influence of ginger (Zingiber officinale) on human sperm quality and DNA fragmentation: a double-blind randomized clinical trial

Background: although the effectiveness of ginger as an antioxidant agent has been exploited, little human research has been conducted on its activity on male reproductive functions

Objective: this study was designed to investigate the effects of ginger [Zingiber officinale] on sperm DNA fragmentation [SDF] in infertile men

Materials and Methods: this randomized double-blind, placebo-controlled trial with a 1:1 allocation was performed on 100 infertility treatment candidates who were admitted to Royan Institute for Reproductive Biomedicine, Tehran, Iran. Patients were randomly assigned to receive one of two treatments: ginger and placebo. Patients were given a 3-month oral treatment [members received capsules containing 250 mg of ginger powder twice a day in ginger and a placebo in other group]. Before and after treatment, standardized semen samples were obtained to determine sperm concentration, motility, and SDF according to World Health Organization

Results: there was no significant difference between two groups regarding SDF at baseline [53.48. 95%CI: 37.95-69.02] in cases and [56.75, 95%CI: 40.01-73.5] in controls. The average positive percentage of SDF in patients receiving ginger [17.77, 95%CI: 6.16-29.39] was lower compared with placebo [40.54, 95%CI: 23.94-57.13] after three month of treatment [p=0.02]. In multivariate analysis, SDF was significantly lower in patients receiving ginger compared with placebo [mean difference: 3.21, 95%CI: 0.78-5.63, p=0.009]. There were no significant differences between two groups regarding to semen parameters

Conclusion: the present study has demonstrated that ginger in a controlled study of efficacy was effective in decreasing SDF in infertile men

Predictive factors of successful microdissection testicular sperm extraction in patients with presumed sertoli cell-only syndrome

To evaluate predictive factors of successful microdissection-testicular sperm extraction [MD-TESE] in patients with presumed Sertoli cell-only syndrome [SCOS]. In this retrospective analysis, 874 men with non-obstructive azoospermia [NOA], among whom 148 individuals with diagnosis of SCOS in prior biopsy, underwent MD-TESE at Department of Andrology, Royan Institute, Tehran, Iran. The predictive values of follicle stimulating hormone [FSH], luteinizing hormone [LH], and testosterone [T] levels, testicular volume, as well as male age for retrieving testicular sperm by MD-TESE were analyzed by multiple logistic regression analysis. Testicular sperm were successfully retrieved in 23.6% men with presumed SCOS. Using receiver operating characteristic [ROC] curve analysis, it was shown that sperm retrieval rate in the group of men with FSH values >15.25% was 28.9%. This was higher than the group of men with FSH

[Predictive value of semen parameters and age of the couple in pregnancy outcome after Intrauterine insemination]

Intrauterine insemination [IUI] is one of the most common methods in infertility treatment, but its efficiency in infertile couples with male factor is controversial. This study is a retrospective study about correlation between semen parameters and male and female age with successful rate of IUI in patients attending to Royan Institute. A total of 998 consecutive couples in a period of 6 months undergoing IUI were included. They were classified into two groups: couples with successful and unsuccessful pregnancy. Main outcome was clinical pregnancy. Data about male and female ages and semen analysis including concentration, total sperm motility, class A motility, class B motility, class A+B motility and normal morphology was extracted from patients' records. Semen samples were collected by masturbation or coitus after 2 to 7 days of abstinence. Their female partners were reported to have no chronic medical conditions and have normal menstrual cycles. One hundred and fifty seven of total 998 cycles [15.7%] achieved pregnancy. The average of female age in successful and unsuccessful group was 28.95 +/- 4.19 and 30.00 +/- 4.56 years, respectively. Mean of male age was 33.97 +/- 4.85 years in successful group and 34.44 +/- 4.62 years in unsuccessful group. In successful and unsuccessful groups, average of sperm concentration was 53.62 +/- 38.45 and 46.26 +/- 26.59 [million sperm/ml], normal morphology of sperm was 8.98 +/- 4.31 [%] and 8.68 +/- 4.81 [%], sperm total motility was 47.24 +/- 18.92 [%] and 43.70 +/- 20.22 [%] and total motile sperm count was 80.10 +/- 63.61 million and 78.57 +/- 68.22 million, respectively. There was no significant difference in mean of females' age and males' age between successful and unsuccessful groups [P<0.05]. In addition, there was no significant difference in semen parameters including concentration, total sperm motility, class A motility, class B motility, class A+B motility and normal morphology between two groups. It was shown that common semen analysis and male and female ages cannot predict IUI outcome.

Enzymatic digestion improves testicular sperm retrieval in non-obstructive azoospermic patients

In patients with non-obstructive azoospermia [NOA], vital spermatozoa from the tissue is obtained from testes by enzymatic treatment besides the mechanical treatment. To increase the sperm recovery success of testicular sperm extraction [TESE], with enzymatic digestion if no sperm is obtained from testis tissue by mechanical method. Tissue samples were collected from 150 men who presented with clinical and laboratory data indicating NOA by means of TESE and micro dissection TESE methods. Initially, mature spermatozoa were examined for by mechanical extraction technique shredding the biopsy fractions. In cases whom no spermatozoa was observed after maximum 30 min of initial searching under the inverted microscope, the procedure was followed by enzymatic digestion using DNaseI and collagenase type IV. Surgery type, pathology, AZF, karyotype, hormones and testis size were compared in patients. Of 150 cases with NOA, conventional mincing method extended with enzymatic treatment yielded successful sperm recovery in 13 [about 9%] patients. Comparison of parameters revealed that level of FSH and LH were significantly different [p=0.04 and 0.08 respectively] between two groups that response negative and positive to enzymatic digestion. The combination of conventional TESE and enzymatic digestion is an effective method to recover spermatozoa. The benefit of the mincing combined with enzyme to sperm retrieval for NOA firstly shorten the mechanical searching time, leading to minimizing further cellular damage as well as exposure to external conditions, and secondly reduce the number of cases with sperm recovery failures. Also, the serum level of FSH and LH are factors that influence the chance of sperm retrieval