Effect of Varicocelectomy on Semen Parameters of Men Seeking Infertility Treatment in Tamale, Ghana

The study aimed to determine the effect of microsurgical sub-inguinal varicocelectomy on semen parameters among men seeking infertility treatment in Ghana. This was an intervention study conducted at Tamale Teaching Hospital in the Tamale Metropolis from September 2017 to August 2021. The study involves two groups;the surgery group (n = 75) and the observed group (n = 63). Duplicate semen samples (mean values adopted) were collected at the onset and assessed according to the criteria established by World Health Organization (WHO), 2010. Varicocelectomy was performed for the surgery group and no intervention was given to the observed group. The two groups were followed for 180 days and repeated semen samples were collected and analyzed. The data was computed using GraphPad Prism (v8.0) at an alpha of 0.05. All the men had varicocele and were aged between 46.0 and 67.0 years old. There was no difference between semen parameters among the two groups before the surgery. However, after 180 days of follow-up, all of the semen parameters significantly improved in the surgery group (p < 0.0001), while sperm concentration (p = 0.0068), progressive motility (p = 0.0281), and normal sperm morphology (p = 0.0015) decreased in the observed group. The surgery group had an overall percent increase in total sperm count (840.7%;p = 0.0197), sperm concentration (582.1%;p = 0.0125), total viable sperms (155.2%;p < 0.0001), and normal sperm morphology (110.9%;p < 0.0001) while immotile sperms (-51.71%;p < 0.0001) reduced. A pregnancy rate of 25.3% (19/75) was reported among the surgery group but none was reported among the observed group after 180 days. Microsurgical sub-inguinal varicocelectomy improves semen parameters and hence effective treatment of infertile men with a clinically palpable varicocele. It is recommended to use this choice for similar patients, however, further studies with a larger sample size are needed to provide more evidence to recommend this therapy.

Association of 25-hydroxy-vitamin D levels with semen and hormonal parameters

Vitamin D levels have been linked to various health outcomes including reproductive disorders. The purpose of this study was to explore the association between serum vitamin D level （25-hydroxy-vitamin D, or 250HD） and semen and hormonal parameters. This is a cross-sectional study that included 170 healthy men recruited for the study of spermatogenesis from the general population. Men completed general and reproductive health questionnaires, and donated blood and semen samples. The main measures were hormonal （total and free testosterone, sex hormone-binding globulin, estradiol, follicle-stimulating hormone and luteinizing hormone） and semen parameters, adjusted （n= 147） for age, body mass index （BMI）, season, alcohol intake and smoking, in relation to categories of vitamin D levels, determined apriori. The mean age of the study population was 29.0±8.5 years and mean BMI was 24.3±3.2 kg m-2. The mean 250HD was 34.1± 15.06 ng m1-1. BMI showed a negative association with 250HD. Sperm concentration, sperm progressive motility, sperm morphology, and total progressively motile sperm count were lower in men with ‘250HD ≥ 50 ng ml-1＇ when compared to men with‘20 ng ml-1 ≤ 250H D〈 50 ng ml-1,. Total sperm count and total progressive motile sperm count were lower in men with ‘250HD〈20 ng ml-1＇ when compared to men with‘20 ng ml-1≤250HD〈50 ng ml-1＇. The adjusted means of various hormonal parameters did not show statistical difference in the different categories of 250HD. In conclusion, serum vitamin D levels at high and low levels can be negatively associated with semen parameters.

Does exposure to computers affect the routine parameters of semen quality?

Aim： To assess whether exposure to computers harms the semen quality of healthy young men. Methods： A total of 178 subjects were recruited from two maternity and children healthcare centers in Shanghai, 91 with a history of exposure to computers （i.e., exposure for 20 h or more per week in the last 2 years） and 87 persons to act as control （no or little exposure to computers）. Data on the history of exposure to computers and other characteristics were obtained by means of a structured questionnaire interview. Semen samples were collected by masturbation in the place where the semen samples were analyzed. Results： No differences in the distribution of the semen parameters （semen volume, sperm density, percentage of progressive sperm, sperm viability and percentage of normal form sperm） were found between the exposed group and the control group. Exposure to computers was not found to be a risk factor for inferior semen quality after adjusting for potential confounders, including abstinence days, testicle size, occupation, history of exposure to toxic substances. Conclusion： The present study did not find that healthy： men exposed to computers had inferior semen quality. （Asian J Andro12005 Sep; 7： 263-266）

Comparative study of the effects of three semen preparation media on semen analysis,DNA damage and protamine deficiency,and the correlation between DNA integrity and sperm parameters

Semen samples collected from 28 male partners of infertile couples were divided into three equal aliquots and prepared with three selected media,such as PureSperm （Nidacon,Gothenburg,Sweden）,Sil-Select Plus^TM （Fertipro,Beemem,Belgium） and SpermGrad^TM（Vitrolife,Gothenburg,Sweden）. The differences in mean percentages of semen parameters were assessed by repeated measures analysis. Correlations of sperm DNA damage,as measured by terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay,and of protamine deficiency,as measured by chromomycin A3 （CMA3） staining with sperm parameters,were determined by Pearson＇s correlation. After preparation with all three media,sperm concentrations decreased （P〈0.05） while percentages of sperm with normal morphology increased （P〈0.05）. Percentages of sperm motility,rapid motility and progressive motile concentration （PMC） increased （P〈0.05） for each ofthese parameters,PureSperm preparation gave the best results （P〈0.05）. The percentage of DNA damage decreased in the PureSperm and Sil-Select Plus preparations （17.9% and 31.3%,respectively,P〈0.05） and increased in the SpermGrad preparation （56.3%,P〈0.05）. Protamine deficiency also decreased in all three kinds of media,59.3%,47.7% and 40.3% for PureSperm,Sil-Select Plus and SpermGrad preparations,respectively （P〈0.05）. The percentage of DNA-damaged sperm was negatively correlated with the percentages of sperm motility,rapid motility and PMC,but was positively correlated with static motility （P〈0.05）. This comparative study and correlation analysis revealed that PureSperm preparation yielded sperm with the best motility and the lowest percentage of protamine deficiency. The Sil-Select Plus preparation yielded sperm with the lowest amount of DNA damage. The SpermGrad preparation had a high percentage of sperm with normal morphology,but also had the highest percentage of sperm with DNA damage. Sperm DNA damage was correlated with percentages of sperm motility,rapid motility,static motility and PMC.

Evaluation of inactivated COVID-19 vaccine on semen parameters in reproductive-age males:a retrospective cohort study

During the coronavirus disease(COVID-19)epidemic,there have been concerns about the impact of vaccines on people’s fertility,including the fertility of those who are currently preparing for pregnancy and those who might become pregnant in future.However,there is still a lack of research on the effect of the COVID-19 vaccine on male fertility,and it is not surprising that couples and donors have concerns regarding vaccination.In this study,a retrospective cohort study was conducted to examine semen quality before and after receipt of the inactivated COVID-19 vaccine.There were no statistically significant changes in semen parameters(volume,sperm concentration,progressive motility,and total progressive motile count)after two doses of vaccine(all P>0.05).In summary,our study updates the most recent studies on the effects of the COVID-19 vaccine on male fertility,and the information from this study could be used to guide fertility recommendations for assisted reproductive technology(ART)patients and donors.

Sperm Donors in Shanghai,China:A Study of Motivations,Characteristics,and Semen Parameters of Actual Sperm Donors

Objective:To identify the sociodemographic characteristics,motivations,and semen parameters of sperm donors in Shanghai,China.Methods:The participants were sperm donors associated with the Human Sperm Bank of Fudan University in Shanghai,China.Among the 334 sperm donors that applied for participation,329 completed the survey process.The responses obtained in the questionnaire and face-to-face interviews were used to investigate the donor motivations and characteristics,and the semen quality was examined to identify the sperm parameter.Results:In terms of the sociodemographic characteristics,an altruistic donor in this study was aged between 26 and 30 years,was single,did not have a child,had a college or undergraduate education level,was of the Han ethnicity,and worked full time.The strongest motivation highlighted by sperm donors was a donation for altruistic(26.4%,n=87)reasons.The second-highest rated motivation was curiosity(20.7%,n=68),followed by a desire to procreate(17.9%,n=59)."Complimentary body checks"(14.3%,n=47)and"financial incentives"(14.7%,n=47)were regarded as less important.The average semen parameters of the 329 donors were as follows:the semen volume was 3.39±1.21 mL,the semen concentration was 82.75×10^(6)/mL,the progressive motility rate(PR%)was 63.77%±3.13%,the total motility rate was 66.26%,the total progressive motile count was 158.31%±54.43×10^(6)/mL,and the round cell concentration was 0.38±0.51×10^(6)/mL.The PR%of the procreation motivation group was significantly higher than that of the other motivation groups(P<0.05).Conclusions:Sperm donors in Shanghai,China,are altruistic about their donation,although curiosity is also a key motivator.In addition,the decisions of donors are culturally influenced,and the motivation to procreate may influence the PR%.

Vleiotic recombination and male infertility： from basic science to clinical reality？

Infertility is a common problem that affects approximately 15% of the population. Although many advances have been made in the treatment of infertility, the molecular and genetic causes of male infertility remain largely elusive. This review will present a summary of our current knowledge on the genetic origin of male infertility and the key events of male meiosis. It focuses on chromosome synapsis and meiotic recombination and the problems that arise when errors in these processes occur, specifically meiotic arrest and chromosome aneuploidy, the leading cause of pregnancy loss in humans. In addition, meiosis-specific candidate genes will be discussed, including a discussion on why we have been largely unsuccessful at identifying disease-causing mutations in infertile men. Finally clinical applications of sperm aneuploidy screening will be touched upon along with future prospective clinical tests to better characterize male infertility in a move towards personalized medicine.

The role of varicocele sclerotherapy in men with severe ol igo-astheno-teratozoos perm ia

The aim of this study was to verify the role of antegrade scrotal sclerotherapy for the treatment of varicoceles in infertile men with severe oligo-astheno-teratozoospermia （OAT）. The 59 patients with severe OAT in this study underwent antegrade scrotal sclerotherapy for the treatment of varicoceles. The outcome was assessed in terms of improvement in semen parameters and spontaneous conception rate. Semen parameters and reproductive hormones were evaluated before antegrade sclerotherapy （AS） and 6 months after AS. After an average follow-up time of 34.8_＋3.2 months, significant improvement was noted in the mean sperm concentration, motility and morphology in 36 patients （61%）. Spontaneous pregnancy occurred in nine couples （15%）. Six months after treatment, inhibin B levels were significantly higher （P〉0.04）, whereas follicle-stimulating hormone （FSH） levels were significantly lower （P〈0.001） than before treatment. Antegrade internal spermatic vein sclerotherapy can significantly improve seminal parameters and hormonal parameters in men with severe OAT and may even result in spontaneous pregnancy in couples who would otherwise be candidates for intracytoplasmic sperm injection （ICSI）.

Comparison of sperm parameters and DNA fragmentation index between infertile men with infection and vaccines of COVID-19

Several preventive measures,including vaccination,have been implemented owing to the severe global effect of coronavirus disease 2019(COVID-19),but there is still limited evidence in the effect of this disease and vaccination against it on male fertility.Therefore,this study is to compare sperm parameters of infertile patients with or without COVID-19 infection and the effect of COVID-19 vaccine types on them.Semen samples of infertile patients were collected consecutively at Universitas Indonesia-Cipto Mangunkusumo Hospital(Jakarta,Indonesia).COVID-19 was diagnosed by rapid antigen or polymerase chain reaction(PCR)tests.Vaccination was performed with three types of vaccine,namely inactivated viral vaccine,messenger RNA(mRNA)vaccine,and viral vector vaccine.Spermatozoa were then analyzed on the World Health Organization recommendations,and DNA fragmentation was assayed with the sperm chromatin dispersion kit.The results showed that the COVID-19 group experienced a significant decrease in sperm concentration and progressive motility(both P<0.05),but there was no significant change in morphology or sperm DNA fragmentation index(DFI;both P>0.05).The viral vector vaccine caused a decrease in morphology as well as an increase in DFI compared with the control(both P<0.05),meanwhile results for those who were vaccinated with the inactivated and mRNA types were not significant compared with the control(both P>0.05).We conclude that COVID-19 has negative effects on sperm parametes and sperm DNA fragmentation,and we found that the viral vector vaccines affect sperm parameter values and DNA fragmentation negatively.Further studies with a larger population and longer follow-up are needed to confirm the results.

Sperm acrosin activity may be a useful factor in choosing between ICSI and IVF for infertile male patients

The clinical applications of acrosin activity are limited.We analyzed 61578 male partners in infertile couples who visited the outpatient department of the Reproductive and Genetic Hospital of CITIC-Xiangya(Changsha,China)between August 2014 and December 2019 to determine the reference ranges and thresholds for acrosin activity in infertile Chinese men;to determine whether correlations exist between acrosin activity and age,sperm concentration,sperm morphology,or sperm motility;and to evaluate whether acrosin activity could serve as an effective prognostic indicator for choosing between in vitro fertilization(IvF)and intracytoplasmic sperm injection(icsl)in the clinic.The cut-off value for the normal reference range of acrosin activity for male partners in infertile couples was 24.78μlU per 106 sperm.There was no significant association between acrosin activity and age,sperm concentration,semen volume,total sperm count,progressive motility,or total motile spermatozoa.A weak positive correlation was found between acrosin activity and normal sperm morphology.There was a statistically significant difference in abnormal acrosome morphology between the group with high acrosin activity(>24.78μlU per 106 sperm)and the group with low acrosin activity(<24.78μlU per 106 sperm).The group with a low IVF fertilization rate had a high index of abnormal acrosomal morphology at 21.2%,while the group with a high IVF fertilization rate had a low index of 0.2%.At an acrosin activity of<24.78μlU per 10 sperm,in one cycle of the same patient,the fertilization rate,normal fertilization rate,and good-quality embryo rate for Icsl were significantly higher than those for IVF.Therefore,the most promising application of acrosin activity could be in the selection of IcsI over IVF for infertile male patients with complete fertilization failure or a low fertilization rate.

Critical appraisal of conventional semen analysis in the context of varicocele

Varicocele is present in approximately 15% of men, and, although it is the most commonly diagnosed cause of male infertility, nearly two-thirds of men with varicoceles remain fertile. It was decided to make use of the current evidence obtained from the previous meta-analyses between 2004 and 2015 as well as available articles covering this field, preferably randomized controlled articles dealing with the topic of semen analysis before and after repair. Two important meta-analyses were discussed as well as other articles dealing with the topic of semen analysis before and after varicocelectomy. The evidence suggests that all semen parameters improve after varicocele repair. Based on the available evidence, it is clear that there is a benefit in treating men with a palpable varicocele. One can expect that all semen parameters will improve within 3 months after repair.

Increased expression of PELP1 in human sperm is correlated with decreased semen quality

Proline-, glutamic acid-, and leucine-rich protein 1 （PELP1） is a scaffolding protein involved in both genomic and nongenomic estrogen signal transduction pathways. To date, the role of PELP1 protein has yet to be characterized in human sperm and has not been associated with sperm parameters. To confirm the presence of PELP1 in human sperm, fresh semen samples were obtained from 178 donors. The study was designed to establish both mRNA and protein presence, and protein cellular localization. Additionally, the number of PELP1-positive spermatozoa was analyzed in men with normal and abnormal semen parameters. Sperm parameters were assessed according to the World Health Organization （WHO） 2010 standards. The presence of PELP1 in spermatozoa was investigated using four precise, independent techniques. The qualitative presence of transcripts and protein was assessed using reverse transcription-polymerase chain reaction （RT-PCR） and western blot protocols, respectively. The cellular localization of PELP1 was investigated by immunocytochemistry. Quantitative analysis of PELP1-positive cells was done by flow cytometry. PELP1 mRNA and protein was confirmed in spermatozoa. Immunocytochemical analysis identified the presence of PELP1 in the midpieces of human sperm irrespective of sperm parameters. Becton Dickinson fluorescence-activated cell sorting （FACSCalibur^Tm） analysis revealed a significantly lower number of PELP1-positive cells in males with normal semen parameters versus abnormal samples （42.78% ± 11.77% vs 61.05% ± 21.70%, respectively; P = 0.014）. The assessment of PELP1 may be a time-saving method used to obtain information about sperm quality. The results of our study suggest that PEPL1 may be utilized as an indicator of sperm quality; thereby, PELP1 may be an additional biomarker useful in the evaluation of male infertility.

Association of sexually transmitted infection with semen quality in men from couples with primary and secondary infertility

This study aims to compare the prevalence of sexually transmitted infections(STIs)with semen quality in men from couples with primary and secondary infertility.Semen samples were collected from 133 men who requested fertility evaluation.Seminal tract infection with Ureaplasma spp.(UU),Mycoplasma hominis(MH),Mycoplasma genitalium(MG),Chlamydia trachomatis(CT),Neisseria gonorrhoeae(NG),and herpes simplex virus-2(HSV-2)was assessed by PCR-based diagnostic assays.Among all patients,the prevalence of STIs was higher in men from couples with primary infertility than that in men from couples with secondary infertility(39.7%vs 21.7%,P=0.03).The prevalence of UU was 28.8%and 13.3%in men from couples with primary and secondary infertility,respectively.Men from couples with primary infertility were more likely to be positive for UU than men from couples with secondary infertility(P=0.04).Regarding the UU subtype,the prevalence of Ureaplasma urealyticum(Uuu)and Ureaplasma parvum(Uup;including Uup1,Uup3,Uup6,and Uup14)did not differ between the two groups.No associations between the prevalence rates of MH,MG,and CT were found in men from either infertility group.A lower sperm concentration was associated with STI pathogen positivity in men with primary infertility according to the crude model(P=0.04).The crude and adjusted models showed that semen volume(both P=0.03)and semen leukocyte count(both P=0.02)were independently associated with secondary infertility.These findings suggest the importance of classifying the type of infertility during routine diagnosis of seminal tract infections.

Changing Tendency Analysis of Chinese Normal Male's Semen Quality in Recent 25 Years:Samples from Chinese Documents

Objective To analyze the trend of change in semen quality of Chinese healthy men over recent 25 years. Methods A total of 115 reports were collected on quality inspection of semen of healthy Chinese men between 1985-2009 through literature search, which involved 23 126 persons from 69 counties and cities. Trend of change in semen parameters was analyzed by linear regression model and rank sum test. Results Sperm concentration and non-progressive motility （c%） declined, and the linear equation was of statistics value. Linear equations include y=2.968-0. 004x （P〈0.05） and y=3.204-0.026x （P〈0.05）. As the results of K-S rank sum test showed, the difference of sperm concentration and total sperm count in the three groups, i.e., the group for 1985-1989, the group for 1990-1999 and the group for 2000-2009 was of statistics value. Conclusion The semen concentration decline over recent 25 years （P〈0.05）. of healthy Chinese men appears a possible

Chlamydia trachomatis infection in the genital tractis associated with inflammation and hypospermia inthe infertile male of China

Chlamydia trachomatis (CT) infection is the most prevalent sexually transmitted bacterial disease worldwide. However, unlikethat in female infertility, the role of CT infection in male infertility remains controversial. The objective of this retrospective studywas to explore the impacts of CT infection in the genital tract on sperm quality, sperm acrosin activity, antisperm antibody levels,and inflammation in a large cohort of infertile males in China. A total of 7154 semen samples were collected from infertile malesubjects, 416 of whom were CT positive (CT+ group) and 6738 of whom were CT negative (CT− group), in our hospital betweenJanuary 2016 and December 2018. Routine semen parameters (semen volume, pH, sperm concentration, viability, motility,morphology, etc.), granulocyte elastase levels, antisperm antibody levels, and sperm acrosin activity were compared between theCT+ and CT− groups. Our results showed that CT infection was significantly correlated with an abnormally low semen volume, aswell as an increased white blood cell count and granulocyte elastase level (all P < 0.05) in the semen of infertile males;otherroutine semen parameters were not negatively impacted. The antisperm antibody level and sperm acrosin activity were not affectedby CT infection. These findings suggested that CT infection might contribute to inflammation and hypospermia but does not impairsperm viability, motility morphology, and acrosin activity or generate antisperm antibodies in the infertile males of China.

Basic Phenotyping of Male Fertility from 2019 to 2020 at the Human Sperm Bank of Fudan University

The aim of this cross-sectional survey was to analyze the semen parameters of volunteers from the Human Sperm Bank of Fudan University,as well as the related factors influencing these parameters.From January 2019 to December 2020,semen parameters from a total of 5214 men were included in this survey.The Kruskal-Wallis test was used to detect differences associated with several independent variables.A total of 5214 volunteers were included.The volunteers were registered in 33 provinces,autonomous regions,municipalities(including Macao and Taiwan)and 294 prefecture-level cities.The average age of volunteers was 27.40 years.Overall,76.50%of the volunteers had a college education or higher.Volunteers with BMI values of 18.5-23.9 kg/m2 accounted for 60.70%of participants.Semen parameters were significantly different according to season,education level,duration of abstinence,age group and BMI.The basic male fertility phenotypes(semen parameters)showed new trends in the study period,and accurate long-term tracking of male semen parameters will help researchers to better understand the changes in male fertility phenotypes(semen).

Random sperm DNA fragmentation index is not associated with clinical outcomes in day-3 frozen embryo transfer

Damage to sperm DNA was proposed to play an important role in embryonic development.Previous studies focused on outcomes after fresh embryo transfer,whereas this study investigated the influence of sperm DNA fragmentation index(DFI)on laboratory and clinical outcomes after frozen embryo transfer(FET).This retrospective study examined 381 couples using cleavage-stage FET.Sperm used for intracytoplasmic sperm injection(ICSI)or in vitro fertilization(IVF)underwent density gradient centrifugation and swim up processing.Sperm DFI had a negative correlation with sperm motility(r=−0.640,P<0.01),sperm concentration(r=−0.289,P<0.01),and fertilization rate of IVF cycles(r=−0.247,P<0.01).Sperm DFI examined before and after density gradient centrifugation/swim up processing was markedly decreased after processing(17.1%vs 2.4%,P<0.01;65 randomly picked couples).Sperm progressive motility was significantly reduced in high DFI group compared with low DFI group for both IVF and ICSI(IVF:46.9%±12.4%vs 38.5%±12.6%,respectively;ICSI:37.6%±14.1%vs 22.3%±17.8%,respectively;both P<0.01).The fertilization rate was significantly lower in high(≥25%)DFI group compared with low(<25%)DFI group using IVF(73.3%±23.9%vs 53.2%±33.6%,respectively;P<0.01)but was equivalent in high and low DFI groups using ICSI.Embryonic development and clinical outcomes after FET were equivalent for low and high DFI groups using ICSI or IVF.In this study,sperm DFI did not provide sufficient information regarding embryo development or clinical outcomes for infertile couples using FET.