Human semen quality as affected by SARS-CoV-2 infection: An up-to-date review.

Revealing the effect of SARS-CoV-2 infection on semen quality is a dynamic priority for many healthcare providers in the field as well as subfertile patients. Therefore, the collective summary in this research approach is still highly needed, especially with the continuous increase in original publications. Here, we provide an up-to-date review and discussion to collectively reveal the effect of SARS-CoV-2 infection on human semen quality. To do this, we reviewed all articles and abstracts published in Scopus and PubMed using the keywords 'SARS-CoV-2' and 'COVID' versus 'sperm' and 'semen'. In summary, it can be revealed that, at both symptomatic and recovery stages of infection, no investigational evidence of SARS-CoV-2 shedding in human semen. Also, the mainstream of the up-to-date published work reveals a negative impact of SARS-CoV-2 infection on semen quality parameters, particularly sperm count and motility. However, long-term post-recovery comparative studies seem very important in this particular setting.

Ranitidine decreases human sperm motility and vitality and increases the activity of seminal creatine kinase.

Ranitidine (brand name: Zantac), an acid reducer, belongs to histamine-2 receptor antagonists. Since 1981, even though several adverse effects of this drug were reported in the body, still, its effects on human sperm parameters have yet to be confirmed. In this work, we attempted to measure sperm motility, sperm vitality and activity of seminal creatine kinase in the ejaculated human semen (n = 31) in the presence of ranitidine at a range of concentrations (0.1, 0.3, 0.6, 0.9 and 1.2 µg/ml) compared with control (without ranitidine). Sperm motility was measured using the Makler counter, whilst sperm vitality was assessed using the Eosin test. Creatine kinase activity was measured using the kinetic spectrophotometric method. Sperm motility (total and progressive) as well as sperm vitality was significantly (p < .05) reduced in the presence of ranitidine in human semen, particularly at the higher tested concentrations (0.6-1.2 µg/ml) compared with the control. On the other hand, creatine kinase activity was significantly increased (p < .05) in the presence of ranitidine at 0.6, 0.9 and 1.2 µg/ml. In conclusion, ranitidine at 0.6-1.2 µg/ml reduced sperm motility and vitality, but increased the activity of creatine kinase in ejaculated human semen.

Perceptions towards sex selection among Jordanian population: A survey study.

Sex selection is becoming a more common practice in the society and worldwide. The current study aimed to examine the perceptions about sex selection options and possible association with sociodemographic factors and relevant characteristics. The study was a cross-sectional survey of adults in Jordan in January and February 2020 using a self-administered questionnaire. Results showed that 40.1% of respondents preferred male gender when having a child, 22.4% of respondents preferred the male gender when having a child, even if they have had children of both genders, and 71.3% preferred having children from both genders. On the other hand, 58.8% of participants preferred a male gender when there is one chance to conceive via assisted reproduction technologies. Also, among participants, 66% thought that sex selection is religiously acceptable, yet 78.0% did not support of the sex selection idea. The above factors were significantly associated with several sociodemographic variables such as gender, marital status, education, career, and place of residence, but not income. In conclusion, the current study shed a light on preferences towards sex selection in a large cohort to better understand the perception and attitude of the population towards this practice.

Effect of diclofenac on semen quality: A review.

Diclofenac is an effective nonsteroidal anti-inflammatory drug and one of the most prescribed medicines worldwide. So far, there are many published articles that directly link between diclofenac and semen quality; however, hitherto, there is no collective review or comprehensive discussion that reveal such imperative link. Therefore, this work reviews and judges the association between diclofenac administration and semen quality, henceforth male infertility. As a tool to accomplish this scientific input, Scopus, Embase and PubMed databases have been searched for all original articles using the keywords "diclofenac" versus "semen" and "sperm" since August 1987 through November 2020. In summary, diclofenac appears to induce negative effects on both qualitative and quantitative measures of sperm; however, this conclusion requires confirmation by human studies. The detected negative effects of diclofenac on semen quality measures may be owed to reduced levels of gonadal hormones, decreased antioxidant defence mechanism, increased oxidative stress, altered concentrations of nitric oxide that are required to maintain normal sperm physiology and reduced synthesis of prostaglandins.

Effect of statin on semen quality characteristics.

Statins are lipid-lowering medications widely used to reduce the risk of cardiovascular diseases. Biochemically, they act by decreasing synthesis of cholesterol via inhibiting 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase. Since 1992, various research studies have investigated the effect of statins on semen quality characteristics; however, to date, there is no collective summary to such effect. Here, we have systematically discussed and abridged all research studies published in Scopus, PubMed and Web of Science databases that are directly linking statin to semen fertility characteristics using the keywords "statin" versus "sperm" and "semen". In summary, considering the animal studies, statins, in general, were found to ameliorate semen quality characteristics in reproductive detrimental conditions, while, in human males or in in vivo systems with normal reproductive conditions, in general, statins showed negative to blunt effects against semen quality characteristics, mainly sperm motility. However, further research studies, in particular human studies, in this specific research setting is still needed to approve these effects.

Seminal plasma vitamin B6 levels in men with asthenozoospermia and men with normal sperm motility, a measurement using liquid chromatography with tandem mass spectrometry.

There is growing evidence that vitamin B6 has a valuable contribution in maintaining normal sperm parameters; however, this contribution has not yet well-identified. Here, we aimed to measure the level of seminal plasma vitamin B6 in men with asthenozoospermia compared to men with normal sperm motility. Ninety-seven human males with asthenozoospermia and eighty-eight human males with normal sperm motility (control) were recruited in this study. Collected semen samples were assessed for sperm motility, sperm count and semen volume. Liquid chromatography with tandem mass spectrometry was used to measure seminal plasma vitamin B6 concentrations. A highly significant difference (p < .0001) in concentrations of seminal plasma vitamin B6 was found between asthenozoospermic and control groups. Besides, no statistical correlations were found between seminal plasma vitamin B6 level and sperm motility, sperm count, semen volume and men age in both tested groups. In conclusion, men with asthenozoospermia have lower seminal plasma vitamin B6 level compared to men with normal sperm motility. Also, seminal plasma vitamin B6 was found not to be correlated with sperm motility and count, semen volume and men age in both tested groups. These results may provide new contribution in the management of male infertility.

Famotidine does not affect human sperm fertility characteristics (motility, viability and DNA integrity) in vitro.

Famotidine, a histamine-2 receptor antagonist, is commonly used to relieve the acid-related gastrointestinal diseases; however, its effect on human sperm parameters, and hence on sperm function, is still undetermined. Here, we intended to measure human sperm motility, viability, and DNA integrity of ejaculated human sperm in the presence of famotidine at 0, 0.1, 1 and 10 mM concentrations in vitro. Forty-nine semen samples of normal count, motility, and morphology were included in this study. Sperm motility was assessed using Makler counting chamber and a phase contrast optics (200× magnification), whereas sperm viability was assessed using eosin-nigrosin staining procedure. The effect of famotidine on sperm DNA integrity was measured using flow cytometry. Famotidine at 0.1, 1 or 10 mM had insignificant effect on human sperm motility (progressive, p = .9594; and total, p = .8420), sperm viability (p = .6471), and content of DNA breaks in sperm (p > .05) compared with the control. In conclusion, famotidine at 0.1, 1 or 10 mM did not alter human sperm motility, viability or DNA integrity in vitro. Although, these findings indicate safety of famotidine in human sperm, further in vivo studies are required to establish the drug's safety.

Effect of ginger (Zingiber officinale) on semen quality.

To date, according to the Scopus database, the biological effects of ginger (binominal name: Zingiber officinale), or ginger extracts, and its derived compounds on semen quality and sperm parameters have been revealed in more than 35 original articles. Though, still, there are no collective systematic or narrative discussion and conclusion of this specific research streak. Here, we systematically review and summarise the current link between ginger and its bioactive compounds with semen quality. To achieve this, we searched the central databases (Scopus and PubMed) for original studies, published in English language from August 2004 through February 2019 using the keywords "ginger" versus "sperm" and "semen." In summary, there is solid evidence that ginger enhances semen quality and improves the main sperm parameters such as concentration, viability, motility and morphology. Such beneficial effects of ginger on semen quality are attributable, at least in part, to increased levels of gonadal hormones, in particular, testosterone and luteinising hormone, decreased oxidative damage to cells, increased production of nitric oxide, hypoglycaemic response of ginger and the presence of valued nutrients in ginger such as manganese. Still, the positive effects of ginger on semen quality require additional approval in men.

Effect of ibuprofen on semen quality.

Ibuprofen is a widely used analgesic/antipyretic medication belongs to the nonsteroidal anti-inflammatory class. Even though the influence of ibuprofen on semen quality has been investigated in various occasions, the comprehensive understanding and discussion of its impact on semen quality is still yet to be determined. In this work, we systematically review and reveal the effect of ibuprofen on semen quality, and thus on fertilising capability. To achieve this goal, we searched the main research databases (Scopus and PubMed) from 1 June 1986 through 13 October 2018 for English-language articles and abstracts using the keywords "ibuprofen" versus "semen" and "sperm". In addition, related published articles or abstracts were also discussed if relevant. Altogether, the main stream of research, from both in vitro and in vivo studies, presents an adverse effect of ibuprofen on different sperm parameters such as motility, viability, count and DNA integrity; however, such effect is not yet confirmed in humans. Mechanisms by which ibuprofen affects semen quality may be by reducing testosterone and prostaglandin synthesis, chelating zinc ions and inhibiting nitric oxide synthesis. However, further research studies, mainly clinical, are still of great importance to confirm the effects of ibuprofen on semen quality.

Fertility testing for men before marriage: Is it acceptable?

Addressing male infertility issue before marriage, at least to the mate and her family, seems reasonable to avoid several psychosocial, economic and biological consequences. Here, we intended to comprehend whether fertility testing (i.e. semen analysis) for men before marriage is acceptable and can be applied in Jordanian society. To achieve this contribution, we designed a questionnaire that shows the opinion of a sample of the Jordanian population in applying fertility testing for men before marriage. A total of 740 adult individuals (>18 years old, 364 males, 382 females) were selected randomly from different martial, economic, social, ethnic, religious and education statuses to fill the questionnaire. A total of 523 (70.11%) participants had a positive attitude towards applying fertility testing for men before marriage. This opinion was found not to be affected by gender (p = 0.305), age (p = 0.329), body mass index (p = 0.061), smoking (p = 0.059), monthly income (p = 0.094), education level (p = 0.131) and family members with infertility (p = 0.074); while, it is found to be affected by the social status of the participant (p = 0.004). In conclusion, applying fertility testing for men before marriage appears to be acceptable in Jordanian society.

Role of Lipoic Acid in Testosterone Production in Males.

Testosterone extends its impact beyond sexual function, playing a crucial role in shaping overall male health, including aspects such as muscle mass, bone density, mood regulation, and energy levels. Lipoic acid, a cofactor for specific enzymes, particularly dehydrogenases involved in cellular energy production, has been studied for its impact on testosterone. This comprehensive review systematically scoured PubMed and Scopus databases using the keywords "lipoic acid" and "testosterone." It encompassed all relevant English papers published from November 1971 to the present, including full texts and abstracts, along with research elucidating the biochemical mechanisms linking lipoic acid to testosterone. In summary, lipoic acid consistently restores testosterone levels, offering promise as an intervention in testicular health, especially in cases of testicular toxicity caused by various harmful agents. Its mechanisms encompass nitric oxide enhancement, fortification of testicular antioxidants, elevation of luteinizing hormone, enhancement of steroidogenesis, and the maintenance of energy production. These mechanisms underscore the therapeutic potential of lipoic acid for testicular health.

Ameliorative effects of propolis upon reproductive toxicity in males.

Propolis is a sticky natural product produced by honeybees. Research studies have discussed the effectiveness of propolis, directly or indirectly, for ameliorating reproductive toxicity in males; however, this research has not yet been reviewed. The current paper presents an integrative summary of all research studies in Scopus and PubMed that investigated the effects of propolis on semen quality, and hence on male fertility, in conditions of reproductive toxicity. The consensus indicates that propolis ameliorates reproductive toxicity and enhances semen quality in vivo in test animals. These effects may be attributable to the ability of propolis to reduce testicular oxidative damage, enhance testicular antioxidant defense mechanisms, increase nitric oxide production, reduce testicular apoptotic injury, and boost testosterone production. However, to generalize these effects in humans would require further research.

Possible Beneficial Effects of Fresh Pomegranate Juice in SARS-CoV-2 Infection Conditions.

Rather than the prophylactic vaccination, any effective synthetic, natural, or nutritional therapy or regimen that may cure or remedy, albeit partially, the complications of SARS-CoV-2 should be highly acknowledged. Here, we reviewed and discussed possible beneficial biological effects of pomegranate juice in such diseased condition of viral infection based on the current published evidence (direct and indirect) and owing to the robust evidence that fresh pomegranate juice is highly rich with unique bioactive compounds that are approved in various occasions to be effective in several chronic diseased conditions. All related references that serve our aim are accessed through available electronic databases, particularly PubMed and Scopus. In summary, there is accepted evidence that pomegranate juice may be beneficial in SARS-CoV-2 infection conditions, especially for patients with the clinical history of chronic diseases such as hypertension, cardiovascular disease, diabetes, and cancer. However, the interventional studies that directly probe and confirm the effectiveness of fresh pomegranate juice in the management of SARS-CoV-2 infection are mandatory.

Sperm Vitality and Necrozoospermia: Diagnosis, Management, and Results of a Global Survey of Clinical Practice.

Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) test. In the 6th (2021) edition of the WHO Laboratory Manual, sperm vitality assessment is mainly recommended if the total motility is less than 40%. Hence, a motile spermatozoon is considered alive, however, in certain conditions an immotile spermatozoon can also be alive. Therefore, the differentiation between asthenozoospermia (pathological decrease in sperm motility) and necrozoospermia (pathological decrease in sperm vitality) is important in directing further investigation and management of infertile patients. The causes leading to necrozoospermia are diverse and can either be local or general, testicular or extra-testicular. The andrological management of necrozoospermia depends on its etiology. However, there is no standardized treatment available presently and practice varies among clinicians. In this study, we report the results of a global survey to understand current practices regarding the physician order of sperm vitality tests as well as the management practices for necrozoospermia. Laboratory and clinical scenarios are presented to guide the reader in the management of necrozoospermia with the overall objective of establishing a benchmark ranging from the diagnosis of necrozoospermia by sperm vitality testing to its clinical management.

Short-term Effect of Fresh Pomegranate Juice on Serum Cortisol and Thyroxine in Patients with type 2 Diabetes.

BACKGROUND: The effect of pomegranate juice on type 2 diabetic conditions has been determined in various occasions. However, such an effect on cortisol and thyroxine hormones, which are major controllers of energy metabolism, is not yet revealed. OBJECTIVES: In this study, we intended to measure the short-term effect of fresh pomegranate juice on serum cortisol and thyroxine in patients with type 2 diabetes. MATERIALS AND METHODS: This study was a randomized clinical trial in which 89 fasted patients with type 2 diabetes were supplemented with fresh pomegranate juice at a dose of 1.5 mL kg-1. Blood specimens were then collected before and at 1 and 3 hours after juice administration. Serum cortisol and thyroxine were assessed using commercial chemiluminescent-immunoassay kits. RESULTS: Serum cortisol, but not thyroxine, was significantly (P < 0.0001) lower in patients with type 2 diabetes after ingesting fresh pomegranate juice. In addition, no significant correlation (r2 = 0.00003, P = 0.9569) was observed between cortisol response to fresh pomegranate juice and the level of fasting serum glucose in the recruited patients. Moreover, no significant difference (P = 0.9118) in cortisol response to fresh pomegranate juice was found between recruited males and females. CONCLUSIONS: In conclusion, fresh pomegranate juice decreased serum cortisol, 1 hour after juice ingestion, but not serum thyroxine 3 hours after juice ingestion, in patients with type 2 diabetes. In addition, cortisol response to fresh pomegranate juice was found not to be affected by patients' gender and the level of fasting serum glucose.

Mechanisms of honey on testosterone levels.

Testosterone is an anabolic steroid and the principal sex hormone in males. Maintaining adequate levels of testosterone throughout the life span of male is very desirable, especially it is now well-known that low levels of testosterone is associated with various aging diseases/disorders. Therefore, still, so many research studies have focused on enhancing serum levels of testosterone in males. Here, we intended to systematically discuss and present the impact of honey on serum levels of testosterone in males. This was conducted by searching PubMed, Scopus, and Embase electronic databases for research articles from May 1993 through April 2019 using the keywords "honey" and "honeybee" versus "testosterone". Moreover, references from relevant published articles were also reviewed and cited to frame an integral discussion, conclusion, and future research needs. In conclusion, the collective evidence, which is mainly based on in vivo system studies, reveals that oral administration of honey increases serum testosterone level in males. Mechanistically, honey may increase serum level of testosterone by increasing the production of luteinizing hormone, enhancing the viability of Leydig cells, reducing oxidative damage in Leydig cells, enhancing StAR gene expression, and inhibiting aromatase activity in the testes. However, further research studies on humans, mainly clinical trials, in this specific research approach are still needed to confirm the effect of honey on testosterone.

Testosterone in Males as Enhanced by Onion (Allium Cepa L.).

Testosterone (17ß-Hydroxyandrost-4-en-3-one) is the main sex hormone in males. Maintaining and enhancing testosterone level in men is an incessant target for many researchers. Examples of such research approaches is to utilize specific types of food or dietary supplements as a safe and easily reached means. Here, specifically, since 1967 until now, many research studies have revealed the effect of onion on testosterone; however, this link has yet to be collectively reviewed or summarized. To accomplish this contribution, we searched the Scopus, Web of Science, and PubMed databases for full articles or abstracts (published in English language) from April 1967 through December 2018 using the keywords "onion" versus "testosterone". In addition, a number of related published articles from the same databases were included to improve the integrity of the discussion, and hence the edge of the future directions. In summary, there is an evidence that onions enhance testosterone level in males. The mechanisms by which this occurs is mainly by increasing the production of luteinizing hormone, enhancing the antioxidant defense mechanism in the tests, neutralizing the damaging effects of the generated free radicals, ameliorating insulin resistance, promoting nitric oxide production, and altering the activity of adenosine 5'-monophosphate -activated protein kinase. However, this effect requires further approval in humans, mainly by conducting clinical trials.

Effect of Coenzyme Q10 Supplementation on Testosterone.

Enhancing testosterone production in males is a continuous research direction for many scientists in the field, due to its role as a principal sex hormone and as a crucial modulator of well-being and general health in humans. Since 1978, there have been more than 30 studies that have connected coenzyme Q10 and testosterone. Such a link is attributable to the vigorous biological role of coenzyme Q10 as a crucial member in the energy production route in humans and animals, which is thought to have a positive influence on testosterone production, and hence on infertility, particularly male infertility. However, this connection has not yet been deliberated. The present work systematically reviews and summarizes the influence of coenzyme Q10 supplementation on testosterone. To accomplish this purpose, the Scopus, PubMed, and Web of Science databases were searched using the keywords "coenzyme Q10" versus "testosterone" for English language papers from November 1978 through October 2018. Relevant articles were also discussed and included to address an integral discussion. In summary, to date the studies conducted on human males reveal insignificant effects of coenzyme Q10 supplementation on testosterone. Similarly, rather than the reproductive toxicity studies, the studies conducted on animals did not show any positive influence of coenzyme Q10 on testosterone. However, coenzyme Q10 supplementation was found to ameliorate the reduction in testosterone induced by chemical reproductive toxicants, mainly by neutralizing the damaging effect of the generated free radicals. However, collectively these findings require further confirmation by additional research studies.

Ginger and Testosterone.

Enhancing and protecting testosterone production is one target for many scientists because of its crucial role as a primary sex hormone in males. Several in vivo trials have utilized different dietary supplements and medicinal plants to enhance testosterone production in males. Since 1991, various in-vivo, as well as basic research studies, have discovered a link between ginger (Zingiber officinale) and testosterone. However, such a link has not yet been collectively reviewed. This review systematically discusses and summarizes the effect of ginger and ginger extracts on testosterone. To achieve this contribution, we searched the PubMed, Scopus, and Web of Science databases for English language articles (full texts or abstracts) from November 1991 through August 2018 using the keywords "ginger" and "Zingiber officinale" versus "testosterone". Additionally, the references from related published articles were also reviewed, only if relevant. In conclusion, the mainstream of research that links ginger to testosterone demonstrated that ginger supplementation, particularly in oxidative stress conditions, enhances testosterone production in males. The mechanisms by which this occurs mainly by enhancing luteinizing hormone (LH) production, increasing the level of cholesterol in the testes, reducing oxidative stress and lipid peroxidation in the testes, enhancing the activity of the antioxidant enzymes, normalizing blood glucose, increasing blood flow in the testes, increasing testicular weight, and recycling testosterone receptors. However, the effect of ginger on testosterone is not yet confirmed in humans. Therefore, clinical studies in this context of research are imperative.

Role of Uric Acid in Semen.

Since 1963, various research studies and reports have demonstrated the role of uric acid (2,6,8-trihydroxypurine), an end product of adenosine and guanosine catabolism, on semen quality and sperm function. However, this effect has not yet been collectively discussed, even though uric acid has been a well-recognized constituent in semen. Here, we systematically and comprehensively discuss and summarize the role/effect of uric acid in semen quality by searching the main databases for English language articles considering this topic. Additionally, certain significant and relevant papers were considered to support discussions and perceptions. In conclusion, uric acid contributes to maintaining and enhancing sperm motility, viability, and morphology; therefore, protecting sperm function and fertilizing ability. This contribution is performed mainly by neutralizing the damaging effect of oxidizing (e.g., endogenous free radicals and exogenous toxins) and nitrating agents and enhancing certain bioactive enzymes in spermatozoa. In contrast, high levels of uric acid may induce adverse effects to sperm function, at least in part, by reducing the activity of vital enzymes in spermatozoa. However, further research, mainly clinical, is still required to fully explore the role/effect of uric acid in semen.