Sperm DNA damage in men from infertile couples

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Epididymal and accessory sex gland function and semen quality

Infertility, defined as the inability to conceive after one year of unprotected regular intercourse, affects up to 15% of all couples of reproductive age. The infertility can originate from female, male or both partners. In up to 50% of the affected couples, a male factor is the cause of infertility. Semen analysis is the cornerstone of male infertility assessment and an abnormal result often triggers a referral for a specialist opinion. It has been hypothesized that epididymal and accessory sex gland dysfunction are involved in pathophysiologies affecting male fertility. However, our knowledge within this area is still very limited. The aims of this study were, therefore, 1) To examine the association between the markers of epididymal (neutral ?-glucosidase [NAG]), prostatic (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose) function and the motility of spermatozoa; 2) To examine the association between the function of these organs and semen visco-elasticity, the length of sexual abstinence and the impact of these two factors on sperm motility in men under infertility assessment; 3) To assess the association between 5?-reductase type 2 gene (SD2R5A) polymorphisms and semen parameters in men from the general population; 4) Finally, to explore the association between exposure to persistent organohalogen pollutants (POPs) and epididymal and accessory sex gland function in a group of Swedish fishermen , fertile men from Greenland, Warsaw, (Poland) and Kharkiv, (Ukraine). Our study demonstrated a positive association between the epididymal marker NAG as well as the prostatic marker PSA and the motility of spermatozoa. Hyperfunction of seminal vesicles was associated with high visco-elasticity and lower proportion of motile spermatozoa. Compared to men delivering semen samples after 4?5 days, those having 2?3 days abstinence presented with lower NAG, zinc and proportion of motile sperm whereas those who delivered samples after 6?7 days exhibited higher percentage spermatozoa with tail defects and lower percentage motile sperm. SD2R5A polymorphism analysis showed, that subjects with the AT genotype had significantly higher sperm concentration compared to those having the AA genotype. Men bearing the V allele showed higher proportion of motile sperms compared to those being homozygotes for the L allele. We demonstrated a negative impact of POPs on the epididymal function, which might help us to understand the previously reported negative impact of POPs on sperm motility. Epididymis and accessory sex glands are potential targets for infertility assessment, therapy and for male contraception. Therefore, an insight into the function of these organs may help us to understand the mechanism behind male infertility and may lead to the development of new therapeutic and contraceptive modalities

Time-to-Ejaculation and the Quality of Semen Produced by Masturbation at a Clinic.

OBJECTIVES: To investigate the association between the length of time-to-ejaculation and semen parameters. METHODS: Ejaculates from 142 men under infertility assessment were analyzed according to the World Health Organization guidelines. Seminal neutral alpha-glucosidase (NAG), prostate-specific antigen (PSA), zinc, and fructose were also measured. Three groups according to the length of the time-to-ejaculation were defined: G(15) (greater than 15 minutes). RESULTS: Time to ejaculation showed negative significant correlation with sperm concentration (rho = -0.20, P = 0.02), total sperm count (rho = -0.20, P = 0.04), NAG (rho = -0.20, P = 0.01), and fructose (rho = -0.30, P = 0.02), respectively. No significant correlations existed among the time-to-ejaculation and age, sexual abstinence, semen volume, sperm motility, PSA, and zinc. There were negative significant associations among time-to-ejaculation and sperm concentration (beta = -3.0; P = 0.004), total sperm count (beta = -10; P = 0.02), total count of progressive motility (beta = -7.0; P = 0.02), and fructose (beta = -0.30; P = 0.02), respectively. No significant associations existed among the time-to-ejaculation and semen volume, motility grades, NAG, PSA, and zinc. G(15) (mean difference = 50 x 10(6)/mL; P = 0.01), (mean difference = 176 x 10(6)/ejaculate; P = 0.02), (mean difference = 110 x 10(6)/ejaculate; P = 0.03), respectively. Fructose was significantly higher in G(15) (mean difference = 5.0 mmol/L; P = 0.03). CONCLUSIONS: The time-to-ejaculation length was associated with semen parameters. These results might reflect the negative effect of acute stress during semen collection via masturbation at a clinic on semen parameters

Non-obstructive azoospermia and clinical varicocele: therapeutic options.

Ten to fifteen percent of infertile men are azoospermic, and sixty percent of these men have been classified as having non-obstructive azoospermia (NOA). NOA results from testicular failure, and one of the causes of this is the presence of varicocele. Varicocele is observed in 5-10 % of men with NOA. This review discusses the impact of varicocele repair on semen quality and pregnancy rate among men with NOA. Based on the best available evidence, varicocele repair of men with NOA is associated with an improvement in semen quality and pregnancy rate. Thus, it appears to be an effective therapeutic option for this group of men, particularly for those with a female partner who is younger than 35 years of age, before an assisted reproductive technique (ART) is initiated. Semen cryopreservation is recommended once the patient has spermatozoa in the ejaculate. In addition, varicocele repair seems to improve the rate of spermatozoa recovery in testicular sperm extraction for those who requested ART

Microsurgical vasovasostomy: An option for men with post vasectomy psychological distress

Vasectomy is a practical and straightforward approach to birth control. This paper presented a 31-year-old patient who desired torestore his fertility five years after being vasectomized. He met several obstacles. He developed severe psychological distress withsymptoms of stress, anxiety, and aggression. He underwent microsurgical vasovasostomy, and vassal patency was confirmedby return of spermatozoa in semen samples 6 and 10 weeks after surgery, and symptoms of psychological distress disappeared.Preoperative vasectomy counseling should include information about vasectomy reversal. At the most, vasectomy reversal can beconsidered in selected men with psychological problems due to vasectomy. Microsurgical training should be offered to moreurological surgeons, especially those who are interested in andrology

Varicocele repair in non-obstructive azoospermic men: diagnostic value of testicular biopsy - A meta-analysis.

Abstract Azoospermia is observed in 10-15% of infertile men and 60% of these cases are classified as having non-obstructive azoospermia (NOA). NOA results from testicular failure, and one of the causes of this is the presence of varicocele. Varicocele is found in 5-10% of men with NOA and its repair is associated with the appearance of spermatozoa in the ejaculate in 21-55% of cases. This review discusses the diagnostic value of testicular biopsy on the outcome of varicocele repair in terms of appearance of spermatozoa in the ejaculate in men with NOA and normal genetic testing. Ninety men met the inclusion criteria and were thus included in the review. The histopathological assessment of testicular biopsies revealed hypospermatogenesis in 30 out of 90 (33%), maturation arrest in 26 out of 90 (29%) and Sertoli cell only in 34 out of 90 (38%). Following varicocele repair, spermatozoa were detected in the ejaculate in 18 of 30 (60%) of men with hypospermatogenesis; 12 of 26 (46%) of those with maturation arrest; and one of 34 (3%) of those with Sertoli cell only. Regarding men with maturation arrest, varicocele repair was successful only in those men who were classified as having arrest at the spermatid stage. In conclusion, based on the best available evidence, diagnostic testicular biopsy seems to be of great value before varicocele repair in men with NOA and normal genetic testing. The best results of varicocele repair are observed in those men with hypospermatogenesis revealed by testicular biopsy or maturation arrest at the spermatid stage

Association between age and epididymal and accessory sex gland function and their relation to sperm motility

Increased male age has been associated with significant reduction in pregnancy rates. This study investigated the association between age, the function of epididymal and accessory sex glands, and their relation to sperm motility. Ejaculates from 498 men assessed for infertility were analysed according to WHO [1999] guidelines. Seminal markers of epididymal (neutral alpha-glucosidase (NAG)), prostatic (prostate-specific antigen (PSA) and zinc), and seminal vesicle function (fructose) were measured. Four groups according to age were defined: G(21-30) (21-30 years), G(31-40) (31-40 years), G(41-50) (41-50 years), and G(> 50) (51-66 years). Percentage progressive motility was significantly lower in G(> 50) compared with G21-30. NAG, PSA, zinc, and fructose were significantly lower in G(> 50) compared with G21-30. In a multiple regression analysis model, NAG and PSA showed positive significant association with percentage progressive motility. The opposite trend was found regarding zinc. No association between fructose and percentage progressive motility was shown. In this cross-sectional study, declined sperm motility observed in men over 50 years of age might be due to age-dependent changes in epididymal and accessory sex gland function

Comparison of semen parameters in samples collected by masturbation at a clinic and at home

OBJECTIVE: To investigate differences in semen quality between samples collected by masturbation at a clinic and at home. DESIGN: Cross-sectional study. SETTING: Fertility center. PATIENT(S): Three hundred seventy-nine men assessed for infertility. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Semen was analyzed according to World Health Organization guidelines. Seminal markers of epididymal (neutral alpha-glucosidase), prostatic (prostate-specific antigen and zinc), and seminal vesicle (fructose) function were measured. Two patient groups were defined according to sample collection location: at a clinic (n = 273) or at home (n = 106). RESULT(S): Compared with clinic-collected semen, home-collected samples had statistically significantly higher values for sperm concentration, total sperm count, rapid progressive motility, and total count of progressive motility. Semen volume, proportion of normal sperm morphology, neutral alpha-glucosidase, prostate-specific antigen, zinc, and fructose did not differ significantly between groups. An abnormal sperm concentration (<20 x 10(6)/mL) was seen in statistically significantly fewer of the samples obtained at home (19/106, 18%) than at the clinic (81/273, 30%), and the same applied to proportions of samples with abnormal (< 25%) rapid progressive motility (68/106 [64%] and 205/273 [75%], respectively). CONCLUSION(S): The present results demonstrate superior semen quality in samples collected by masturbation at home compared with at a clinic. This should be taken into consideration in infertility investigations

Effects of ejaculation-to-analysis delay on levels of markers of epididymal and accessory sex gland functions and sperm motility

This study aimed to examine the association between the interval from ejaculation to analysis and epididymal and accessory sex gland function in relation to sperm motility. Ejaculates from 1079 men assessed for infertility were analyzed according to World Health Organization guidelines. Biochemical markers were measured in semen to assess the function of the epididymi;s (neutral alpha-glucosidase [NAG]), prostate (prostate-specific antigen [PSA] and zinc), and seminal vesicles (fructose). Three groups were defined according to time from ejaculation to analysis: G 60) (63-80 minutes). The proportion of progressively motile sperm was significantly lower in G(>60) than in G(60) were 29% and 31% significantly lower than in G(60) had 29% and 17% significantly lower zinc compared with those in G(<= 30) (95% CI, 4.0%-69%) and G(31-60) (95% CI, 4.0%-64%), respectively. Levels of NAG and fructose did not differ significantly between the groups. There were negative associations between the ejaculation-to-analysis interval and sperm motility and levels of PSA and zinc. In male infertility assessments, semen analysis should be performed within 60 minutes of ejaculation

Vasovasostomy and predictors of vasal patency: A systematic review.

About 3-6% of vasectomized men requested vasectomy reversal, for various reasons. Vasal patency (VP) is an important surrogate outcome of vasectomy reversal. This article reviews the impact of surgical skills, surgical approaches, intraoperative vasal fluid characteristics and the length of obstructive interval on VP. Based on the best available evidence, the rate of patency is related to the operative frequency of the surgeons, with better results obtained by surgeons who perform the operations at least 10 times annually. Microsurgical vasovasostomy is the preferred technique for durable good results. One-layer vasovasostomy and two-layer vasovasostomy seem to be equal with regard to VP. The rate of patency following vasovasostomy in the convoluted vas and vasovasostomy in the straight vas is comparable. The patency rate is high in men with clear intraoperative vasal fluid in at least one vas. VP is still high among patients with a long obstructive interval. In conclusion, surgical skills and intraoperative vasal fluid characteristics are the most important predictors of VP. Postoperative semen quality and the age of the female partner determine the chance of spontaneous conception in these couples