EFFECT OF ELECTROACUPUNCTURE ON ANTISPERM ANTIBODIES IN MALE INFERTILITY PATIENTS

Aims: To explore the therapeutic effect of electroacupuncture (EA) for treatment of male immune infertility patients and to observe the effect of EA on antisperm antibody (AsAb) positive reaction. Methods: A total of 100 male infertility AsAb positive patients were randomized into EA group (n=50, BL 15, BL 17, 18, 23, etc.) and medication group (n=50, oral administration of prednisone, 5 mg/time, t.i.d.). Serum and sperm AsAb were determined with enzyme immunoassay technique. Results: Following 4 months’ treatment, the cure rates and the total effective rates of EA and medication groups were 40.4% (20 cases/50 cases) and 92.0% (45/50), 10.0% (5/50) and 64.0% (32/50) respectively. The cure rate of EA group was significantly superior to that of medication group (P<0.01). But, no significant difference was found between two groups in the total effective rate (P>0.05). After treatment, AsAb positive rates of both groups particularly that of EA group decreased significantly compared with pre treatment of each group (P<0.05-0.01). Conclusion: EA treatment can work well in the treatment of some immune mediated male infertility patients and possesses a favorable regulation action on AsAb reaction.

Changes in soluble interleukin-2 receptor level in serum and Na^+ -K^+ -exchanging ATPase activity in semen of infertile men caused by antisperm antibody

Aim: To explore the possible mechanisms of male infertility caused by antisperm antibody (AsAb). Methods: Thesoluble interleukin-2 receptor (sIL-2R) level in serum was analyzed by ELISA and Na^+ -K^+ -exchanging ATPase activi-ty in semen by phosphorus (Pi) assay. Results: The slL-2R level in serum was significantly higher and the Na^+ -K^+ -exchanging ATPase activity in semen significantly lower in AsAb positive infertile men when compared with thecontrols. Conclusion: The AsAb titer varies with the slL-2R level in serum. A decrease in Na^+ -K^+ -exchangingATPase activity in semen may play a role in male infertility caused by AsAb.

Analysis of Sperm Membrane Protein Relevant to Antisperm Antibody by Two-Dimensional Gel Electrophoresis and Western Blotting

Objective To identify the sperm membrane proteins that are associated with antisperm antibody Methods Using antisperm antibody positive serum through unidimensional polyacrylamide gel electrophoresis and 2-dimensional gel electrophoresis followed by Western blot analysis to determine the molecular weights (MW) and isoelectric points (pI) of sperm membrane proteins that are associated with antisperm antibody. Results Eight kinds of MW with more than ten sperm membrane proteins can be recognized by antisperm antibody positive serum, of which the MWs and pI were 23 kD, 31 kD, 32 kD, 34 kD, 41 kD, 51 kD, 60 kD, 78 kD and 5.3, 5.5,5.7, 5.0, 5.3, 5.8, 6.0, 5.5～6.2, 4.6,5.1,5.5～5.8 respectively. The identification ratios of the sperm membrane proteins on 78 kD (60.7%), 60 kD (71.4%), 51 kD (14.9%) and 23 kD (14.29%) were higher. Conclusion The sperm membrane proteins with MW of 78 kD, 60 kD, 51 kD and 23 kD were associated with antisperm antibody and immunological infertility. Two- dimensional gel electrophoresis and Western blotting can precisely identify the sperm membrane proteins that are associated with antisperm antibody.

Analysis of sperm membrane antigens relevant to antisperm antibody using Western blot

To identify the sperm membrane antigens associated with antisperm antibody. Methods: The antisperm antibody in serum was tested by ELISA. Antisperm antibody positive sera from 18 infertile men and 15 infertile women were used. The molecular weight (MW) of sperm membrane antigens associated with the antisperm antibody was analyzed with antisperm antibody positive serum using Western blot. Results: Eight kinds of MW of sperm membrane antigens were identified. The ratio of identification on the 78 KD(60.7 %), 60KD (71.4 %), 51 KD (14.9 %) and 23 KD (14.29 %) sperm antigen was higher than others. Conclusion: Sperm membrane antigens with MW of 78 KD, 60 KD, 51 KD and 23 KD were associated with antisperm antibody and immunological infertility. (Chin J Andro12002; 16: 345)

Effects of Medicines and Supplements on Spontaneous Pregnancy and Semen Parameters in Male Infertility:A Systematic Review Update and Network Meta-Analysis

In this study,we used a network meta-analysis(NMA)to compare the effectiveness of medicines and supplements for idiopathic male infertility and to identify the best treatment.Medline,Excerpta Medica Database(EMBASE),Ovid,and China National Knowledge Infrastructure(CNKI),were searched for the period from January 1990 to June 2021 using the keywords"male infertility,""medical therapy,""supplement/nutrient therapy,"and related terms.Randomized controlled trials(RCTs)investigating medicines(mainly follicle-stimulating hormone(FSH),androgen,and clomiphene/tamoxifen)or supplements(mainly zinc,selenium,vitamin C or E,carnitine,coenzyme Q10(CoQ10),or combined treatment)for idiopathic infertile men were selected for meta-analysis.Preferred reporting items for systematic reviews and meta-analysis(PRISMA)was used for data extraction,and a risk-of-bias tool and grades of recommendation,assessment,development,and evaluation(GRADE)system adapted to the NMA were employed to assess the quality of the evidence.The primary outcomes were live birth and spontaneous pregnancy rate(SPR).The secondary outcomes were sperm parameters(including concentration,progressive motility,and morphology)and side effects.In total,65 RCTs involving 7541 men with sperm abnormalities but normal hormone levels were included.A total of 36 studies reported SPR but only three reported live birth rates.The quality of the included studies was found to be moderate to high.Compared with a placebo or being untreated,carnitine plus vitamins significantly improved SPR(relative risk(RR)=3.7,95%confidence interval(95%CI),1.6-8.5);fatty acids significantly increased sperm concentrations(mean difference(MD)=12.5×10^(6)mL-1,95%CI,3.1×10^(6)-22.0×10^(6));and selective estrogen receptor modulator(SERM)plus CoQ10 significantly improved sperm progressive motility(MD=11.0%,95%CI,0.1%-21.9%)and normal sperm morphology(MD=11.0%,95%CI,4.6%-17.4%).The most optimal intervention was carnitine plus vitamins and fatty acids for SPR and sperm concentrations,respectively,even after excluding trials at a high risk of bias.Compared with a placebo or being untreated,FSH(RR=4.9,95%CI,1.1-21.3)significantly increased SPR,whereas SERM plus kallikrein increased sperm concentration(MD=16.5×10^(6)mL^(-1),95%CI,1.6×10^(6)-31.4×10^(6)),and SERM plus CoQ10 significantly improved sperm progressive motility(MD=11.3%,95%CI,7.3%-15.4%)and normal morphology(MD=11.2%,95%CI,5.4%-16.9%)in men with oligoasthenozoospermia(OA).In terms of side effects,fatty acids and pentoxifylline were associated with foul breath and/or a bad taste(RR=8.1,95%CI,1.0-63.5)and vomiting(RR=8.0,95%CI,1.0-63.0),respectively.In conclusion,the optimal treatment for male infertility for live birth is still unknown.Carnitine plus vitamins and FSH are likely to be better than other therapies in achieving successful spontaneous pregnancy in couples overall and in cou ples with men with OA,respectively.The efficacy of other treatments on pregnancy outcomes warrants further verification.

Lycopene and male infertility

Excessive amounts of reactive oxygen species （ROS） cause a state of oxidative stress, which result in sperm membrane lipid peroxidation, DNA damage and apoptosis, leading to decreased sperm viability and motility. Elevated levels of ROS are a major cause of idiopathic male factor infertility, which is an increasingly common problem today. Lycopene, the most potent singlet oxygen quencher of all carotenoids, is a possible treatment option for male infertility because of its antioxidant properties. By reacting with and neutralizing free radicals, lycopene could reduce the incidence of oxidative stress and thus, lessen the damage that would otherwise be inflicted on spermatozoa. It is postulated that lycopene may have other beneficial effects via nonoxidative mechanisms in the testis, such as gap junction communication, modulation of gene expression, regulation of the cell cycle and immunoenhancement. Various lycopene supplementation studies conducted on both humans and animals have shown promising results in alleviating male infertility--lipid peroxidation and DNA damage were decreased, while sperm count and viability, and general immunity were increased. Improvement of these parameters indicates a reduction in oxidative stress, and thus the spermatozoa is less vulnerable to oxidative damage, which increases the chances of a normal sperm fertilizing the egg. Human trials have reported improvement in sperm parameters and pregnancy rates with supplementation of 4-8 mg of lycopene daily for 3-12 months. However, further detailed and extensive research is still required to determine the dosage and the usefulness of lycopene as a treatment for male infertility.

Decline of semen quality among 10 932 males consulting for couple infertility over a 20-year period in Marseille, France

Semen from 10 932 male partners of infertile couples was analysed and sperm parameter trends were evaluated at the Reproduction Biology Laboratory of the University Hospital of Marseille （France） between 1988 and 2007. After 3-6 days of abstinence, semen samples were collected. Measurements of seminal fluid volume, pH, sperm concentration, total sperm count, motility and detailed morphology of spermatozoa were performed. Sperm parameters were analysed on the entire population and in men with normal total numeration （ 〉~ 40 million per ejaculate）. The whole population demonstrated declining trends in sperm concentration （1.5% per year）, total sperm count （1.6% per year）, total motility （0.4% per year）, rapid motility （5.5% per year） and normal morphology （2.2% per year）. In the group of selected samples with total normal sperm count, the same trends of sperm quality deterioration with time were observed. Our results clearly indicate that the auality of semen decreased in this population over the study period.

Ameliorative effect of Punica granatum on sperm parameters in rats exposed to mobile radioelectromagnetic radiation

Objective:To study the effect of mobile emitted radio frequency electromagnetic radiation(RF-EMR)on sperm parameters(sperm count,viability,motility,progressivity,and morphology)and ameliorative effect of pomegranate juice in rats.Methods:Thirty male Sprague Dawley rats were divided into five groups(n=6 in each group).GroupⅠwas neither exposed to RF-EMR nor given pomegranate juice,groupⅡ,ⅢandⅣwere exposed to mobile emitted RF-EMR for 60 min/day for 90 days.After 90-day exposure to RF-EMR,groupⅢwas supplemented with pomegranate juice for 90 days(1 mL/day)and groupⅣwas allowed to recover for 90 days without supplementation of pomegranate juice.GroupⅤwas supplemented with pomegranate juice for 90 days without exposure to RF-EMR.At the end of intervention,epididymal sperm parameters(sperm count,viability,motility,progressivity,and morphology)were measured.Results:The microscopic examination of sperm parameters such as sperm count,sperm viability,sperm motility,progressivity were significantly decreased in groupⅡ(the mobile RF-EMR group)compared to groupⅠ(the control group)(P<0.05).In addition,sperm morphology was also significantly altered(abnormal)in groupⅡcompared to groupⅠ(P<0.05).However,the sperm parameters including sperm morphology were significantly altered in groupⅢ(mobile RF-EMR+pomegranate juice)compared to groupⅡ(P<0.05).The sperm parameters including sperm morphology were not significantly altered in groupⅣ(the mobile RF-EMR recovery group)compared to groupⅡ(P>0.05).The sperm parameters were non-significantly increased in group V(the pomegranate juice group)compared to groupⅠ(P>0.05).Conclusions:Mobile RF-EMR exposure reduces the sperm parameters,which,however,can be reversed by treatment with pomegranate juice,indicating that pomegranate juice can be used as a nutritional supplement to improve sperm quality.

Evaluation of the Concentration of Anti-Spermatozoa Antibodies in Seminal Plasma of Normozoosperms and Azoosperms of Patients at the Pasteur Institute of Cote d’Ivoire

Under normal circumstances, spermatozoa are protected from the immune system by the blood-testis barrier. The breakdown of this barrier is the origin of the synthesis of antisperm antibodies (ASA). The presence of sperm agglutinates in semen is characteristic of ASA. But is the presence of agglutinates in semen necessarily linked to the level of ASA in semen? The objective of this study was to assess the concentration of anti-sperm antibodies (ASA) in normozoosperms and infertile men with azoospermia. The biological material consisted of samples of human sperms: 30 samples with azoospermia and 32 with normozoospermia. The ASA assay was performed in seminal plasma using the DRG® Sperm Antibody ELISA (seminal plasma) kit (EIA-4249). The reading was carried out using a microplate reader at 450 nm. Data analysis was performed using Graph Pad Prism 7 software. The results obtained showed that the difference in ASA concentration between these two categories of sperm was not significant, with an average ASA level of 31.54 ± 2.45 U/mL in azoospermic ejaculate and 27.63 ± 1.51 U/mL in normozoosperms. Statistical analysis showed higher ASA concentrations in azoosperms with 6.67% of these declared positive. The ASA positivity rate made it possible to distinguish secretory azoospermias from obstructive ones. Also, the presence of ASA is not necessarily linked to the presence of agglutinates in the semen.

Does alcohol have any effect on male reproductive Function？ A review of literature

Although alcohol is widely used, its impact on the male reproductive function is still controversial. Over the years, many studies have investigated the effects of alcohol consumption on sperm parameters and male infertility. This article reviews the main preclinical and clinical evidences. Studies conducted on the experimental animal have shown that a diet enriched with ethanol causes sperm parameter abnormalities, a number of alterations involving the reproductive tract inhibition, and reduced mouse oocyte in vitro fertilization rate. These effects were partly reversible upon discontinuation of alcohol consumption. Most of the studies evaluating the effects of alcohol in men have shown a negative impact on the sperm parameters. This has been reported to be associated with hypotestosteronemia and low-normal or elevated gonadotropin levels suggesting a combined central and testicular detrimental effect of alcohol. Nevertheless, alcohol consumption does not seem to have much effect on fertility either in in vitro fertilization programs or population-based studies. Finally, the genetic background and other concomitant, alcohol consumption-related conditions influence the degree of the testicular damage. In conclusion, alcohol consumption is associated with a deterioration of sperm parameters which may be partially reversible upon alcohol consumption discontinuation.

中医药对男性不育患者疗效的Meta分析

目的运用Meta分析观察中医药对男性不育患者的治疗效果,并进行相应的评价。方法使用计算机检索重庆维普中文科技期刊数据库(VIP)、中国知网(CNKI)、中国学术期刊数据库(万方数据)、Pubmed、EMbase、Cochrane图书馆,检索从开始到结束的时间均为各数据库建库至2022年12月1日,搜集中医药与西药对比治疗男性不育的随机对照试验,由两位研究者按照纳入和排除的标准筛选文献,并将文献中的有关信息纳入。应用REVMAN5.4.1软件进行Meta分析。结果共22篇治疗男性不育的文献被纳入。对1879例病例进行Meta分析结果表明,总有效率[RD=0.22,(95%CI:0.18~0.26),P<0.01]、精子DNA碎片率[MD=-5.84,(95%CI:-6.99~-4.69),P<0.01]、精子总活力[MD=5.90,(95%CI:3.68~8.15),P<0.01]、精子浓度[MD=7.37,(95%CI:4.65~10.1),P<0.01]、前向运动精子百分比[MD=7.50,(95%CI:5.91~9.08),P<0.01]。结论中医药可明显降低患者精子DNA损伤,提高总有效率、精子总活力,并改善了精子浓度、前向运动精子百分比等指标,对男性不育症有良好的治疗效果。

《世界卫生组织人类精液检查与处理实验室手册》版本演变及临床意义

精液分析是男性生育力评估的基石,《世界卫生组织人类精液检查与处理实验室手册》是公认的精液分析指南,为全世界精液检查程序的标准化和参考值提供了基础。自第1版问世以来已经过去了40余年,期间用于评价精液质量的实验室方法发生了显著变化,检测的精确度和准确性得到了提高。随着男科学和生殖医学的不断进步及辅助生殖技术的出现和进展,该手册不断更新并引入新的、基于循证医学的检测方法,除了进行精液常规分析,还可以评估精子功能以满足临床需要。2021年第6版发布,提供了满足评估男性生殖功能、生育保健、不育症的诊断与治疗所需实验室程序的最新循证信息。本文对手册的演变进行了梳理和分析,并强调了更新之处及其临床应用价值,希望其能够获得广泛接受和应用。

Evaluation on Antisperm Antibody in Infertile Men with Oligoasthenoteratozoospermia

To evaluate the level of antisperm antibody （ASA） in infertile men with oligoasthenoteratozoospermia （OAT）. Methods Forty-six infertile men with OAT were enrolled into this study. Sperm samples were screened by the direct immunobead test for ASA type IgG and lgA according to the WHO laboratory manual. Results Of the 46 patients with OAT assessed for ASA-IgG, 2 had immunobead binding which were 22% and 27%, respectively, and the sub-positive rate was 4.3%. No case had the clinical positive level according to the WHO criteria （ ≥ 50% of the motile sperm with immunobead binding）. ASA-IgA was not detected in all cases. Conclusion A significant incidence or high level of ASA could not be found in infertile men with OAT, which suggests that ASA is not associated with the pathogenesis of infertile men with OAT.

精浆抗精子抗体对精子形态及运动特征的影响

目的:探讨精浆抗精子抗体(AsAb)对精子形态和运动特征的影响。方法:检测251例男性不育患者精液样本,采用酶联免疫法进行AsAb检测,计算机自动分析精子运动特征,采用精子形态检测系统下人工修正方法进行精子形态分析。结果:251例男性不育患者中,AsAb阳性率为17·13%。AsAb阳性组正常形态精子百分率与阴性组无显著性差异(P>0·05),大头精子和锥形头精子百分率显著高于AsAb阴性组(P<0·05,P<0·005)。精浆AsAb阳性组a+b级精子百分率,精子运动参数MAD、LIN、WOB均明显低于阴性组,两组比较差异有显著性(P<0·05,P<0·01)。结论:精浆AsAb不影响正常形态精子百分率,但能使锥形头精子百分率显著升高;使a+b级精子百分率、精子运动参数MAD、LIN、WOB明显降低。

男性不育者精子顶体酶活性影响因素分析

目的 :分析某些因素对男性不育者精子顶体酶活性的影响。方法 :分光光度比色法检测3767例男性不育者精子顶体酶活性。结果 :精液液化时间延长组、p H值降低组、白细胞数 >5个 /HP组的精子顶体酶活性均显著低于其相应对照组 ( P<0 .0 0 1 ,P<0 .0 0 1 ,P<0 .0 5 )。顶体酶活性与支原体感染和精浆 As Ab无关 ( P>0 .0 5 ,P>0 .0 5 )。结论 :精液液化时间、p H值和白细胞数影响顶体酶活性 ,精液支原体感染和精浆 As

虎杖丹参饮治疗免疫性不育男性的临床研究

目的:探讨中药“虎杖丹参饮”治疗免疫性不育男性的临床疗效,为临床采用中医药治疗免疫性不育男性提供一种有效方法。方法:将符合纳入病例标准的90例患者随机分成两组,治疗组60例,采用口服“虎杖丹参饮”治疗;对照组30例,采用口服泼尼松治疗,分别治疗3个月,观察两组治疗前后临床症状改善、免疫指标[血清抗精子抗体(AsAb),精浆AsAb]、精液质量指标(液化时间、活力、活动率、密度、畸形率等)的变化,并对上述结果进行统计学分析。结果:①治疗组AsAb总转阴率明显优于对照组(P<0.01),其中血清AsAb转阴率疗效更好;②治疗组临床治愈率及总有效率明显优于对照组(P<0.01),治疗后的中医症状积分明显低于对照组(P<0.01),治疗组在改善临床症状方面明显优于对照组(P<0.01),尤以改善腰膝酸软、会阴睾丸坠胀、性欲强烈、局部疼痛症状明显;③治疗组治疗后精子活力、活动率明显优于治疗前(P<0.01),精子密度明显优于治疗前(P<0.05),而治疗前后的精液量、液化时间、精子畸形率及pH值没有明显差异(P>0.05)。结论:“虎杖丹参饮”治疗免疫性不育男性的疗效明显优于泼尼松。“虎杖丹参饮”能较好地提高AsAb转阴率,改善临床症状和精子质量,且无明显不良反应。“虎杖丹参饮”是治疗免疫性不育男性的有效方法。

人精浆抗精子抗体与顶体酶活性关系的探讨

目的 :研究精浆抗精子抗体 (AsAb)对精子顶体酶活力的影响。 方法 :用间接血凝法测定 34 32例不育男性和 6 5例生育男性精浆的AsAb ,并对其中的 2 882例不育男性精子用比色法进行了顶体酶活性的测定。 结果 :34 32例不育者精浆AsAb阳性率为 10 .2 0 %,2 882例进行了顶体酶活性测定的不育者精浆AsAb阳性率为 9.37%,对照组精子顶体酶活性明显高于各不育组 (P <0 .0 0 1)。不育组AsAb阳性组与AsAb阴性组比较顶体酶活性没有明显差异 (P >0 .0 5 ) ,顶体酶活性正常与异常组AsAb阳性率比较差异无显著性 (P >0 .0 5 )。 结论 :精浆AsAb对精子顶体酶活性没有影响。

精子形态与精子运动参数关系研究

目的:探讨精子形态与精子运动参数关系。方法:783例不育患者,采用精子自动分析系统分析精子运动参数,采用精子形态检测系统下人工修正方法进行精子形态分析。精子形态正常组241例,异常组542例。结果:精子形态异常组精子曲线速度(VCL)、摆动性(WOB)、平均路径速度(VAP)均显著高于精子形态正常组(P<0.05,P<0.001),而精子形态异常组精子平均移动角度(MAD)、直线性(LIN)、前向性(STR)均显著低于精子形态正常组(P<0.05,P<0.001);形态正常精子百分率与MAD、LIN、WOB、STR有显著正相关性,而与侧摆幅度(ALH)有显著负相关。结论:精子形态异常和运动能力弱相伴产生,形态异常对精子运动的影响可能只是这一现象产生的次要原因,而一些共同作用于精子形态和运动能力的因素也许是导致这一现象产生的主要原因。

抗精子抗体的研究现状

免疫因素是引起男性不育的原因之一。由于抗原 (Ag)所在部位、分子量大小和结构各异 ,精子Ag在免疫性不育中所起的作用不同。抗精子抗体 (AsAb)可直接作用于精子或通过改变局部微环境而间接影响精子功能。本文就精子Ag多样性、AsAb作用部位和机制、AsAb类别及滴度对生育的影响作一综述。

免疫因素与男性不育的相关性

目的 :观察不育男性血清抗精子抗体 (AsAb) ,抗心磷脂抗体 (ACA) ,抗弓形虫抗体与精液各指标之间的关系 ,揭示免疫因素与不育症的相关性及致病机制 .方法 :用ELISA(Enzyme linkedimmunosorbentassay)法测定 2 86例男性不育患者及 198例正常生育者血清的AsAb ,ACA ,抗弓形虫抗体并常规检测精液的各项指标 .结果 :不育者血清中的AsAb ,ACA ,抗弓形虫抗体阳性率 (2 9.4 % ,18.2 % ,17.1% )明显高于正常生育组 (9.0 % ,7.0 % ,9.0 % ) ,P <0 .0 1;不育患者血清AsAb水平变化能导致精子的活动力明显下降 ,呈显著性正相关 ,P<0 .0 1.结论 :AsAb与男性不育有密切关系 ,可引起精子活率、活力明显下降 ,但对精子密度及液化无明显影响 .