Fragmentasi DNA Spermatozoa: Penyebab, Deteksi, dan Implikasinya pada Infertilitas Laki-Laki

Prediksi fertilitas laki-laki dapat dilakukan dengan analisis semen. Analisis semen konvensionalmerupakan pemeriksaan sederhana dan tidak mahal, tetapi memiliki variabilitas yang tinggi.Integritas DNA spermatozoa penting untuk transmisi informasi genetik. Fragmentasi DNAspermatozoa sebagai akibat gangguan spermatogenesis, maturasi spermatozoa, stres oksidatifdan infeksi, dapat menyebabkan infertilitas laki-laki, gangguan perkembangan embrio dan abortusberulang. Hubungan fragmentasi DNA spermatozoa dengan luaran teknologi reproduksi berbantu(TRB) mengarahkan fragmentasi DNA spermatozoa sebagai pemeriksaan infertilitas laki-laki. Dariberbagai metode fragmentasi DNA spermatozoa yang umum dilakukan, sperm chromatin dispersion(SCD) merupakan metode pemeriksaan fragmentasi DNA spermatozoa yang sederhana, akuratdan tidak mahal, sehingga dapat dilaksanakan di laboratorium andrologi. Selain menghasilkandiagnosis yang lebih baik, pemeriksaan fragmentasi DNA spermatozoa juga menggambarkanprognosis infertilitas termasuk luaran program TRB

Azoospermia: a Genomic Review

Azoospermia or the absence of sperm in semen is one of the sperm disorders that results in male infertility. There are two types of azoospermia, the first one isazoospermia caused by obstruction of the vas deferens (obstructive azoospermia) and the second one is azoospermia due to the damage of testes (nonobstructive azoospermia). The etiology of azoospermia could be genetic or non-genetic. Genetic factors may occur in genomics starting from chromosome until gene level or single nucleotide polymorphism (SNPs). At the chromosome level, there is Klinefelter’s syndrome (47, XXY) to the Y chromosome microdeletion, whereas at the gene level there is mutation of jsd, Bmp8b and other genes. At the level of SNPs, Genome Wide SNP Association Study (GWAS) had uncovered 20 SNPs which were related significantly to azoospermia. Extensive knowledge of genomics review on male infertility, is expected to promote the development of investigation and management of azoospermia

Induction of Rat Germ Cell Apoptosis by Testosterone Undecanoate and Depot Medroxyprogesterone Acetate and Correlation of Apoptotic Cells with Sperm Concentration

Aim: to investigate the safety and effectiveness of dose TU+DMPA hormones in developing potential male contraceptives. Methods: suppression of rat sperm concentration through increased apoptotic germ cells by in vivo administration of a long-acting androgen composed of a combination of testosterone undecanoate (TU) and depot medroxyprogesterone acetate (DMPA) was performed. Adult Sprague-Dawley rats received 2.5 mg TU every 6 week and 1.25 mg DMPA every 12 week for 60 week, a regimen known to rapidly reduce testosterone production by the testes and produce azoospermia within 12 week. Sperm concentration data were log transformed before analysis. Results are expressed as the mean±SEM. ANOVA, followed by post hoc test was used to determine differences across time and phase. T test was employed to determine differences between two groups. Results: apoptosis revealed significant increase in apoptotic germ cells (80% when rats were administered with TU+DMPA. Apoptotic germ cells can be found in several spermatogonia (20%), spermatocytes (30%), and spermatids (50%). Conclusion: dose TU+DMPA hormones may be a safe and effective way to develop potential male contraceptives. Key words: TU, DMPA, sperm concentration, apoptosis

Molecular Marker-Assisted Selection of Rice Grain Quality on Rice (Oryza Sativa L.) Lines Tolerant to Fe Toxicity Stress

The elite rice has been produced, including iron (Fe) tolerant varieties. To get the appropriate rice lines which superior not only Fe tolerant but also have good grain quality needs to be developed selection system, especially in the use of molecular markers. This study was aimed to develop molecular markers for selection the rice grain quality characters of selected rice lines Fe tolerant. A total of 30 selected Fe tolerant rice lines and 5 parents as control lines were used in this research. Characterization of grain quality were quantitatively using the standard. While for genotyping analysis used 19 molecular markers of STS, SSR, Indel and SNP. This study showed that 14 of 19 markers result polymorphic DNA band (DNA markers). Association analysis of genotype and phenotype showed that 10 of 14 markers were significantly (p < 0.05) related to high quality of rice grain. Among four types of markers used in this study, STS was the most widely associated significantly with four characters of rice quality. The phenotyping analysis showed that the physical grain and palatability quality which obtained from the total mean of 30 rice lines tested tend to nearly with the parent\u27s value as controls lines. The most of these lines were included in the group IV of National Rice Grain Quality Standard (SNI). The amylose content (AC) showed that the texture was varied from firm and dry (high AC) to soft and sticky (low AC). The association results showed that there were significant (p ≤ 0.05) markers related with the biosynthesis starch genes, i.e: SBE1, SS1, SSIIa, GPA, PUL and S3cl which contributed on the character of rice palatability. These selected significant markers could be useful for screening of other population with Fe tolerant and/ or other desired morpho-agronomical traits in support of rice breeding program in Indonesia

Male Infertility As A Bad News: A Review

Having children is a dream for every married couple. However, this process is not that easy for 15% couples worldwide who suffer infertility. Infertility is the failure to achieve a clinical pregnancy after twelve months of regular and unprotected intercourse. Half of infertility causes come from the man called male infertility. Male factors of infertility vary greatly from mild one like oligozoospermia to severe one like extreme oligozoospermia which make the natural pregnancy difficult to happen, hence a help from assisted reproductive technology is needed. In more extreme case like testicular agenesis, having children really becomes a necessity and it will bring bad news to him. Bad News (BN) refers to a condition of hopelessness, threatening life and body or anything which raises the patients’ anxiety about his future. In this case, male infertility can be categorized as BN since it causes loss of hope and anxiety. The process of Breaking Bad News (BBN) requires good communication skill. There were several BBN protocols formulated previously covering Advance preparation, Build relationships, Communicate well, Deal with the patient, Encourage emotion (ABCDE), Background, Rapport, Explore, Announce, Kindling, Summarize (BREAKS) and Settings, Perception, Invitation, Knowledge, Empathy, Strategy (SPIKES). Each protocol had been applied to other medical fields such as oncology, pediatric etc. Whilst its application on male infertility cases has never been published. Even if this protocol is able to be applied properly, it is capable to increase the patients’ knowledge, improve their psychological condition and maintain the threshold of hope for having childre

An Update of Male Contraception: A Review of Cellular Perspective

Introduction: Similar to the world, Indonesia also undergoes a population explosion. One solution to overcome this population problem is to conduct contraception. Although woman contraception is widely used, still the role of man is needed. There are a few methods in male contraception, but all is still not proven optimally. Therefore, it is intend to understand more about the cellular mechanism of male contraception. Methods: A computerized finding process of database in Pub med which related to the keywords was performed for obtaining data. After that, the most update and relevant articles were reviewed and selected. Results: The results are mainly revealing the regimens that are administered in male hormonal contraception and substances that are used in immunocontraception. Furthermore, this reviews also reveales the cellular mechanism of both types of male contraception. In male hormonal contraception, the mechanism was depends on negative feedback in hypothalamic-pituitary-gonadal axis by regimens to impair the spermatogenesis into severe-oligozoospermia or azoospermia. In addition, immunocontraception was based on ‘vaccination’ concept in which antibodies recognize proteins in the spermatozoa as "non-self” thus spermatozoa may be destroyed. Conclusion: It is necessary to understand the cellular mechanism, thus the development of male contraception increases. Further researches should be conducted to confirm the cellular mechanisms

Efficacy and Safety of an Injectable Combination Hormonal Contraceptive for Men

CONTEXT: The development of a safe and effective reversible method of male contraception is still an unmet need. OBJECTIVE: Evaluation of suppression of spermatogenesis and contraceptive protection by coadministered im injections of progestogen and testosterone. DESIGN: Prospective multicentre study. SETTING: Ten study centers. PARTICIPANTS: Healthy men, aged 18-45 years, and their 18- to 38-year-old female partners, both without known fertility problems. INTERVENTION: Intramuscular injections of 200-mg norethisterone enanthate combined with 1000-mg testosterone undecanoate, administered every 8 weeks. MAIN OUTCOMES MEASURES: Suppression of spermatogenesis by ejaculate analysis, contraceptive protection by pregnancy rate. RESULTS: Of the 320 participants, 95.9 of 100 continuing users (95% confidence interval [CI], 92.8-97.9) suppressed to a sperm concentration less than or equal to 1 million/mL within 24 weeks (Kaplan-Meier method). During the efficacy phase of up to 56 weeks, 4 pregnancies occurred among the partners of the 266 male participants, with the rate of 1.57 per 100 continuing users (95% CI, 0.59-4.14). The cumulative reversibility of suppression of spermatogenesis after 52 weeks of recovery was 94.8 per 100 continuing users (95% CI, 91.5-97.1). The most common adverse events were acne, injection site pain, increased libido, and mood disorders. Following the recommendation of an external safety review committee the recruitment and hormone injections were terminated early. CONCLUSIONS: The study regimen led to near-complete and reversible suppression of spermatogenesis. The contraceptive efficacy was relatively good compared with other reversible methods available for men. The frequencies of mild to moderate mood disorders were relatively high

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat