ABSTRACT
Premature ejaculation (PE) is the most common male sexual dysfunction, which represents a diagnostic as well as a therapeutic challenge for physicians. However, no universally accepted definition is currently available for PE. As a result, physicians continue to diagnose patients with PE according to major guidelines set by the professional societies. These guidelines either recommend the use of validated questionnaires or patient-reported outcomes. Recent efforts directed toward classifying PE may help provide a better understanding of the prevalence and risk factors of this disorder. While the exact etiology of PE has not been clearly elucidated, several risk factors have been strongly reported in the literature. Clearly, to understand the revised definition of PE, its etiology and pathophysiology is necessary to improve the clinical management of this medical condition and form the basis of future research in this regard. In this review, we highlight the past and current definitions of PE and present an appraisal on the classifications and theories suggested for the etiopathogenesis of PE.
Subject(s)
Humans , Male , Premature Ejaculation/physiopathologyABSTRACT
According to the World Health Organization (WHO), oxidative stress (OS) is a significant contributor to male infertility. Seminal OS can be measured by a number of assays, all of which are either costly or time sensitive and/or require large semen volume and complex instrumentation. One less expensive alternative is to quantify the oxidation-reduction potential (ORP) with the MiOXSYS. In this international multi-center study, we assessed whether ORP levels measured by the MiOXSYS could distinguish semen samples that fall within the 2010 WHO normal reference values from those that do not. Semen samples were collected from 2092 patients in 9 countries; ORP was normalized to sperm concentration (mV/106 sperm/ml). Only those samples with a concentration >1 × 106 sperm ml-1 were included. The results showed that 199 samples fell within the WHO normal reference range while the remaining 1893 samples did not meet one or more of the criteria. ORP was negatively correlated with all semen parameters (P < 0.01) except volume. The area under the curve for ORP was 0.765. The ORP cut-off value (1.34 mV/106 sperm/ml) was able to differentiate specimens with abnormal semen parameters with 98.1% sensitivity, 40.6% specificity, 94.7% positive predictive value (PPV) and 66.6% negative predictive value (NPV). When used as an adjunct to traditional semen analysis, ORP levels may help identify altered functional status of spermatozoa caused by OS in cases of idiopathic male infertility and in male partners of couples suffering recurrent pregnancy loss, and thereby directing these men to relevant medical therapies and lifestyle modifications.
Subject(s)
Adult , Humans , Male , Middle Aged , Young Adult , Area Under Curve , Infertility, Male/metabolism , Oxidation-Reduction , Oxidative Stress , ROC Curve , Reference Values , Semen/metabolism , Semen Analysis/standards , Sensitivity and Specificity , Sperm Count/standards , Spermatozoa/metabolismABSTRACT
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
Subject(s)
Female , Humans , Male , Antioxidants , Classification , Clinical Protocols , Diagnosis , DNA , Embryonic Structures , Fertility , Health Expenditures , Infertility , Infertility, Male , Membranes , Ovum , Oxidants , Oxidation-Reduction , Oxidative Stress , Reactive Oxygen Species , Reducing Agents , Reproductive Health , Semen , Spermatozoa , Subject HeadingsABSTRACT
OBJECTIVE: To investigate the effects of in vitro myo-inositol (Myo-Ins) supplementation of cryopreserved human semen on the cryo-survival rate (CSR). METHODS: Semen samples were obtained from 41 infertile men. Following routine semen analysis, each sample was divided into two equal aliquots (0.5 mL each). One aliquot was treated with 1 mg of Myo-Ins dissolved in 10 µL of sperm preparation medium. The second aliquot was treated with 10 µL of the same medium (control). Both aliquots were incubated for 20 minutes prior to freezing to slow the freezing process. The frozen samples were examined for post-thaw percentages of total motility (TM), progressive motility (PM), and the CSR, defined as the percentage of post-thaw TM divided by the percentage of pre-freeze TM and multiplied in 100. The results were expressed as median and interquartile range (25th and 75th percentiles). RESULTS: The pre-freeze TM (50% [30%–50%]) and PM (35% [20%–35%]) were significantly higher than the post-thaw TM and PM in the Myo-Ins group (15% [10%–35%] and 10% [5%–20%]; p < 0.001 and p < 0.001, respectively) and the control group (10% [6%–30%] and 5% [3%–15%]; p < 0.001 and p < 0.001, respectively). The CSR of the 41 semen aliquots supplemented with Myo-Ins (40% [25%–70%]) was significantly higher than that of the control samples (30% [13%–58%], p=0.041). The CSR of the 26 abnormal semen samples that were supplemented with Myo-Ins (38% [20%–50%]) was significantly higher than that of the control samples (23% [12%–30%], p=0.031). CONCLUSION: In vitro Myo-Ins supplementation of ejaculated human sperm from infertile men resulted in a significant increase in the CSR in samples with abnormal pre-freeze sperm parameters.
Subject(s)
Humans , Male , Freezing , In Vitro Techniques , Semen , Semen Analysis , SpermatozoaABSTRACT
OBJECTIVE: Zearalenone (ZEA) is a mycotoxin with potent estrogenic effects. Saffron is an herbal product that has antioxidant activities. The objective of this study was to investigate the protective role of saffron against reproductive toxicity induced by ZEA in female mice. METHODS: Ninety 8-week-old female mice were randomly allocated into three treatment groups. The first group received an intraperitoneal injection of ZEA (2.5 mg/kg) on alternate days. The second group received ZEA (2.5 mg/kg) on alternate days plus oral saffron daily (50 mg/kg). The third group was treated with a vehicle of 1% dimethyl sulfoxide (DMSO) on alternate days, as a control. Ten mice were euthanized from each group at 30, 60, and 90 days of treatment. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol (E2), and progesterone (P) were assessed. The uterus and ovaries were examined for changes in size or morphology. RESULTS: Serum levels of LH, FSH, E2, and P in the female mice treated with ZEA plus saffron were significantly higher than in those treated with ZEA alone, and were not significantly different from those treated with 1% DMSO. The female mice treated with ZEA alone showed a reduction in size of the uterus and abnormal architecture of the ovaries. CONCLUSION: The administration of saffron to female mice resulted in a significant reduction in ZEA-induced alterations in reproductive hormone levels, the size of the uterus, and the morphology of the ovaries.
Subject(s)
Animals , Female , Humans , Mice , Antioxidants , Crocus , Dimethyl Sulfoxide , Estradiol , Estrogens , Follicle Stimulating Hormone , Injections, Intraperitoneal , Luteinizing Hormone , Ovary , Progesterone , Uterus , Zea mays , ZearalenoneABSTRACT
Recent studies indicated that interleukin-1 beta [IL-1beta] enhance the activity of nitric oxide [NO] synthase resulting in release of excess amounts of NO. The later has been implicated in the pathogenesis of vitiligo. The objective of this study was to determine the correlations between levels of IL-1beta and NO in both tissues and sera from patients with generalized vitiligo. Our study included 30 patients with generalized vitiligo and 15 normal controls. Tissue and serum levels of IL-1 beta and NO were measured using enzyme immunoassay and a spectrophotometer, respectively. Tissue and serum levels of NO were significantly higher in patients with generalized vitiligo than controls [0.58 +/- 0.19 vs 0.41 +/- 0.17 and 58.05 +/- 12.19 vs 28.82 +/- 3.98; p <0.01 and p <0.001; respectively]. Tissue and serum levels of IL-1 beta in patients with generalized vitiligo were significantly higher than controls [4.86 +/- 1.94 vs 2.18 +/- 0.71 and 22.09 +/- 2.64 vs 15.34 +/- 3.55; p <0.001 and p<0.001; respectively]. A significant positive correlation was found between tissue levels of NO and IL-1 beta [r = 0.82, p <0.001]. Tissue levels of IL-1 beta were significantly correlated with extent of vitiligo [r = 0.57, p <0.01]. Patients with generalized vitiligo had significantly increased tissue and serum levels of NO and IL-1 beta. Tissue levels of IL-1 beta were positively correlated with tissue levels of NO, and extent of vitiligo
Subject(s)
Humans , Male , Female , Interleukin-1beta/blood , Nitric Oxide/blood , Immunoenzyme TechniquesABSTRACT
To evaluate the effect of semen incubation at different temperatures on sperm motility and motion kinetics. A prospective study. Computer assisted semen analysis [CASA]. Sperm motility and motion kinetics [curvilinear velocity [VCE], straight-line velocity [VSL]. average path velocity [VAP], linearity [L1N] and amplitude of lateral head displacement [ALH]]. Semen samples were collected from infertile patients [n = 20] and fertile donors [n = 20] after sexual abstinence of 2 to 3 days. Each sample was divided into 4 aliquots right alter liquefaction. One aliquot was analyzed as fresh and the remaining 3 were analyzed after simultaneous incubation at 4°C, 25°C and 37°C for 1 hour. Sperm motility and motion kinetics were determined in fresh and incubated aliquots using CASA. Motility, VCL, VSE, VAP. and ALH significantly decreased [P <0.05] from baseline values in both patients and donors after incubation at 4°C. Our results indicated that 37°C is a suitable temperature for semen storage after collection, and during transportation and processing
Subject(s)
Humans , Male , Temperature , Numerical Analysis, Computer-Assisted , Infertility, MaleABSTRACT
The etiology of vitiligo is unknown. Increased oxidant stress may explain melanocyte dysfunction and destruction. Increases in pro-oxidants as well as decreases in anti-oxidant agents have been reported in patients with vitiligo. In this study we investigated the role of oxidative stress by determining the levels of the free radical nitric oxide [NO] and the antioxidant systems: superoxide dismutase [SOD], and L-ascorbic acid in addition to interleukin-1beta [IL-1beta] in both serum and tissue of lesional skin in patients with generalized vitiligo. Levels of NO and IL-1beta were significantly higher in the serum and tissue of lesional skin of patient with generalized vitiligo compared to the control group. While L-ascorbic acid and superoxide dismutase levels were significantly reduced in patients compared to controls. Extent of vitiligo showed a significant positive correlation with tissue levels of IL-1beta. Oxidative stress may play a role in the pathogenesis of generalized vitiligo with increased production of NO and decreased SOD activity and ascorbic acid levels. IL-1beta could have a role in the pathogenesis of vitiligo possibly through the induction of NO production