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1.
Int J Mol Sci ; 23(21)2022 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-36361912

RESUMO

Infertility is a worldwide health issue defined by the World Health Organization (WHO) as the inability to establish a pregnancy after 12 months or more of regular and unprotected sexual intercourse. Male infertility etiology can be related to either congenital or acquired factors. The therapeutical approach to male infertility depends on the underlying causes and includes medical and surgical treatments. In recent studies, the potential role of nerve growth factor (NGF) in male reproductive physiology has been proposed. It has been hypothesized that neurotrophins might be involved in testis morphogenesis and regulation of several aspects of spermatogenesis. Moreover, it has been shown that NGF exerts its role on gonadotropin-releasing hormone (GnRH) neurons through the activation of the PKC/p-ERK1/2/p-CREB cascade, which leads to the activation of hypothalamic cells and the consequent activation of hypothalamus-pituitary-gonadal axis (HPG) with the secretion of GnRH. Lastly, it has been shown that the physiology of mature sperm is affected by both exogenous and endogenous NGF. The NGF impact on the HPG axis and its effect on GnRH neurons might be exploited in the therapy of male hypogonadism or used as a protective strategy against gonadal dysfunction related to chemotherapeutic agents. Moreover, the improving effect of NGF on sperm motility and vitality could be useful to enhance assisted reproduction outcomes. NGF could be supplemented to cryopreserved sperm samples to counteract the oxidative stress induced by the frozen and thawing processes. Indeed, the potential clinical applications of NGF in male infertility treatment have been discussed.


Assuntos
Infertilidade Masculina , Fator de Crescimento Neural , Humanos , Gravidez , Feminino , Masculino , Fator de Crescimento Neural/farmacologia , Motilidade Espermática , Sêmen/metabolismo , Hormônio Liberador de Gonadotropina/metabolismo , Infertilidade Masculina/tratamento farmacológico , Infertilidade Masculina/etiologia , Genitália Masculina/metabolismo
2.
Front Endocrinol (Lausanne) ; 13: 1009537, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36329891

RESUMO

Fertility, a social, cultural, and medical issue, has aroused public attention because of its potential to predict future health. In recent years, the incidence of male infertility has increased significantly, and various risk factors, such as congenital factors, acquired factors, and idiopathic factors, have led to this situation. Male infertility causes substantial psychological and social distress in patients. With the implementation of the two-child policy, male infertility has brought enormous psychological and social pressure and huge economic burden to patients and the healthcare system. This has attracted the attention of not only men of childbearing age but also many male experts. The conventional therapeutic approaches for treating male infertility, including drugs, varicocele surgery, intrauterine insemination, in vitro fertilization, and intracytoplasmic sperm injection, can restore fertility to a certain extent, but their efficacy is far from satisfactory, not to mention some adverse events. Therefore, acupuncture has been chosen by many men to treat their infertility and produced significant effects. In the present paper, the efficacy and mechanism of acupuncture in the treatment of male infertility were analyzed from different perspectives such as regulating hormone secretion, reducing inflammation, and improving semen parameters. The existing literature shows that acupuncture can effectively treat male infertility.


Assuntos
Terapia por Acupuntura , Infertilidade Masculina , Varicocele , Masculino , Humanos , Espermatozoides , Sêmen , Infertilidade Masculina/terapia , Infertilidade Masculina/etiologia , Varicocele/terapia , Varicocele/cirurgia , Terapia por Acupuntura/efeitos adversos
3.
JAMA ; 328(20): 2056-2057, 2022 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-36413249

RESUMO

This article summarizes guidelines on identifying and addressing infertility in men from the American Urological Association and American Society for Reproductive Medicine.


Assuntos
Infertilidade Masculina , Masculino , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia
4.
Adv Gerontol ; 35(4): 485-491, 2022.
Artigo em Russo | MEDLINE | ID: mdl-36401856

RESUMO

According to the Russian Society of Urologists, the frequency of infertility in marriage in the Russian Federation is 8-17,2%; half of the cases are associated with the male factor. Among the risk factors for the development of male infertility, there are mainly medical reasons, lifestyle factors and negative environmental factors. Despite the fact that the problem of infertility is addressed by men of different ages, from youth to the elderly, the correction of risk factors is usually carried out without taking into account the age of the patient, which makes it difficult to develop a personalized strategy for the treatment or prevention of infertility. The aim of the study was to study the structure of the leading risk factors for the development of infertility in men from infertile couples, to identify and characterize their age-associated features. The analysis of the medical histories of 1 198 men from infertile couples and the collection of information on all available risk factors for infertility were carried out. The analysis of age features was performed by dividing the sample into 5 age groups: 1st (n=271) - men ≤29,9 years; 2nd (n=415) - 30-34,9 years; 3rd (n=291) - 35-39,9 years; 4th (n=141) - 40-44,9 years; 5th (n=80) - ≥45 years. It was shown that in the general sample of medical causes, factors associated with chronic inflammation predominate: sexually transmitted infections (STIs) - 54%; prostatitis - 32%; obesity - 27%; from non-medical: alcohol - 73%; stress - 47%; smoking - 41%. With increasing age, the frequency of obesity, STIs, prostatitis, hepatitis B/C, mumps increases statistically significantly, while the most unfavorable group of men is 40-45 years old for factors such as STIs, hepatitis B/C and mumps, and the group of men over 45 years old for factors such as obesity and prostatitis.


Assuntos
Hepatite B , Infertilidade Masculina , Caxumba , Prostatite , Infecções Sexualmente Transmissíveis , Humanos , Masculino , Idoso , Adolescente , Prostatite/complicações , Caxumba/complicações , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/etiologia , Fatores de Risco , Infecções Sexualmente Transmissíveis/complicações , Obesidade/complicações , Hepatite B/complicações
5.
Actas urol. esp ; 46(9): 515-520, nov. 2022. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-211492

RESUMO

Objetivos: Evaluar el impacto de la varicocelectomía subinguinal con gafas de aumento sobre la calidad del semen, el nivel de testosterona sérica y las tasas de embarazo espontáneo.MétodosSe recogieron datos de forma prospectiva de 102 hombres infértiles con varicocele clínico. Se compararon los valores preoperatorios de los parámetros de análisis de semen y el nivel de testosterona sérica con los valores postoperatorios a los 6 meses. Se evaluó la tasa de embarazo espontáneo a los 6 meses.ResultadosLa edad media de los pacientes era de 31,56±4,31 años. Se registró infertilidad primaria en 86 pacientes e infertilidad secundaria en 16. Se observó varicocele bilateral en 79 pacientes y varicocele unilateral en 23. La concentración total de espermatozoides (×106/ml) antes y después de la varicocelectomía fue de 12,82±3,91 y 20,06±2,13, respectivamente (p<0,0001). La motilidad espermática total (%) pre y posvaricocelectomía fue de 37,67±7,23 y 55,46±4,51 respectivamente (p<0,0001). La morfología espermática (criterios estrictos de morfología Kruger, %) antes y después de la varicocelectomía fue de 3,11±0,80 y 3,70±0,78, respectivamente (p<0,0001). El nivel de testosterona sérica (ng/dl) antes y después de la varicocelectomía fue de 323,90±67,81 y 396,74±40,88 respectivamente (p<0,0001). La tasa de embarazo espontáneo en las parejas con infertilidad primaria y secundaria fue de 18,60% y 31,25%, respectivamente. La diferencia de tasas no fue significativa (p=0,251). La tasa global de embarazo espontáneo fue del 20,5%.ConclusiónLa varicocelectomía subinguinal con gafas de aumento es una modalidad segura y eficaz para el tratamiento de varones infértiles, especialmente cuando no se dispone de medios para la cirugía microscópica. Sin embargo, solo los estudios comparativos de gran tamaño o los ensayos multicéntricos pueden confirmarlo. (AU)


Objectives: To study the impact of loupe assisted subinguinal varicocelectomy on semen quality, serum testosterone level, and spontaneous pregnancy rate.MethodsThe data were prospectively collected for 102 infertile men with clinical varicocele. The preoperative values of semen analysis parameters and serum testosterone level were compared with postoperative values at 6 months. Spontaneous pregnancy was assessed at 6 months.ResultsThe mean age of patients was 31.56±4.31 years. Primary infertility was reported in 86 patients, while 16 had secondary infertility. Bilateral varicocele was seen in 79 patients while 23 had a unilateral varicocele. The total sperm concentration (x106/ml) before and after varicocelectomy was 12.82±3.91 and 20.06±2.13 respectively (P<.0001). The total sperm motility (%) before and after varicocelectomy was 37.67±7.23 and 55.46±4.51 respectively (P<.0001). The sperm morphology (Kruger/Strict morphology criteria, %) before and after varicocelectomy was 3.11±0.80 and 3.70±0.78 respectively (P<.0001). The serum testosterone level (ng/dl) before and after varicocelectomy was 323.90±67.81 and 396.74±40.88 respectively (p<0.0001). The Spontaneous pregnancy rate in couples with primary and secondary infertility was 18.60% and 31.25% respectively. The difference in their rates was not significant (P=.251). The overall spontaneous pregnancy rate was 20.5%.ConclusionLoupe-assisted sub-inguinal varicocelectomy is a safe and effective modality for treating infertile men, particularly when provision for microscopic surgery is unavailable. However, only large size comparative studies or multi-centric trials can confirm this. (AU)


Assuntos
Humanos , Masculino , Feminino , Gravidez , Adulto , Infertilidade Masculina/etiologia , Infertilidade Masculina/cirurgia , Testosterona/sangue , Varicocele/complicações , Varicocele/cirurgia , Estudos Prospectivos , Estudos de Viabilidade , Microcirurgia , Análise do Sêmen , Motilidade Espermática
6.
BMC Pregnancy Childbirth ; 22(1): 791, 2022 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-36289465

RESUMO

INTRODUCTION: The current challenge for the treatment of varicocele is identifying patients who could benefit the most from surgery. We aimed to develop and validate a nomogram for predicting spontaneous pregnancy following microscopic varicocelectomy in infertile men, based on a large cohort. METHODS: Two hundred eighty-two consecutive patients who underwent microscopic varicocelectomy from January 2018 to December 2020 were enrolled as participants in the study. Xiang Hua center (206 patients) as a development cohort. Hu Nan center (76 patients) as a validation cohort. Patient clinicopathologic data were recorded. Multivariate logistic regression was used to build a predictive model with regression coefficients. Then, backward stepwise selection was applied, and the likelihood ratio test with Akaike's information criterion was used as the stopping rule. The performance of this predictive model was assessed for discrimination, calibration, and clinical usefulness. RESULTS: Predictors of this model included the age of female partners, diameter of veins, initial and increased total progressively motile sperm count. The model demonstrated good discrimination with an AUROC of 0.925 (p < 0.001) and calibration (Unreliability test, p = 0.522) in the validation cohort. Furthermore, the model was clinically useful, according to decision curve analysis. CONCLUSIONS: Our findings indicated that younger female partners, larger diameter of veins, higher initial and increased total progressively motile sperm count were significant predictors of spontaneous pregnancy in infertile men, post microscopic varicocelectomy. This nomogram may assist in individual decision-making on the treatment strategy of varicocele preoperatively and improve the treatment outcome.


Assuntos
Infertilidade Masculina , Varicocele , Gravidez , Humanos , Masculino , Feminino , Varicocele/complicações , Varicocele/cirurgia , Contagem de Espermatozoides , Infertilidade Masculina/etiologia , Infertilidade Masculina/cirurgia , Taxa de Gravidez , Nomogramas , Microcirurgia , Sêmen , Hormônios
7.
In Vivo ; 36(5): 2002-2013, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099087

RESUMO

The process of fertilization includes sperm capacitation, hyperactivation, an acrosome reaction and the release of acrosome enzymes, membrane fusion and channel formation, the release of the sperm nucleus, and gamete fusion. This process is closely related to the shape and vitality of the sperm, acrosome enzyme release, and the zona pellucida structure of the egg, as well as the opening and closing of various ion (e.g., calcium) channels, the regulation of signaling pathways such as cyclic adenosine monophosphate-protein kinase A, the release of progesterone, and the coupling of G-proteins. The interaction among multiple factors and their precise regulation give rise to multiple cascading regulatory processes. Problems with any factor will affect the success rate of fertilization. Recent studies have shown that with rapid societal development, the incidence of male infertility is increasing and occurs at younger ages. According to World Health Organization statistics, 15% of couples of childbearing ages have infertility problems, of which 50% are caused by male factors. Additionally, the cause of infertility cannot be identified in as many as 60% to 75% of male infertility patients. In this article, we review the research progress on the microregulation of fertilization and mechanisms underlying this process to identify causes and develop novel prevention and treatment strategies for male infertility.


Assuntos
Infertilidade Masculina , Sêmen , Reação Acrossômica/fisiologia , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Masculino , Capacitação Espermática/fisiologia , Espermatozoides/metabolismo
8.
In Vivo ; 36(5): 2392-2399, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099105

RESUMO

BACKGROUND/AIM: Doppler ultrasound was successfully implemented as part of the diagnostic plan of medical emergencies in scrotal pathology. This study aimed to investigate whether it could play an important role in managing not only varicocele, but patients with secondary infertility as well. PATIENTS AND METHODS: The current study included 135 patients with varicocele and infertility. Surgery was performed in 18 cases with painful varicocele, 15 cases with testicular hypotrophy, and 48 cases with infertility. RESULTS: Among cases with infertility who underwent surgery, aged between 19 and 36 years old, 80% showed a significant improvement in the spermogram after curing the varicocele. In patients over 36 years of age, only 42% had some improvement in the spermogram after surgery. In addition, after surgery, antispermatic antibodies showed a significant decrease in all patients. CONCLUSION: Varicocele and secondary infertility are a well-known pathology. While the role of Doppler ultrasonography is established in varicocele diagnosis, we found an important pool of patients with secondary infertility and asymptomatic varicocele that would not have been diagnosed in the absence of Doppler ultrasound investigations. Since the best results in fertility were observed in patients younger than 36 years of age, we reiterate the importance of Doppler ultrasonography in addressing infertility.


Assuntos
Infertilidade Masculina , Varicocele , Adulto , Humanos , Infertilidade Masculina/diagnóstico por imagem , Infertilidade Masculina/etiologia , Masculino , Escroto/diagnóstico por imagem , Ultrassonografia , Ultrassonografia Doppler , Varicocele/diagnóstico , Varicocele/diagnóstico por imagem , Adulto Jovem
10.
Front Cell Infect Microbiol ; 12: 815786, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36176582

RESUMO

Seminal microflora is crucial to male fertility. Dysbiosis-disturbance of quantitative ratios of individual bacteria or appearance of pathogenic species-rarely results in symptomatic disease. Inflammation results in decreased sperm production, lower motility, or morphological changes and, in the long term, can cause ejaculatory duct obstruction, leading to infertility. Moreover, it may cause infection of the partner's female genital tract. Dysbiosis in both partners results in fertility problems, disorders in embryo implantation, or miscarriages. In addition, chronic inflammation of the male genitourinary system may accelerate the appearance of antisperm antibodies. A comprehensive examination of seminal microflora can clarify the causes of infertility or prevent pathological conditions that affect seminal parameters. Seminal microflora as a direct impact on fertility problems as well as a decrease in the effectiveness of assisted reproduction methods, insemination, or in vitro procedures.


Assuntos
Infertilidade Masculina , Sêmen , Anticorpos , Disbiose/complicações , Feminino , Humanos , Infertilidade Masculina/etiologia , Inflamação/complicações , Masculino , Sêmen/microbiologia
11.
Andrologia ; 54(10): e14556, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36177795

RESUMO

This study aims to evaluate the expression of genes associated with the fertilisation potential and embryo development, sperm DNA fragmentation (SDF), and acrosome reaction in male partners of infertile couples with different sperm parameters compared to fertile men. First, male partners of infertile couples with abnormal (N = 25) and normal sperm parameters (N = 25), and fertile men (N = 10) were included in experimental groups I, II, and controls respectively. The mRNA levels of the Annexin A2 (ANXA2), Sperm protein 17 (SP17), Plasma serine protease inhibitor (SERPINA5), and Peroxiredoxin-2 (PRDX2) genes and SDF were evaluated. To evaluate the maturity of the sperm and oxidative stress, the acrosome reaction, the lipid peroxidation, and total antioxidant were measured. As result, SP17 showed a significantly lower expression in both experimental groups. SERPINA5 was significantly down-regulated in experimental group I that was aligned with the low rate of acrosome reaction. Significant overexpression of PRDX2 was found between experimental group II and controls. Significant higher rates of SDF were seen in both experimental groups compared to the controls. Finally, our data suggest that differentially gene expression of SP17 is a potential diagnostic biomarker in infertile men either with normal or abnormal sperm parameters. SDF is one of the causes of male infertility, independent of the sperm parameters.


Assuntos
Anexina A2 , Proteínas de Ligação a Calmodulina , Infertilidade Masculina , Proteínas de Membrana , Peroxirredoxinas , Inibidor da Proteína C , Anexina A2/genética , Antioxidantes/metabolismo , Biomarcadores/metabolismo , Proteínas de Ligação a Calmodulina/genética , Fragmentação do DNA , Humanos , Infertilidade Masculina/etiologia , Masculino , Proteínas de Membrana/genética , Peroxirredoxinas/genética , Inibidor da Proteína C/genética , RNA Mensageiro/metabolismo , Sêmen/metabolismo , Espermatozoides/metabolismo
12.
Arch Ital Urol Androl ; 94(3): 360-365, 2022 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-36165486

RESUMO

BACKGROUND: Varicocele is known to have impacts in infertility cases and sperm quality. This review aimed to evaluate the effects of microsurgical varicocelectomy on sperm DNA fragmentation index (DFI) and sperm parameters. METHODS: Open full English text articles from January 2017 to October 2021 were searched from online database including PubMed, EMBASE, Scopus, Cochrane Library and Google Scholar. RESULTS: Systematic search resulted in 277 potential papers. After throughout paper analysis, 5 studies were included in this review. From all five analyzed studies, microsurgical varicocelectomy was statistically proven to reduce DNA fragmentation index by 5.46% (mean difference -5.46; 95% CI: -4.79, -6.13; p < 0.00001). Moreover, the procedure also significantly improved other sperm parameters (sperm concentration +8.23%, sperm motility +7.17%, sperm progressive motility +2.77%, sperm morphology +0.64%). CONCLUSION: Microsurgical varicocelectomy significantly improves spermatogenesis as reflected by biomarkers of infertile men including semen parameters and sperm DNA fragmentation (SDF).


Assuntos
Infertilidade Masculina , Varicocele , Biomarcadores , Fragmentação do DNA , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/cirurgia , Masculino , Microcirurgia/métodos , Sêmen , Contagem de Espermatozoides , Motilidade Espermática , Espermatozoides , Varicocele/complicações , Varicocele/cirurgia
13.
Urologiia ; (4): 114-117, 2022 Sep.
Artigo em Russo | MEDLINE | ID: mdl-36098604

RESUMO

This review provides up-to-date information on the molecular basis of the pathogenesis of male infertility at the cellular and subcellular levels. The emphasis is on the importance of new next-generation sequencing technologies as a high-performance tool for studying the genome and epigenomic mechanisms, transcriptome, proteome and metabolome of ejaculate, and organs of the reproductive system. This methodology made it possible to identify differentially expressed metabolic and signaling pathways in fertile and infertile men that combine the genotype and phenotype of a particular individual into a single whole. The current ideas about the relationship between oxidative stress and imbalance of redox systems with DNA damage in spermatozoa as the leading mechanism for the development of idiopathic infertility are summarized. The role of miRNAs, methyloma aberrations, deficiency of phospholipase C zeta in spermatozoa in the pathology of fertility is given. Deciphering the molecular profile and molecular phenotypes of infertility as a result of the interaction of genetic and environmental factors is a necessary condition for screening the most informative biomarkers, assessing their stratification potential, and validating new molecules as potential targets for targeted therapy.


Assuntos
Infertilidade Masculina , MicroRNAs , Fertilidade , Humanos , Infertilidade Masculina/etiologia , Masculino , MicroRNAs/genética , MicroRNAs/metabolismo , Estresse Oxidativo/genética , Espermatozoides/metabolismo
14.
Andrologia ; 54(10): e14539, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35914741

RESUMO

Varicocele is the most common reversible cause of male infertility, affecting up to 20% of healthy men and 40% of men with primary infertility. The objective of this study was to investigate the prevalence of varicocele in men evaluated for infertility, and to determine rates of subsequent varicocele repair. Since reproductive endocrinologists are the first specialists seen for male infertility care in North America, we hypothesized that varicocele would be underdiagnosed when compared to its reported prevalence among men with infertility. TriNetX, a large, multicenter electronic health record (EHR) database was queried to establish a cohort of all men (above 18 years of age) with a diagnosis of male infertility. This cohort was used to identify those with ensuing varicocele diagnosis. Men who received varicocelectomy or venous embolization after a diagnosis of varicocele were then identified. Out of 101,309 men with a diagnosis of male infertility in the network, only 9768 (9.6%) had a diagnosis of varicocele. Mean age of men with varicocele was 34. Varicocelectomy or venous embolization was performed in 1699 (20.2%) and 69 (0.76%) of men with varicocele, respectively. In this cross-sectional EHR study, varicocele was underdiagnosed in men evaluated for infertility when compared with prior epidemiological studies.


Assuntos
Infertilidade Masculina , Varicocele , Estudos Transversais , Registros Eletrônicos de Saúde , Humanos , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/etiologia , Masculino , Varicocele/complicações , Varicocele/epidemiologia , Veias
15.
Andrologia ; 54(10): e14537, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35920088

RESUMO

Varicocele is a common disease in men, with a global incidence of approximately 25%. A comprehensive and systematic analysis of the knowledge map on it will help in assessing frontier research and identify knowledge gaps. In total, 4103 articles published from 2002 to 2021 in 1066 journals were included. They represent the current research status worldwide, potential hotspots and future research directions. In the past decades, the number of publications and citations of varicocele-related studies have increased steadily. Academic institutions in the United States played a leading role in varicocele research. The country, institution, journal and author with the most publications were the United States (779), Cleveland Clinic Foundation (132), Andrologia (246) and Agarwal A (106), respectively. The most frequently used keywords were Varicocele (1620), Male Infertility (944), Varicocelectomy (288), Testis (245), Sperm (166), Oxidative Stress (144), Azoospermia (119), Semen Analysis (118), Laparoscopy (116) and Adolescent (97). Currently, the main focus of current varicocele research is its surgical treatment method and effect on sperm quality. The frontier research hotspot is the specific mechanism of varicocele-induced decrease in sperm quality.


Assuntos
Infertilidade Masculina , Varicocele , Adolescente , Bibliometria , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/cirurgia , Masculino , Sêmen , Análise do Sêmen , Varicocele/complicações , Varicocele/cirurgia
16.
Andrology ; 10(8): 1581-1592, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36018886

RESUMO

BACKGROUND: Varicocoele is the most common correctable cause of male infertility; however, predicting varicocoelectomy outcomes is difficult. "Omics" techniques have been increasingly used to develop new diagnostic and prognostics tools for several male infertility causes, and could be applied to study varicocoele. OBJECTIVES: The objective is to create metabolomics models capable of segregating men who improved semen analysis (SA) parameters or achieved natural pregnancy after microsurgical varicocoelectomy (MV) from those who did not, using hydrogen-1 nuclear magnetic resonance (1 H NMR) spectra of seminal plasma of pre-operative samples. MATERIAL AND METHODS: We recruited 29 infertile men with palpable varicocoele. 1 H NMR spectra of seminal plasma were obtained from pre-operative samples and used to create metabonomics models. Improvement was defined as an increase in the total motile progressive sperm count (TMC) of the post-operative SA when compared to the baseline, and pregnancy was assessed for 24 months after MV. RESULTS: Using linear discriminant analysis (LDA), we created a model that discriminated the men who improved SA from those who did not with accuracy of 93.1%. Another model segregated men who achieved natural pregnancy from men who did not. We identified seven metabolites that were important for group segregation: caprylate, isoleucine, N-acetyltyrosine, carnitine, N-acetylcarnitine, creatine, and threonine. DISCUSSION: We described the use of metabonomics model to predict with high accuracy the outcomes of MV in infertile men with varicocoele. The most important metabolites for group segregation are involved in energy metabolism and oxidative stress response, highlighting the pivotal role of these mechanisms in the pathophysiology of varicocoele. CONCLUSIONS: 1 H NMR spectroscopy of seminal plasma can be used in conjunction with multivariate statistical tools to create metabonomics models useful to segregate men with varicocoele based on the reproductive outcomes of MV. These models may help counseling infertile men with varicocoele regarding their prognosis after surgery.


Assuntos
Infertilidade Masculina , Varicocele , Acetilcarnitina/metabolismo , Caprilatos/metabolismo , Creatina/metabolismo , Feminino , Humanos , Hidrogênio , Infertilidade Masculina/etiologia , Isoleucina/metabolismo , Espectroscopia de Ressonância Magnética , Masculino , Gravidez , Sêmen/metabolismo , Análise do Sêmen , Contagem de Espermatozoides , Motilidade Espermática/fisiologia , Treonina/metabolismo , Varicocele/complicações , Varicocele/diagnóstico , Varicocele/cirurgia
18.
JBRA Assist Reprod ; 17(6): 351-352, 2022 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-35939554

RESUMO

Most causes of male infertility are treatable, and the goal of many treatments is to restore the ability to conceive naturally. The process of spermatogenesis is essential for human reproduction. A simple sounding process is mediated by a variety of factors, including multiple hormonal influences. Fertility should be discussed with all patients at risk of gonadal failure due to treatment. Ideally, this discussion should be held by a fertility expert with special interest in fertility preservation. This mini review aims to provide the current status of male infertility, the fertility preservation options and the impact of stem cells in it today.


Assuntos
Preservação da Fertilidade , Infertilidade Masculina , Fertilidade , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Masculino , Espermatogênese
19.
Andrologia ; 54(9): e14521, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35934995

RESUMO

Diabetes is a rising global health concern and an increasingly common cause of male infertility. Although the definitive pathophysiological mechanisms underpinning the association between diabetes and infertility is unclear, there are several animal studies showing diabetes to be a detrimental factor on reproductive health through apoptosis, oxidative stress and impairment of steroidogenesis. Furthermore, as reflected in animal models, antidiabetic strategies and relevant treatments are beneficial in the management of infertile men with diabetes as the recovery of euglycemic status affects positively the spermatogenesis. However, the available data are still evolving and specific conclusion in human populations are not possible yet. In this review, we are discussing the current literature concerning the association of diabetes and male infertility, focusing on the therapeutic approach as illustrated in animals' models.


Assuntos
Diabetes Mellitus , Infertilidade Masculina , Animais , Humanos , Infertilidade Masculina/etiologia , Masculino , Modelos Animais , Modelos Teóricos , Espermatogênese
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