Seminal oxidation-reduction potential and sperm DNA fragmentation index increase among infertile men with varicocele.

Varicocele is a common cause of male infertility. It is reported that low sperm concentration, motility and morphology are indicative of increased sperm DNA fragmentation index (DFI) in men with varicocele. Although research has been conducted into the relationship between varicocele and DFI, little is known about seminal oxidation-reduction potential (ORP) in varicocele patients. We assessed the relationship between varicocele with seminal ORP and sperm DFI in both fertile and infertile men. This prospective case-control study compared the findings from infertile men with varicocele to those of men with normal spermatogenesis without varicocele. Semen samples were collected and assessed using the WHO (2010) guidelines. ORP was measured (mV) and normalized to sperm concentration (mV/106 sperm/mL). DFI was measured using the sperm chromatin structure assay (SCSA) method. For group comparisons, only samples with a concentration >1 × 106 sperm/mL were included. Infertile men with varicocele had significantly lower mean sperm concentration, motility and total sperm count. Conversely, infertile men with varicocele had a significantly higher mean serum FSH level, and higher ORP and DFI values than fertile controls. ORP was higher in patients with varicocele and positively correlated with DFI (p < 0.01). ORP and DFI showed significant negative correlations with semen parameters (sperm concentration, motility and total sperm count) in infertile men with a varicocele.

Combination therapy with antioxidants improves total motile sperm counts: A Preliminary Study.

PURPOSE: Optimal strategies to treat idiopathic male infertility have remained unclear. The aim of this study was to evaluate the effectiveness of combination antioxidant therapy with several vitamins and supplements on semen parameters. METHODS: Thirty-one men with oligozoospermia and/or asthenozoospermia evaluated by a Makler counting chamber were randomly assigned to two treatment groups: a combination of antioxidant supplements (L-carnitine, zinc, astaxanthin, coenzyme Q10, vitamin C, vitamin B12, and vitamin E) and a Chinese herbal medicine, hochu-ekki-to (HE). Serum endocrinological profiles and semen parameters, especially total motile sperm count, were compared between before and after 12 weeks of treatment in both groups. RESULTS: In the supplement group, endocrinological findings were not significantly improved. The semen parameters of semen volume, sperm concentration, and sperm motility were not statistically significantly improved, whereas total motile sperm count was significantly improved. In contrast, none of the endocrinological factors or semen findings were significantly improved by the Chinese herbal medicine although semen concentration, semen motility, and total motile sperm count showed a tendency to increase. CONCLUSION: Because combination antioxidant therapy could improve sperm motility significantly for patients with idiopathic oligoasthenozoospermia, our supplement could be one treatment option for idiopathic male infertility.

Erectile Dysfunction is Predictive Symptom for Poor Semen in Newlywed Men in Japan.

INTRODUCTION: As a continuous decline in semen concentration has been reported, the concept of male infertility has gained increased attention. Although several surveys of semen quality have been conducted in young men in general, no study has reported only on newlywed men. AIM: The aim of this study was to evaluate semen quality and assess its characteristics in newlywed men. METHODS: This study included 564 men visiting our hospital or clinic for fertility screening just before their wedding or as newlywed men. Based on the World Health Organization criteria, the rates of men who did not have a semen volume of ≥1.5 mL, a sperm concentration of ≥15 million/mL, and a sperm motility rate of ≥40% were calculated. The characteristics of the poor semen findings group with any 1 of the 3 items of semen volume, sperm concentration, or sperm motility rate not reaching the reference value were evaluated. MAIN OUTCOME MEASURE: Independent factors, which are involved in the poor semen findings group, were evaluated. RESULTS: The poor findings in semen volume, sperm concentration, and sperm motility were found in 11.0%, 9.2%, and 10.6%, respectively. The poor semen findings group included 143 men (25.4%) with any 1 of the 3 items not reaching the reference value. As compared to the normal group, age and body mass index were significantly higher, testicular volume was significantly smaller, and blood gamma-glutamyltransferase and fasting blood sugar levels were significantly higher in the poor semen findings group. Logistic multivariate analysis, including symptom questionnaire scores, blood biochemistry items, and endocrinological items, showed 3 independent factors were involved in the poor semen findings group: age, luteinizing hormone, and erection (Erection Hardness Score). CONCLUSION: It was clarified that even among men beginning their attempts at pregnancy, semen findings were poor and erectile dysfunction was involved in poor semen quality in one-quarter of the men. Tsujimura A, Hiramatsu I, Nagashima Y, et al. Erectile Dysfunction is Predictive Symptom for Poor Semen in Newlywed Men in Japan. Sex Med 2019;8:21-29.

Development and Validation of a Novel Recurrence Risk Stratification for Initial Non-muscle Invasive Bladder Cancer in Asia.

BACKGROUND: Some risk classifications to determine prognosis of patients with non-muscle invasive bladder cancer (NMIBC) have disadvantages in the clinical setting. We investigated whether the EORTC (European Organization for Research and Treatment of Cancer) risk stratification is useful to predict recurrence and progression in Japanese patients with NMIBC. In addition, we developed and validated a novel, and simple risk classification of recurrence. METHODS: The analysis was based on 1085 patients with NMIBC at six hospitals. Excluding recurrent cases, we included 856 patients with initial NMIBC for the analysis. The Kaplan-Meier method with the log-rank test were used to calculate recurrence-free survival (RFS) rate and progression-free survival (PFS) rate according to the EORTC risk classifications. We developed a novel risk classification system for recurrence in NMIBC patients using the independent recurrence prognostic factors based on Cox proportional hazards regression analysis. External validation was done on an external data set of 641 patients from Kyorin University Hospital. FINDINGS: There were no significant differences in RFS and PFS rates between the groups according to EORTC risk classification. We constructed a novel risk model predicting recurrence that classified patients into three groups using four independent prognostic factors to predict tumour recurrence based on Cox proportional hazards regression analysis. According to the novel recurrence risk classification, there was a significant difference in 5-year RFS rate between the low (68.4%), intermediate (45.8%) and high (33.7%) risk groups (P<0.001). INTERPRETATION: As the EORTC risk group stratification may not be applicable to Asian patients with NMIBC, our novel classification model can be a simple and useful prognostic tool to stratify recurrence risk in patients with NMIBC. FUNDING: None.