Chlamydia trachomatis infection in the genital tract is associated with inflammation and hypospermia in the infertile male of China / 亚洲男科学杂志(英文版)

Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide. However, unlike that in female infertility, the role of CT infection in male infertility remains controversial. The objective of this retrospective study was to explore the impacts of CT infection in the genital tract on sperm quality, sperm acrosin activity, antisperm antibody levels, and inflammation in a large cohort of infertile males in China. A total of 7154 semen samples were collected from infertile male subjects, 416 of whom were CT positive (CT+ group) and 6738 of whom were CT negative (CT- group), in our hospital between January 2016 and December 2018. Routine semen parameters (semen volume, pH, sperm concentration, viability, motility, morphology, etc.), granulocyte elastase levels, antisperm antibody levels, and sperm acrosin activity were compared between the CT+ and CT- groups. Our results showed that CT infection was significantly correlated with an abnormally low semen volume, as well as an increased white blood cell count and granulocyte elastase level (all P < 0.05) in the semen of infertile males; other routine semen parameters were not negatively impacted. The antisperm antibody level and sperm acrosin activity were not affected by CT infection. These findings suggested that CT infection might contribute to inflammation and hypospermia but does not impair sperm viability, motility morphology, and acrosin activity or generate antisperm antibodies in the infertile males of China.

Association of sexually transmitted infection with semen quality in men from couples with primary and secondary infertility / 亚洲男科学杂志(英文版)

This study aims to compare the prevalence of sexually transmitted infections (STIs) with semen quality in men from couples with primary and secondary infertility. Semen samples were collected from 133 men who requested fertility evaluation. Seminal tract infection with Ureaplasma spp. (UU), Mycoplasma hominis (MH), Mycoplasma genitalium (MG), Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and herpes simplex virus-2 (HSV-2) was assessed by PCR-based diagnostic assays. Among all patients, the prevalence of STIs was higher in men from couples with primary infertility than that in men from couples with secondary infertility (39.7% vs 21.7%, P = 0.03). The prevalence of UU was 28.8% and 13.3% in men from couples with primary and secondary infertility, respectively. Men from couples with primary infertility were more likely to be positive for UU than men from couples with secondary infertility (P = 0.04). Regarding the UU subtype, the prevalence of Ureaplasma urealyticum (Uuu) and Ureaplasma parvum (Uup; including Uup1, Uup3, Uup6, and Uup14) did not differ between the two groups. No associations between the prevalence rates of MH, MG, and CT were found in men from either infertility group. A lower sperm concentration was associated with STI pathogen positivity in men with primary infertility according to the crude model (P = 0.04). The crude and adjusted models showed that semen volume (both P = 0.03) and semen leukocyte count (both P = 0.02) were independently associated with secondary infertility. These findings suggest the importance of classifying the type of infertility during routine diagnosis of seminal tract infections.

Novel biallelic loss-of-function mutations in / 亚洲男科学杂志(英文版)

Multiple morphological abnormalities of the sperm flagella (MMAF) is a specific type of asthenoteratozoospermia, presenting with multiple morphological anomalies in spermatozoa, such as absent, bent, coiled, short, or irregular caliber flagella. Previous genetic studies revealed pathogenic mutations in genes encoding cilia and flagella-associated proteins (CFAPs; e.g., CFAP43, CFAP44, CFAP65, CFAP69, CFAP70, and CFAP251) responsible for the MMAF phenotype in infertile men from different ethnic groups. However, none of them have been identified in infertile Pakistani males with MMAF. In the current study, two Pakistani families with MMAF patients were recruited. Whole-exome sequencing (WES) of patients and their parents was performed. WES analysis reflected novel biallelic loss-of-function mutations in CFAP43 in both families (Family 1: ENST00000357060.3, p.Arg300Lysfs*22 and p.Thr526Serfs*43 in a compound heterozygous state; Family 2: ENST00000357060.3, p.Thr526Serfs*43 in a homozygous state). Sanger sequencing further confirmed that these mutations were segregated recessively in the families with the MMAF phenotype. Semiquantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) was carried out to detect the effect of the mutation on mRNA of the affected gene. Previous research demonstrated that biallelic loss-of-function mutations in CFAP43 accounted for the majority of all CFAP43-mutant MMAF patients. To the best of our knowledge, this is the first study to report CFAP43 biallelic loss-of-function mutations in a Pakistani population with the MMAF phenotype. This study will help researchers and clinicians to understand the genetic etiology of MMAF better.

Proton-pump inhibitor use does not affect semen quality in subfertile men / 亚洲男科学杂志(英文版)

Proton-pump inhibitors (PPIs) are among the most widely used drugs worldwide. PPI use has recently been linked to adverse changes in semen quality in healthy men; however, the effects of PPI use on semen parameters remain largely unknown specifically in cases with male factor infertility. We examined whether PPI use was associated with detrimental effects on semen parameters in a large population of subfertile men. We retrospectively reviewed data from 12 257 subfertile men who had visited our fertility clinic from 2003 to 2013. Patients who reported using any PPIs for >3 months before semen sample collection were included; 7698 subfertile men taking no medication served as controls. Data were gathered on patient age, medication use, and conventional semen parameters; patients taking any known spermatotoxic medication were excluded. Linear mixed-effect regression models were used to test the effect of PPI use on semen parameters adjusting for age. A total of 248 patients (258 samples) used PPIs for at least 3 months before semen collection. In regression models, PPI use (either as the only medication or when used in combination with other nonspermatotoxic medications) was not associated with statistically significant changes in semen parameters. To our knowledge, this is the largest study to compare PPI use with semen parameters in subfertile men. Using PPIs was not associated with detrimental effects on semen quality in this retrospective study.

Incidence of Y-chromosome microdeletions in children whose fathers underwent vasectomy reversal or in vitro fertilization with epididymal sperm aspiration: a case-control study / Incidência de microdeleções do cromossomo Y em filhos de pais que passaram por reversão de vasectomia ou fertilização in vitro com aspiração do epidídimo: um estudo caso-controle

ABSTRACT Objective To evaluate the incidence of Y-chromosome microdeletions in individuals born from vasectomized fathers who underwent vasectomy reversal or in vitro fertilization with sperm retrieval by epididymal aspiration (percutaneous epididymal sperm aspiration). Methods A case-control study comprising male children of couples in which the man had been previously vasectomized and chose vasectomy reversal (n=31) or in vitro fertilization with sperm retrieval by percutaneous epididymal sperm aspiration (n=30) to conceive new children, and a Control Group of male children of fertile men who had programmed vasectomies (n=60). Y-chromosome microdeletions research was performed by polymerase chain reaction on fathers and children, evaluating 20 regions of the chromosome. Results The results showed no Y-chromosome microdeletions in any of the studied subjects. The incidence of Y-chromosome microdeletions in individuals born from vasectomized fathers who underwent vasectomy reversal or in vitro fertilization with spermatozoa recovered by percutaneous epididymal sperm aspiration did not differ between the groups, and there was no difference between control subjects born from natural pregnancies or population incidence in fertile men. Conclusion We found no association considering microdeletions in the azoospermia factor region of the Y chromosome and assisted reproduction. We also found no correlation between these Y-chromosome microdeletions and vasectomies, which suggests that the assisted reproduction techniques do not increase the incidence of Y-chromosome microdeletions.

RESUMO Objetivo Avaliar a incidência de microdeleções do cromossomo Y em indivíduos nascidos de pais vasectomizados submetidos à reversão de vasectomia ou fertilização in vitro com recuperação de espermatozoides por aspiração do epidídimo (aspiração percutânea de espermatozoides do epidídimo). Métodos Estudo caso-controle que compreende crianças do sexo masculino de casais em que o homem havia sido previamente vasectomizado e escolheu reversão da vasectomia (n=31) ou fertilização in vitro com recuperação espermática por aspiração percutânea de espermatozoides do epidídimo (n=30) para obtenção de novos filhos, e um Grupo Controle de crianças do sexo masculino de homens férteis com vasectomia programada (n=60). A pesquisa de microdeleções do cromossomo Y foi realizada por reação em cadeia da polimerase nos pais e filhos, avaliando 20 regiões do cromossomo. Resultados O resultado não revelou microdeleções do cromossomo Y em qualquer indivíduo estudado. A incidência de microdeleções do cromossomo Y em indivíduos nascidos de pais vasectomizados que sofreram reversão de vasectomia ou fertilização in vitro com espermatozoides recuperados pela aspiração percutânea de espermatozoides do epidídimo não diferiu entre os grupos, e não houve nenhuma diferença entre indivíduos controle nascidos de gestações naturais ou incidência populacional em homens férteis. Conclusão Não foi encontrada nenhuma associação considerando microdeleções da região do fator de azoospermia no cromossomo Y e reprodução assistida. Não houve correlação entre microdeleções do cromossomo Y e vasectomia, o que sugere que as técnicas de reprodução assistida não aumentam a incidência de microdeleções do cromossomo Y.

Leucocitos seminales y calidad espermática de hombres en estudio de infertilidad / Seminal leukocytes and sperm quality in men involved in infertility study

Introducción: los leucocitos en exceso en el semen humano pueden estar asociados a la disminución de la calidad espermática. La elevada incidencia de leucocitos en el semen de hombres que acuden a nuestro servicio, pudiera estar vinculada al deterioro de las variables de calidad espermática, y vincularse con problemas de infertilidad masculina. Objetivo: determinar la frecuencia de leucocitospermia en el semen de hombres que consultan por infertilidad, e identificar si existe asociación entre la presencia de leucocitospermia y alteraciones en las variables de calidad del semen. Métodos: se realizó un estudio descriptivo transversal, en el cual se incluyeron 136 hombres, con edades entre 20 y 45 años, que acudieron al examen de calidad del semen, procedentes de las consultas de atención a parejas en estudio de infertilidad, del Instituto Nacional de Endocrinología, en La Habana, y que no refirieron síntomas de infección genitourinaria clínicamente activa, ni causas demostrables que afectaran la calidad seminal. El análisis del semen, para determinar las variables seminales, se realizó siguiendo los lineamientos de la OMS, incluyendo la técnica de peroxidasa para determinar la concentración de leucocitos seminales. Se consideraron los aspectos éticos en la investigación y los resultados se analizaron mediante la aplicación de la prueba de chi cuadrado. Un valor de p< 0,05 se consideró estadísticamente significativo. Resultados: de las 136 muestras de semen evaluadas, se encontraron leucocitospermia en 31 (22,7 por ciento). Todos los indicadores de calidad seminal fueron menores en presencia de leucocitospermia, aunque solo se obtuvo una diferencia significativa en relación con la concentración espermática (p< 0,05). Conclusiones: la frecuencia de leucocitospermia en la muestra estudiada es prevalente y asociada con un deterioro estadísticamente significativo de la concentración espermática(AU)

Introduction: excessive amount of leukocytes in the human semen can be related to lower sperm quality. The high incidence of leukocytes in semen from males who went to our service could be linked to deterioration of the sperm quality variables and to male infertility problems. Objective: to determine the frequency of leukocytospermia in the semen of men who visited our infertility service and to identify the possible association between the leukocytospermia and altered quality variables of semen. Methods: a cross-sectional and descriptive study of 136 men aged 20 to 45 years, who were performed the semen quality exam and came from the service provided to couples under infertility study in the National Institute of Endocrinology in Havana. These men had not stated any symptom of clinically active urogenital infection and no proven causes that might affect the semen quality. The semen analysis to determine the seminal variables complied with the WHO guidelines including the peroxidase technique to estimate the seminal leukocyte concentrations. The ethical aspects of research were respected whereas the Chi-square test served to analyze the results; the p< 0.05 was considered as statistically significant. Results: of 136 evaluated semen samples, leukocytospermia was found in 31 (22.7 percent). All the seminal quality indicators were lower in leukocytospermia, although the significant difference was only found in the sperm concentration (p< 0.05). Conclusions: the frequency of leukocytospermia in the studied sample is prevalent and associated to statistically significant deterioration of the sperm concentration(AU)

Decline in semen quality among infertile men in Brazil during the past 10 years

ABSTRACTPurpose:To investigate whether the semen quality of men undergoing conventional semen analysis is deteriorating over time.Materials and Methods:We analyzed and compared the sperm count, motility and morphology of 2300 semen samples provided by males undergoing conventional seminal analysis, from years 2000 to 2002 and 2010 to 2012. The incidences of severe oligozoospermia and azoospermia over time were also compared.Results:A total of 764 sperm samples were analyzed in 2000-2002 and 1536 in 20102012. Over time, the mean sperm concentration/ml decreased significantly from 61.7 million in 2000-2002 to 26.7 million in 2010-2012 (R2=11.4%, p<0.001), the total sperm concentration decreased significantly from 183.0 million to 82.8 million (R2=11.3%, p<0.001), and the percentage of normal forms decreased significantly from 4.6% to 2.7% (R2=9.8%, p<0.001). The incidence of severe oligozoospermia significantly increased from 15.7% to 30.3% (OR: 1.09, p<0.001) and the incidence of azoospermia increased from 4.9% to 8.5% (OR: 1.06, p=0.001).Conclusions:This study demonstrated a significant time-related decline in semen quality of infertile patients. This finding might have implications on fertility and emphasizes the need for further studies addressing subject's life-style in order to find and reduce the causative agents. Future prospective and multicenter studies including representative samples of the general population are needed to confirm whether semen quality is really declining.

No CAG repeat expansion of polymerase gamma is associated with male infertility in Tamil Nadu, South India.

Mitochondria contains a single deoxyribonucleic acid (DNA) polymerase, polymerase gamma (POLG) mapped to long arm of chromosome 15 (15q25), responsible for replication and repair of mitochondrial DNA. Exon 1 of the human POLG contains CAG trinucleotide repeat, which codes for polyglutamate. Ten copies of CAG repeat were found to be uniformly high (0.88) in different ethnic groups and considered as the common allele, whereas the mutant alleles (not -10/not -10 CAG repeats) were found to be associated with oligospermia/oligoasthenospermia in male infertility. Recent data suggested the implication of POLG CAG repeat expansion in infertility, but are debated. The aim of our study was to explore whether the not -10/not -10 variant is associated with spermatogenic failure. As few study on Indian population have been conducted so far to support this view, we investigated the distribution of the POLG CAG repeats in 61 infertile men and 60 normozoospermic control Indian men of Tamil Nadu, from the same ethnic background. This analysis interestingly revealed that the homozygous wild type genotype (10/- 10) was common in infertile men (77% - 47/61) and in normozoospermic control men (71.7% - 43/60). Our study failed to confirm any influence of the POLG gene polymorphism on the efficiency of the spermatogenesis.

Enfermedad periodontal como factor de riesgo asociado a la infertilidad / Periodontal disease as a risk factor for infertility

La infertilidad se define como una condición en la que existe incapacidad de una pareja para concebir después de un año de mantener relaciones sexuales sin protección, o para llevar un embarazo a término con un producto vivo. Estudios recientes han demostrado una relación entre la enfermedad periodontal y múltiples condiciones adversas durante el embarazo, incluyendo el parto pretérmino, bajo peso al nacer, restricción del crecimiento fetal, preeclampsia y mortalidad perinatal. Sin embargo, poco se ha estudiado sobre el periodo previo a la concepción, a pesar de que algunos autores han sugerido poco beneficio del tratamiento periodontal durante el embarazo, y esto pudiera ser un indicador de que la intervención está siendo llevada a cabo de forma tardía.Las hipótesis que sugieren los autores acerca de esta relación es que en presencia de una enfermedad periodontal severa, los microorganismos orales se pueden diseminar vía hematológica y llegar a afectar las membranas, impidiendo la implantación, o que, incluso, pueden contaminar el semen, provocando infertilidad; o bien, que la enfermedad periodontal pudiera ser un indicador de hiperrespuesta inflamatoria sistémica ante infecciones a distancia.

Infertility is defined as a condition in which a couple has been unable to conceive after one year of unprotected intercourse or the inability to carry a pregnancy through to a live birth. Recent studies have shown a relationship between periodontal disease and a range of adverse conditions during pregnancy, including preterm birth, low birth weight, restricted fetal growth, preeclampsia, and perinatal mortality. However, little research has been done into the period prior to conception, despite the fact that some authors have suggested that periodontal treatment during pregnancy is of little benefit, which could indicate that the in-tervention is being carried out too late in the process. The hypothesis that such authors suggest in regard to this relationship is that, in cases where there is severe periodontal disease, oral microorganisms can disseminate via the bloodstream and harm membranes, thus impeding implantation and, in the case of males, even contaminate semen, result-ing in infertility. Furthermore, it has been suggested that periodontal disease is an indicator of a systemic inflammatory hyper-response to remote infections.

The epidemiology and etiology of azoospermia

The misconception that infertility is typically associated with the female is commonly faced in the management of infertile men. It is uncommon for a patient to present for an infertility evaluation with an abnormal semen analysis report before an extensive female partner workup has been performed. Additionally, a man is usually considered fertile based only on seminal parameters without a physical exam. This behavior may lead to a delay in both the exact diagnosis and in possible specific infertility treatment. Moreover, male factor infertility can result from an underlying medical condition that is often treatable but could possibly be life-threatening. The responsibility of male factor in couple's infertility has been exponentially rising in recent years due to a comprehensive evaluation of reproductive male function and improved diagnostic tools. Despite this improvement in diagnosis, azoospermia is always the most challenging topic associated with infertility treatment. Several conditions that interfere with spermatogenesis and reduce sperm production and quality can lead to azoospermia. Azoospermia may also occur because of a reproductive tract obstruction. Optimal management of patients with azoospermia requires a full understanding of the disease etiology. This review will discuss in detail the epidemiology and etiology of azoospermia. A thorough literature survey was performed using the Medline, EMBASE, BIOSIS, and Cochrane databases. We restricted the survey to clinical publications that were relevant to male infertility and azoospermia. Many of the recommendations included are not based on controlled studies.

Alteraciones del espermiograma en pacientes asistidos en la Unidad de Biología de la Reproducción de la Universidad de Chile / Alterations in the semen analysis of patients attending the reproductive biology unit at the University of Chile

En Chile, 10 a 15 por ciento de las parejas son consideradas como infértiles y el factor masculino es responsable en un 50 por ciento de los casos. El espermiograma, es un examen fundamental para el diagnóstico inicial de parejas infértiles. Objetivo: Determinar cambios en cuatro parámetros del espermiograma de mayor valor diagnóstico, según edad, estableciendo el parámetro alterado de mayor frecuencia. Métodos: Se realizo un estudio descriptivo retrospectivo de una muestra de 100 pacientes atendidos por problemas de fertilidad entre los años 2004 y 2009, clasificándolos en cuatro grupos etarios. Resultados: Al evaluar la concentración espermática, el 33 por ciento presenta: 5 baja concentración. El 86 por ciento de los pacientes presento astenozoospermia. El 81 por ciento de los pacientes presento anormalidad en la morfología espermática. La viabilidad espermática fue anormal en el 8 por ciento de los pacientes, siendo significativamente más alto en el grupo etario de mayor edad. Conclusiones: Los parámetros estudiados muestran un alto porcentaje de anormalidad en la población en estudio. Al comparar entre grupos, el grupo de mayor edad (sobre los 47 &los) presenta un aumento significativo del- porcentaje de alteraciones en morfología, motilidad y viabilidad respecto a los otros grupos etarios, estableciéndose la edad como un factor negativo en la calidad espermática. La movilidad corresponde al parámetro mas frecuentemente alterado seguido por la morfología espermática a medida que el varón consultante envejece.

In Chile, 10 to 15 percent of the couples are considered as infertile. Since the male factor is responsible of 50 percent of the cases, spermogram is an essential test for initial diagnosis of the infertile couple. Objective: To analyze the frequency of change in four spermogram parameters -according to age- to determine their diagnostic value. Method: A descriptive retrospective study of spermogram data from 100 patients -subdivided in four age groups- analyzed in our Unit for fertility problems between 2004 and 2009 was performed. Results: In sperm count, 33 percenr showed an abnormally low concentration. An 86 percent of the patients has astenozoospermia. 81 percent of the patients showed abnormal sperm morphology. Sperm viability was subnormal in 8 percent of the patients, being significantly higher in the oldest group. Conclusions: The seminal parameters analyzed revealed a high percentage of anomalies in the studied population. The oldest group had significant percentages of anomalies in sperm motility, morphology and viability, thus corroborating that age is a negative factor that affects semen quality. Sperm motility was the most frequently altered parameter followed by sperm morphology in the population under study.

Epidemiological Study of Male Infertility.

Advanced male age has been associated with signicant reductions in pregnancy rates, increased time-to-pregnancy and increased subfecundity.The present study was aimed at analyzing the male factor causing infertility and epidemiological factors in the rural institute situated in the eastern part of Maharashtra. Aims and Objectives: Study the profile of male infertility in this rural area over a period of 20 years and correlate the various factors responsible for male infertility. Materials and Methods: The present study comprised of retrospective as well as prospective analysis of infertility cases over a period of 20 years. Analysis of the records was done for male factors thoroughly in relation to age, duration and type of infertility, age at marriage, addiction. Statistical Evaluation: Statistical analysis was done in EPI-6 software. Chi square test and variance analysis was used for analyzing the data. Observations:The incidence of primary infertility (62.00%) was higher as compared to secondary infertility (38.00%) in all the five blocks.The semen analysis reports revealed that the most affected age group was 31-40 years. The abnormalities of semen were 35.49%, 86.49% and 53.75% in smokers, alcoholics and in cases having more than one addictions respectively. Cases with no addictions were having the maximum of (82.96%) normozoospermic males. Conclusions:The relationship between smoking and alcoholism was evident. Both of these addictions were found to impair the reproductive functions in male.

Cytogenetic abnormalities in 222 infertile men with azoospermia and oligospermia in Iran: Report and review.

Background: Infertility affects approximately 10%-15% of couples in reproductive age. In half of the couples, causes are male-related, associated with impaired spermatogenesis. There is a complex correlation between genetics and infertility. Several factors affect on gametogenesis, from which factors that lead to chromosomal abnormalities are one of the best known. The aim of this study was to determine type and rate of chromosomal abnormalities in infertile azoospermic and oligospermic males in Iranian population. Materials and Methods: The records of a total of 222 participants were evaluated retrospectively. Results: As a whole we observed 13.96% chromosomal abnormality, from which 12.15% showed numerical and 1.8% showed structural abnormalities. Conclusion: Comparison of our results with the review of the literature shows a higher incidence (4- fold) of gonosomal, in particular, numerical gonosomal, chromosomal anomalies. Cytogenetic analysis is strongly suggested for infertile men, particularly in those who suffer from azoospermia.

Identifying potential pitfalls in interpreting mitochondrial DNA mutations of male infertility cases.

Background & objectives: Recently, a significantly higher ratio of nucleotide changes in the mtDNA genes: COII, ATPase 6, ATPase 8, ND2, ND3, ND4, and ND5 was reported in spermatozoa from populations of infertile Indian men, compared suggesting that screening for mtDNA mutations could provide insight into the aetiology of male infertility. In this study, we examined the published data and found serious errors in the original acquisition and analysis of the data. Methods: The mtDNA data associated with male infertility in Indian populations were retrieved from the published sources. The mtDNA substitution values of infertile and control groups were evaluated using phylogenetic methods and previously published mtDNA phylogenies. Results: Most of the mtDNA polymorphisms reported as significantly correlated with infertility were more commonly found in general populations. Further, our analysis showed that some of the mtDNA substitutions were erroneously overestimated in the infertile groups and underestimated in the control groups, and vice-versa. Interpretation & conclusions: Contrary to earlier claims, our analysis demonstrated no significant association between the mtDNA polymorphisms and male infertility in these studies. Further, these errors in the published data impune the usefulness of mitochondrial molecular analyses in male infertility diagnosis.

Evaluación y estandarización de la calidad del espermiograma: nuevos límites inferiores de referencia / Evaluation and standardization of the quality of semen: new lower reference limit

El análisis seminal o espermiograma es uno de los parámetros más usados en la evaluación de la fertilidad masculina. La OMS (WHO, 2010), presentó el 5 Manual para el examen y procesamiento del semen humano, documento que fue analizado durante el primer taller de estandarización del análisis seminal (PLEAS), realizado en Santiago de Chile, mayo del 2010. Posteriormente se aplicaron los nuevos valores indicados como "límite de referencia inferior" (LIR), en el estudio del análisis seminal realizados por varios autores (2003 al 2010). Los resultados obtenidos indican que el 81 por ciento de los investigadores latino americanos creen que el nuevo manual estandariza mejor la concentración espermática, un 96 por ciento está de acuerdo con la nueva subclasificación en la motilidad espermática en progresiva (A), no progresiva (B) e inmóviles (C). El 68 por ciento estima que el mejor instrumental de recuento es la cámara de Neubauer. Respecto a los controles de calidad solo el 18 por ciento realiza controles de calidad externa. El 100 por ciento de los investigadores estima conveniente realizar continuos talleres de estandarización. Respecto a la aplicación de los LIR en las poblaciones en estudio, todos ellos cumplirían con los estándares actuales para ser considerada una población con capacidad de fertilidad. Sin embargo varios autores opinan que una nueva versión del manual OMS, debe realizarse urgentemente para estandarizar mejor la concentración espermática (15 millones por mL) y la morfología según criterios estrictos (4 por ciento), valores de referencia que consideran muy bajos.

Spermogram or semen analysis is one of the most used parameters in the evaluation of male fertility. WHO (2010) presented the 5th Manual for review and processing of human semen, a document that was discussed during the first workshop of standardization of semen analysis (PLEAS), held in Santiago de Chile, May 2010. Subsequently applied the new values expressed in "lower referencelimit" (LRL) for semen in several analysis studies conducted by various authors (2003 to 2010). The results indicate that 81 percent of Latin American researchers believe the new manual standardizes best sperm concentration, 96 percent agree with the new subclassification in progressive sperm motility (A), non-progressive (B) and immobile (C). 68 percent determined that the best instruments for the sperm countis the Neubauer haemocytometerchamber. Regarding quality control only 18 percent performed external quality control. 100 percent of researchers believe it is appropriate to conducton going standardization workshops. Regarding the application of LRL in the study populations (2003-2010), 100 percent comply with the standards to be considered a population with fertility capacity. However, several authors argue that a new version of the WHO manual, must be re-done urgently to better standardize sperm concentration (15 million/mL) and morphology according to strict criteria (4 percent), reference values considered very low.

Mitochondrial DNA mutations and male infertility.

Infertility can be defined as difficulty in conceiving a child after 1 year of unprotected intercourse. Infertility can arise either because of the male factor or female factor or both. According to the current estimates, 15% of couples attempting their first pregnancy could not succeed. Infertility is either primary or secondary. Mitochondria have profound effect on all biochemical pathways, including the one that drivessperm motility. Sperm motility is heavily dependent on the ATP generated by oxidative phosphorylation in the mitochondrial sheath. In this review, the very positive role of mitochondrial genome's association with infertility is discussed

Métodos em toxicologia do sistema reprodutor masculino e fertilidade em roedores / Methods in toxicology of the male reproductive system and fertility in rodents

A influência de fatores ambientais na fertilidade masculina vem sendo cada vez mais discutida. A despeito de diferenças regionais e étnicas da população humana e falta de padronização de técnicas de contagem de espermatozóides, diversos estudos demonstraram que, ao longo dos anos, houve redução da fertilidade masculina humana; tal redução se deve provavelmente à modificação do estilo de vida, fatores ocupacionais e da exposição a substâncias e a agentes físicos. Dentre as substâncias potencialmente capazes de causar infertilidade destacam-se novos medicamentos, produtos químicos como plásticos, agentes de limpeza e pesticidas. Além da perda de fertilidade, a radiação ionizante e os quimioterápicos podem ocasionar alterações genéticas nas células germinativas com conseqüentes manifestações neoplásica e de malformações, além de infertilidade nos descendentes. Diante do exposto, ressaltamos a necessidade de estudos pré-clínicos em animais de laboratório, a fim de apontar substâncias com capacidade de alterar a reprodução e a fertilidade dos mamíferos e, a partir daí, calcular-se o risco para o ser humano. Nesse sentido, os testes para avaliação da toxicidade reprodutiva são de extrema importância e precisam ser gradativamente aprimorados.

The influence of environmental factors on male fertility has been increasingly discussed. Despite regional and ethnic differences in human population and lack of standardization of techniques for sperm count, several studies have shown that over the years, a reduction of human male fertility, such a reduction is probably due to modification of lifestyle, occupational factors and exposure to substances and physical agents. Among the substances that can potentially cause infertility stand out new drugs and chemicals such as plastics, cleaning agents and pesticides. Besides the loss of fertility, ionizing radiation and chemotherapy may cause genetic changes in the germ cells with subsequent manifestations of cancer and malformations, and infertility in the offspring. Given the above, we emphasize the need for preclinical studies in laboratory animals, to point substances capable of altering the reproduction and fertility in mammals and, from there, calculate the risk to humans. In this sense, tests to evaluate reproductive toxicity are extremely important and must be gradually improved.

Y-haplotypes and idiopathic male infertility in an Indian population.

Infertility being a multifactorial disorder, both genetic and environmental factors contribute to the etiology of infertile phenotype. Chromosomal anomalies and Y-microdeletion are the established genetic risk factors of male infertility. Y-haplotypes has been found as risk factor for male infertility in certain populations, though in certain others no association has been reported, suggesting a population-specific association of these variations with male infertility. In a case-control study, 165 azoo-/oligospermic patients and 200 controls were haplotyped for certain Y-haplogroups for a possible association with idiopathic male infertility in an Indian population. Analysed Y-haplogroups showed no association with infertile phenotype. Thus this genetic factor is not a risk for infertility in the studied Indian population but that does not rule out the possibility of any of them, to be a risk in other populations.

Effect of emotional stress on sperm quality.

BACKGROUND & OBJECTIVE: Emotional stress plays a detrimental role on fertility. In this study male patients with idiopathic infertility were selected after evaluation of psychological stress to evaluate a positive effect of a stress therapy on their semen quality. METHODS: A total of 20 patients with infertility were enrolled in the study and randomly divided in two groups. Ejaculates were examined by light and transmission electron microscopy (TEM). Meiotic segregation was also investigated by fluorescence in situ hybridization (FISH). Ten patients were treated with Conveyer of Modulating Radiance (CRM) therapy and sperm characteristics and meiotic segregation were evaluated again three months at the end of treatment. RESULTS: TEM data showed that, among sperm pathologies, necrosis and apoptosis were higher and the number of "healthy" sperm was significantly reduced in both groups of stressed men compared to reference values. The number of "healthy" sperm was significantly higher in the treated group after therapy, indicating a recovery of sperm quality, although no significant decrease in sperm pathologies was observed. FISH analysis showed that the mean frequencies of sex chromosomes disomies and diploidies significantly decreased after stress therapy. INTERPRETATION & CONCLUSION: The effects induced by stress also seem to include meiotic and structural alterations in sperm cells. The spermatogenic process was improved after a cycle of CRM therapy indicating that stress is an additional risk factor for idiopathic infertility.