Sperm vitality and necrozoospermia: diagnosis, management, and results of a global survey of clinical practice

Sperm vitality testing is a basic semen examination that has been described in the World Health Organization (WHO) Laboratory Manual for the Examination and Processing of Human Semen from its primary edition, 40 years ago. Several methods can be used to test sperm vitality, such as the eosin-nigrosin (E-N) stain or the hypoosmotic swelling (HOS) test. In the 6th (2021) edition of the WHO Laboratory Manual, sperm vitality assessment is mainly recommended if the total motility is less than 40%. Hence, a motile spermatozoon is considered alive, however, in certain conditions an immotile spermatozoon can also be alive. Therefore, the differentiation between asthenozoospermia (pathological decrease in sperm motility) and necrozoospermia (pathological decrease in sperm vitality) is important in directing further investigation and management of infertile patients. The causes leading to necrozoospermia are diverse and can either be local or general, testicular or extra-testicular. The andrological management of necrozoospermia depends on its etiology. However, there is no standardized treatment available presently and practice varies among clinicians. In this study, we report the results of a global survey to understand current practices regarding the physician order of sperm vitality tests as well as the management practices for necrozoospermia. Laboratory and clinical scenarios are presented to guide the reader in the management of necrozoospermia with the overall objective of establishing a benchmark ranging from the diagnosis of necrozoospermia by sperm vitality testing to its clinical management

Antisperm antibody testing: a comprehensive review of its role in the management of immunological male infertility and results of a global survey of clinical practices

Antisperm antibodies (ASA), as a cause of male infertility, have been detected in infertile males as early as 1954. Multiple causes of ASA production have been identified, and they are due to an abnormal exposure of mature germ cells to the immune system. ASA testing (with mixed anti-globulin reaction, and immunobead binding test) was described in the WHO manual 5th edition and is most recently listed among the extended semen tests in the WHO manual 6th edition. The relationship between ASA and infertility is somewhat complex. The presence of sperm agglutination, while insufficient to diagnose immunological infertility, may indicate the presence of ASA. However, ASA can also be present in the absence of any sperm agglutination. The andrological management of ASA depends on the etiology and individual practices of clinicians. In this article, we provide a comprehensive review of the causes of ASA production, its role in immunological male infertility, clinical indications of ASA testing, and the available therapeutic options. We also provide the details of laboratory procedures for assessment of ASA together with important measures for quality control. Additionally, laboratory and clinical scenarios are presented to guide the reader in the management of ASA and immunological male infertility. Furthermore, we report the results of a recent worldwide survey, conducted to gather information about clinical practices in the management of immunological male infertility

Impact of varicocele repair on semen parameters in infertile men: a systematic review and meta-analysis

Purpose: Despite the significant role of varicocele in the pathogenesis of male infertility, the impact of varicocele repair (VR) on conventional semen parameters remains controversial. Only a few systematic reviews and meta-analyses (SRMAs) have evaluated the impact of VR on sperm concentration, total motility, and progressive motility, mostly using a before-after analytic approach. No SRMA to date has evaluated the change in conventional semen parameters after VR compared to untreated controls. This study aimed to evaluate the effect of VR on conventional semen parameters in infertile patients with clinical varicocele compared to untreated controls. Materials and Methods: A literature search was performed using Scopus, PubMed, Embase, and Cochrane databases following the Population Intervention Comparison Outcome (PICOS) model (Population: infertile patients with clinical varicocele; Intervention: VR [any technique]; Comparison: infertile patients with clinical varicocele that were untreated; Outcome: sperm concentration, sperm total count, progressive sperm motility, total sperm motility, sperm morphology, and semen volume; Study type: randomized controlled trials and observational studies). Results: A total of 1,632 abstracts were initially assessed for eligibility. Sixteen studies were finally included with a total of 2,420 infertile men with clinical varicocele (1,424 patients treated with VR vs. 996 untreated controls). The analysis showed significantly improved post-operative semen parameters in patients compared to controls with regards to sperm concentration (standardized mean difference [SMD] 1.739; 95% CI 1.129 to 2.349; p<0.001; I2 =97.6%), total sperm count (SMD 1.894; 95% CI 0.566 to 3.222; p<0.05; I2 =97.8%), progressive sperm motility (SMD 3.301; 95% CI 2.164 to 4.437; p<0.01; I 2 =98.5%), total sperm motility (SMD 0.887; 95% CI 0.036 to 1.738; p=0.04; I2 =97.3%) and normal sperm morphology (SMD 1.673; 95% CI 0.876 to 2.470; p<0.05; I2 =98.5%). All the outcomes showed a high inter-study heterogeneity, but the sensitivity analysis showed that no study was sensitive enough to change these results. Publication bias was present only in the analysis of the sperm concentration and progressive motility. No significant difference was found for the semen volume (SMD 0.313; 95% CI -0.242 to 0.868; I2 =89.7%). Conclusions: This study provides a high level of evidence in favor of a positive effect of VR to improve conventional semen parameters in infertile men with clinical varicocele. To the best of our knowledge, this is the first SRMA to compare changes in conventional semen parameters after VR with changes in parameters of a control group over the same period. This is in contrast to other SRMAs which have compared semen parameters before and after VR, without reference to a control group. Our findings strengthen the available evidence and have a potential to upgrade professional societies’ practice recommendations favoring VR to improve conventional semen parameters in infertile men

Does varicocele repair improve conventional semen parameters? A meta-analytic study of before-after data

Purpose The purpose of this meta-analysis is to study the impact of varicocele repair in the largest cohort of infertile males with clinical varicocele by including all available studies, with no language restrictions, comparing intra-person conventional semen parameters before and after the repair of varicoceles. Materials and Methods The meta-analysis was performed according to PRISMA-P and MOOSE guidelines. A systematic search was performed in Scopus, PubMed, Cochrane, and Embase databases. Eligible studies were selected according to the PICOS model (Population: infertile male patients with clinical varicocele; Intervention: varicocele repair; Comparison: intra-person before-after varicocele repair; Outcome: conventional semen parameters; Study type: randomized controlled trials [RCTs], observational and case-control studies). Results Out of 1,632 screened abstracts, 351 articles (23 RCTs, 292 observational, and 36 case-control studies) were included in the quantitative analysis. The before-and-after analysis showed significant improvements in all semen parameters after varicocele repair (except sperm vitality); semen volume: standardized mean difference (SMD) 0.203, 95% CI: 0.129–0.278; p<0.001; I2=83.62%, Egger’s p=0.3329; sperm concentration: SMD 1.590, 95% CI: 1.474–1.706; p<0.001; I2=97.86%, Egger’s p<0.0001; total sperm count: SMD 1.824, 95% CI: 1.526–2.121; p<0.001; I2=97.88%, Egger’s p=0.0063; total motile sperm count: SMD 1.643, 95% CI: 1.318–1.968; p<0.001; I2=98.65%, Egger’s p=0.0003; progressive sperm motility: SMD 1.845, 95% CI: 1.537%–2.153%; p<0.001; I2=98.97%, Egger’s p<0.0001; total sperm motility: SMD 1.613, 95% CI 1.467%–1.759%; p<0.001; l2=97.98%, Egger’s p<0.001; sperm morphology: SMD 1.066, 95% CI 0.992%–1.211%; p<0.001; I2=97.87%, Egger’s p=0.1864. Conclusions The current meta-analysis is the largest to date using paired analysis on varicocele patients. In the current meta-analysis, almost all conventional semen parameters improved significantly following varicocele repair in infertile patients with clinical varicocele. Keywords Controlled before-after studies; Infertility, male; Meta-analysis; Varicocel

The anti-genotoxic effect of some lichenic acids

Four lichen secondary metabolites; diffractaic acid, lecanoric acid, lobaric acid and vulpinic acid were evaluated for the anti-genotoxic effects on human lymphocytes in vitro using single cell gel electrophoresis (SCGE) or comet assay. Carbon tetrachloride, a known mutagenic agent was used as the positive control in the comet test system. The results revealed that at all concentrations, the tested compounds mediated a significant decrease in total DNA damage (comet assay) as compared with positive controls (p &gt; 0.05). The most effective doses of lichen acids were found to be 100 ?gmL-1 of diffractic acid, lobaric acid and vulpinic acid, and 50 ?gmL-1 of lecanoric acid. In addition, it was determined that the most effective among the tested compounds was vulpinic acid. © 2018, National Science Foundation. All rights reserved

Antagonistic effects of Satureja hortensis essential oil against AFB₁ on human lymphocytes in vitro

Satureja hortensis L. (Lamiaceae) используется как народное средство для лечения разных заболеваний, таких как спазмы, мышечные боли, тошнота, нарушения пищеварения, диарея и инфекционные заболевания. В настоящей работе на примере лимфоцитов человека in vitro изучали антагонистическое действие эфирного масла S. hortensis (SHE) на афлатоксины B₁ (AFB₁). Анализ эфирных масел проводился с помощью газовой хроматографии – масс-спектрометрии (GC-MS). Антигенотоксический эффект SHE был оценен на основании изучения обмена сестринских хроматид (SCE) и микроядерного теста против AFB₁. Кроме того, для оценки антиоксидативных эффектов SHE использовали уровень активностей малоновых диальдегидов (MDA), супероксиддисмутазы (SOD) и глютатионпероксидазы (GPx). Показано, что AFB₁ (5 µM) увеличивает частоту SCE, MN и уровень MDA. AFB₁ в той же концентрации снижает активность SOD и GPx. Однако различные концентрации SHE с AFB₁ снижали частоту SCE, MN и уровень MDA, а также существенно увеличивали активность SOD и GPx. Концентрации SHE 1.0, 1.5, 2.0 µL были наиболее эффективными. Результаты работы четко показали, что SHE имеет сильный антиоксидативный и анти-генотоксический эффект. Такая биологическая активность определяется химическим составом SHE.Satureja hortensis L. (Lamiaceae) has been used as a folk remedy to treat various such as cramps, muscle pains, nausea, indigestion, diarrhea, and infectious diseases. In this study, the antagonistic effects of essential oil of S. hortensis (SHE) were studied against aflatoxin B₁ (AFB₁) in human lymphocytes in vitro. The analysis of the essential oil was performed by using Gas chromatography-mass spectrometry (GC-MS). Anti-genotoxic effects of the SHEs was evaluated using sister chromatid exchange (SCE), micronuclei (MN) tests against AFB₁. Also level of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities used to determine the anti-oxidative effects of the SHEs. This result showed AFB₁ (5 μM) increased the frequencies of SCE, MN and the level of MDA. AFB₁ at the same concentration decreased the activities of SOD and GPx. However, different concentrations of SHE with AFB₁ decreased the frequency of SCE and MN and level of MDA and also increased the activities of SOD and GPx significantly. Especially, the 1.0, 1.5, 2.0 μL dose of SHE are more effective than other doses. The results of this experiment have clearly shown that SHE has strong antioxidative and antigenotoxic effects, these biological activities of SHEs can be due to its component

Protective Role of Mentha longifolia L. ssp. longifolia against Aflatoxin B

The aim of this study was to investigate the effects of essential oil of Mentha longifolia L. ssp. longifolia, used since ancient times for the treatment of many digestive tract diseases, on the genotoxicity and oxidative stress by a single dose of Aflatoxin B1 (5 ?M) in the human lymphocyte culture. The total of the 12 identified components accounted for 97.69 % by Gas chromatography (GC). Major components of the oil were cis-piperitone epoxide (26.52 %), piperitenone oxide (26.40 %), pulegone (15.66 %) and piperitenone (13.57 %). According to the results obtained from GC-MS systems, monoterpenes consist of 89.19 % of the total oil approximately while sesquiterpenes were represented in small quantities in the oil. We studied the anti-genotoxic effects of essential oils of M. longifolia (MEO) by using sister chromatid exchange (SCE) and micronucleus (MN) test systems. Also, the anti-oxidative effects of MEO were evaluated by using superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA) assay. The SCE frequency and the number of MN were increased when treated with AFB1. Especially, MEO at 1.5 and 2.0 ?l reduced SCE frequency and MN number in the human lymphocyte (p &lt;0.05). In addition, AFB1 treatment significantly reduced the activity of SOD and GPx and elevated the level of MDA (p&lt;0.05). MEOs treatment led to significant attenuation of AFB1-induced oxidative stress by normalization of the activities of SOD and GPx and the MDA (p &lt; 0.05). These results suggest that MEOs could provide anti-oxidative and anti-genotoxic protection for the oxidative and genotoxic agents that cause many diseases including cancer and neurodegenerative disease. © 2013 Har Krishan Bhalla &amp; Sons

Determination of antigenotoxic effects of four lichen species by using human lymphocytes

In this study, the geno-toxic and antigeno-toxic properties of the total extracts of four lichen species were investigated by using human lymphocytes. We obtained total extracts from R farinacea, X. parietina, U. articulataand U. filipendula lichen species. The results of our studies showed that 5 ?M concentrations of AFB1 changed the frequencies of micronucleus (MN) and malondialdehyde (MDA) levels, as well as superoxide dismutase (SOD), glutathione (GSH) and glutathione peroxidase (GPx) activities. When 5,10 and 20 ?g/ml concentrations of total extract were added to AFB1, the frequencies of MN and MDA levels were decreased, and SOD, GSH and GPx levels were increased. Consequently, our findings show that four lichen total extracts have strong antigenotoxic properties against aflatoxin Bi. © by PSP

Investigation of anti-oxidative and anti-genotoxic effects of Origanum vulgare L. essential oil on human lymphocytes in vitro

Origanum vulgare L. (Lamiaceae) is a flavoring herb widely using around the world. Some preparations and extracts from O. vulgare have been used in Turkish traditional medicine to treat several ailments including digestive disorders and menstrual problems. This study is designed to examine the chemical composition and in vitro antigenotoxic and antioxidant activity of the essential oil of O. vulgare (OVE) from Turkey. The essential oil of O. vulgare was analized by using GC. OVEs that were investigated antagonistic effects against oxidative stress and the genotoxic effects of aflatoksin B1 (AFB1). Anti-genotoxic activity was evaluated by sister chromatid exchanges (SCEs) and micronucleus (MN) tests. In additional to investigating protective role of OVEs against the oxidative stress of AFB1 in vitro, oxidative status was assessed on erythrocytes by measuring following oxidative stress markers like; super oxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA).The total of the 25 identified components are accounted for 96.03 % (GC). Major components of the oil were ?-caryophyllene (20.40%), and caryophyllene oxide (34.44%). In the SCE and MN tests, it was observed that OVEs suppressed the mutagenic effects of AFB1. OVEs were observed to modulate the adverse effects of AFB1. The results of this experiment clearly reveal that OVEs have strong anti-oxidative and anti-genotoxic effect. These anti-genotoxic effects of O. vulgare essential oils are probably related to its action on the enzymatic activation system. Anti-oxidative and anti-genotoxic effect may be role of these compounds (?-caryophyllene and caryophyllene oxide). © 2012, Har Krishan Bhalla &amp; Sons