Micro-TESE strategy in patients with NOA caused by AZFc deletion: synchronous or asynchronous?

In the treatment of infertile patients with non-obstructive azoospermia (NOA) caused by the deletion of the azoospermia factor c region (AZFc) on the Y chromosome, synchronous and asynchronous surgical strategies are discussed. Clinical data from NOA patients with the AZFc deletion who underwent micro-TESE were analyzed retrospectively. The sperm retrieval rate (SRR) and sperm utilization rate of synchronous and asynchronous operation groups were followed up and compared. The fertilization rate, high-quality embryo rate, clinical pregnancy rate, abortion rate, and cumulative live birth rate of ICSI in patients with successful sperm retrieval were compared between the two groups. The two groups had sperm utilization rates of 98.9% (93/94) and 50.0% (14/28), respectively. The asynchronous group's sperm consumption rates were much lower than those of the synchronous operation group. Fertilization rate, high-quality embryo rate, clinical pregnancy rate of fresh transfer cycle, abortion rate, and cumulative live birth rate of patients in the synchronous operation group with fresh sperm, and the asynchronous operation group with thawed sperm, respectively, were 30.6% vs 33.8%, 33.8% vs 40.7%, 40.0% vs 12.5%, 30.4% vs 7.1%. Between the two groups, there was no significant difference. This suggests that individuals with NOA caused by the AZFc deletion have a high possibility of successfully acquiring sperm using micro-TESE and ICSI to conceive their own offspring. Synchronous micro-TESE is recommended to improve sperm utilization rate and the cumulative live birth rate.

Sodium-Hydrogen-Exchanger expression in human sperm and its relationship with semen parameters.

PURPOSE: Sperm-specific sodium-hydrogen exchanger (sNHE) is essential to maintain sperm normal function in mice; however, its role in human sperm has not been clarified to date. The aim of this study is to investigate the expression pattern of sNHE in human spermatozoa and its relationship with sperm functional parameters. METHOD: Semen samples from 68 asthenozoospermic and 61 normozoospermic men were analyzed for sperm concentration, motility, and acrosome reaction, and high motile spermatozoa were collected by swim-up method. The expression of sNHE in spermatozoa was detected by Western blot and immunofluorescence staining. The relationship between sNHE expression and sperm parameters was assessed. RESULTS: We identified sNHE is mainly localized to the principal piece of the human sperm tail. The expression of sNHE was positively correlated with sperm concentration, total number, and progressive motility. Moreover, sNHE expression was upregulated in swim-up sperm and associated with most of sperm motility parameters including straight line velocity and curvilinear velocity. Our results also showed that sNHE expression is decreased in sperm from patients with asthenozoospermia compared with that from normal controls. However, no correlation was found between sNHE expression and acrosome reaction in spermatozoa. CONCLUSIONS: The expression pattern of sNHE suggested that this protein may be involved in the regulation of sperm motility, and aberration of its expression in sperm may contribute to the pathogenesis of asthenozoospermia.

[Qilin Pills for idiopathic oligoasthenospermia: A multi-centered randomized double-blind controlled clinical trial].

OBJECTIVE: To evaluate the clinical efficacy and safety of Qilin Pills in the treatment of oligoasthenospermia in infertile men. METHODS: This multi-centered randomized double-blind controlled clinical trial included 216 infertile males with oligoasthenospermia, 108 in the trial group and the other 108 in the control, the former treated with Qilin Pills at the dose of 6 g tid while the latter with Wuziyanzong Pills at 6 g bid, both for 12 weeks. We examined the total sperm count, sperm motility and the count of progressively motile sperm of the patients before and at 4, 8 and 12 weeks after medication and evaluated the safety of the drug based on the adverse events and the laboratory results of blood and urine routine examinations and liver and kidney function tests. RESULTS: Compared with the baseline, the patients in the trial group showed a significant time-dependent improvement after 4, 8 and 12 weeks of medication in sperm motility (21.75% vs 27.54%, 29.04% and 32.95%, P <0.05), total sperm count (156.27 ×106 vs 177.33, 188.18 and 205.44 ×106, P <0.05), and the count of progressively motile sperm (32.08 ×106/ml vs 46.33, 50.98 and 61.10 ×106/ml, P <0.05). The three parameters above were also improved in the controls, but more significantly in the trial group (P <0.05). CONCLUSIONS: Qilin Pills can evidently improve the semen quality of oligoasthenospermia patients with no obvious adverse events.

[Microdissection testicular sperm extraction for patients with nonmosaic Klinefelter syndrome: A report of 143 cases].

OBJECTIVE: To investigate the clinical application and outcomes of microdissection testicular sperm extraction (micro-TESE) in patients with nonmosaic Klinefelter syndrome (KS). METHODS: A total of 143 nonmosaic KS patients underwent micro-TESE in the Center of Reproductive Medicine of Peking University Third Hospital between July 2012 and August 2016. We analyzed their clinical and follow-up data and evaluated the outcomes. RESULTS: Spermatozoa were successfully retrieved from the testicular tissue in 44.76% (64/143) of the patients, 84.4% (54/64) by unilateral and 15.6% (10/64) by bilateral micro-TESE. Seventy-five of the KS patients were followed up in the years of 2014 and 2015. Of the 34 patients with successful sperm retrieval, 73.52% (25/34) achieved clinical pregnancy and 8 boys and 8 girls were already born in 14 of the 25 cases. CONCLUSIONS: The micro-TESE is a useful method for sperm retrieval in nonmosaic KS patients, with high rates of sperm retrieval, clinical pregnancy, and birth of biological offspring.

[Impact of the CFTR chloride channel on the cytoskeleton of mouse Sertoli cells].

OBJECTIVE: To study the impact of the chloride channel dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) on the cytoskeleton of Sertoli cells in the mouse. METHODS: TM4 Sertoli cells were cultured and treated with CFTR(inh)-172 at the concentrations of 1, 5, 10 and 20 µmol/L for 48 hours. Then the cytotoxicity of CFT(inh)-172 was assessed by CCK-8 assay, the expressions of F-actin and Ac-tub in the TM4 Sertoli cells detected by immunofluorescence assay, and those of N-cadherin, vimentin and vinculin determined by qPCR. RESULTS: CFTR(inh)-172 produced cytotoxicity to the TM4 Sertoli cells at the concentration of 20 µmol/L. The expressions of F-actin and Ac-tub were decreased gradually in the TM4 Sertoli cells with the prolonging of treatment time and increasing concentration of CFTR(inh)-172 (P < 0.05). The results of qPCR showed that different concentrations of CFTR(inh)-172 worked no significant influence on the mRNA expressions of N-cadherin, vimentin and vinculin in the Sertoli cells. CONCLUSION: The CFTR chloride channel plays an important role in maintaining the normal cytoskeleton of Sertoli cells. The reduced function and expression of the CFTR chloride channel may affect the function of Sertoli cells and consequently spermatogenesis of the testis.

RNA-Seq Analysis Revealed circRNAs and Genes Associated with Abdominal Fat Deposition in Ducks.

Fat deposition is an important factor affecting meat quality and feed conversion efficiency in meat ducks. This study aims to identify key circRNAs and genes affecting abdominal fat deposition. The correlations between abdominal fat and other growth performances were analyzed in 304 F2 generation of Cherry Valley duck Runzhou Crested White ducks, and an RNA-seq analysis of abdominal fat tissues from ducks with high and low rates of abdominal fat was performed. Growth performance results showed that Abdominal fat ratio and Intramuscular fat were significantly higher in the high rates of abdominal fat (HF)group than in the low rates of abdominal fat (LF) group for ducks. RNA-seq analysis of abdominal fat tissue unveiled 85 upregulated and 72 downregulated circRNAs among the differentially expressed ones. Notably, 74 circRNAs displayed more than four-fold differential expression, constituting 47.13% of the differentially expressed genes. Functional enrichment analysis of the differentially expressed circRNA source and target genes indicated that 17 circRNAs might partake in regulating duck abdominal fat production by influencing pathways like PPAR signaling, lipid droplets, and triglyceride metabolism. Lastly, multiple circRNA-microRNA-messenger RNA interaction networks were constructed. The results of this study establish the groundwork for understanding the molecular mechanisms that regulate abdominal fat deposition in ducks, offering a theoretical reference for the selective breeding of high-quality meat-producing ducks.

Sperm retrieval outcomes of contralateral testis in men with nonobstructive azoospermia and unsuccessful unilateral microdissection testicular sperm extraction.

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[Detection of spermatozoa in the testicular tissue of non-obstructive azoospermia patients: cell suspension examination versus histopathology].

OBJECTIVE: To compare cell suspension examination with histopathology in detecting spermatozoa in the testicular tissue of non-obstructive azoospermia (NOA) patients, and to investigate the reliability of sperm retrieval and appropriate therapeutic options when the results of the two methods are inconsistent. METHODS: A total of 1 112 NOA patients underwent testicular sperm extraction (TESE), their testicular tissues subjected to cell suspension examination and histopathology, respectively. RESULTS: The consistency rate of the two methods was 92.63%, with the sperm detection rate of 41.82% and non-sperm detection rate of 50.81%. Sperm were retrieved from 96.0% (24/25) of the patients on the day of oval retrieval, in whom sperm were found in cell suspension examination but not in histopathology. After intracytoplasmic sperm injection (ICSI), pregnancy was achieved in 8 cases (33.33%), abortion occurred in 4 (16.67%), and non-pregnancy in 12 (50.0%). CONCLUSION: Cell suspension examination combined with histopathology for detecting sperm in the testicular tissue of NOA patients gives instant, accurate, reliable and consistent results, and therefore insures successful sperm retrieval for NOA patients during the IVF cycle. In case of inconsistency between the results of the two methods, cell suspension examination is more helpful for clinical therapeutic option.

[Influence of recombination abnormality in spermatocyte meiosis on the pathology of patients with non-obstructive azoospermia].

OBJECTIVE: To primarily study the influence of recombination abnormality in human spermatocyte meiosis on the pathology of the patients with non-obstructive azoospermia (NOA). METHODS: We obtained testis tissues from 6 NOA patients by testicular biopsy and divided the tissue of each patient into 2 portions, one for pathological examination and the other for immunofluorescent staining. We observed the synaptonemal complex and the numbers of the recombination sites on homologous chromosomes, and analyzed the relationship between abnormal recombination and pathological findings. RESULTS: Pathological examination showed that the basement membrane of the seminiferous tubules was thickened in 3 of the cases and atrophied in the other 3, the number of autosomal MLH1 foci in a spermatocyte ranging from 10 to 50 in the former 3, and from 30 to 50 in the latter 3. CONCLUSION: The increased range of the homologous chromosomal recombination frequency may be one of the possible factors for the thickening of seminiferous tubule basement membrane and even lumen occlusion in NOA patients.

[Tadalafil combined with behavior therapy for semen collection from infertile males in whom masturbation fails].

OBJECTIVE: To study the effect of Tadalafil combined with behavior therapy in helping obtain semen from infertile men in whom masturbation has failed. METHODS: Sixty male infertile patients from whom masturbation had failed to obtain semen were equally assigned to receive Tadalafil combined with behavior therapy (combination group) or Tadalafil only (control group). All the patients took Tadalafil 20 mg orally the night before the day of semen collection by masturbation. Before this procedure, the patients of the combination group practiced masturbation 16 - 24 times at home. RESULTS: The average ages of the patients were (37.0 +/- 5.1) yr and (37.5 +/- 5.2) yr and their IIEF-5 scores were 16.50 +/- 1.25 and 16.90 +/- 1.09 in the combination and the control group, respectively, neither with statistically significant difference between the two groups. Semen was successfully obtained from 9 patients (30.0%) of the combination group and 1 patient (3.33%) of the control group, with statistically significant difference between the two groups (chi2 = 7.680, P < 0.01). CONCLUSION: By training the patients and establishing a conditioned response to masturbation, Tadalafil combined with behavior therapy can significantly increase the success rate of semen collection from the male infertile patients in whom masturbation fails.

Performance and response of coupled microbial fuel cells for enhanced anaerobic treatment of azo dye wastewater with simultaneous recovery of electrical energy.

The anaerobic baffled reactor (ABR) is an anaerobic bioreactor that uses baffles to separate the working area into multiple reaction zones. The ABR-microbial fuel cell (MFC) reactor was constructed by embedding MFC in each reaction zone of the ABR. Its degradation of azo dye type (acid mordant red) wastewater and microbial power generation performance were investigated. For different electrode area ratios, the best enhanced treatment and electrical energy output of the coupled system was achieved with an anode/cathode area ratio of 1:1. Compared with the electrode area ratio of 2:1 and 1:2, the power density increased by 82.5% and 80.6%, and the Coulomb efficiency increased by 133.3% and 64.7%. In addition, the best enhanced treatment of printing and dyeing wastewater was achieved by ABR-MFC at 1:1. At a dye concentration of 200 mg/L and a sucrose concentration of 1000 mg/L, the coupled system obtained a COD removal of 92.85% and a chromaticity removal of 96.2%, which achieved a relative COD and chromaticity removal improvement of 1.82% and 2.64%, respectively, relative to the ABR. Scanning electron microscopy (SEM) observation of the electrodes at 1:1 revealed that more microorganisms were attached to the anode surface of the coupled system, the particle size of the granular sludge within the system was larger, and the UV scanning pattern showed lower dye concentration in the water. In conclusion, the microbial fuel cell enhanced anaerobic treatment of dyeing wastewater was the most effective when the electrode area ratio was 1:1, and the best electrical energy output was obtained at the same time. ABR-MFC provides a new idea for the enhanced treatment of dyeing wastewater and electrical energy production.

Inhibin B-to-Anti-Mullerian Hormone Ratio as Noninvasive Predictors of Positive Sperm Retrieval in Idiopathic Non-Obstructive Azoospermia.

Background: The lack of clinically useful biomarkers for predicting micro-TESE outcomes in males with idiopathic NOA. To find clinically reliable serum reproductive hormone markers to predict the outcome of sperm retrieval in men with idiopathic NOA undergoing micro-TESE. Methods: We analyzed the clinical data of 168 men with idiopathic NOA treated with micro-TESE. The clinical predictors of a successful sperm retrieval were put to the test using logistic regression analysis. The clinical net benefit was calculated using a decision-curve analysis, and the predictive power of each variable was assessed using the ROC-derived area under the curve. Result: Between positive group and negative group for sperm retrieval, there was a statistically significant difference in INHB, AMH, and INHB/AMH. AMH, INHB, and INHB/AMH were each independent predictors of successful sperm retrieval, with INHB (OR1.02, p = 0.03), AMH (OR0.85, p = 0.01), INHB/AMH (OR1.08, p < 0.01). The ROC curve determined the optimal cut-off values for serum INHB and INHB/AMH in positive sperm retrieval patients undergoing micro-TESE. 21.51 pg/mL was the cut-off value for INHB. The cut-off value for INHB/AMH was 3.19, which had a 86.3% sensitivity and a 53.8% specificity. Using INHB and INHB/AMH prior to micro-TESE sperm retrieval in idiopathic NOA patients improved the net benefit of positive sperm retrieval, and the net benefit score of INHB/AMH was better than that of INHB, according to decision analysis curves. Conclusion: Serum INHB have predictive value for sperm retrieval outcomes in idiopathic NOA patients undergoing micro-TESE. Combining INHB and AMH, INHB/AMH seems to be a better predictor.

Testicular sperm aspiration has a poor effect in predicting micro-TESE outcomes in NOA patients with AZFc deletion.

BACKGROUND: Testicular sperm aspiration (TESA) is widely used in the diagnosis and management of nonobstructive azoospermia. However, its ability for predicting microdissection testicular sperm extraction in nonobstructive azoospermia (NOA) patients with AZFc deletion remains uncertain. To investigate whether TESA affected the sperm retrieval rate (SRR) in NOA patients with AZFc deletion, a retrospective analysis of the clinical data of NOA patients with AZFc deletion who underwent microdissection testicular sperm extraction (micro-TESE) was conducted. The effects of age, testicular volume, follicle-stimulating hormone (FSH) levels, luteinizing hormone (LH) levels, testosterone (T) levels and TESA on the SRR were analyzed in this group of patients. RESULTS: A total of 181 individuals had their sperm successfully collected and underwent micro-TESE, with an SRR of 67.4%. The patients were separated into two groups based on their micro-TESE results (sperm acquisition and nonsperm acquisition), with no significant variations in age, testicular volume, FSH levels, LH levels, or T levels between the two groups. There was no significant difference in the SRR between any of the groups into which patients were classified based on reproductive hormone reference value ranges. Binary logistic regression was used to explore the absence of significant effects of age, testicular volume, FSH levels, LH levels, and T levels on sperm acquisition in patients undergoing micro-TESE. In the preoperative testicular diagnostic biopsy group, the sperm acquisition and nonsperm acquisition groups had SRRs of 90.1% and 65.1%, respectively. More significantly, there was no significant difference in the SRR between the negative preoperative testicular diagnostic biopsy group and the nonpreoperative testicular diagnostic biopsy group (65.1 vs. 63.8%, p = 0.855). CONCLUSION: There is a high probability of successful sperm acquisition in the testis of men undergoing micro-TESE. In this group of patients, age, testicular volume, FSH levels, LH levels, and T levels may have little bearing on the micro-TESE outcome. In patients whose preoperative TESA revealed the absence of sperm, the probability of obtaining sperm by micro-TESE remained high (65.1%); negative TESA results appeared to not influence the SRR (63.8%) in patients undergoing micro-TESE.

RéSUMé: CONTEXTE: L'aspiration testiculaire de spermatozoïdes (TESA) est largement utilisée dans le diagnostic et la prise en charge de l'azoospermie non obstructive. Cependant, sa capacité à prédire la présence de spermatozoïdes testiculaires lors de l'extraction par microdissection chez les patients atteints d'azoospermie non obstructive (NOA) et porteurs de la délétion AZFc reste incertaine. Pour déterminer si la TESA affectait le taux de récupération de spermatozoïdes (SRR) chez les patients atteints d'ANO avec délétion AZFc, nous avons mené une analyse rétrospective des données cliniques des patients atteints de NOA et d'une délétion AZFc ayant subi une extraction testiculaire de spermatozoïdes (micro-TESE) par microdissection. Les effets de l'âge, du volume testiculaire, des taux d'hormone folliculostimulante (FSH), d'hormone lutéinisante (LH), de testostérone (T) et de TESA sur le SRR ont été analysés chez ces patients. RéSULTATS: Au total, 181 personnes ont eu leur spermatozoïdes collectés avec succès par micro-TESE, avec un SRR de 67,4%. Les patients ont été répartis en 2 groupes en fonction de leurs résultats à la micro-TESE (obtention de spermatozoïdes et non obtention de spermatozoïdes), sans variations significatives de l'âge, du volume testiculaire, des taux de FSH, LH ou de T entre les 2 groupes. Aucune différence significative du SRR n'a été retrouvée entre les groupes dans lesquels les patients ont été classés en fonction des plages de valeurs de référence des hormones reproductives. La régression logistique binaire a été utilisée pour explorer l'absence d'effets significatifs de l'âge, du volume testiculaire, des taux de FSH, de LH et de T sur la récupération de spermatozoïdes chez les patients bénéficiant d'une micro-TESE. Dans le groupe de biopsie diagnostique testiculaire préopératoire, les groupes avec récupération de spermatozoïdes et sans récupération de spermatozoïdes avaient respectivement des SRR de 90,1% et 65,1%. Plus important encore, il n'y avait pas de différence significative du SRR entre le groupe de biopsie diagnostique testiculaire préopératoire négatif et le groupe sans biopsie diagnostique testiculaire préopératoire (65,1 vs 63,8%, p = 0,855). CONCLUSIONS: Il existe une forte probabilité de récupération réussie de spermatozoïdes testiculaires chez les hommes bénéficiant d'une micro-TESE. Dans ce groupe de patients, l'âge, le volume testiculaire, les taux de FSH, de LH et de T ont peu d'incidence sur le résultat de la micro-TESE. Chez les patients dont la TESA préopératoire a révélé l'absence de spermatozoïdes, la probabilité d'obtenir des spermatozoïdes par micro-TESE est restée élevée (65,1%); les résultats négatifs d'une TESA ne semblaient pas influencer le SRR (63,8%) chez les patients bénéficiant d'une micro-TESE.

Factors influencing the sperm retrieval rate of microdissection testicular sperm extraction in patients with nonmosaic Klinefelter syndrome.

To investigate the factors affecting the sperm retrieval rate of microdissection testicular sperm extraction (micro-TESE) in patients with nonmosaic Klinefelter syndrome (KS), 64 patients with nonmosaic KS who underwent micro-TESE in the Center for Reproductive Medicine of Peking University Third Hospital (Beijing, China) between January 2016 and December 2017 were included in the study. Data on medical history, physical examination and laboratory examination results, and micro-TESE outcomes were collected. Patients were divided into two groups according to micro-TESE outcomes. The following factors were compared between the two groups by the Mann‒Whitney U test or Student's t-test based on the distribution (nonnormal or normal) of the factors: age, testicular size, follicle-stimulating hormone level, luteinizing hormone level, testosterone level, and anti-Müllerian hormone level. The overall success rate of sperm retrieval was 50.0%. Correlation analysis showed that testicular volume was positively correlated with testosterone level. Using a logistic regression model, age and anti-Müllerian hormone levels were found to be better predictors for the sperm retrieval rate than the other parameters.

Development of a predictive model for increasing sperm retrieval success by microdissection testicular sperm extraction in patients with nonobstructive azoospermia.

Microdissection testicular sperm extraction (micro-TESE) is widely used to treat nonobstructive azoospermia. However, a good prediction model is required to anticipate a successful sperm retrieval rate before performing micro-TESE. This retrospective study analyzed the clinical records of 200 nonobstructive azoospermia patients between January 2021 and December 2021. The backward method was used to perform binary logistic regression analysis and identify factors that predicted a successful micro-TESE sperm retrieval. The prediction model was constructed using acquired regression coefficients, and its predictive performance was assessed using the receiver operating characteristic curve. In all, 67 patients (sperm retrieval rate: 33.5%) underwent successful micro-TESE. Follicle-stimulating hormone, anti-Müllerian hormone, and inhibin B levels varied significantly between patients who underwent successful and unsuccessful micro-TESE. Binary logistic regression analysis yielded the following six predictors: anti-Müllerian hormone (odds ratio [OR] = 0.902, 95% confidence interval [CI]: 0.821-0.990), inhibin B (OR = 1.012, 95% CI: 1.001-1.024), Klinefelter's syndrome (OR = 0.022, 95% CI: 0.002-0.243), Y chromosome microdeletion (OR = 0.050, 95% CI: 0.005-0.504), cryptorchidism with orchiopexy (OR = 0.085, 95% CI: 0.008-0.929), and idiopathic nonobstructive azoospermia (OR = 0.031, 95% CI: 0.003-0.277). The prediction model had an area under the curve of 0.720 (95% CI: 0.645-0.794), sensitivity of 65.7%, specificity of 72.2%, Youden index of 0.379, and cut-off value of 0.305 overall, indicating good predictive value and accuracy. This model can assist clinicians and nonobstructive azoospermia patients in decision-making and avoiding negative micro-TESE results.

Psychological status of infertile men during the Coronavirus Disease 2019 Pandemic in China: a cross-sectional investigation.

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak has had a widespread and profound impact on people's mental health. The factors associated with mental symptoms among men diagnosed with infertility, a disease closely related to psychological conditions, remain unclear. The aim of this study is to investigate the risk factors associated with mental symptoms among infertile Chinese men during the pandemic. RESULTS: A total of 4,098 eligible participants were recruited in this cross-sectional, nationwide study, including 2,034 (49.6%) with primary infertility and 2,064 (50.4%) with secondary infertility. The prevalence of mental health conditions was 36.3%, 39.6%, and 6.7% for anxiety, depression, and post-pandemic stress, respectively. Sexual dysfunction is associated with a higher risk with adjusted odds ratios (ORs) of 1.40 for anxiety, 1.38 for depression, and 2.32 for stress. Men receiving infertility drug therapy displayed a higher risk for anxiety (adjusted OR, 1.31) and depression (adjusted OR, 1.28) symptoms, while those receiving intrauterine insemination had a lower risk of anxiety (adjusted OR, 0.56) and depression (adjusted OR, 0.55) symptoms. CONCLUSION: The COVID-19 pandemic has had a significant psychological impact on infertile men. Several psychologically vulnerable populations were identified, including individuals with sexual dysfunction, respondents receiving infertility drug therapy, and those experiencing control measures for COVID-19. The findings provide a comprehensive profile of the mental health status of infertile Chinese men during the COVID-19 outbreak and provide potential psychological intervention strategies.

RéSUMé: CONTEXTE: L'épidémie de maladie à coronavirus 2019 (COVID-19) a eu un impact étendu et profond sur la santé mentale des gens. Les facteurs associés aux symptômes mentaux chez les hommes diagnostiqués comme infertiles, une maladie étroitement liée aux conditions psychologiques, restent flous. L'objectif de cette étude est d'étudier les facteurs de risque associés aux symptômes mentaux chez les hommes chinois infertiles pendant la pandémie. RéSULTATS: Au total, 4 098 participants admissibles ont été recrutés dans cette étude transversale à l'échelle nationale, dont 2 034 (49,6%) présentaient une infertilité primaire et 2 064 (50,4%) une infertilité secondaire. La prévalence des problèmes de santé mentale était respectivement de 36,3 %, 39,6 % et 6,7 % pour l'anxiété, la dépression, et le stress postpandémique. La dysfonction sexuelle est associée à un risque plus élevé avec des odds ratios ajustés (OR) de 1,40 pour l'anxiété, 1,38 pour la dépression et 2,32 pour le stress. Les hommes recevant un traitement médicamenteux contre l'infertilité présentaient un risque plus élevé de symptômes d'anxiété (OR ajusté, 1,31) et de dépression (OR ajusté, 1,28), alors que ceux dont le traitement consistait à faire des inséminations intra-utérines présentaient un risque plus faible de symptômes d'anxiété (OR ajusté, 0,56) et de dépression (OR ajusté, 0,55). CONCLUSIONS: La pandémie de COVID-19 a eu un impact psychologique important sur les hommes infertiles. Plusieurs populations psychologiquement vulnérables ont été identifiées, notamment les personnes souffrant de dysfonction sexuelle, les hommes recevant un traitement médicamenteux contre l'infertilité, et ceux subissant des mesures de contrôle de la COVID-19. Les résultats fournissent un profil complet de l'état de santé mentale des hommes Chinois infertiles pendant l'épidémie de COVID-19 et fournissent des stratégies potentielles d'intervention psychologique.

A retrospective cohort study of geographic differences in the semen of 1,012 sperm donors in China.

Background: Male reproductive health has become a serious public health concern, and semen quality is essential to male reproduction. We aimed to investigate geographical differences in the semen quality of sperm donors from northern and southern China by enrolling donors across the country. Methods: A total of 1,012 sperm donors were enrolled in this study between 2015 and 2019. Donors were first divided into two parts based on their birthplace according to the "Qinling-Huaihe" line, and secondly, by their residential latitude. Finally, donors were re-classified into two groups (typically north and south) which contained 667 samples. Results: Statistically significant differences in sperm concentration were observed among men from different latitudes in China (P=0.04). The sperm concentrations of males from 18° to 27° north latitude were significantly lower than those from 36° to 45° and 45° to 54° [median 131, 134, and 146, respectively, P=0.021 (18° to 27° vs. 36° to 45°) and P=0.01 (18° to 27° vs. 45° to 54°)]. Conclusion: We hypothesize environmental pollution and mental stress due to the increased population size may be the main factors underlying differences in the sperm quality of men in northern and southern China.

Rhesus macaques develop metabolic syndrome with reversible vascular dysfunction responsive to pioglitazone.

BACKGROUND: The metabolic syndrome (MetS) is a constellation of clinical features that include central obesity, hypertension, atherogenic dyslipidemia, and insulin resistance. However, the concept remains controversial; it has been debated whether MetS represents nothing more than simultaneous co-occurrence of individual risk factors or whether there are common shared pathophysiological mechanisms that link the individual components. METHODS AND RESULTS: To investigate the emergence of metabolic and cardiovascular components during the development of MetS, we identified MetS-predisposed animals (n=35) in a large population of rhesus macaques (Macaca mulatta, 12.7±2.9 years old, n=408), acclimated them to standardized conditions, and monitored the progression of individual component features over 18 months. In 18 MetS animals with recently developed fasting hyperinsulinemia, central obesity, hypertension, and atherogenic dyslipidemia, we found that individual metabolic and cardiovascular components track together during the transition from pre-MetS to onset of MetS; MetS was associated with a 60% impairment of flow-mediated dilation, establishing the mechanistic link with vascular dysfunction. Pioglitazone treatment (3 mg/kg body weight/d for 6 weeks), a peroxisome proliferator-activated receptor γ agonist, reversibly improved atherogenic dyslipidemia and insulin resistance and fully restored flow-mediated dilation with persistent benefits. CONCLUSIONS: Coemergence of metabolic and cardiovascular components during MetS progression and complete normalization of vascular dysfunction with peroxisome proliferator-activated receptor γ agonists suggest shared underlying mechanisms rather than separate processes, arguing for the benefit of early intervention of MetS components. Predictive nonhuman primate (NHP) models of MetS should be highly valuable in mechanistic and translational studies on the pathogenesis of MetS in relation to cardiovascular disease and diabetes mellitus.

[Successful microdissection testicular sperm extraction in patients with nonmosaic Klinefelter syndrome: three cases report].

OBJECTIVE: To discuss the method for patients with nonmosaic Klinefelter syndrome (KS) to father children. METHODS: Microdissection testicular sperm extraction (micro-TESE) was performed for three patients with nonmosaic KS in our hospital. RESULTS: Three patients (their ranging from 23 years to 36 years), were diagnosed with azoospermia after several semen analyses. By palpation, their testis size was estimated about 3 mL,1 mL, and 4 mL, respectively. Follicle-stimulating hormone (FSH) was 37.2 IU/L, 42.2 IU/L, and 30.5 IU/L, respectively. Luteinizing hormone (LH) was 15.5 IU/L, 11.2 IU/L, and 10.1 IU/L, respectively. Testosterone was 1.2 nmol/L, 5.6 nmol/L, and 8.2 nmol/L, respectively. The volume of semen was 0.8 mL, 0.2 mL, and 0.5 mL, respectively. There was no sperm and fructose was positive. The transrectal B-bilateral showed vas deferens and seminal vesicles were not abnormal. And all the patients had a uniform 47, XXY karyotype. During the operation, normal formation sperms were found in two patients. They only underwent one-side micro-TESE. Active sperms were found after being cultured. The sperms were kept under cryopreservation. The other patient underwent two-side micro-TESE. No sperm was found during the operation. After the operation, a few deformity sperms were found during the second searching. No active sperm was found after being cultured. The sperm wasn't kept under cryopreservation. CONCLUSION: Although patients with nonmosaic KS have small testis and decreased spermatogenesis, some of them can obtain sperms by micro-TESE instead of accepting artificial insemination by donors.

[Correlation of testicular volume and reproductive hormone level with the results of testicular sperm aspiration in non-obstructive azoospermia patients].

OBJECTIVE: To investigate the correlation of the testis volume and reproductive hormone level with the results of testicular sperm aspiration (TESA) in non-obstructive azoospermia (NOA) patients, and to explore the cut-off value of the testis volume and reproductive hormone level in predicting the results of TESA so as to provide reliable information for the diagnosis and treatment of NOA. METHODS: We enlisted 121 NOA patients in this study, divided them into a sperm group and a non-sperm group based on the results of TESA, and measured their testis volumes and reproductive hormone levels. RESULTS: The left testis volume, the right testis volume, and the levels of prolactin (PRL), follicle-stimulating hormone (FSH), luteinising hormone (LH), estradiol (E2) and total testosterone (T) in the non-sperm and sperm groups were (7.07 +/- 1.06) ml vs (11.75 +/- 1.38) ml, (7.37 +/- 1.37) ml vs (11.70 +/- 1.98) ml, (12.43 +/- 11.69) ng/ml vs (9.60 +/- 4.55) ng/ml, (15.77 +/- 10.84) mIU/ml vs (8.01 +/- 7.43) mIU/ml, (6.12 +/- 2.92) mIU/ml vs (8.11 +/- 20.11) mIU/ml, (119.36 +/- 43.52) pmol/L vs (141.12 +/- 48.33) pmol/L, and (11.43 +/- 4.05) nmol/L vs (12.46 +/- 4.60) nmol/L, respectively. The mean levels of serum FSH and PRL were significantly higher in the non-sperm than in the sperm group. Although the mean testis volume of the former was less than that of the latter, there were no significant differences between the two groups, and nor were any significant differences in age and the levels of E2 and T. The cut-off value of the testis volume was 9 ml, with sensitivity of 93.8%/89.6% (left/right) and specificity of 100%/94.3% (left/right). The area under curve (AUC) of the left testis volume was 0.984 and that of the right was 0.961, indicating a high diagnostic accuracy. The cut-off value of the serum FSH level was 8.18 mIU/ml, with a sensitivity of 71.2% and a specificity of 75.0%. The AUC of the FSH level was 0.743, suggestive of a moderate diagnostic accuracy. CONCLUSION: The testis volume and FSH level are important for predicting the TESA results of NOA patients, and the former has even a higher diagnostic accuracy than the latter.