Fatherhood and sperm DNA damage in testicular cancer patients

Testicular cancer (TC) is one of the most treatable of all malignancies and the management of the quality of life of these patients is increasingly important, especially with regard to their sexuality and fertility. Survivors must overcome anxiety and fears about reduced fertility and possible pregnancy-related risks as well as health effects in offspring. There is thus a growing awareness of the need for reproductive counseling of cancer survivors. Studies found a high level of sperm DNA damage in TC patients in comparison with healthy, fertile controls, but no significant difference between these patients and infertile patients. Sperm DNA alterations due to cancer treatment persist from 2 to 5 years after the end of the treatment and may be influenced by both the type of therapy and the stage of the disease. Population studies reported a slightly reduced overall fertility of TC survivors and a more frequent use of ART than the general population, with a success rate of around 50%. Paternity after a diagnosis of cancer is an important issue and reproductive potential is becoming a major quality of life factor. Sperm chromatin instability associated with genome instability is the most important reproductive side effect related to the malignancy or its treatment. Studies investigating the magnitude of this damage could have a considerable translational importance in the management of cancer patients, as they could identify the time needed for the germ cell line to repair nuclear damage and thus produce gametes with a reduced risk for the offspring

Terapia della eiaculazione precoce

L’eiaculazione precoce (EP) è il più frequente disturbo sessuale riferito nel maschio, ed è a tutti gli effetti un sintomo auto-identificato, auto-riportato e auto-valutato da chi ne soffre. Attualmente la International Society for Sexual Medicine ha definito l’EP come un’eiaculazione che avviene sempre o quasi sempre entro 1 minuto (EP life-long) o 3 minuti (EP acquisita) dalla penetrazione, con incapacità di ritardare l’eiaculazione e conseguenze negative sul piano personale come frustrazione, sofferenza e/o condotte di rifiuto dell’atto sessuale [1]. Dal punto di vista tassonomico, possiamo riconoscere forme assolute e relazionali, organiche e psicogene (o meglio non-organiche), acquisite o life-long. Il corretto approccio all’EP consiste nel non considerarla esclusivamente una patologia a sé stante, ma un possibile sintomo di una condizione latent

Ambulatorio Oncofertilità: gestione clinica del paziente della Banca del Seme

L’oncofertilità rappresenta un nuovo campo della medicina che comprende una rete integrata di specialisti focalizzati a sviluppare metodi e strategie in grado di preservare e/o ripristinare la potenzialità riproduttiva in soggetti che hanno avuto una diagnosi di cancro. L’oncofertilità prevede quindi l’integrazione di una serie di discipline quali l’oncologia, la medicina della riproduzione, la sessuologia clinica, la pediatria e la bioetica. Appaiono pertanto superati i tempi in cui l’unico obiettivo era la cura del tumore senza badare alle ricadute su fertilità, sessualità e, in definitiva, sulla qualità di vita del paziente. L’oncofertilità rappresenta lo sforzo degli specialisti in tale direzione

Ciproterone acetato e meningiomi: lo stato dell’arte

L’impiego di ciproterone acetato è stato associato all’insorgenza di meningiomi nella popolazione generale e in quella transgender. Il maggiore rischio sembra correlato alla dose impiegata e al tempo in cui si segue la terapia e più alta è l’incidenza di meningiomi nella popolazione transgender femminile che non nella popolazione generale. Massima attenzione deve essere posta dal clinico a eventuali sintomi presenti e, per minimizzare tale rischio, scegliere il minor dosaggio efficace possibile

L-carnitine fumarate, L-acetyl-carnitine and other components in male infertility: A pilot study of nutraceutics on sperm motility

The aim of this study was to evaluate any possible effect a combination of L-carnitine, fumarate, acetyl-Lcarnitine, fructose, citric acid, selenium, coenzime Q10, vitamin C, zinc, folic acid and vitamin B12 (Proxeed®) on sperm motility in a group of patients with unexplained asthenozoospermia. Thirty two patients received 1 sachet/day of Proxeed® for three months. Sperm parameters were studied before, during and after this treatment. Motility was also studied by the means of a computerized analysis (CASA system). The results of this study indicate that Proxeed® is able to increase sperm motility, both in a quantitative and qualitative manner. We conclude that oral administration of Proxeed® may improve sperm quality, at least in patients with idiopathic asthenozoospermia

Effects of endocrine disruptors on fetal testis development, male puberty, and transition age

Purpose Endocrine disruptors (EDs) are exogenous substances able to impair endocrine system; consequently, they may cause numerous adverse effects. Over the last years, particular focus has been given to their harmful effects on reproductive system, but very little is known, especially in males. The aim of this review is to discuss the detrimental effects of EDs exposure on fetal testis development, male puberty, and transition age. Methods A search for the existing literature focusing on the impact of EDs on fetal testis development, male puberty, andrological parameters (anogenital distance, penile length, and testicular volume), and testicular cancer with particular regard to pubertal age provided the most current information available for this review. Human evidence-based reports were given priority over animal and in vitro experimental results. Given the paucity of available articles on this subject, all resources were given careful consideration. Results Information about the consequences associated with EDs exposure in the current literature is limited and often conflicting, due to the scarcity of human studies and their heterogeneity. Conclusions We conclude that current evidence does not clarify the impact of EDs on human male reproductive health, although severe harmful effects had been reported in animals. Despite controversial results, overall conclusion points toward a positive association between exposure to EDs and reproductive system damage. Further long-term studies performed on wide number of subjects are necessary in order to identify damaging compounds and remove them from the environment

A Wide Range of 3243A>G/tRNALeu(UUR) (MELAS) Mutation Loads May Segregate in Offspring through the Female Germline Bottleneck

Segregation of mutant mtDNA in human tissues and through the germline is debated, with no consensus about the nature and size of the bottleneck hypothesized to explain rapid generational shifts in mutant loads. We investigated two maternal lineages with an apparently different inheritance pattern of the same pathogenic mtDNA 3243A>G/tRNALeu(UUR) (MELAS) mutation. We collected blood cells, muscle biopsies, urinary epithelium and hair follicles from 20 individuals, as well as oocytes and an ovarian biopsy from one female mutation carrier, all belonging to the two maternal lineages to assess mutant mtDNA load, and calculated the theoretical germline bottleneck size (number of segregating units). We also evaluated “mother-to-offspring” segregations from the literature, for which heteroplasmy assessment was available in at least three siblings besides the proband. Our results showed that mutation load was prevalent in skeletal muscle and urinary epithelium, whereas in blood cells there was an inverse correlation with age, as previously reported. The histoenzymatic staining of the ovarian biopsy failed to show any cytochrome-c-oxidase defective oocyte. Analysis of four oocytes and one offspring from the same unaffected mother of the first family showed intermediate heteroplasmic mutant loads (10% to 75%), whereas very skewed loads of mutant mtDNA (0% or 81%) were detected in five offspring of another unaffected mother from the second family. Bottleneck size was 89 segregating units for the first mother and 84 for the second. This was remarkably close to 88, the number of “segregating units” in the “mother-to-offspring” segregations retrieved from literature. In conclusion, a wide range of mutant loads may be found in offspring tissues and oocytes, resulting from a similar theoretical bottleneck size

Democrazia, populismo e autoritarismo: Trasformazioni politiche in Asia, Africa, Europa centro-orientale e Americhe

La democrazia alla prova di auoaritarismi e populismi, fra Covid-19 e guerra russo-ucraina