Prevalences of oligozoospermia and azoospermia in male partners of infertile couples from different parts of India

Aim:To determine whether there was any regional variation in the prevalence of azoospermia,oligozoospermia andmean sperm counts in male partners of infertile couples from different parts of India.Methods:Data on 16 714semen samples analyzed over the past five years from six different laboratories located in five cities of India werecollated and evaluated.Results:There was a regional variation in the prevalence of azoospermia.The prevalence ofazoospermia was extremely high in Kurnool and Jodhpur(38.3% and 37.4%,respectively).There was also aregional variation in the prevalence of oligozoospermia(51%)in Kurnool.There was no significant difference in themean sperm counts in normospermic men.Conclusion:There is a regional variation in the prevalence of azoosper-mia and oligozoospermia in the male partners of infertile couples from different regions of India.The prevalence ofazoospermia in Kurnool and Jodhpur is higher than any other worldwide reported literature.Further studies need tobe carried out to determine the cause of this.(Asian J Androl 2006 Jan;8:89-93)     

Relationships between personality traits,seminal parameters and hormones in male infertility

In this study we investigated the relationship between personality attitudes, psychopathological symptoms and biological parameters in male infertility. Eighty-four infertile men underwent a psychological and medical examination at our clinic. The psychological tests comprised the Symptom Checklist 90-R, the Toronto Alexithymia Scale and the NEO-Five Factor Inventory. Seminal parameters, gonadotrophins, sex steroids, cortisol and prolactin were analyzed to obtain biological data. Compared with questionnaires completed by normal populations those in the study group scored higher on the scales for 'conscientiousness', 'agreeableness', 'alexithymia' and 'somatization' and lower on the scale for 'neuroticism'. Regarding psychobiological correlations we found a negative correlation between seminal parameters and 'extraversion', 'anxiety' and 'psychoticism'. 'Alexithymia' was negatively correlated with stress hormones and 'conscientiousness' was correlated with sex steroids. The findings suggest above average social competence in the study group. The psychobiological correlations indicate a link between social-competence-related personality traits such as 'extraversion' and 'conscientiousness' and biological fertility characteristics. Implications of a higher alexithymia in infertile men, which is negatively correlated with stress hormones, are discussed.     

氧化应激损伤在男性不育症中的影响

造成精子数量、质量及生殖机能下降的原因十分复杂。随着自由基理论的建立和发展,研究者们逐渐发现活性氧介导的氧化应激对精子的损伤作用可能是男性不育的发病原因之一。本文将对氧化应激损伤在男性不育症中的影响进行阐述。     

Relationship between seminal ascorbic acid and sperm DNA integrity in infertile men

Ascorbic acid has recently been reported to protect sperm DNA from the damage induced by exogenous oxidative stress in vitro. But, there is no report on seminal ascorbic acid and sperm DNA fragmentation in infertile men. In this study, we asked whether sperm DNA damage correlates with seminal ascorbic acid levels. Sperm DNA fragmentation index (DFI) was analysed in 75 men by flow cytometry after acridine orange staining. We also measured the levels of seminal plasma ascorbic acid and total antioxidant capacity. Abnormal sperm DNA integrity (DFI >or= 30%) was observed in 12% of the patients with normal semen parameters and in 52% of the patients with abnormal semen parameters. There were significant correlations between the level of DFI and conventional semen parameters including sperm count, motility and morphology (r = -0.29, -0.55 and -0.53 respectively; p < 0.05). Seminal ascorbic acid level was significantly lower in the patients with leucospermia than the patient with normal semen parameters. Interestingly, a significantly greater percentage of men with abnormal DFI were observed in the patients with low levels of seminal ascorbic acid compared with those with normal or high levels of ascorbic acid (59% vs. 33%, p < 0.05). Men with insufficient seminal ascorbic acid frequently have sperm DNA damage.     

Teratozoospermia and its effect on male fertility potential

Teratozoospermia and its significance for male fertility problems is discussed. Different points of view and available information concerning the phenomenon of teratozoospermia have been presented. Ongoing debate about the influence of sperm morphology on male infertility and IVF results emphasizes the fact that when sperm morphology is evaluated using strict criteria, this parameter is thought to have an excellent predictive value and shows a significant positive correlation with successful fertilization. Selective abilities of zona pellucida to differentiate between morphologically normal and abnormal spermatozoa, the superior role of acrosomal morphology assessment in the prediction of IVF outcome, and the involvement of cell surface molecules in the adhesion of spermatozoa to oocytes are described. The usefulness of the hamster oocyte penetration assay (HOPA), which is important not only because of its predictive value of sperm function, but also because of its role as a tool for visualizing sperm chromosomes, was found to be questionable in cases of teratozoospermia. Cytogenetic findings related to teratozoospermia are controversial as classical methodology of visualizing sperm chromosomes (through HOPA) may cause selection of sperm metaphases which can be obtained only from good-penetrating spermatozoa. There are few reports presenting chromosome complements of abnormal sperm visualized with the help of micromanipulation. There is clear evidence that a variety of genetic defects can affect spermatogenesis. The possible genetic background of teratozoospermia is discussed.     

Assay of total glutathione and glutathione disulphide in seminal plasma of male partners of couples presenting for a fertility evaluation

A method is described here for the determination of total glutathione (TGSH) and glutathione disulphide (GSSG) in the seminal plasma of the male partners of couples requesting a fertility evaluation. A suitable sample preparation procedure prior to high‐performance liquid chromatography analysis is discussed. After adequate sample preparation, the samples were derivatised with ortho‐phthaldialdehyde to form a stable, highly fluorescent tricyclic derivative. Reversed‐phase column chromatography was used for the separation, and the effluent was monitored with a fluorescence detector at an excitation wavelength of 350 nm and an emission wavelength of 420 nm. The analytical performance of this method was satisfactory. The intra‐assay and inter‐assay coefficients of variation were below 10%. The recoveries were as follows: 94.1% (CV 2.3%) for TGSH and 93.2% (CV 4.0%) for GSSG. No significant differences were found in either TGSH or GSSG concentration between the smokers and nonsmokers (2.07 ± 1.28 μm versus 1.56 ± 1.20 μm , P = 0.431 and 95 ± 56 nm versus 112 ± 138 nm , P = 0.825).     

Oxidative stress status and sperm DNA fragmentation in fertile and infertile men

Evidence suggests that disturbing the balance between reactive oxygen species levels and antioxidant contents in seminal plasma leads to oxidative stress resulting in male infertility. This study was carried out to identifying clinical significance of seminal oxidative stress and sperm DNA fragmentation in treatment strategies of male infertility in southwest Iran. Sperm parameters, lipid peroxidation and activity of antioxidant enzymes were assessed in fertile (n = 105) and infertile (n = 112) men. Malondialdehyde (MDA) levels in seminal plasma were found to be higher significantly (p < .001) in patients. Superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities in seminal plasma were significantly (p < .001) lower in infertile men. Significant negative correlations were observed between MDA levels and sperm motility and normal morphology. Spermatozoa with fragmented DNA were higher (p < .001) in infertile men and significantly correlated with MDA levels and SOD and GPx activities. MDA of 4.2 nmol/ml, SOD of 4.89 U/ml and GPx of 329.6 mU/ml were optimum cut‐off limits to discriminate infertile patients from fertile men. The results show the leading role of oxidative stress in aetiology of male infertility in southwest Iran and indicate that evaluation of seminal antioxidant status and DNA integrity can be helpful in men attending infertility clinics during fertility assessment.     

Function of seminal vesicles and their role on male fertility

The present review has been designed to update the recent developments on the function of seminal vesicles and their role on male fertility. It is indicated that the true corrected fructose level is a simple method for the assessment of the seminal vesicular function. Measttrement of seminal fructose used universally as a marker of the seminal vesicle function is not an appropriate approach due to its inverse relationship with the sperm count. The llue corrected fructose defined as [ log. motile sperm concentration ] multiplied by [ seminal fructose concentration ] has been shown to be a better marker of the seminal vesicle function. Seminal vesicular secretion is important for semen coagulation, sperm motility, and stability of sperm chromatin and suppression of the immune activity in the female reproductive tract. In conclusion, the function of seminal vesicle is important for fertility. Parameters as sperm motility, sperm chromatin stability, and immuno-protection may be changed in case of its hypofunction.     

Association of seminal angiotensinogen with sperm motility and morphology in male infertility

Many researchers have shown that renin–angiotensin system (RAS) is involved in various important aspects of male reproduction. In this study, we assessed whether abnormal levels of seminal angiotensinogen (AGT) may be associated with semen parameters in infertile males. A total of 115 male patients were recruited, and semen parameters, seminal AGT and the electrolytes including K⁺, Na⁺, Cl^?, P and Ca were evaluated. According to the World Health Organization (WHO) 2010 criteria, the patients were divided into two groups: G1 group with normal semen parameters (n = 42) and G2 group with subnormal semen parameters (n = 73). The level of seminal AGT was significantly higher in G2 group compared with G1 group. Moreover, the level of AGT was negatively correlated with the percentage of total motility (r = ?.322, p = .000), progressive motility (PR) (r = ?.339, p = .000) and morphologically normal forms (r = ?.263, p = .004). This study suggests that elevated seminal AGT level is associated with increased risk of asthenospermia and teratozoospermia.     

Leptin levels in infertile male patients are correlated with inhibin B, testosterone and SHBG but not with sperm characteristics

In the present study, differences in leptin levels between different groups of male patients presenting with infertility problems and possible correlations between leptin levels and clinical, spermiological, histological and hormonal characteristics were examined. Two hundred and ten male partners from infertile couples were included in the study. Based on clinical examination, spermiogram and testicular histology results, patients were divided into four groups: 42 men with non-obstructive azoospermia, 15 men with obstructive azoospermia, 68 men with oligoasthenoteratozoospermia and 85 men with normozoospermia. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, testosterone, sex hormone binding globulin (SHBG) and leptin were measured. After adjustment for body mass index, there was a negative correlation between serum levels of leptin and inhibin B, total testosterone and SHBG (r = -0.189, p = 0.009, r = -0.250, p = 0.001 and r =-0.221, p = 0.003 respectively) but there was no correlation between leptin and classical sperm characteristics. Our results therefore demonstrate a link between leptin and testicular function, independently of FSH and LH, possibly involving testosterone and SHBG through a regulation of Leydig cell function.     

宁夏不育群体男性生育力与指长比关系的初步调查

目的:探讨指长比与男性生育力的关系。方法:采用电子游标卡尺测量136例宁夏地区不育群体男性左右手各指长。其中精液正常男性45例;需要助孕的精液异常男性91例包括少弱精子症28例、阻塞性无精子症(OA)10例、非阻塞性无精子症(NOA)53例,比较组间各指长比(D2∶D3、D2∶D4、D2∶D5、D3∶D4、D3∶D5、D4∶D5)差异。结果:不育群体男性左、右手指长比均呈现D2∶D3少弱精子症组>OA组>精液正常组趋势;D3∶D5呈NOA组>OA组>少弱精子症组>精液正常组趋势。NOA组右手D2∶D3、D2∶D4、D3∶D5、D4∶D5显著高于精液正常组,D2∶D4、D3∶D5、D4∶D5显著高于少弱精子症组,D2∶D3显著高于OA组(P<0.05)。右手D4∶D5汉族高于回族(t=2.01,P<0.05)。结论:男性右手高D2∶D3、D2∶D4、D2∶D5、D3∶D5、D4∶D5指长比与宁夏地区不育群体男性生育力降低有关。指长比可反映男性的生精功能和生育力。不孕群体男性不同民族间右手D3∶D4、D4∶D5指长比可能存在差异。     

Chlamydia trachomatis infection as a problem among male partners of infertile couples

Chlamydia trachomatis infection is the most common bacterial sexually transmitted disease supposed to cause urethritis, epididymitis, prostatitis and infertility in men. The objective of this study was to assess the frequency of C. trachomatis infection in male partners of infertile couples at childbearing age. Sixty infertile couples and a control group of 40 healthy volunteers were included in the study. Urethral swabs were taken from all the male participants and cervical swabs from the female partners of the infertile couples. Culturing on McCoy cell line and PCR were the methods used for detection of the infection. C. trachomatis was found in five out of the 60 male urethral samples. Three of the female partners of these five positive males were diagnosed with C. trachomatis infection, too. We registered a woman with C. trachomatis infection whose partner's samples were negative for the bacterium. The control group showed one specimen positive for C. trachomatis . The frequency of C. trachomatis infection was 8.3% in the male partners of infertile couples at childbearing age when compared with 2.5% in the control group. It is most likely that infertility in the couples with chlamydial infection was due to the pathogen studied.     

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.     

Sperm aneuploidy in infertile male patients: a systematic review of the literature

Males with abnormal karyotypes and subgroups of fertile and infertile males with normal karyotypes may be at risk of producing unbalanced or aneuploid spermatozoa. Biological, clinical, environmental and other factors may also cause additional sperm aneuploidy. However, increased risk of sperm aneuploidy is directly related to chromosomally abnormal embryo production and hence to poor reproductive potential. This systemic literature review focuses on the identification of these males because this is an essential step in the context of assisted reproduction. This research may allow for a more personalised and, hence, more accurate estimation of the risk involved in each case, which in turn will aid genetic counselling for affected couples and help with informed decision‐making.     

An additional marker for sperm DNA quality evaluation in spermatozoa of male partners of couples undergoing assisted reproduction technique (IVF/ICSI): Protamine ratio

The aim of this study was to evaluate the relationship between the protamine ratio (P1/P2), DNA fragmentation of spermatozoa and protamine deficiency. Patients were grouped into fertile (G1; n = 151) and sub‐fertile (G2; n = 121). DNA fragmentation in spermatozoa was analysed by a TUNEL assay (terminal deoxynucleotidyl transferase‐mediated deoxyuridine triphosphate nick‐end labelling), and the protamination was determined by CMA3 staining, while Western blot was used to measure protamine P1 and P2. While sperm DNA fragmentation (SDF) and protamine ratio were significantly elevated in G2 compared with G1 (12.31 ± 7.01% vs. 17.5 ± 9.5%; p = .001) and (0.91 ± 0.43 vs. 0.75 ± 0.42; p = .003); respectively, the CMA3 positive showed no difference at all between G1 and G2. In G1, the CMA3 positive correlated negatively with the P1/P2 ratio and SDF (r = ?.586, r = ?.297; p = .001 respectively). In contrast, the protamine ratio correlated positively with SDF (r = .356; p = .001). In G2, no correlation was observed between CMA3 positive, SDF and the P1/P2 ratio but the P1/P2 ratio showed a positive correlation with SDF (r = .479; p = .001). In conclusion, the spermatozoa DNA deterioration was closely associated with abnormal protamination but showed an association with the protamine ratio, more than with CMA3 positive. Therefore, for the evaluation of DNA damage in spermatozoa, the P1/P2 ratio might act as an additional biomarker.     

Cytogenetic and andrological status and ICSI-results in couples with severe male factor infertility

Aim: To pursue whether cytogenetic aberrations correlate with specific spermatological or hormonal abnormalities.Methods: 305 infertile couples were investigated. All male partners were referred to a complete andrological workup with physical examination, determination of hormones, HIV testing and semen analysis. Cytogenetic analysis was carried out in both partners by means of standard techniques using cultured lymphocytes from peripheral blood. Results: Among the 305 couples, 10 men (3.2%) and 10 women (3.2%) showed constitutional chromosomal aberrations, including reciprocal translocations (n=7), Robertsonian translocations (n=3), inversions (n=3), other structural aberrations (n=4) and sex chromosome aberrations (n=3). In addition to the impaired sperm count in most of the patients, a tendency to an increased proportion of spermatozoa with acrosome defect was observed. Conclusion. Chromosomal aberrations may contribute to the low fertilization and pregnancy rates in the infertile couples.(Asian J Androl 2000 Dec;2:293-296)     

Characteristics of male fertility after renal transplantation

We investigated factors such as time span between transplantation and having offspring, the dosage of immunosuppressive agents during fertilisation and the effects of fertilisation on recipient's renal allograft function in 212 male recipients registered at eight Chinese organ transplantation centres. Our results are as follows: the 212 male renal allograft recipients conceived with their wives between 15 and 204 months after transplantation. The wives who became pregnant at 15-24 months after the renal transplantation gave birth to a total of 20 babies with an average weight of 3115 ± 517 g, of which 3 (15.0%) were premature. The wives who became pregnant at 25-204 months after the renal transplantation gave birth to a total of 196 babies with an average weight of 3384 ± 438 g, of which 6 (3.1%) were premature. All recipients had normal renal function during the fertile period. In conclusion, the fertility capacity of male renal allograft recipients was associated with the time after transplantation and the dose of immunosuppressive agents used during fertilisation. It might be helpful to have a fertility capacity evaluation before fertilisation. There were no effects of fertility on renal allograft function.     

男性不育伴慢性病毒性肝炎患者血清和精液氧化应激水平及相关参数分析

目的:探讨男性不育伴慢性病毒性肝炎患者血清和精液丙二醛(MDA)、对氧磷酶-1(PON-1)水平及对精液相关参数的影响。方法:选择有生育力的男性健康对照组50例,男性不育组42例,男性不育伴慢性病毒性肝炎组45例,采用分光光度法测定血清和精浆MDA水平、PON-1活性,采用吖啶橙荧光染色法测定精子DNA碎片化指数(DFI)。结果:不育伴肝炎组血清和精浆MDA水平明显高于对照组和不育组(P<0.01和P<0.05),而PON-1活性明显低于对照组和不育组(P<0.01和P<0.05)。不育伴肝炎组精子活动率、精子存活率均明显低于对照组和不育组(P<0.01和P<0.05),而精子DFI明显高于对照组和不育组(P<0.01和P<0.05)。三组精子浓度无显著性差异(P>0.05);不育组与不育伴肝炎组精液WBC显著高于对照组(P<0.05)。男性不育伴慢性病毒性肝炎组精浆中的MDA水平、PON-1活性分别与血清中的MDA和PON-1呈显著正相关(r=0.57和0.48,P<0.01)。结论:病毒引起慢性活动性肝炎会使生殖系统氧化应激加强,加重对精子的损害,影响精子质量。