Surgical management of male infertility: An overview.

BACKGROUND: The general practitioner is often the first to assess couples with infertility. In up to half of all infertile couples, a male factor may be found as a contributing cause. OBJECTIVE: The aim of this article is to provide a broad understanding of the options available for surgical management of male infertility to assist couples in navigating their treatment journey. DISCUSSION: Treatments may be classified into four categories: surgery for diagnostic purposes, surgery to improve semen parameters, surgery to improve sperm delivery and surgery to retrieve sperm for in vitro fertilisation. Assessment and treatment of the male partner by urologists trained in male reproductive health, working collaboratively within a team, can maximise fertility outcomes.

Lactoferrin is a potent regulator of bone cell activity and increases bone formation in vivo.

Lactoferrin is an iron-binding glycoprotein present in epithelial secretions, such as milk, and in the secondary granules of neutrophils. We found it to be present in fractions of milk protein that stimulated osteoblast growth, so we assessed its effects on bone cell function. Lactoferrin produced large, dose-related increases in thymidine incorporation in primary or cell line cultures of human or rat osteoblast-like cells, at physiological concentrations (1-100 microg/ml). Maximal stimulation was 5-fold above control. Lactoferrin also increased osteoblast differentiation and reduced osteoblast apoptosis by up to 50-70%. Similarly, lactoferrin stimulated proliferation of primary chondrocytes. Purified, recombinant, human, or bovine lactoferrins had similar potencies. In mouse bone marrow cultures, osteoclastogenesis was dose-dependently decreased and was completely arrested by lactoferrin, 100 microg/ml, associated with decreased expression of receptor activator of nuclear factor-kappaB ligand. In contrast, lactoferrin had no effect on bone resorption by isolated mature osteoclasts. Lactoferrin was administered over calvariae of adult mice for 5 d. New bone formation, assessed using fluorochrome labels, was increased 4-fold by a 4-mg dose of lactoferrin. Thus, lactoferrin has powerful anabolic, differentiating, and antiapoptotic effects on osteoblasts and inhibits osteoclastogenesis. Lactoferrin is a potential therapeutic target in bone disorders such as osteoporosis and is possibly an important physiological regulator of bone growth.