease are related to sperm deterioration. Studies on children treated in the first 2 years of life are required to clarify the usefulness of early treatment of cryptorchidism.     

Impact of body mass index on seminal oxidative stress

Male obesity has been linked with a reduction in sperm concentration and motility, an increase in sperm DNA damage and changes in reproductive hormones. Recent large observational studies have linked male obesity with a reduced chance of becoming a father. One of the potential underlying pathological mechanisms behind diminished reproductive performance in obese men is sperm oxidative stress. The primary aim of this study was to determine if sperm oxidative stress was more common in obese/overweight men. A total of 81 men had their body mass index (BMI) correlated with seminal reactive oxygen species (ROS) production (Nitro Blue Tetrazolium assay), sperm DNA damage (TUNEL), markers of semen inflammation (CD45, seminal plasma PMN elastase and neopterin concentration) and routine sperm parameters, together with reproductive hormones. The principal finding from this study was that oxidative stress did increase with an increase in BMI, primarily due to an increase in seminal macrophage activation. However, the magnitude of this increase was small and only of minor clinical significance as there was no associated decline in sperm DNA integrity or sperm motility with increasing ROS production. Increased BMI was also found to be significantly linked with a fall in sperm concentration and serum testosterone, and an increase in serum oestradiol.     

Effect of body weight on testosterone/estradiol ratio in oligozoospermic patients

To evaluate the effect of body mass on the hormonal and semen profiles of subfertile men with oligozoospemia, sperm concentration and reproductive hormone levels were compared in two body mass index (BMI) groups: underweight or normal weight patients (BMI = 25 kg/m2) vs. overweight or obese patients (BMI > 25 kg/m2). The mean BMI was 27 +/- 4.6 kg/m2. The testosterone/estradiol ratio was significantly reduced in the high BMI group as compared to the low BMI group (17 +/- 4 vs. 12 +/- 3; p < 0.05). A similar difference was found in the sperm concentration (11.2 +/- 3.16 x 10(6)/ml vs. 8.1 +/- 2.6 x 10(6)/ml). A nonsignificant difference was found in the LH/FSH ratio (1.41 +/- 0.64 vs. 1.63 +/- 0.72). We concluded that obesity and the consequent estrogen excess decrease the sperm concentration by influencing the hypothalamo-pituitary system.