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1.
Niger J Clin Pract ; 23(12): 1744-1747, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33355829

RESUMO

Background: Varicocele is the most common correctable cause of male infertility. But, it is still controversial in patients with severe oligospermia. Aim: The aim of this study is to evaluate how varicocelectomy impacts pregnancy rates (natural or assisted reproductive techniques) in infertile couples when the male partner has severe oligospermia and history of varicocele. Materials and Methods: A retrospective examination was made of males with total motile sperm count <5 million/mL with varicocele in the period April 2013 to October 2019. Pregnancy rates were compared at the end of 1-year follow-up of 52 patients (Group 1) who underwent varicocelectomy and 36 patients (Group 2) who applied for assisted reproductive techniques without surgery. The postoperative third-month sperm parameters were compared for Group 1. Spontaneous pregnancy and conception rates with assisted reproductive techniques for Groups 1 and 2 were also investigated after 1 year. Results: In the semen analysis performed in the 3rd month, a statistically significant increase was observed in sperm number, motility, and morphology of the patients in Group 1. Spontaneous pregnancy was obtained in 7 (13.4%) of the 56 Group 1 patients who underwent varicocelectomy, in 7 (13.4%) patients with intrauterine insemination, and in 6 (11.5%) patients with intracytoplasmic injection (ICSI). In Group 2, pregnancy occurred with the help of ICSI in 4 of 32 patients (11.1%). Conclusions: Varicocele surgery before assisted reproductive techniques will be more beneficial in terms of both cost-effectiveness and pregnancy rates.


Assuntos
Infertilidade Masculina , Oligospermia , Varicocele , Feminino , Humanos , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/etiologia , Masculino , Oligospermia/epidemiologia , Oligospermia/cirurgia , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Contagem de Espermatozoides , Varicocele/cirurgia
2.
Rev. int. androl. (Internet) ; 18(3): 117-123, jul.-sept. 2020.
Artigo em Espanhol | IBECS | ID: ibc-192625

RESUMO

OBJETIVO: El objetivo de esta revisión es resumir la evidencia disponible sobre los posibles efectos adversos del SARS-CoV-2 en el sistema reproductor masculino y proporcionar una declaración de posición oficial de la Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA). MÉTODOS: Se realizó una búsqueda exhaustiva en las bibliotecas Pubmed, Web of Science, Embase, Medline, Cochrane y MedRxiv. RESULTADOS: No se ha confirmado la orquitis como una posible complicación de la infección por SARS-CoV-2. Un estudio informó que el 19% de los hombres con COVID-19 presentaban molestias escrotales sugestivas de orquitis viral, que no se pudo confirmar. Es posible que el virus no infecte los testículos directamente, si no que desencadene una respuesta autoinmune secundaria y que cause una orquitis autoinmune. COVID-19 se ha asociado con anormalidades en la coagulación por lo que la orquitis podría ser el resultado de una vasculitis segmentaria. Los datos disponibles sobre la presencia del virus en semen son contradictorios. Sólo un estudio informó de la presencia de ARN en el 15,8% de enfermos de COVID-19. La presencia de ácido nucleico o antígeno en el semen no implica la existencia de virus con capacidad de replicación o infección. En hombres con COVID-19 se ha observado un incremento significativo de LH en suero y una drástica disminución de la ratio T/LH y FSH/LH, congruente con un hipogonadismo subclínico. CONCLUSIONES: Los datos disponibles y los hallazgos de los estudios recientes se basan en tamaños de muestra pequeños y proporcionan informaciones contradictorias. Existe la posibilidad teórica de que pueda producirse daño testicular y posterior infertilidad después de la infección por COVID-19, por lo que especialmente para aquellos hombres en edad reproductiva, se debe sugerir consulta y evaluación de la función gonadal y análisis de semen. En cuanto a la posibilidad de transmisión sexual, no hay evidencia suficiente para respaldar la necesidad de que las parejas asintomáticas eviten las relaciones sexuales para protegerse contra la transmisión del virus. Se necesita más investigación para comprender los impactos a largo plazo del SARS-CoV-2 en la función reproductiva masculina, incluidos sus posibles efectos sobre la fertilidad y la función endocrina testicular


OBJECTIVE: The main objective of this revision is to summarize the current existing evidence of the potential adverse effects of SARS-CoV-2 on the male reproductive system and provide the recommendations of the Asociación Española de Andrología, Medicina Sexual y Reproductiva (ASESA) concerning the implications of COVID-19 infection in the management of male infertilty patients and testicular endocrine dysfunction. METHODS: A comprehensive systematic literature search of the databases of PubMed, Web of Science, Embase, Medline, Cochrane and MedRxiv, was carried out. RESULTS: The presence of orchitis as a potential complication of the infection by SARS-CoV-2 has not yet been confirmed. One study reported that 19% of males with COVID-19 infection had scrotal symptoms suggestive of viral orchitis which could not be confirmed. It is possible that the virus, rather than infecting the testes directly, may induce a secondary autoimmune response leading to autoimmune orchitis. COVID-19 has been associated with coagulation disorders and thus the orchitis could be the result of segmental vasculitis. Existing data concerning the presence of the virus in semen are contradictory. Only one study reported the presence of RNA in 15.8% of patients with COVID-19. However, the presence of nucleic acid or antigen in semen is not synonyms of viral replication capacity and infectivity. It has been reported an increase in serum levels of LH in males with COVID-19 and a significant reduction in the T/LH and FSH/LH ratios, consistent with subclinical hypogonadism. CONCLUSIONS: The findings of recent reports related to the potential effects of COVID-19 infection on the male reproductive system are based on poorly designed, small sample size studies that provide inconclusive, contradictory results. Since there still exists a theoretical possibility of testicular damage and male infertilty as a result of the infection by COVID-19, males of reproductive age should be evaluated for gonadal function and semen analysis. With regard to the sexual transmission of the virus, there is not sufficient evidence to recommend asymptomatic couples to abstein from having sex in order to protect themselves from being infected by the virus. Additional studies are needed to understand the long-term effects of SARS-CoV-2 on male reproductive function, including male fertility potential and endocrine testicular function


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Orquite/epidemiologia , Infertilidade Masculina/epidemiologia , Infecções por Coronavirus/complicações , Síndrome Respiratória Aguda Grave/complicações , Vírus da SARS/patogenicidade , Saúde Sexual e Reprodutiva , Sêmen/virologia
4.
Sex Med Rev ; 8(4): 518-530, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32713674

RESUMO

INTRODUCTION: The 21st century has seen a series of viral pandemics that have collectively infected millions of individuals. To understand factors that may contribute to viral spread and address long-term health sequelae for survivors, it is important to review evidence regarding viral presence in semen, sexual transmission potential, and possible effects on fertility. AIM: To review the current literature regarding the sexual transmissibility of recent viral pandemics and their effects on semen parameters and fertility. We review evidence for the following viruses: Ebola, Zika, West Nile, pandemic influenza, severe acute respiratory syndrome (SARS), and SARS-corona virus-2 (SARS-CoV-2). METHODS: A literature search was conducted to identify relevant studies. Titles and abstracts were reviewed for relevance. References from identified articles were searched and included, if appropriate. MAIN OUTCOME MEASURES: The main outcome measure of this study was reviewing of peer-reviewed literature. RESULTS: Both the Ebola virus and Zika virus are present in semen, but only the Zika virus shows consistent evidence of sexual transmission. Current evidence does not support the presence of the West Nile virus, pandemic influenza, SARS, and SARS-CoV-2 in semen. The Zika virus appears to alter semen parameters in a way that diminishes fertility, but the effect is likely time limited. The West Nile virus and SARS have been associated with orchitis in a small number of case reports. Viruses that cause febrile illness, such as pandemic influenza, SARS, and SARS-CoV-2, are associated with decreased sperm count and motility and abnormal morphology. SARS and SARS-CoV-2 may interact with angiotensin-converting enzyme 2 receptors present in the testes, which could impact spermatogenesis. CONCLUSIONS: We have reported the presence in semen, sexual transmission potential, and fertility side effects of recent viral pandemics. Overall, semen studies and fertility effects are highly understudied in viral pandemics, and rigorous study on these topics should be undertaken as novel pandemics emerge. Payne K, Kenny P, Scovell JM, et al. Twenty-First Century Viral Pandemics: A Literature Review of Sexual Transmission and Fertility Implications for Men. Sex Med Rev 2020;8:518-530.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/virologia , Pneumonia Viral/transmissão , Doenças Virais Sexualmente Transmissíveis/epidemiologia , Doenças Virais Sexualmente Transmissíveis/transmissão , Infecções por Coronavirus/epidemiologia , Humanos , Masculino , Pandemias , Pneumonia Viral/epidemiologia
5.
Acta Clin Croat ; 59(1): 37-49, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32724273

RESUMO

The purpose of this study was to determine the prevalence of allele and genotype variants of the follicle-stimulating hormone receptor (FSHR) gene polymorphic region at position Asn680Ser in the Albanian male population and associate them with the clinical parameters of infertility. The study included 114 infertile men (mean age 35.04±5.85 years) stratified according to the level of spermatogenetic impairment (oligoasthenozoospermia, asthenozoospermia and normospermia) and 112 fertile men (mean age 36.44±7.05 years) with normal semen parameters. Genotyping of the FSHR gene at position 680 was performed by TaqMan genotyping assay. All the participants underwent semen analysis, and serum reproductive hormones (FSH, luteinizing hormone, prolactin and testosterone) were also measured. The FSHR Asn680Ser genotype frequencies were as follows: Asn/Ser 42%, Ser/Ser 33.9% and Asn/Asn 24.1% in the control group, and Asn/Ser 56.1%, Ser/Ser 22.8% and Asn/Asn 21.1% in the whole group of infertile men (χ2-test: P=0.08). There was no statistically significant correlation between serum hormone levels and semen characteristics or between fertility status and FSHR Asn680Ser gene variants in the control group and the group of infertile men. However, adjusted logistic regression analysis (age, body mass index, smoking and alcohol as covariates) revealed increased odds ratio for male infertility among heterozygous Asn/Ser genotype carriers associated with lower values of semen parameters (normal morphology, concentration, total sperm count and motility). In conclusion, our case-control study further confirmed previous reports on no significant association between the FSHR Asn680Ser polymorphisms and male infertility. Nevertheless, the data presented herein indicate that the Asn/Ser genotype may increase the risk of male infertility in Albanian population.


Assuntos
Infertilidade Masculina , Receptores do FSH , Adulto , Estudos de Casos e Controles , Hormônio Foliculoestimulante , Humanos , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/genética , Masculino , Polimorfismo Genético , Receptores do FSH/genética , Motilidade Espermática
7.
Medicine (Baltimore) ; 99(26): e20894, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590798

RESUMO

RATIONALE: Couples with male balanced-translocation carriers may experience recurrent pregnancy loss (RPL). Although the expectant management of RPL has developed over many years, genetic counseling for RPL couples with male balanced-translocation carriers remains challenging. Here, we describe the expectant management of 2 male carriers of balanced translocations. PATIENT CONCERNS: A 32-year-old and a 28-year-old man presented at the clinic with diagnoses of infertility following spontaneous abortions by their wives. DIAGNOSIS: Both patients had normal semen diagnosed by routine semen analysis and underwent cytogenetic diagnoses. INTERVENTIONS: Following genetic counseling and informed consent, both couples voluntarily chose expectant management with natural conception. OUTCOMES: One couple experienced 2 natural pregnancies, the first of which ended in spontaneous abortion and the second produced a phenotypically normal infant. The other couple's first pregnancy resulted in a fetus with a balanced translocation confirmed by amniocentesis and cytogenetic analysis. LESSONS: Expectant management with natural conception may be an alternative to genetic counseling in male balanced-translocation carriers with RPL, especially those who are reluctant to undergo preimplantation diagnosis.


Assuntos
Infertilidade Masculina/genética , Resultado da Gravidez/genética , Translocação Genética/genética , Aborto Espontâneo/epidemiologia , Adulto , China/epidemiologia , Feminino , Humanos , Infertilidade Masculina/complicações , Infertilidade Masculina/epidemiologia , Masculino , Gravidez , Resultado da Gravidez/epidemiologia , Análise do Sêmen/métodos
8.
Metabolism ; 107: 154229, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32289345

RESUMO

Chronic energy deficiency can impair the hypothalamic-pituitary-gonadal (HPG) axis and lead to hypothalamic anovulation in underweight women. This review presents the syndromes related to underweight status that are associated with infertility, summarizes the underlying mechanisms, and reviews the available treatment options. Eating disorders, such as anorexia nervosa (AN), constitute the most common cause of infertility in underweight women, who, in addition, experience miscarriages, and sexual dysfunction. The relative energy deficiency in sports (RED-S; former terminology: athlete's triad) involves menstrual dysfunction due to low energy availability, which results in anovulation. Moreover, lipodystrophies, malnutrition, starvation, systematic illnesses (malignancies, endocrinopathies, infectious diseases, advanced chronic diseases, neurologic illnesses), and the utilization of drugs can cause excessive weight loss. They may result in fertility problems due to the loss of adipose tissue and the subsequent hormonal disturbances. Each of these conditions requires multidisciplinary management. Nutritional counseling should target the restoration of energy balance by increasing intake and reducing output. Medical treatment, recommended only for patients who did not respond to standard treatment, may include antipsychotics, antidepressants, or leptin administration. Finally, psychiatric treatment is considered an integral part of the standard treatment.


Assuntos
Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Reprodução , Magreza/complicações , Anorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Masculino , Magreza/epidemiologia , Magreza/fisiopatologia
9.
Urol Clin North Am ; 47(2): 193-204, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32272991

RESUMO

Although infertility is now recognized as a disease by multiple organizations including the World Health Organization and the American Medical Association, private insurance companies rarely include coverage for infertility treatments. In this review, the authors assess the current state of care delivery for male infertility care in the United States. They discuss the scope of male infertility as well as the unique burdens it places on patients and review emerging market forces that could affect the future of care delivery for male infertility.


Assuntos
Assistência à Saúde/métodos , Assistência à Saúde/tendências , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/terapia , Cobertura do Seguro/legislação & jurisprudência , Seguro Saúde/legislação & jurisprudência , Comorbidade , Assistência à Saúde/estatística & dados numéricos , Previsões , Política de Saúde/legislação & jurisprudência , Humanos , Infertilidade/diagnóstico , Infertilidade/economia , Infertilidade/terapia , Infertilidade Masculina/economia , Infertilidade Masculina/epidemiologia , Masculino , Estados Unidos/epidemiologia
10.
Urol Clin North Am ; 47(2): 211-217, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32272993

RESUMO

Somatic health is associated with male infertility; potential links between infertility and health may arise from genetic, developmental, and lifestyle factors. Studies have explored possible connections between male infertility and oncologic, cardiovascular, metabolic, chronic, and autoimmune diseases. Male infertility also may be a predictor of hospitalization and mortality. Additional research is required to elucidate the mechanisms by which male infertility affects overall health.


Assuntos
Infertilidade Masculina/epidemiologia , Comorbidade , Humanos , Infertilidade Masculina/etiologia , Estilo de Vida , Masculino , Saúde do Homem
11.
BMC Public Health ; 20(1): 307, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164645

RESUMO

BACKGROUND: Little is known about the potential role of central obesity among men. Our first aim was to confirm what is already known from prior research, namely that both BMI and WHR are inversely associated with selected semen parameters. Our second aim was to examine the potential role of central obesity by assessing if there was a difference between BMI and WHR regarding their relationships to these selected semen parameters. METHODS: In this cross-sectional study between January 2011 to January 2018, we analyzed semen samples from 1169 patients who visited an andrology clinic in Budapest for infertility reasons. Variables assessed were: body measurements (height, weight, waist circumference, and hip circumference), and the results of semen analysis (sperm concentration, total sperm count, progressive sperm motility, and normal sperm morphology). RESULTS: The mean height and weight were 180.6 cm and 87.3 kg, respectively - the mean BMI was 26.8. The mean waist and hip circumferences were 100.9 cm and 94.8 cm, respectively - the mean waist to hip ratio was 0.94. The mean sperm concentration, total sperm count, and percents of progressive motility and normal morphology were 48.7 M/ml, 165 million, 21.2, and 4.8%, respectively. Both BMI and WHR were significant correlates in all semen parameter regression models. When comparing the parameter estimates for BMI with those for WHR for each semen parameter, the parameter estimate for WHR was significantly lower (indicating a stronger negative association) than that for BMI for progressive motility and total sperm count, but not for normal morphology or concentration. CONCLUSIONS: Our study is the first to examine, using a large patient sample, the potential role of central obesity by comparing the difference between BMI and WHR as they relate to selected semen parameters. Our findings indicate a potential role of central obesity for progressive motility and total sperm count, but not for normal morphology and concentration. Despite the limitations and the exploratory nature of this study, we can conclude that our results point to a potential role of central obesity in male infertility, but this finding should be confirmed and further explored in future research. TRIAL REGISTRATION: The trial was retrospectively authorized after the data collection on September 24, 2018. Registration number: SE RKEB: 169/2018.


Assuntos
Índice de Massa Corporal , Infertilidade Masculina/epidemiologia , Obesidade Abdominal/epidemiologia , Análise do Sêmen/estatística & dados numéricos , Relação Cintura-Quadril , Adolescente , Adulto , Idoso , Estudos Transversais , Humanos , Masculino , Pessoa de Meia-Idade , Contagem de Espermatozoides/estatística & dados numéricos , Motilidade Espermática , Adulto Jovem
12.
Metabolism ; 107: 154193, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32119876

RESUMO

The dramatic increase in the prevalence of obesity coincides with a decline in reproductive health indices in both sexes. Energy excess mediates changes to the regulatory mechanisms of the reproductive system. Obese individuals exhibit increased estrogen concentrations, due to the overexpression of aromatase in the adipose tissue; via a negative feedback loop, men present with symptoms of hypogonadotropic hypogonadism. These hormonal changes, along with increased oxidative stress, lipotoxicity and disturbances in the concentrations of adipokines, directly affect the gonads, peripheral reproductive organs and the embryo. Clinical evidence is somewhat contradicting, with only some studies advocating worse semen parameters, increased incidence of erectile dysfunction, increased doses of ovulation induction medications, and worse live birth rates in assisted reproductive technology (ART) cycles in obese individuals compared with those of normal weight. Similar conclusions are drawn about patients with insulin resistance syndromes, namely polycystic ovary syndrome (PCOS). As far as treatment options are concerned, lifestyle changes, medical therapy and bariatric surgery may improve the reproductive outcome, although the evidence remains inconclusive. In this review, we summarize the evidence on the association of obesity and reproductive health on both the molecular and the clinical level, and the effect of weight-loss interventions on reproductive potential.


Assuntos
Infertilidade Feminina/etiologia , Infertilidade Masculina/etiologia , Obesidade/complicações , Sobrepeso/complicações , Reprodução , Transtornos da Alimentação e da Ingestão de Alimentos/complicações , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/fisiopatologia , Feminino , Humanos , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Masculino , Obesidade/epidemiologia , Obesidade/fisiopatologia , Sobrepeso/epidemiologia , Sobrepeso/fisiopatologia
13.
Andrologia ; 52(3): e13519, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32003032

RESUMO

The declining trend of male fecundity is a major global health and social concern. Among numerous other confounding factors, variations in male fertility parameters in different regions have repeatedly been suggested to be influenced by geographic locations. The impact of overall lifestyle, behavioural patterns, ethnicity, work stress and associated factors upon health differ greatly between developed and developing countries. These factors, individually or in combination, affect male reproductive functions ensuing the discrepancies in semen qualities in connection with geographic variations. However, reports comparing semen characteristics between developed and developing countries are sparse. The present study finds its novelty in presenting a comparison in semen parameters of infertile men in the United States (n = 76) that fairly represents the population of a highly developed region and Iraq (n = 102), the representative of male populations of a developing region. Samples were collected and analysed according to WHO (WHO laboratory manual for the examination and processing of human semen, WHO; 2010) criteria by means of the Mann-Whitney test. The US population demonstrated lower sperm concentration, total count, and total and progressive sperm motility with a higher seminal total antioxidant capacity (TAC) as compared to the Iraqi population. This report encourages further investigations concerning the confounding factors leading to such alterations in semen qualities between these two geographic areas.


Assuntos
Fertilidade/fisiologia , Infertilidade Masculina/patologia , Espermatozoides/patologia , Adulto , Fatores de Confusão Epidemiológicos , Geografia , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/fisiopatologia , Iraque/epidemiologia , Masculino , Pessoa de Meia-Idade , Sêmen/fisiologia , Contagem de Espermatozoides , Motilidade Espermática/fisiologia , Estados Unidos/epidemiologia
14.
Nutr Health ; 26(1): 53-64, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31992124

RESUMO

BACKGROUND: Studies have shown that the amount of protein in the diet affects the hypothalamic-pituitary-testis axis and sub-optimal quantity reduces male fertility potential in both animals and humans. However, individual research reports on the factors associated with male infertility are collectively uncharacterized. AIM: We systematically reviewed, and meta-analysed animal (rats) studies on the effect of low protein diet on factors associated with male infertility. METHODS: PubMed Central, EMBASE and Scopus databases were searched from inception to 30 March 2019 for the study concepts and related keywords in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Data on the outcome measures were extracted and pooled across trials using random-effects model and expressed as mean differences (MD) at a 95% confidence interval (CI). RESULTS: Twelve trials identified from 3327 studies, met our inclusion criteria in the comparison of a low protein diet (2-10% protein) vs control protein diet (17-23% protein). The results showed that a low protein diet caused a significant reduction in the body weight (P = 0.0001) testis weight (P = 0.0001), seminal vesicle weight (P = 0.0003), epididymis weight P = 0.02), serum testosterone (P = 0.001) and follicle-stimulating hormone (FSH) concentrations (P = 0.04) compared with the control treatments. No effect on luteinizing hormone (LH) plasma concentration (P = 0.13) was observed. CONCLUSION: This study revealed that low protein diet caused significant reductions in body weight, testis, epididymis and seminal vesicle weights, serum testosterone and FSH concentration in rats. We infer that sub-optimal protein consumption reduces the gonadal and endocrine function, and consequently male infertility.


Assuntos
Dieta com Restrição de Proteínas/métodos , Infertilidade Masculina/epidemiologia , Animais , Ensaios Clínicos Veterinários como Assunto , Proteínas na Dieta/administração & dosagem , Modelos Animais de Doenças , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Masculina/sangue , Hormônio Luteinizante/sangue , Masculino , Ratos , Testículo/metabolismo , Testosterona/sangue
15.
J Urol ; 203(4): 832-840, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31642739

RESUMO

PURPOSE: One of the concerns surrounding cryptorchidism is the risk of impaired fertility. Current guidelines recommend orchiopexy at age 6 to 12 months to optimize fertility outcome. We evaluated the fertility potential of boys with nonsyndromic cryptorchidism who underwent orchiopexy within the recommended age range to clarify the need for eventual supplemental treatment modalities. MATERIALS AND METHODS: We retrospectively evaluated mini-puberty hormones (follicle-stimulating hormone, luteinizing hormone and inhibin B) and testicular biopsies from boys with cryptorchidism who underwent orchiopexy within the first year of life between 2010 and 2019. We histologically analyzed germ cell number and type A dark spermatogonia number per seminiferous tubule cross-section in relation to normal values. RESULTS: Of the 333 boys with nonsyndromic cryptorchidism 83 (25%, 21% with bilateral cryptorchidism) had a reduced number of germ cells. A total of 70 boys (21%) had low serum inhibin B, of whom 32 (46%) had a decreased number of germ cells and 23 (33%) had a decreased number of type A dark spermatogonia (p <0.01). Overall, 75 boys (23%) had no type A dark spermatogonia present. CONCLUSIONS: Despite early and successful orchiopexy, 20% to 25% of boys with cryptorchidism may be at risk for infertility based on hormonal and histological data. Blood test and testicular biopsy are mandatory to identify boys at high risk for infertility, in whom additional treatment modalities and followup may be needed.


Assuntos
Criptorquidismo/cirurgia , Fertilidade/fisiologia , Infertilidade Masculina/epidemiologia , Orquidopexia , Espermatogônias/patologia , Biópsia , Pré-Escolar , Criptorquidismo/complicações , Criptorquidismo/fisiopatologia , Humanos , Lactente , Infertilidade Masculina/sangue , Infertilidade Masculina/etiologia , Infertilidade Masculina/patologia , Inibinas/sangue , Masculino , Estudos Retrospectivos , Medição de Risco , Túbulos Seminíferos/citologia , Túbulos Seminíferos/patologia , Maturidade Sexual/fisiologia , Espermatogônias/citologia , Resultado do Tratamento
16.
Andrologia ; 52(1): e13433, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31773771

RESUMO

Infertility is somewhat more prevalent in men who are obese. They are also reported to have low sperm concentration, higher fraction of spermatozoa that look morphologically abnormal, higher DNA fragmentation index and evidence of oxidative stress. The precise cause for this remains uncertain. Leptin levels in serum and percentage body fat correlate positively, and obese men therefore usually have elevated serum leptin levels. Although leptin is important for normal reproductive function, but when present in excess, leptin could seriously affect reproductive function in men. Reports on the findings of sperm parameters in obese men, particularly those who are subfertile or infertile, seem to be similar to those reported from studies on normal-weight rats treated with leptin. Collectively, the observations reported in human and experimental animal studies point to leptin as a possible link between infertility and obesity. Herein, we review some findings on sperm function in obese subfertile or infertile men and those from animal studies following leptin treatment, and discuss the possible link between leptin and reproductive dysfunction in obese men. The large amounts of leptin secreted by the adipose tissue and its higher circulating levels could indeed be responsible for the higher prevalence of infertility in obese men.


Assuntos
Infertilidade Masculina/etiologia , Leptina/metabolismo , Obesidade/complicações , Animais , Modelos Animais de Doenças , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/metabolismo , Leptina/sangue , Masculino , Obesidade/sangue , Obesidade/metabolismo , Prevalência , Ratos , Contagem de Espermatozoides , Motilidade Espermática
17.
Afr Health Sci ; 20(1): 1-3, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33402886

RESUMO

Background: Seminal hyperviscosity has been shown to be associated with male infertility. The aim of this study was to assess the prevalence of hyperviscosity in semen of Malawian males seeking infertility treatment. Methods: A total of 120 men visiting our laboratory for fertility assessment donated semen samples. The semen samples were assessed for hyperviscosity, volume, concentration, total motility, progressive motility, viability, and morphology. Results: Out of the 120 samples analyzed, 34 samples were hyperviscous representing 28.3%. No significant statistical difference in semen volume between samples with normal viscosity compared to those with hyperviscosity (p>0.05). Sperm concentration, progressive motility, total motility, viability, and normal morphology were significantly higher in the normal viscosity group when compared to the abnormal viscocity group (p<0.05). Conclusion: Hyperviscosity affects a significant number of men in Malawi and may be the cause of decreased fertility as it was associated with poor sperm concentration, total motility, progressive motility, viability, and morphology.


Assuntos
Infertilidade Masculina/etiologia , Sêmen/química , Espermatozoides/química , Viscosidade , Adulto , Humanos , Incidência , Infertilidade Masculina/epidemiologia , Malaui/epidemiologia , Masculino , Análise do Sêmen , Contagem de Espermatozoides , Motilidade Espermática , Espermatozoides/patologia
18.
Afr Health Sci ; 20(1): 4-13, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33402887

RESUMO

Background: Infections caused by Extended spectrum beta lactamase (ESBL) producing bacterial are global challenge. There is limited information on the magnitude of bacteriospermia, ESBL producing Gram-negative bacteria (GNB) causing bacteriospermia and factors associated with male infertility. This study determined magnitude of bacteriospermia, ESBL-GNB and other factors association with infertility among presumptive infertile men in Mwanza, Tanzania. Methods: A cross-sectional hospital-based study was conducted between May 2017 and July 2018 among 137 presumptive infertile men. Semen specimens were self-collected by masturbation into clean, sterile and none-spermicidal containers and processed following laboratory standard operating procedures (SOPs). Data analysis was done using STATA 13.0. Results: Gram-negative bacteria were predominantly isolated (86.4%), of which 31.6% were ESBL producers. In a total 44 bacteria were isolated from semen culture. The blaCTX-M gene was detected in 75% of phenotypically confirmed ESBL producers. Infertility was independently found to be associated with abnormal spermatozoa morphology (OR (95%CI): 14.48(3.17-66.05)) and abnormal spermatozoa motility (OR (95%CI): 0.05(0.01-0.24)). However, neither bacteriospermia (OR (95%CI): 0.86(0.29-2.59)) nor ESBL bacteriospermia (OR (95%CI): 0.13(0.01-1.22)) was found to be associated with infertility. Conclusion: One third of bacteriospermia is due to ESBL-producers with history of antibiotic use being protective factor for infertility. Abnormal spermatozoa morphology and poor spermatozoa forward motility independently predicted infertility.


Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Infertilidade Masculina/microbiologia , Sêmen/microbiologia , Espermatozoides/microbiologia , Espermatozoides/fisiologia , beta-Lactamases/metabolismo , Adulto , Estudos Transversais , Bactérias Gram-Negativas/efeitos dos fármacos , Humanos , Infertilidade Masculina/epidemiologia , Masculino , Tanzânia/epidemiologia , Resistência beta-Lactâmica
19.
Pan Afr Med J ; 37: 155, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33425188

RESUMO

The purpose of this study was to determine the prevalence of spermogram abnormalities in men consulting for premarital screening and in infertile couples in Butembo. We conducted a retrospective descriptive study at the Graben University Diagnostic Center. The study population consisted of 890 male subjects aged 21-57 years, of whom 779 underwent prenuptial screening and 111 subjects fertility tests. The overall prevalence of spermogram anomalies in this population was 25.8%, corresponding to a total incidence of 22.9% of premarital consultants and 46,0% of males in infertile couples. Mean pH was: 7.22+/- 0.22. The average volume of semen collected was: 2.56 +/- 1.41 ml. Abnormalities were detected in all spermogram parameters, with a predominance of abnormalities in the same subject (86.5%), mainly in oligoasthenoteratozoospermia (44.8% of cases). Asthenozoospermia was the most common abnormality (90.9% of cases), followed by oligozoospermia (87.4% of cases), teratozoospermia (66.9% of cases), necrozoospermia (55.6% of cases), and azoospermia (10.4% of cases). This study highlights that the cytological profile of the spermogram of this population in Butembo is dominated by associations of anomalies. Other tests such as bacteriological examinations and biochemical marker assays are necessary, in order to identify the causes of abnormalities and to provide appropriate therapies.


Assuntos
Infertilidade Masculina/diagnóstico , Análise do Sêmen , Espermatozoides/anormalidades , Adulto , República Democrática do Congo , Humanos , Incidência , Infertilidade Masculina/epidemiologia , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Exames Pré-Nupciais , Prevalência , Estudos Retrospectivos , Adulto Jovem
20.
Clín. investig. ginecol. obstet. (Ed. impr.) ; 46(4): 143-147, oct.-dic. 2019. graf
Artigo em Espanhol | IBECS | ID: ibc-184301

RESUMO

Introducción: La fertilidad y la virilidad suelen relacionarse socialmente con el concepto de masculinidad; esto genera cierto grado de incertidumbre debido a que podría conllevar una serie de procesos emocionales al relacionar los conceptos anteriores con la palabra infertilidad. Objetivo: El objetivo del presente trabajo fue relacionar las respuestas sobre las percepciones de la calidad seminal con algunos conceptos relacionados con la masculinidad. Materiales y métodos: Se llevó a cabo una encuesta virtual anónima a 500 hombres en la cual se realizaron preguntas con relación a la percepción de algunas variables sobre la calidad seminal. Resultados: Respecto a la pregunta ¿para usted qué significa tener un conteo alto de espermatozoides?, en hombres con y sin pareja la respuesta más frecuente fue buena capacidad para fecundar, siendo mayor en hombres con pareja (p = 0,013); en contraste, la segunda respuesta más frecuente (buena salud) fue más alta en el grupo que no tenía pareja (p = 0,028), mientras que la mayoría de los participantes respondieron que no sentirían nada (58,8% sin pareja y 64,5% con pareja) frente a las preguntas ¿qué sentiría si tiene un conteo bajo de espermatozoides? y ¿qué sentiría si no tiene ningún espermatozoide?, respectivamente. Por otro lado, en cuanto a la respuesta «avergonzado», los participantes sin pareja decían sentirse más avergonzados en ambas preguntas (p = 0,011 y p = 0,0057). Conclusión: El termino infertilidad debería ser usado cuidadosamente, pues es de gran impacto en la vida del individuo, afecta tanto el bienestar de la pareja como el bienestar psicosocial y la propia satisfacción sexual


Introduction: Fertility and virility are often socially related to the concept of masculinity, and this generates a certain degree of uncertainty because it could lead to a series of emotional processes by relating these concepts with the word infertility. Objective: The objective of the present work was to relate the responses on the perceptions of seminal quality with some concepts related to masculinity. Materials and methods: An anonymous virtual survey of 500 men was carried out, in which questions were asked regarding the perception of some variables on seminal quality. Results: As regards the question, 'what does it mean for you to have a high sperm count?'; in men with and without partners, the most frequent response was, good ability to fecundate, being higher in men with a partner (P = .013). In contrast, the second most frequent response (good health) was higher in the group that had no partner (P = .028). While the majority of participants answered that they would not feel anything (58.8% without a partner, and 64.5% with a partner) in response to the questions, 'How would you feel if you have a low sperm count?', and 'How would you feel if you did not have any sperm?', respectively. On the other hand, as regards the response 'embarrassed', the participants without a partner said they felt more embarrassed in both questions (P = .011 and P = .0057). Conclusion: The term infertility should be used carefully, since it has a significant impact an individual's life. It affects the well-being of the couple, as well as psychosocial well-being and sexual satisfaction itself


Assuntos
Humanos , Masculino , Fertilidade/fisiologia , Análise do Sêmen , Comportamento Sexual/estatística & dados numéricos , Infertilidade Masculina/epidemiologia , Masculinidade , Coito/fisiologia , Contagem de Espermatozoides/estatística & dados numéricos , Colômbia/epidemiologia
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