Health-Related Quality of Life in Adult Spanish Women with Endometriomas or Deep Infiltrating Endometriosis: A Case-Control Study.

Endometriosis is a disabling disease that may significantly compromise a woman's social relationships, sexuality, and mental health. Considering the impact of endometriomas and deep infiltrating endometriosis (DIE) on quality of life and the limited number of papers on this topic, the objective of this study was to assess health-related quality of life (HRQoL) in adult Spanish women with the condition. A case-control study was conducted on a group of 99 patients with ovarian endometriomas or DIE and 157 controls. Women underwent physical and gynecological examinations, and they completed health questionnaires including the Short Form-12v2 (SF-12v2), a survey for HRQoL. Eight scales and two component summary scores (Physical (PCS) and Mental (MCS), respectively) were calculated. Women with endometriomas or DIE had significantly worse PCS: 47.7 ± 9.7 vs. 56.1 ± 5.9, respectively (p < 0.001) compared to controls, as well as lower scores on seven out of the eight scales (p < 0.01). No significant differences were found for the MCS. Conclusions: HRQoL was significantly lower in patients with endometriomas or DIE compared to controls. If confirmed, these results may have important implications for prevention, clinical practice, and intervention.

Health-related quality of life in women with polycystic ovary syndrome attending to a tertiary hospital in Southeastern Spain: a case-control study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is a chronic condition with symptoms affecting many women at reproductive age and evaluating their health-related quality of Life (HRQoL) is an important issue. Moreover, differences in the HRQoL between women with different PCOS phenotypes have never been analyzed. Therefore, the aim of our study was to compare the HRQoL between women with PCOS -and its phenotypes- and controls attending to a tertiary hospital. METHODS: A group of 117 women with PCOS and 153 controls were studied between 2014 and 2016. Controls were women without PCOS attending the gynecological outpatient clinic for routine examinations. Cases were women attending the same setting and diagnosed with PCOS. PCOS diagnose was performed following the Rotterdam Criteria and women were further classified by anovulatory or ovulatory phenotypic subtype. Women underwent physical and gynecological exams and completed health questionnaires including the Short Form-12v2. Eight scales and two component summary scores [Physical (PCS) and Mental (MCS), respectively] were calculated. Bivariate and multivariate analyses were performed to assess differences in HRQoL between women with PCOS and controls. RESULTS: All women with PCOS and anovulatory PCOS presented lower score in PCS compared to controls [mean (95%CI): 53.7 (52.5-54.9) and 52.9 (51.5-54.4) vs. 55.8 (54.8-56.8); p-values< 0.01], as well as lower scores for five out of the eight scales (p-values < 0.05) after adjusting by age, body mass index, infertility, educational level and current occupation. No significant differences were observed for the MCS between women with or without PCOS or its phenotypic subtypes. CONCLUSIONS: HRQoL was significantly decreased in adult women with PCOS and its anovulatory phenotype compared to controls attending the outpatient clinic of a tertiary hospital. These results may have implications for the clinical practice and suggest the need for specific interventions in women with PCOS.

Adherence to diet quality indices in relation to semen quality and reproductive hormones in young men.

STUDY QUESTION: Is adherence to an a priori defined diet quality indices [Alternate Healthy Index 2010 (AHEI-2010), relative Mediterranean diet score (rMED) or dietary approaches to stop hypertension (DASH)] associated with semen quality and reproductive hormone levels in young men? SUMMARY ANSWER: Greater adherence to the DASH diet is related to higher sperm counts. WHAT IS KNOWN ALREADY: Studies assessing the relationship between dietary intake and male reproductive function have mainly been focused on specific nutrients, food groups or data-driven dietary patterns, but the evidence on a priori defined dietary indices is still scarce. STUDY DESIGN, SIZE, DURATION: Cross-sectional study of 209 male university students recruited from October 2010 to November 2011 in Murcia Region (Southern Spain). PARTICIPANTS/MATERIALS, SETTING, METHODS: Healthy young men aged 18-23 years were included in this study. Diet was assessed using a validated food frequency questionnaire and three a priori-defined dietary indices (AHEI-2010, rMED and DASH) were calculated. Linear regression was used to analyze the relation between the three dietary indices and semen quality parameters and reproductive hormone levels accounting for potential confounders and covariates. MAIN RESULTS AND THE ROLE OF CHANCE: We found statistically significant positive associations between the DASH index and sperm concentration (P, trend = 0.04), total sperm count (P, trend = 0.04) and total motile sperm count (P, trend = 0.02). No associations were observed for other semen parameters or male reproductive hormones. LIMITATIONS, REASONS FOR CAUTION: Even though we adjusted for several known and suspected confounders we cannot exclude the possibility of residual or unmeasured confounding or chance findings. Subjects were blinded to the study outcomes thus reducing the potential influence on their report of diet. Our sample size may be too small to rule out associations with other semen parameters or reproductive hormones. Causal inference is limited, as usual with all observational studies. WIDER IMPLICATIONS OF THE FINDINGS: The results suggest that greater adherence to the DASH may help improve sperm counts. This study was carried out on young men from the general population. However, results may differ among other populations (e.g. infertile men). Therefore, further research is needed to confirm these findings and extend these results to other populations. STUDY FUNDING/COMPETING INTEREST(S): This work was supported by Fundación Séneca, grants No 08808/PI/08 and No 19443/PI/14; Ministerio de Ciencia e Innovación, Instituto de Salud Carlos III (AES), grants No PI10/00985 and No PI13/01237; and grant P30DK046200 from the National Institutes of Health. Authors have no competing interests to declare.

Oligoelementos en la dieta y calidad seminal y niveles de hormonas reproductivas en varones jóvenes: relación con la fertilidad / Dietary intake of trace elements and semen quality and reproductive hormone levels in young men: relationship with fertility

Objetivo: El objetivo de este trabajo fue analizar las asociaciones entre la ingesta dietaria de oligoelementos y la calidad seminal y los niveles de hormonas reproductivas en varones jóvenes. Material y método: Se trata de un estudio transversal realizado en jóvenes universitarios sanos (n = 209) de la Región de Murcia entre 2010 y 2011. Los valores de ingesta dietaria de oligoelementos (hierro, yodo y cinc) se obtuvieron mediante un cuestionario de frecuencia alimentaria validado. Los análisis seminales (concentración, movilidad y morfología espermática) se llevaron a cabo siguiendo los criterios y guía de la Organización Mundial de la Salud. Se analizaron los niveles séricos de las hormonas folículo-estimulante, luteinizante y testosterona. Se utilizaron pruebas no paramétricas (Kruskal-Wallis) y la χ2 para los análisis bivariantes, y modelos de regresión lineal múltiple para ajustar por covariables significativas. Resultados: Se mostró una asociación inversa estadísticamente significativa entre la ingesta dietaria de hierro y la concentración espermática (P, tendencia = 0,01) y el porcentaje de espermatozoides móviles progresivos (P, tendencia = 0,004). No se encontraron asociaciones significativas con el resto de parámetros espermáticos, ni con las hormonas reproductivas. Conclusiones: Nuestros resultados muestran que niveles altos de ingesta dietaria de hierro estarían asociados con una disminución de la concentración y movilidad espermática en jóvenes varones. No obstante, son necesarios más estudios para confirmar estos hallazgos, en particular, en otras poblaciones de varones que consultan por problemas de infertilidad

Objective: The aim of this study was to study the associations between dietary intake of trace elements and semen quality and reproductive hormones levels in young men. Material and method: This is a cross-sectional study in healthy male university students (n = 209) recruited in Murcia Region (Spain) between 2010 and 2011. Dietary intake of trace elements (iron, iodine and cinc) was assessed using a validated food frequency questionnaire. Semen analysis (sperm concentration, motility and morphology) was carried out according to World Health Organization guidelines. Serum concentrations of follicle-stimulating and luteinizing hormones and testosterone were also determined. Kruskal-Wallis and Chi-squared tests were used in bivariate analysis and multiple lineal regression was used to adjust for significant covariates. Results: A statistically significant inverse association between dietary intake of iron and sperm concentration (P, trend = 0.01) and the percentage of progressive motile sperm (P, trend = 0.004) were observed. No other significant associations for the remaining sperm parameters or reproductive hormones were detected. Conclusions: Our results show that high levels of iron may be associated with reduced sperm concentration and motility in young men. However, further studies are needed, particularly in other male populations consulting for infertility problems

[Dietary intake of trace elements and semen quality and reproductive hormone levels in young men: relationship with fertility]. / Oligoelementos en la dieta y calidad seminal y niveles de hormonas reproductivas en varones jóvenes: relación con la fertilidad.

OBJECTIVE: The aim of this study was to study the associations between dietary intake of trace elements and semen quality and reproductive hormones levels in young men. MATERIAL AND METHOD: This is a cross-sectional study in healthy male university students (n=209) recruited in Murcia Region (Spain) between 2010 and 2011. Dietary intake of trace elements (iron, iodine and cinc) was assessed using a validated food frequency questionnaire. Semen analysis (sperm concentration, motility and morphology) was carried out according to World Health Organization guidelines. Serum concentrations of follicle-stimulating and luteinizing hormones and testosterone were also determined. Kruskal-Wallis and Chi-squared tests were used in bivariate analysis and multiple lineal regression was used to adjust for significant covariates. RESULTS: A statistically significant inverse association between dietary intake of iron and sperm concentration (P, trend=0.01) and the percentage of progressive motile sperm (P, trend=0.004) were observed. No other significant associations for the remaining sperm parameters or reproductive hormones were detected. CONCLUSIONS: Our results show that high levels of iron may be associated with reduced sperm concentration and motility in young men. However, further studies are needed, particularly in other male populations consulting for infertility problems.

Urinary concentrations of benzophenone-type ultra violet light filters and reproductive parameters in young men.

BACKGROUND: Benzophenone (BP)-type ultraviolet (UV) light filters are chemicals frequently added to personal care products, insect repellents, sunscreens, and beverage and food packaging to diminish the harmful effects of UV sunlight on human skin or foodstuffs. BP-type UV filters have shown negative effects on male reproduction function in in vitro and animal models, but human epidemiologic studies are limited. The goal of this study was to examine associations between urinary concentrations of BP-type UV filters and semen quality and reproductive hormone levels. METHODS: This is a cross-sectional study with 215 young university students (18-23 years old) recruited between 2010 and 2011 in Southern Spain (Murcia Region). All men provided a urine, blood and semen sample on a single day. Urinary concentrations of 2,4-dihydroxybenzophenone (BP-1); 2,2',4,4'-tetrahydroxybenzophenone (BP-2); 2-hydroxy-4-methoxybenzophenone (BP-3); 2,2'-dihydroxy-4-methoxybenzophenone (BP-8) and 4-hydroxybenzophenone (4OH-BP) were measured by dispersive liquid-liquid microextraction and ultra-high performance liquid chromatography with tandem mass spectrometry detection. Semen quality was evaluated by measuring volume, sperm counts, motility and morphology. Serum samples were analyzed for reproductive hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), inhibin B and estradiol (E2). Associations between urinary concentrations of BP-type UV filters and semen quality parameters and reproductive hormone levels were examined using linear regression, adjusting for potential confounders. RESULTS: Ninety-seven percent of the men had detectable urinary concentrations of at least one of the five BP-type UV filters quantified. After adjustment for important covariates (body mass index, smoking status and time of blood sample collection), there was a significant positive association between urinary BP-1 and BP-3 concentrations and serum FSH levels (ß = 0.08, 95%CI: 0.009; 0.15 and ß = 0.04, 95%CI: 0.0002; 0.08, respectively). Urinary BP-1 concentration was also significantly positively associated with T/E2 (ß = 0.04, 95%CI: 0.002; 0.07) and negatively with inhibin b/FSH (ß = -0.11, 95%CI: -0.21; -0.006) ratio. No significant associations were found between other urinary BP-type UV filters and other reproductive hormone levels or between any semen parameters and any of the urinary BP-type UV filters quantified. CONCLUSIONS: Our results suggest that, in young men, urinary BP-type UV filters may be associated with a modest alteration of some reproductive hormones, but the effects we report on reproductive function are likely to be small, and of unclear clinical significance. Further research is needed to replicate these findings in other male populations.

Urinary concentrations of parabens and reproductive parameters in young men.

Parabens are a group of alkyl esters of p-hydroxybenzoic acid that are commonly added to personal care products, cosmetics, pharmaceuticals and beverage and food processing as antimicrobial preservatives. Parabens have been reported to show estrogenic effects and affect male reproduction function in animal models, but human epidemiologic studies are still scarce. The objective of this study was to examine associations between urinary concentrations of parabens and semen quality and reproductive hormone levels. This was a cross-sectional study with 215 young university students (18-23years old) recruited between 2010 and 2011 in Southern Spain (Murcia Region). All men provided a urine, blood and semen sample on a single day. Urinary paraben concentrations (methylparaben, ethylparaben, propylparaben and butylparaben) were measured by dispersive liquid-liquid microextraction and ultra-high performance liquid chromatography with tandem mass spectrometry detection. Semen quality was evaluated by measuring volume, sperm concentration, total sperm count (TSC), motility and morphology following WHO guidelines. Serum samples were analyzed for reproductive hormones, including follicle-stimulating hormone, luteinizing hormone, testosterone, inhibin B and estradiol using immunoassays. Associations between urinary concentrations of parabens and semen quality parameters and reproductive hormone levels were examined using linear regression, adjusting for potential covariates. Ninety-four percent of the men had detectable urinary concentrations of parabens. After taking into account important covariates, urinary concentrations of parabens or their molar sum were not significantly associated with any semen parameters or any of the reproductive hormone levels. Relative to men in the lowest quartile of sum of urinary paraben concentrations, the adjusted difference (95% CI) of TSC (millions) for men in the 2nd, 3rd, and 4th quartiles were 4.1% (-37.1;45.3), -1.6% (-41.9;38.8), and -9.8% (-52.5;32.8), respectively (P-trend=0.55). Our results suggest that, in young men, urinary parabens may not adversely impact reproductive function, but further research is warranted to confirm these findings in other male populations.

Associations between oxidative stress biomarkers in different body fluids and reproductive parameters in male partners of subfertile couples / Asociaciones entre biomarcadores de estrés oxidativo en diferentes fluidos biológicos y parámetros reproductivos en varones de parejas subfértiles

Objective. To evaluate the relationships between oxidative stress (OS) biomarkers and total antioxidant capacity (TAC) in blood serum and seminal plasma, and their associations with semen quality and serum reproductive hormone concentrations in potential subfertile men. Material and method. A cross-sectional study was conducted on men (n = 122) attending an infertility clinic in the Murcia Region (Southern Spain) between 2012 and 2013. Concentrations of malondialdehyde (MDA), nitric oxide (NO) and TAC were measured in blood and semen. Follicle-stimulating hormone, luteinising hormone, testosterone, prolactin and oestradiol concentrations were measured in serum. Semen analyses were performed according to World Health Organization criteria. Correlation analysis and multiple linear regression models were performed, controlling for important covariates. Results. There was a significant inverse association between serum MDA concentrations and all sperm parameters, except for seminal volume. Serum TAC concentrations were positively related to sperm count and motility. A positive association was observed between seminal plasma NO levels and the percentage of morphologically normal sperm. With regard to reproductive hormones, serum MDA concentrations were positively related to FSH and LH levels, and TAC inversely associated with FSH levels. Conclusions. Our results suggest that oxidative stress may be associated with semen parameters and reproductive hormone levels in male partners of couples seeking infertility treatment. However, further studies are needed to confirm and extend these findings, in particular, with regard to serum reproductive hormones (AU)

Objetivo. Evaluar las correlaciones entre marcadores de estrés oxidativo (OS) y capacidad antioxidante total (TAC) en suero sanguíneo y plasma seminal, y sus asociaciones con calidad seminal y hormonas reproductivas en varones potencialmente subfértiles. Material y método. Estudio transversal realizado en varones (n = 122) que acudían a un servicio de infertilidad de Murcia entre 2012-2013. Las concentraciones de malondialdehído (MDA), óxido nítrico (NO) y TAC se midieron en sangre y semen. Se analizaron los niveles séricos de las hormonas foliculoestimulante, luteinizante, testosterona, prolactina y estradiol. Los análisis espermáticos se llevaron a cabo siguiendo las normas de la Organización Mundial de la Salud. Se utilizaron análisis de correlación y modelos de regresión lineal múltiple ajustando por covariables importantes. Resultados. Se mostró una asociación inversa significativa entre las concentraciones séricas de MDA y todos los parámetros espermáticos, excepto el volumen seminal. Las concentraciones séricas de TAC se relacionaron positivamente con el recuento y la movilidad espermática. Los niveles de NO en plasma seminal se asociaron directamente con el porcentaje de espermatozoides morfológicamente normales. Con respecto a las hormonas reproductivas, las concentraciones séricas de MDA se asociaron positivamente con los niveles de FSH y LH, y las de TAC se asociaron inversamente con los niveles de FSH. Conclusiones. Nuestros resultados sugieren que el estrés oxidativo estaría asociado con los parámetros seminales y hormonales en varones de parejas que consultan por problemas de infertilidad. Sin embargo, son necesarios más estudios para confirmar estos hallazgos, en particular con respecto al papel de las hormonas reproductivas (AU)

Associations between urinary organophosphate pesticide metabolite levels and reproductive parameters in men from an infertility clinic.

Organophosphate (OP) pesticides are compounds used for pest control at home or in agriculture activities. Almost all OP pesticides are metabolized to at least one of six possible dialkylphosphates (DAPs). Despite wide use, their potential effects on human reproductive health have not yet been fully characterized. The aim of this study was to evaluate the associations between urinary concentrations of six DAP metabolites and reproductive parameters in men. All men were attended an infertility clinic and provided urine, serum and semen samples on the same day. Six DAP metabolites were measured in urine (dimethylphosphate [DMP], dimethylthiophosphate [DMTP], dimethyldithiophosphate [DMDTP], diethylphosphate [DEP], diethylthiophosphate [DETP], and diethyldithiophosphate [DEDTP]). Sperm quality was assessed by measuring volume, concentration, total sperm count (TSC), motility and morphology, and serum samples were analyzed for reproductive hormones, including follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, prolactin and estradiol. Pearson correlations were used for unadjusted analyses, and multiple linear regression analysis was performed controlling for appropriate covariates. All men presented detectable concentrations of at least one urinary OP metabolite. After adjustment by important covariates, there was a significant positive association between DEDTP concentrations and LH [(ß)=11.4; 95% CI 0.81-22.1] as well as FSH levels [(ß)=3.2; 95% CI 0.08-6.2]. Sperm concentration and TSC were both significantly inversely associated with DMP, DMDP, DMDTP and ∑DAP in multivariate analysis. Besides, there was a significant inverse association between percentage of motile sperm and DMTP, DMDTP and DEP metabolite concentrations. Our results suggest that exposure to OP pesticides may be associated with decreased sperm counts and motility and altered reproductive hormone levels in male partners of couples seeking for infertility treatment. However, further studies are warranted to confirm and extent these findings.