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1.
Int J Surg ; 71: 101-109, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31561004

RESUMO

PURPOSE: A number of studies have examined the association between vitamin D, fertility and semen quality, however, findings have been inconclusive. Herein, we systematically reviewed available observational studies to elucidate the overall relationship between vitamin D, fertility and semen quality in adult population. METHODS: PubMed, Cochrane's Library, Science Direct, Scopus, Google Scholar and ISI Web of Science databases were searched until December 2018 for all available studies evaluating the association between vitamin D, fertility and semen quality. The Newcastle-Ottawa Quality Assessment Scale was used to examine the quality of each study. RESULTS: A total of 18 studies out of 1843 met our inclusion criteria and were included in our systematic review and meta-analysis. Serum 25(OH)D3 was significantly higher in fertile subjects compared to infertile ones (WMD -0.63; 95% CI, -1.06 to -0.21; P = 0.003). Furthermore, there was a significant association between serum 25(OH)D, sperm motility (WMD -5.84; 95% CI, -10.29 to -1.39; P = 0.01) and sperm progressive motility (WMD -5.24; 95% CI, -8.71 to -1.76; P = 0.003). CONCLUSION: Our findings add to the existing literature supporting the concept that nutrition, especially vitamin D, plays an important role in men's sexual health. It should be noted that because of significant heterogeneity among the included studies, caution is warranted when interpreting the results. Further well-designed prospective cohort studies and clinical trials are needed for better understanding of the relationship between vitamin D and fertility and its components.


Assuntos
Fertilidade/fisiologia , Infertilidade Masculina/sangue , Infertilidade/sangue , Sêmen/fisiologia , Vitamina D/sangue , Adulto , Humanos , Masculino , Estado Nutricional , Estudos Observacionais como Assunto , Estudos Prospectivos , Projetos de Pesquisa , Análise do Sêmen
2.
Anim Reprod Sci ; 208: 106115, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31405477

RESUMO

In this study, there was investigation of the effect of heavy metals on the fertility of dromedary camels. Fourteen camels at the Camel Research Center, King Faisal University, and 41 infertile dromedaries admitted to the Veterinary Teaching Hospital were used for semen evaluation during the breeding season. Seminal plasma and blood serum were collected from all males until analysis. Concentrations of three heavy metals [arsenic (As), cadmium (Cd), and lead (Pb)] were determined in the seminal plasma and serum using an atomic absorption spectrophotometer. The results indicate there are differences (P < 0.05 - P < 0.01) in pH, sperm motility, sperm concentration, and sperm abnormalities between the fertile and infertile male camels. In seminal plasma, there were marked differences (P < 0.01- P < 0.0001) between the control and infertile male camels in As, Cd, and Pb concentrations. In serum, there were differences (P < 0.01 - P < 0.001) between the fertile and infertile camels in serum As, Cd, and Pb concentrations. There was a positive correlation (P < 0.05; r = 0.77 and r = 0.94, respectively) between serum and seminal plasma concentrations of both As and Cd in the infertile dromedaries. In the control group, there was a positive correlation (P < 0.05; r = 0.70) between seminal plasma concentrations of Cd and percent sperm abnormalities. In conclusion, relatively greater seminal plasma and serum concentrations of As, Cd, and Pb are associated with lesser values for semen quality variables and infertility in dromedary camels.


Assuntos
Arsênico/sangue , Cádmio/sangue , Camelus/sangue , Infertilidade Masculina/veterinária , Chumbo/toxicidade , Testículo , Animais , Poluentes Ambientais/sangue , Infertilidade Masculina/sangue , Masculino , Análise do Sêmen
3.
Andrologia ; 51(9): e13367, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31286559

RESUMO

Protamines are considered the most important structure in the sperm nucleus, and they are proteins with a significantly large amount of amino acids carrying a positive charge, which allows the formation of the tight package of the genomic DNA in the spermatozoa. Many authors studied the abnormalities in the protamine 1 (PRM1) and/or protamine 2 (PRM2) genes and reported their possible association with male infertility. The chromosome 16 (16p13.2) carries these genes containing multiple undiscovered single nucleotide polymorphisms. The aim of the present study was to investigate the association of c.-190 C>A transversions that occur in PRM1 with idiopathic infertility in a sample of Egyptian men. It was a case-control study, and blood samples were collected from sixty male patients complaining of idiopathic infertility and forty healthy fertile males. The c.-190 C>A transversion in promotor region protamine 1 gene (rs2301365) was assessed by 5' nuclease assay, using Rotor-Gene Q real-time PCR system. The results of the present study revealed that CA and AA genotypes in PRM1 gene were associated significantly with low sperm concentration and decreased sperm motility (p = 0.001). Cases carrying A allele had a 6.05-fold increased risk for idiopathic infertility than cases carrying the C allele (OR: 6.05, 95% CI: 2.038-17.98 p statistically significant ≤0.05). Analysis of the results revealed that the c.-190 C>A transversion may be involved in the development of male infertility.


Assuntos
Predisposição Genética para Doença , Infertilidade Masculina/genética , Regiões Promotoras Genéticas/genética , Protaminas/genética , Adulto , Alelos , Estudos de Casos e Controles , Egito/epidemiologia , Voluntários Saudáveis , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/epidemiologia , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Medição de Risco , Fatores de Risco , Contagem de Espermatozoides , Motilidade Espermática/genética , Adulto Jovem
4.
PLoS One ; 14(7): e0219179, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31276533

RESUMO

Semen abnormality (SA) male infertility has become a worldwide reproductive health problem. The invasive tests (e.g., testicular biopsy) and labor-intensive methods of semen collection severely inhibit diagnosis of male infertility. In addition, the pathogenesis and biological interpretation of male infertility are still obscure. In this report, a total of 84 semen abnormality (SA) patients, diagnosed as teratozoospermia (TE, n = 21), asthenozoospermia (AS, n = 23), oligozoospermia (OL, n = 20), azoospermia (AZ, n = 20), and age-matched healthy controls (HC, n = 29) were analyzed by GC-MS for discrimination analysis and discovery of potential biomarkers. Twenty-three biomarkers were obtained by multivariate statistical method (partial least squares-discriminant analysis, PLS-DA) and univariate statistical method (analysis of variance, ANOVA) with comparisons of TE versus HC, AS versus HC, OL versus HC and AZ versus HC. Based on those biomarkers, the most relevant pathways were mainly associated with the metabolism of carbohydrates, amino acids, and lipids. The principal metabolic alternations in SA male infertility included increased levels of energy-related metabolisms, such as tricarboxylic acid cycle, pyruvate metabolism, glyoxylate and dicarboxylate metabolism, glycine, serine, threonine metabolism and saturated fatty acid metabolism. Furthermore, increased levels of glutathione metabolism were related to oxidative stress. Finally, decreased levels of arginine and proline metabolism and inositol phosphate metabolism were observed. In conclusion, blood plasma metabolomics is powerful for characterizing metabolic disturbances in SA male infertility. From metabolic pathway analysis, energy production, oxidation stress and the released enzyme during spermatogenesis take the primary responsibilities for SA male infertility.


Assuntos
Infertilidade Masculina/metabolismo , Plasma/metabolismo , Sêmen/metabolismo , Adulto , Astenozoospermia/metabolismo , Biomarcadores/metabolismo , China , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Infertilidade Masculina/sangue , Metabolismo dos Lipídeos/fisiologia , Masculino , Redes e Vias Metabólicas/fisiologia , Metabolômica/métodos , Oligospermia/metabolismo , Estresse Oxidativo/fisiologia , Análise do Sêmen/métodos
5.
Andrologia ; 51(9): e13370, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31332817

RESUMO

Kisspeptin, a peptide hormone, plays a pivotal role in fertility and neuroendocrine regulation of hypothalamo-pituitary-gonadal axis. Increased kisspeptin and reproductive hormones are responsible for fertility in male and females. This study aimed to explore the role of kisspeptin on hypothalamo-pituitary-gonadal axis by comparing the levels of kisspeptin in fertile and infertile subjects and identifying single nucleotide polymorphisms (SNPs) of KISS1 gene in exon 2 and exon 3 of infertile male and female cohorts. A cross-sectional study was carried out on 80 males (44 infertile and 36 fertile) and 88 females (44 in each group). Significantly high levels of kisspeptin (KP), follicle-stimulating hormone (FSH), luteinizing hormone and testosterone were observed in fertile male and female subjects except low FSH levels in comparison with infertile female subjects. One polymorphism in exon 2 (E1225K [G/A 3673]) and three in exon 3 (P1945A [C/G 5833]; Insertion of T at 6075; G2026G [C/G 6078]) in infertile group were detected, with low KP and hormonal levels. Male subjects had abnormal sperm parameters and unsuccessful attempt of intracytoplasmic sperm injection in females. Expression of SNP in exon 2 and exon 3 of KISS1 could be responsible for alteration in release of reproductive hormones and gonadal functions, hence causing infertility.


Assuntos
Sistema Hipotálamo-Hipofisário/fisiopatologia , Infertilidade Feminina/genética , Infertilidade Masculina/genética , Kisspeptinas/genética , Adulto , Estudos Transversais , Éxons/genética , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/sangue , Infertilidade Masculina/epidemiologia , Kisspeptinas/sangue , Hormônio Luteinizante/sangue , Masculino , Pessoa de Meia-Idade , Mutação , Paquistão/epidemiologia , Polimorfismo de Nucleotídeo Único , Testosterona/sangue
6.
Andrologia ; 51(9): e13343, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31332821

RESUMO

The aim of this systematic review and meta-analysis was to evaluate the effect of vitamin D supplementation on total testosterone (TT) and sex hormone-binding globulin (SHBG) in men. We searched PubMed, Scopus and Web of Science for randomized, controlled trials of vitamin D supplementation in men ≥18 years old up to September 2018, without language restrictions. Meta-analysis was based on a random effects model. The systematic review was registered as CRD42018094498. We identified 3,402 articles, of which eight studies with 10 effect sizes met the inclusion criteria. Vitamin D daily dose equivalents ranged from 600 to 4,000 per day to 60,000 IU per week; duration was 6 weeks to 36 months. In general, vitamin D supplementation had no significant effect on TT (MD = 0.20, 95% CI: -0.20, 0.60, p = 0.336) and SHBG (MD = 1.56, 95% CI: -0.85, 3.97, p = 0.204). Subgroup analysis conducted with duration of prescription, type (daily or weekly), dosing frequency and baseline vitamin D and TT concentration showed that vitamin D did not significantly affect TT. The present study did not find any evidence to support beneficial effect of vitamin D supplementation on TT and SHBG in men. Thus, further large-scale randomised controlled trials are required to evaluate the effects of vitamin D supplementation on androgen in men.


Assuntos
Infertilidade Masculina/prevenção & controle , Globulina de Ligação a Hormônio Sexual/análise , Testosterona/sangue , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/administração & dosagem , Ensaios Clínicos Controlados como Assunto , Suplementos Nutricionais , Relação Dose-Resposta a Droga , Esquema de Medicação , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/etiologia , Masculino , Resultado do Tratamento , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/complicações
7.
Nutrients ; 11(7)2019 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-31252555

RESUMO

Obesity plays an important role in human fertility in both genders. The same is true for vitamin D, for which accumulating evidence from observational human studies suggests a key role for both male and female fertility. In the latter case, however, robust data from relevant interventional studies are currently lacking. It is also not clear whether obesity and vitamin D deficiency, besides their independent effect on human infertility, act in synergy. Several pathogenetic mechanisms may be proposed as a linkage between vitamin D deficiency and obesity, with respect to infertility. In any case, the independent contribution of vitamin D deficiency in obese infertile states needs to be proven in interventional studies focusing on either vitamin D supplementation in obese or weight loss strategies in vitamin D-deficient infertile patients.


Assuntos
Fertilidade , Infertilidade Feminina/epidemiologia , Infertilidade Masculina/epidemiologia , Obesidade/epidemiologia , Deficiência de Vitamina D/epidemiologia , Vitamina D/sangue , Animais , Biomarcadores/sangue , Suplementos Nutricionais , Feminino , Humanos , Infertilidade Feminina/sangue , Infertilidade Feminina/fisiopatologia , Infertilidade Feminina/terapia , Infertilidade Masculina/sangue , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/terapia , Masculino , Obesidade/sangue , Obesidade/fisiopatologia , Obesidade/terapia , Gravidez , Prognóstico , Técnicas de Reprodução Assistida , Medição de Risco , Fatores de Risco , Vitamina D/uso terapêutico , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/fisiopatologia
8.
Andrologia ; 51(8): e13300, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31058347

RESUMO

Oxidative stress plays an important role in the development of infertility secondary to varicocele. We aimed to investigate the dynamic thiol-disulphide homeostasis as an oxidative stress marker in the spermatic vein of infertility secondary to varicocele. Sixty-one patients with varicocele were included in the study. Blood was drawn from the median cubital vein and the testicular venous return side before the spermatic vein was separated during surgery. Total thiol, native thiol, disulphide, ischaemia modified albumin (IMA) and albumin values were measured from both the dilated spermatic vein and the median cubital vein. The disulphide/native thiol, disulphide/total thiol and native thiol/total thiol ratios were determined. The mean age of the patients was 27.0 ± 6.68 (15-50) years. While the albumin, native thiol and total thiol values and the native thiol/total thiol ratio were significantly lower (p = 0.004, p < 0.001, p < 0.001, p < 0.001 respectively), the IMA value and the disulphide/native thiol and disulphide/total thiol ratios were significantly higher (p < 0.001, p < 0.001, p < 0.001 respectively) in the samples taken from spermatic venous blood. Thiol-disulphide balance had deteriorated towards disulphide formation in the spermatic vein compared with the peripheral vein. Abnormal thiol-disulphide balance may be an independent risk factor for infertility secondary to varicocele.


Assuntos
Dissulfetos/metabolismo , Infertilidade Masculina/metabolismo , Cordão Espermático/irrigação sanguínea , Compostos de Sulfidrila/metabolismo , Varicocele/metabolismo , Adolescente , Adulto , Biomarcadores/sangue , Biomarcadores/metabolismo , Dissulfetos/sangue , Homeostase , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/etiologia , Masculino , Pessoa de Meia-Idade , Estresse Oxidativo , Estudos Prospectivos , Fatores de Risco , Albumina Sérica Humana/metabolismo , Compostos de Sulfidrila/sangue , Varicocele/sangue , Varicocele/complicações , Veias , Adulto Jovem
9.
Andrologia ; 51(8): e13318, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31131463

RESUMO

Male infertility is adversely affected by tobacco cigarette smoking. Herein, the effects of prenatal waterpipe tobacco smoke (WTS) exposure on reproductive hormones and oxidative stress of adult offspring rats were evaluated. Pregnant rats received either fresh air or mainstream WTS (2 hr daily). Pregnancy outcomes, circulatory levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and prolactin, testicular levels of oestrogen, testosterone and oxidative stress biomarkers [catalase, superoxide dismutase (SOD), glutathione peroxidase (GPx) and thiobarbituric acid reactive substances (TBARS)] were assessed in their adult male offspring rats. Prenatal WTS exposure reduced the number of born offspring, female to pups ratio and birthweight (p < 0.05). Prenatal WTS exposure increased the circulatory levels of FSH and the testicular levels of oestrogen, testosterone and TBARS and catalase activity compared with control group (p < 0.05). However, GPx activity was reduced by WTS exposure (p < 0.05). There appeared to be a trend of increased LH and prolactin levels with prenatal WTS exposure; however, it was not statistically significant compared with control group (p > 0.05). The activity of SOD was not affected by prenatal WTS exposure (p > 0.05). In conclusion, prenatal WTS exposure altered reproductive hormones as well as oxidative stress biomarkers in adult male offspring rats.


Assuntos
Infertilidade Masculina/patologia , Exposição Materna/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/patologia , Fumar Tabaco/efeitos adversos , Tabaco para Cachimbos de Água/toxicidade , Animais , Biomarcadores/sangue , Biomarcadores/metabolismo , Modelos Animais de Doenças , Estrogênios/análise , Estrogênios/metabolismo , Feminino , Gonadotropinas Hipofisárias/sangue , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/etiologia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/sangue , Efeitos Tardios da Exposição Pré-Natal/etiologia , Ratos , Superóxido Dismutase/análise , Superóxido Dismutase/metabolismo , Testículo/patologia , Testosterona/análise , Testosterona/metabolismo , Substâncias Reativas com Ácido Tiobarbitúrico/análise , Substâncias Reativas com Ácido Tiobarbitúrico/metabolismo
10.
Eur J Obstet Gynecol Reprod Biol ; 238: 104-109, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31128532

RESUMO

OBJECTIVE: To determine the effect of a 3-month course of clomiphene citrate (CC) on plasma testosterone (T) level and on semen parameters in 18 infertile men with low T level and normal or low gonadotropines level. STUDY DESIGN: A retrospective study was conducted by reviewing the medical records of men referred to a university fertility medicine unit for infertility management between January 2010 and March 2015. Men treated with CC for at least 3 months were included if they presented with: RESULTS: 18 patients met the inclusion criteria. CC was prescribed for 3 months at the dose of 50 mg every 48 h. Plasma T level was assessed at baseline and after 1 month of CC administration. Semen parameters were assessed at baseline and after 3 months of CC administration. The median pre-treatment T level was 9.1 nmol/l; after 1 month of CC treatment the median post-treatment T level increased to 20.2 nmol/l (p = <0.001). Median baseline sperm concentration was 7 millions/ml with a median progressive motility of 18%. After 3 months of CC, the median post-treatment sperm concentration was 17.5 millions/ml (p = 0.024) and the median post-treatment progressive sperm motility was 18% (p = 0.40). Three natural pregnancies occurred during the treatment period. CONCLUSION: CC is an effective and inexpensive treatment to increase plasma T level in infertile men with low T level and normal or low gonadotropines level. Our study suggests that CC could increase sperm concentration even in oligospermic infertile men, without, however, a significant effect on progressive sperm motility. More powered randomized controlled trials are needed to definitively assess CC effect on sperm parameters and on natural pregnancy rates.


Assuntos
Clomifeno/uso terapêutico , Gonadotropinas/sangue , Infertilidade Masculina/tratamento farmacológico , Moduladores Seletivos de Receptor Estrogênico/uso terapêutico , Testosterona/sangue , Adulto , Humanos , Infertilidade Masculina/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise do Sêmen , Adulto Jovem
11.
Fertil Steril ; 111(6): 1129-1134, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30982604

RESUMO

OBJECTIVE: To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity. DESIGN: Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS). SETTING: Infertility clinics. PATIENT(S): Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome. RESULT(S): Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318-520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4% strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95% CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 106/mL, or motility < 40%. Among couples whose male partner had low TT, 21 (18.8%) had a live birth, compared with 184 (27.5%) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR, 0.60; 95% CI, 0.36, 1.00; adjusted OR, 0.65; 95% CI, 0.38, 1.12). CONCLUSION(S): In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates. CLINICAL TRIAL REGISTRATION NUMBER: NCT01044862.


Assuntos
Infertilidade Masculina/terapia , Inseminação Artificial Homóloga , Espermatogênese , Testosterona/sangue , Adulto , Biomarcadores/sangue , Regulação para Baixo , Feminino , Fertilidade , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/fisiopatologia , Inseminação Artificial Homóloga/efeitos adversos , Nascimento Vivo , Masculino , Estudos Multicêntricos como Assunto , Gravidez , Taxa de Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Contagem de Espermatozoides , Motilidade Espermática , Resultado do Tratamento
12.
Biomed Res Int ; 2019: 7934328, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30984784

RESUMO

Varicocele, a vascular event, is associated with infertility due to testicular damage that causes abnormal spermatogenesis in males. The goal of this study is to ascertain the diagnostic significance of scrotal color Doppler ultrasonography (CDUS) by measuring peak systolic value (PSV) and resistive index (RI) of the arteries supplying blood to the testis and their association with semen quality attributes. Sixty prospective patients (age: 20-50 years) undergoing microsurgical varicocelectomy at a teaching hospital were included in the study. Semen parameters and CDUS were recorded and testicular blood flow was determined as PSV and RI of subcapsular artery and intraparenchymal artery of the testes. Nonparametric statistics was applied to test the correlation/association of the semen quality with the PSV, RI, and other variables. Results revealed a significant negative correlation (r = -0.28; p < 0.05) between progressive motility of spermatozoa and resistive index of the intraparenchymal arterial blood flow. Furthermore, it was noticed that the progressive motility of spermatozoa was tended to be negatively correlated (r = -0.236) with resistive index of subcapsular arterial blood flow. In conclusion, this study has revealed that progressive motility of sperms has correlation with the intraparenchymal blood flow of testes. The progressive motility of sperms could be correlated with RI of testicular blood flow. The apparent lack of association between diameter of varicocele vein and semen quality signifies the need of investigating some other factors that may be involved in pathogenicity of varicocele. The diagnostic value of CDUS may be carefully interpreted and clinically correlated in assessment of severity of varicocele.


Assuntos
Velocidade do Fluxo Sanguíneo/fisiologia , Infertilidade Masculina/sangue , Testículo/irrigação sanguínea , Varicocele/sangue , Adulto , Hemodinâmica , Humanos , Infertilidade Masculina/patologia , Infertilidade Masculina/cirurgia , Masculino , Microcirurgia , Pessoa de Meia-Idade , Paquistão , Sêmen/metabolismo , Análise do Sêmen , Motilidade Espermática/fisiologia , Espermatogênese/fisiologia , Testículo/patologia , Testículo/cirurgia , Varicocele/patologia , Varicocele/cirurgia , Veias/patologia , Veias/cirurgia , Adulto Jovem
13.
Endocrinology ; 160(5): 1223-1233, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30920587

RESUMO

Aberrant exposure to estrogen-like compounds during the critical developmental period may cause improper hypothalamic programming, thus resulting in reproductive dysfunction in adulthood in male mammals. Kisspeptin-neurokinin B-dynorphin A (KNDy) neurons in the arcuate nucleus (ARC) have been suggested to govern tonic GnRH/gonadotropin release to control reproduction in male mammals. In this study, we report that chronic exposure to supraphysiological levels of estrogen during the neonatal period caused an irreversible suppression of KNDy genes in the ARC, resulting in reproductive dysfunction in male rats. Daily estradiol benzoate (EB) administration from days 0 to 10 postpartum caused smaller seminiferous tubules, abnormal spermatogenesis, and a decrease in plasma testosterone in adult male rats. The neonatal EB treatment profoundly suppressed LH pulse and ARC KNDy gene expression at adulthood, but it failed to affect the number of GnRH gene-expressing cells in male rats. The EB treatment failed to affect gene expression of other neuropeptides, such as GHRH, proopiomelanocortin, and agouti-related protein in the ARC, suggesting that ARC KNDy neurons would be a specific target of neonatal estrogen to cause male reproductive dysfunction. Because LH secretory responses to kisspeptin challenge and GnRH expression were spared in male rats with the EB treatment, LH pulse suppression is most probably due to ARC KNDy deficiency. Taken together, the current study indicates that chronic exposure to estrogenic chemicals in the developing brain causes a defect of ARC KNDy neurons, resulting in an inhibition of pulsatile GnRH/LH release and the failure of spermatogenesis and steroidogenesis.


Assuntos
Núcleo Arqueado do Hipotálamo/efeitos dos fármacos , Estradiol/análogos & derivados , Regulação da Expressão Gênica no Desenvolvimento/efeitos dos fármacos , Infertilidade Masculina/genética , Kisspeptinas/genética , Neurônios/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Núcleo Arqueado do Hipotálamo/metabolismo , Dinorfinas/genética , Dinorfinas/metabolismo , Estradiol/administração & dosagem , Estradiol/farmacologia , Hibridização In Situ , Infertilidade Masculina/sangue , Kisspeptinas/metabolismo , Masculino , Neurocinina B/genética , Neurocinina B/metabolismo , Neurônios/metabolismo , Ratos Wistar , Espermatogênese/efeitos dos fármacos , Espermatogênese/genética , Testosterona/sangue
14.
J Urol ; 202(2): 379-384, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30835629

RESUMO

PURPOSE: We sought to determine whether lower fertility related quality of life or depression in men of couples with unexplained infertility is associated with low total testosterone levels, abnormal semen quality or erectile dysfunction. MATERIALS AND METHODS: This study is a secondary analysis of a large, multicenter, randomized controlled trial in couples with unexplained infertility. Male partners underwent baseline semen analysis with measurement of fasting total testosterone and gonadotropin. They also completed surveys, including the FertiQOL (Fertility Quality of Life), the PHQ-9 (Patient Health Questionnaire-9) and the IIEF (International Index of Erectile Function). The primary study outcomes were total testosterone with low total testosterone defined as less than 264 ng/dl, semen parameters and the IIEF score. We performed multivariable logistic regression analyses adjusted for patient age, race, body mass index, education, smoking, alcohol use, infertility duration and comorbidity. RESULTS: A total of 708 men with a mean ± SD age of 34.2 ± 5.6 were included in study. Of the men 59 (8.3%) had a PHQ-9 score of 5 or greater, which was consistent with depression, 99 (14.0%) had low total testosterone and 63 (9.0%) had mild or worse erectile dysfunction. Neither the FertiQOL score nor depression was associated with total testosterone or any semen parameter. The FertiQOL score was inversely associated with erectile dysfunction (for every 5-point score decline AOR 1.30, 95% CI 1.16-1.46). Depressed men were significantly more likely to have erectile dysfunction than nondepressed men (AOR 6.31, 95% CI 3.12-12.77). CONCLUSIONS: In men in couples with unexplained infertility lower fertility related quality of life and depression are strongly associated with erectile dysfunction. However, neither is associated with spermatogenesis or testosterone levels. Erectile dysfunction in infertile men merits longitudinal investigation in future studies.


Assuntos
Depressão/complicações , Disfunção Erétil/complicações , Infertilidade Masculina/complicações , Qualidade de Vida , Adulto , Depressão/sangue , Depressão/fisiopatologia , Disfunção Erétil/fisiopatologia , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/fisiopatologia , Masculino , Estudos Prospectivos , Análise do Sêmen , Testosterona/sangue
15.
Andrologia ; 51(5): e13257, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30779195

RESUMO

Clomiphene citrate (CC) is commonly used off-label for the treatment of male infertility, yet there is limited data to guide patient selection. To identify a subset of patients more likely to benefit from CC, we aimed to define predictors of improvement in semen parameters among men receiving CC. We retrospectively analysed 151 men treated with at least 25 mg CC daily for male infertility and/or hypogonadism at two institutions between 2004 and 2014. Men previously on testosterone were excluded. The primary outcome was change in semen parameters. Variables included baseline patient characteristics, pre-treatment hormone profiles and pre-treatment semen analyses. A total of 77 men met inclusion criteria. Median length of therapy was 2.8 months. There was significant improvement in sperm concentration (14-21 million/ml; p = 0.002) and total motile count (TMC; 13-28 million; p = 0.04). One third of patients who began with fewer than 5 million motile spermatozoon improved to a TMC > 5 million, increasing reproductive options to include intrauterine insemination. Patient characteristics, pre-treatment hormone profile and degree of oligozoospermia did not predict treatment response. While no predictors of improvement were identified, clinically useful response rates are described for use in shared decision-making.


Assuntos
Clomifeno/uso terapêutico , Hipogonadismo/tratamento farmacológico , Infertilidade Masculina/tratamento farmacológico , Contagem de Espermatozoides , Motilidade Espermática/efeitos dos fármacos , Adulto , Clomifeno/farmacologia , Hormônio Foliculoestimulante/sangue , Humanos , Hipogonadismo/sangue , Infertilidade Masculina/sangue , Hormônio Luteinizante/sangue , Masculino , Uso Off-Label , Estudos Retrospectivos , Testosterona/sangue , Resultado do Tratamento
16.
Biomed Res Int ; 2019: 5129263, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30729125

RESUMO

Objectives: To study the associations between kisspeptin levels in seminal plasma and blood plasma and semen quality. Materials and Methods: We conducted a male reproductive health survey in June 2014. A total of 666 volunteers were recruited from colleges in Chongqing, China. All volunteers completed a questionnaire including information on domestic characteristics and some potential confounders. We tested the kisspeptin levels in both blood and seminal plasma. Total seminal kisspeptin was calculated as the concentration of kisspeptin in seminal plasma multiplied by semen volume. Semen samples were tested according to the 2010 World Health Organization's (WHO) guidelines. Spearman correlation and multivariate linear regression were used to explore the association between kisspeptin concentrations in seminal plasma and blood plasma and semen quality. Potential confounders that were adjusted for included age, abstinence time, body mass index (BMI), grade, and smoking. Results: The median of kisspeptin levels in seminal plasma was 60,000 times higher than kisspeptin in blood plasma (28.0 × 106 pg/ml versus 448.9 pg/ml). Each interquartile range (IQR) of kisspeptin in seminal plasma was associated with a 4.6% (95% confidence interval [CI]: 1.6%-7.6%) increase in sperm concentration. Each IQR of total kisspeptin was associated with a 7.7% (95% CI: 4.4%-11.0%) increase in total sperm number and a 7.8% (95% CI: 4.0%-11.7%) increase in total motile sperm count. Kisspeptin levels were further classified into quartiles and Q1 was set as the reference level. Subjects in the high total kisspeptin group had 57.5% (95% CI: 33.2%-86.2%) higher total sperm number than the reference group. Conclusion: The positive association between kisspeptin levels in seminal plasma and semen quality supported an important role for the KISS1/GPR54 system in male reproductive health. Kisspeptin may be a potential marker of male reproductive health and an alternative strategy for treating infertility.


Assuntos
Infertilidade Masculina/genética , Kisspeptinas/genética , Receptores de Kisspeptina-1/genética , Reprodução/genética , Adulto , Índice de Massa Corporal , China/epidemiologia , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/patologia , Kisspeptinas/sangue , Masculino , Receptores de Kisspeptina-1/sangue , Sêmen/metabolismo , Análise do Sêmen , Contagem de Espermatozoides , Motilidade Espermática/genética
17.
Food Chem Toxicol ; 125: 562-565, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30738989

RESUMO

BACKGROUND: Bisphenol A (BPA) has been associated with male reproductive dysfunction. However, few studies have assessed BPA according to the cause of male infertility. AIM: To investigate serum BPA concentrations in infertile men according to infertility cause. PATIENTS AND METHODS: Men with infertility (n = 55) [non-obstructive azoospermia (n = 23), cryptorchidism (n = 12), varicocele (n = 20)] compared with fertile men (n = 25). Serum BPA concentrations were measured along with clinical and hormonal assessment. RESULTS: BPA was detected in all men, with no difference between infertile and control groups [median (IQR) 0.19 (0.45) vs. 0.18 (0.28) ng/ml, p = 0.689] or among the infertility cause [azoospermia 0.30 (0.69), cryptorchidism 0.12 (0.39), varicocele 0.17 (0.23) ng/ml, p = 0.316]. High concentrations of BPA (>3 ng/ml) were observed only in infertile men. Α negative correlation was observed between ΒΡΑ concentrations and AMH (r = -0.320, p < 0.01). CONCLUSIONS: Although male infertility cannot be attributed to exposure to BPA, high concentrations of BPA could contribute to infertility.


Assuntos
Compostos Benzidrílicos/sangue , Disruptores Endócrinos/sangue , Infertilidade Masculina/sangue , Fenóis/sangue , Adulto , Hormônio Antimülleriano/sangue , Humanos , Masculino , Análise do Sêmen
18.
Int Urol Nephrol ; 51(3): 401-408, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30701399

RESUMO

PURPOSE: We studied prospectively the role of FSH, testis volume, age, duration of infertility, hormonal therapy, varicocelectomy and testicular histopathology in determining the sperm retrieval rate (SRR) in fresh versus salvage micro-TESE. METHODS: Our study analysed retrospectively the prospectively maintained database of 330 NOA patients who underwent micro-TESE either 1st or 2nd or 3rd timers from January 2017 to August 2018 from the Andrology Clinic of a specialized IVF centre. They were divided equally into 3 groups, group (1) were 1st timers, group (2) were 2nd timers and group (3) were 3rd timers, respectively. RESULTS: Interestingly, our study demonstrated a positive correlation between high FSH level and favourable micro-TESE outcome in 1st timers who underwent micro-TESE (p 0.015). Additionally, our study revealed a positive correlation between age and favourable micro-TESE outcome in 2nd timers who underwent micro-TESE (p 0.031). Further, our study revealed a positive correlation between right testicular volume and favourable micro-TESE outcome in 1st timers who underwent micro-TESE (p 0.023). Eventually, there was a significant positive correlation between histopathology which was mainly sertoli cell only syndrome and favourable micro-TESE outcome in 1st timers micro-TESE (p 0.001). CONCLUSION: Our study demonstrates that sperms can be retrieved despite high FSH level, and preoperative histopathology is not essential in predicting SRR in NOA patients. Further, age can be considered a good prognostic factor in patients who undergo salvage micro-TESE for the 2nd time.


Assuntos
Hormônio Foliculoestimulante/sangue , Infertilidade Masculina/terapia , Recuperação Espermática , Testículo/patologia , Adulto , Fatores Etários , Azoospermia/sangue , Azoospermia/complicações , Hormônios/uso terapêutico , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/etiologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Estudos Retrospectivos , Terapia de Salvação , Varicocele/cirurgia
19.
Andrologia ; 51(5): e13258, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30809834

RESUMO

Seminal oxidative stress (OS) is a major cause of male factor infertility and can be measured as oxidation-reduction potential (ORP). Studies showed significant negative relationships of ORP with sperm count, motility or DNA integrity. Since these parameters are also positively or negatively associated with reproductive hormones follicle-stimulating hormone (FSH), luteinising hormone (LH), testosterone, testicular volume and the occurrence of varicocele, it is important to understand the mechanistic relationship between ORP and hormonal and/or testicular parameters. Therefore, we studied the relationship between ORP levels, standard hormone profiles and testicular volume in infertile men with and without varicocele. Results show a highly significant negative relationship of ORP with testicular volume and significantly positive correlations with FSH and LH. Yet, when adding varicocele as covariate, the relationship with FSH/LH became nonsignificant. Contrary, the presence of varicocele had only a contributing influence on the association of ORP with the testis volume. No association was found with estradiol. We propose that since OS causes degeneration of Sertoli cell with testicular shrinkage, such negative effect would result in a negative feedback on the hypothalamus with less inhibin secretion. This may result in increased secretion of LH and FSH. Thus, systemic and/or local OS may be responsible for smaller testis volumes.


Assuntos
Infertilidade Masculina/diagnóstico , Estresse Oxidativo/fisiologia , Testículo/patologia , Varicocele/patologia , Adulto , Idoso , Estradiol/sangue , Hormônio Foliculoestimulante/sangue , Hormônio Foliculoestimulante/metabolismo , Humanos , Hipotálamo/fisiologia , Infertilidade Masculina/sangue , Infertilidade Masculina/etiologia , Infertilidade Masculina/patologia , Inibinas/metabolismo , Hormônio Luteinizante/sangue , Hormônio Luteinizante/metabolismo , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Oxirredução , Estudos Retrospectivos , Sêmen , Contagem de Espermatozoides , Testosterona/sangue , Testosterona/metabolismo , Varicocele/complicações , Adulto Jovem
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