A COMPARATIVE STUDY ON INTERRELATIONS AMONG MICROELEMENTS,INFECTION OF UREAPLASMA UREALYTICUM,AND MALE INFERTILITY

This study investigated the association among male infertility, infection of Ureaplasma urealyticum (Uu), and microelements in semen fluid. Semen analysis and cultivation of Uu are carried out to 165 samples of semen fluid. Then the contents of microelements, such as Cu, Fe, Se, Cd, Mn, and Zn, in the samples are measured respectively by an Inductively Coupled Plasma Quantometer (ICP). The contents of Fe, Se, and Zn in seminal plasma of the normal spermatic quality group are obviously higher than those of the poor spermatic quality group ( p <.05), while the content of Cd in seminal plasma of the normal spermatic quality group is obviously lower than that of the poor spermatic quality group ( p <.05), and the contents of Cu and Mn show no difference. The contents of Zn, Se, and Cu in seminal plasma infected with Uu are markedly lower than those of seminal plasma not infected with Uu ( p <.05), while the content of Cd in seminal plasma infected with Uu is obviously higher than that in samples not infected with Uu, and the contents of Fe and Mn show no statistic difference. The contents of Zn and Se in seminal plasma of the poor spermatic qualitative semen that were infected with Uu are obviously lower than those of seminal plasma not infected with Uu ( p <.05), while the content of Cd in seminal plasma of the poor spermatic qualitative semen with Uu infection is markedly higher than that of the normal seminal plasma ( p <.05). Uu infection leads to the decrease of the contents of Zn and Se in semen fluid, and therefore causes spermatic quality decline. Lack of Fe or overdose of Cd may also contribute to spermatic quality decline.     

A comparison of ejaculated and testicular spermatozoa aneuploidy rates in patients with high sperm DNA damage

Testicular spermatozoa are utilized to achieve pregnancy in couples with severe male factor infertility. Several studies suggest that aneuploidy rates in spermatozoa are elevated at the testicular level in infertile patients compared to ejaculates of normal controls. However, essential data regarding aneuploidy rates between ejaculated and testicular spermatozoa in the same individuals is lacking. The purpose of our study was to compare aneuploidy rates at the testicular and post-testicular level from the same patients with persistently high sperm DNA damage. Ejaculates and testicular biopsies were obtained from eight patients with persistently high DNA damage (>30%). Both ejaculated and testicular samples were analyzed for sperm DNA damage and sperm aneuploidy for chromosomes 13, 18, 21, X, and Y. In addition, semen samples from ten normozoospermic men presenting for fertility evaluation served as a control group. A strong correlation between the alteration of spermatogenesis and chromatin deterioration was observed in our study. In the same individuals, testicular samples showed a significantly lower DNA damage compared to ejaculated spermatozoa (14.9%?±?5.0 vs. 40.6%?±?14.8, P?<?0.05), but significantly higher aneuploidy rates for the five analyzed chromosomes (12.41%?±?3.7 vs. 5.77%?±?1.2, P?<?0.05). While testicular spermatozoa appear favourable for ICSI in terms of lower DNA damage, this potential advantage could be offset by the higher aneuploidy rates in testicular spermatozoa.     

Relationship Between Hypoosmotic Swelling Test,Semen Analysis,and Zona-Free Hamster Ovum Test

The hypoosmotic swelling test is a simple test for measuring the functional competence of the human sperm membrane. Fifty-four patients with idiopathic infertility were assessed by hypoosmotic swelling test and the results were compared with those of routine semen analysis and zona-free hamster ovum human sperm penetration test (ZSPT). Semen samples with abnormal semen parameters had lower percentage of swollen sperm in comparison with those with normal semen parameters. A positive correlation was observed between sperm concentration and sperm swelling (r -. 50, p <. 05). A strong positive correlation was observed between the percentage of sperm motility and the percentage of swollen sperm (r - 0.60, p <. 01), and between motile sperm concentration and sperm swelling (r -. 62, p <. 01). On the other hand, sperm swelling correlated only weakly with the percentage of sperm penetration. The results indicate that the hypoosmotic swelling test appears to evaluate different functional qualities of sperm than ZSPT.     

PHOSPHOLIPID COMPOSITION OF HUMAN SPERM AND SEMINAL PLASMA IN RELATION TO SPERM FERTILITY

The phospholipid and fatty acid composition of sperm was studied in 8 healthy and 16 infertile men. Infertile men randomly formed from the patients with normal semen parameters according to WHO criterion. Therefore, all semen parameters of infertile patients were similar to the same characteristics of the semen of healthy men, except the abnormal forms. The amount of abnormal forms in infertile men was significantly higher than in healthy men. Sperm from infertile men show a drastic loss of phosphatidyl ethanolamine. At the same time, the significant increase of phosphatidyl serine in the sperm and seminal plasma of sterile patients was found. Lysophosphatidyl serine in the sperm of the infertile men was detected. Fatty acid composition of the semen of infertile men was altered. The levels of stearic and n-3 polyunsaturated fatty acids (eicosopentaenoic and docosahexaenoic acids) was dramatically lowered, but the values of some n-6 polyunsaturated fatty acids (linolenic and docosatetraenoic) acids increased. There was significant positive correlation between docosahexaenoic acid and sperm motility (r =. 82, p &lt;. 001) and negative correlation between linolenic acid and spermatozoa motility (r=-0.58, p&lt;.05). Infertility of men with normal semen quality can originate from the disorder of sperm lipid metabolism. The drastic loss of phosphatidyl ethanolamine and n-3 polyunsaturated fatty acids with simultaneous enhancement of phosphatidyl serine and some n - 6 polyunsaturated fatty acids in sperm could be an important cause of male infertility.     

SPERM MORPHOLOGY AND CHROMATIN CONDENSATION BEFORE AND AFTER SEMEN PROCESSING

Semen analysis constitutes the most important investigation of male infertility. However, the true anomalies present in defective sperm cells have been only partially characterized. The integrity of the sperm chromatin may play the most important role, particularly in ICSI, where most of the natural selection mechanisms are bypassed. This study was carried out to characterize sperm morphology (strict criteria), to evaluate chromatin condensation and sperm count in native semen as well as after semen preparation by the swim-up technique, and to eventually evaluate any correlation between these parameters. Semen from 90 men was analyzed for the above parameters in both the fresh and processed semen. Whereas the sperm count decreased after sperm preparation by the swim-up technique in comparison to the value in the fresh semen (p&lt;.001), there was an increase in the percentage of morphologically normal (p&lt;.001) and chromatin-condensed sperm (p=.99). However, there was no correlation between sperm morphology, chromatin condensation, and sperm count either in the fresh or in the processed semen samples. These results suggest that sperm morphology, sperm count, and chromatin condensation are independent parameters that should be evaluated separately in the assessment of male fertility in an assisted reproduction program.     

解脲支原体感染与精液质量关系临床研究

目的 探讨解脲支原体感染对精液质量的影响.方法 选2010年3月～2011年12月在某院就诊的不育男性患者163例,同时收集147例正常生育男性作为对照组,比较两组人群解腺支原体感染情况,同时比较不育组阳性者与对照组阴性者精液参数.结果 解脲支原体感染与患者不育存在显著的相关(P＜0.01);不育组UU阳性者与生育组UU阴性者精液量、pH值,差异无统计学意义(P＞0.05);不育组UU阳性者精子密度、精子活动率、a+b均显著低于生育组UU阴性者,差异均有统计学意义(P＜0.05);而精子畸形率显著高于生育组UU阴性者,差异有统计学意义(P＜0.05).结论 解脲支原体感染可严重影患者的精液质量,造成男性患者的不育.     

The psychological correlates of psychogenic impotence: A retrospective comparison of psychologenically and organically impotent men

Although there are psychogenic consequences of impotence for all impotent men, it is assumed that the psychogenic causes of impotence will only be evident in those men diagnosed as psychogenically impotent. Research into the psychogenic causes of impotence has been sparse. We developed a model of psychogenic impotence, and compared a group of organically impotent men and a group of psychogenically impotent men. Ninety subjects were selected from those referred to our multi-disciplinary sexual dysfunction clinic. It was hypothesised that psychogenically impotent men would score higher in the categories of problems with sexuality, interactional problems, lovemaking and relationship problems, companionship, friendship and partnership problems, problems in the family situation, and life stresses: and, that organically impotent men would score higher in the health problems category. The results suggested that interactional problems between patient and partner were common to both diagnostic groups, and that in all other categories (with the exception of health problems) psychogenically impotent men experienced more difficulty (p<.05). Organically impotent men, as expected, exhibited more health problems (p<.05); however, a large number of psychogenically impotent patients suffered from the same health problems. It was suggested that some psychogenically impotent men suffered from an insidious organic deterioration which was undectable at the time of diagnosis, and that with the progress of time, the diagnosis of some of these patients might change to organic impotence.Supported by a grant from the Medical Research Council of Canada.     

Human Sperm Velocity and Postinsemination Cervical Mucus Test in the Evaluation of the Infertile Couple

Homologous artificial insemination (A1H) followed by postinsemination cervical mucus test (PIT) was performed in 100 couples in a prospective study to evaluate suspected cervical or male factor infertility. A portion of the ejaculate was submitted for standard semen analysis as well as turbidimetric analysis of sperm velocity. In a review of 333 cases evaluated for infertility, the average sperm velocity in a normal semen analysis was 96.5 μ/sec, for those with normal postcoital test (PCT) 96.6 μ/sec, and in those that established a pregnancy 91.6 μ/sec. These are significantly higher than the values obtained for abnormal semen analysis and abnormal PCT (64.6 and 63.6 μ/sec, respectively; p < 0.001).

Patients with normal PIT (WHO criteria for normal PCT consisting of ≥ 7 motile sperm/hpf) had sperm velocity of 87 μ/sec compared to velocities of 46 μ/sec for abnormal PIT (p < 0.001). Four of the five patients with abnormal PIT (in spite of normal semen analysis and normal cervical mucus) had sperm velocities < 75 μ/sec. Likewise, all 8 patients who had normal PIT in spite of abnormal semen analysis had sperm velocities > 75 μ/sec, even though the sperm motility was below normal in 5 of them. Sperm velocity is a more sensitive indicator of sperm function when compared to standard semen analysis results.     

INTERLEUKIN-6 (IL-6) IN SEMINAL PLASMA OF INFERTILE MEN,AND LIPID PEROXIDATION OF THEIR SPERM

Concentrations of tumor necrosis factor- &#102 (TNF- &#102 ) and interleukin-6 (IL-6) in seminal fluid, as well as levels of sperm lipid membrane peroxidation, were investigated in fertile and infertile men. Semen samples, obtained by masturbation from 37 infertile and 14 fertile men, were examined for the presence of TNF- &#102 and IL-6. The level of lipid peroxidation of the sperm membrane was measured by determining malondialdehyde (MDA) formation. The correlation between the IL-6 and the TNF- &#102 concentrations in seminal plasma with the levels of lipid peroxidation of the sperm membranes was statistically evaluated. The IL-6 concentration in seminal plasma of infertile men was significantly higher than that of fertile men ( p <. 05). Similarly, the level of membrane lipid peroxidation was higher for the semen of infertile men than that of fertile men ( p <. 001). A significant positive correlation was found between IL-6 levels in seminal plasma and membrane sperm lipid peroxidation ( p <. 002), but not between this parameter and TNF- &#102 levels in seminal plasma. These findings suggest a possible association between IL-6 seminal plasma levels and lipid peroxidation of sperm membrane. Stimulation of reactive species production by human sperm and leucocytes, induced by the high levels of IL-6, could explain these results.     

Determining the association between physical activity prior to conception and pregnancy rate: A systematic review and meta-analysis of prospective cohort studies

Abstract

We investigated the association between physical activity (PA) before pregnancy and pregnancy rate according to intensity and amount of exercise. Eleven prospective cohort studies were included in this meta-analysis. Any amount of moderate-intensity PA was associated with a statistically higher rate of pregnancy compared to that in patients with no PA (p < .05). Any amount of vigorous PA was associated with decreased pregnancy rate; regular PA was associated with decreased infertility (p > .05). In contrast, vigorous PA was associated with increased infertility (p > .05). Therefore, women who are preparing for pregnancy are recommended to perform regular, moderate-intensity PA.     

Zinc levels in seminal plasma are associated with sperm quality in fertile and infertile men

Zinc has antioxidative properties and plays an important role in scavenging reactive oxygen species. We hypothesized that in the absence of Zn, the possibility of increased oxidative damage exists that would contribute to poor sperm quality. Therefore, measurement of seminal Zn in the seminal plasma of males with a history of subfertility or idiopathic infertility is necessary and can be helpful in fertility assessment. The primary objective of the present study was to assess the relationship between Zn levels in seminal plasma with sperm quality in fertile and infertile men. Semen samples were provided by fertile (smoker [n = 17], nonsmoker [n = 19]) and infertile men (smoker [n = 15], nonsmoker [n = 21]). After semen analysis, concentrations of Zn, Mg, Ca, Na, and K in the seminal plasma of all groups were determined by atomic absorption spectroscopy. Element concentrations in seminal plasma of all groups were in the order Na > K > Ca > Zn > Mg. Fertile subjects, smoker or not, demonstrated significantly higher seminal Zn levels than any infertile group (P < .001). A trend was observed for a lower Zn levels in seminal plasma of smokers compared with nonsmokers. Seminal Zn in fertile and infertile (smokers or nonsmokers) males correlated significantly with sperm count (P < .01) and normal morphology of sperm (P < .001). There was a significantly positive correlation between seminal Zn with Ca (P < .01) and K (P < .01) levels in all specimens. In conclusion, poor Zn nutrition may be an important risk factor for low quality of sperm and idiopathic male infertility.     

PACTR结构化管理在男性肿瘤患者生育力保存中的实践与效果

目的探讨PACTR结构化管理在男性肿瘤患者生育力保存中的实践与效果。方法将2016年10~12月在四川省肿瘤医院就诊的男性肿瘤患者纳入对照组(31例),采用传统方式管理。2017年1~3月就诊的男性肿瘤患者纳入研究组(28例),采用PACTR结构化管理(包括评估患者接受度和意愿,考虑不育风险和保存生育能力安全性,结合宣教手册告知患者不育风险,提供生育力保存信息,有意愿者及时转诊给生殖专家)。自设问卷调查研究对象的生育力保存及肿瘤治疗生殖毒性认知,以及生育力保存意愿。结果研究组与对照组的生育力保存意愿相比较,差异有统计学意义(P<0.05)。结论PACTR结构化管理是促进男性肿瘤患者保存生育力的有效举措。     

男性不育症患者生殖道解脲支原体感染与细胞因子、自身抗体的相关性研究

目的:探讨男性不育症生殖道解脲支原体(UU)感染与细胞因子水平及自身抗体的相关性。方法:按WHO的标准对生育组和不育组(包括少精组、弱精组及无精组)进行精液常规分析,解脲支原体培养;采用酶联免疫吸附实验(ELISA)检测血液和(或)精浆IL-2、IL-6、TNF、AcAb的水平;采用混合抗球蛋白反应试验(MAR)法检测AsAb;采用间接免疫荧光(IFA)法检测ANA。结果:与生育组比较,无精组血液和精浆中IL-2、IL-6、TNF-α水平显著增高,其差异具有统计学意义(P<0.01);弱精症组血液及精浆IL-6水平与生育组相比差异有统计学意义(P<0.05),血液及精浆IL-2、TNF-α水平与生育组相比差异无统计学意义(P>0.05);少精症组血液和精浆中IL-2及血清IL-6与生育组相比差异有统计学意义(P<0.05);在生殖道解脲支原体的培养中不育各组的阳性率均高于生育组;在AsAb、AcAb、ANA的检测中,不育症各组的阳性率均高于对照组,用IFA检测ANA阳性结果中发现,ANA核型均为胞浆颗粒/核颗粒型,而弱精症血清以及不育症各组精浆中未检测出AcAb、ANA。结论:男性生殖道UU感染可诱生细胞因子,打破细胞因子间的平衡,引起体内自身抗体的产生;同时也会影响精液质量,与男性不育密切相关;对男性不育症患者上述指标的检测,并探讨感染、细胞因子及自身抗体之间的相关性,可为不育症的诊断与治疗提供实验依据。     

1426例男性不育患者精液常规结果分析

目的对引起男性不育的各种因素进行分析和探讨。方法用北京中科恒业的精液检测系统对1426例不孕不育中心就诊的男性不育患者及107例正常生育者进行精液常规项目分析及统计。结果（1）不育组与正常组结果比较显示两组精液量、pH值差异无统计学意义（P〉0.05）,而精子密度、a＋b级精子活动率比例、正常精子形态百分率三项指标与正常对照组差异有统计学意义（P〈0.05）;（2）将精液白细胞数〉1×109/L设为阳性组,精液白细胞数≤1×109/L设为阴性组,两组间各类精液异常症状比率的差异有统计学意义（P〈0.05）。结论男性不育症患者的精液精子密度、a＋b级精子活动率比例、正常形态精子百分率三项指标与正常对照组均较正常者低。     

CORRELATION OF THE BOVINE CERVICAL MUCUS PENETRATION TEST WITH HUMAN SPERM CHARACTERISTICS IN 1406 EJACULATES

The bovine cervical mucus penetration test (BCMPT) was performed to determine its usefulness in screening the ability of sperm to successfully penetrate mucus in vitro. Ejaculates were obtained by masturbation from patients attending an infertility clinic. Routine semen analysis was performed using a microcomputerized multiple-exposure photography system. The BCMPT was performed. Overall, the average penetration of the mucus was 38+/-0.46 mm. Of the 1406 ejaculates analyzed, 244 (17%) displayed a negative result (0-20 mm), 291 (21%) a questionable result (21-30 mm), and 871 (62%) a positive result (&gt;30 mm). A highly significant (p&lt;.001) correlation between mucus penetration distance and sperm MD (r=0.541), MI (r=0.484), count (r=0.475), motility (r=0.448), velocity (r=0.400) and morphology (r=0.369) was observed. Overall, the finding of an abnormal semen parameter resulted in a 34+/-5% accurate prediction of a negative or questionable BCMPT (&lt;30 mm), while a normal semen parameter resulted in a 90+/-4% accurate prediction of a positive BCMPT (&gt;30 mm). Sperm MD showed the strongest positive predictive value (98%), while morphology showed the greatest negative predictive value (50%). Of the 1406 samples, 25+/-2% of the samples with normal semen parameters displayed a negative BCMPT. Conversely, 6+/-2% of samples with abnormal parameters showed a positive BCMPT. The BCMPT successfully identifies a significant subpopulation of patients as having an inadequate penetration of mucus with otherwise normal semen characteristics.     

ANTIOXIDANT ACTIVITY OF SEMINAL PLASMA IN FERTILE AND INFERTILE MEN

This study was conducted to evaluate and compare the total antioxidant capacity among fertile and infertile men. Thirty infertile patients and 20 fertility-proven healthy donors with normal sperm analysis were included in the study. Total antioxidant capacity, zinc and fructose levels of seminal plasma, and various sperm parameters were compared among fertile controls and idiopathic infertility patients prospectively. The mean antioxidant capacity of fertile controls (2.02 &#45 0.16 mmol/L) was significantly higher than that of the infertile patients group (1.78 &#45 0.23 mmol/L) ( p <.01). Furthermore, asthenozoospermic and asthenoteratozoospermic groups had significantly lower mean antioxidant values (1.73 &#45 0.11 and 1.64 &#45 0.13, respectively) when compared to fertile control group ( p <.01). The mean fructose level was significantly lower in the fertile control group and mean zinc level was significantly lower in the entire infertile group. On the other hand, antioxidant capacity is positively correlated to sperm motility ( p =.001). Decreased antioxidant capacity was associated with impaired sperm function as a result of either increased ROS production or insufficient antioxidant capacity.     

A comparison of ejaculated and testicular spermatozoa aneuploidy rates in patients with high sperm DNA damage

Testicular spermatozoa are utilized to achieve pregnancy in couples with severe male factor infertility. Several studies suggest that aneuploidy rates in spermatozoa are elevated at the testicular level in infertile patients compared to ejaculates of normal controls. However, essential data regarding aneuploidy rates between ejaculated and testicular spermatozoa in the same individuals is lacking. The purpose of our study was to compare aneuploidy rates at the testicular and post-testicular level from the same patients with persistently high sperm DNA damage. Ejaculates and testicular biopsies were obtained from eight patients with persistently high DNA damage (>30%). Both ejaculated and testicular samples were analyzed for sperm DNA damage and sperm aneuploidy for chromosomes 13, 18, 21, X, and Y. In addition, semen samples from ten normozoospermic men presenting for fertility evaluation served as a control group. A strong correlation between the alteration of spermatogenesis and chromatin deterioration was observed in our study. In the same individuals, testicular samples showed a significantly lower DNA damage compared to ejaculated spermatozoa (14.9%?± 5.0 vs. 40.6%?± 14.8, P<0.05), but significantly higher aneuploidy rates for the five analyzed chromosomes (12.41%?± 3.7 vs. 5.77%?± 1.2, P<0.05). While testicular spermatozoa appear favourable for ICSI in terms of lower DNA damage, this potential advantage could be offset by the higher aneuploidy rates in testicular spermatozoa.     

Analysis of PAEs in semen of infertile men

Abstract

Objectives:

Phthalates are environmental chemicals with reproductive toxicity and estrogenic effects in animals. They are of increasing concern to human health.

Aim:

To determine whether phthalate levels in semen were associated with infertility.

Methods:

Using semen samples from 107 infertile and 94 fertile men, the presence and quantity of five phthalate esters were measured using high-performance liquid chromatography (HPLC). Using data collected from questionnaires and clinical examinations, the correlation between phthalate exposure and semen quality was analyzed.

Results:

The cumulative levels of the measured phthalate esters were significantly higher in the infertility group compared to the control group (P<0·05). Concentrations of the five phthalate esters in men varied by age with older men showing higher cumulative levels.

Conclusions:

The presence of phthalates may contribute to male infertility in our study population.     

FERTILIZATION RATES OF SMALL-HEAD SPERM IN CONVENTIONAL IVF AND ICSI

Five men produced 23 ejaculates in 23 assisted reproductive technology cycles for semen analysis. In 11 of the 14 ICSI cycles and in 5 of the 9 IVF cycles, small-head sperm were found in more than 70% of the cells, having a length of <3.5 µm and a width of <2 µm. In 6 of the 14 ICSI cycles, the embryologist who performed the ICSI was not alerted to the presence of small-head sperm. Subsequent fertilization rate was significantly lower than a) the fertilization rate of the remaining 5 ICSI cycles that acted as a control, in which the embryologist was alerted to the presence of small-head sperm, and b) was lower than the 3 ICSI cycles with normal sperm head ( p <. 05). The 8 cell embryo and blastocyst rates in the former group were also decreased, although not significantly, compared to the latter groups. Likewise, in the 5 IVF cycles with small-head sperm, the fertilization rate was significantly lower than in the 4 IVF with normal sperm head ( p <. 05). Embryologists should be alerted when a high percentage of small-head sperm are detected during routine semen analysis because they may be associated with reduced fertilization and embryo outcome.