Human circBOULE RNAs as potential biomarkers for sperm quality and male infertility

Reliable molecular biomarkers to predict fertility remain scarce.The current study investigated the potential of testis-specific circBOULE RNAs as biomarkers for male infertility and sperm quality.Using reverse transcription-PCR and real-time reverse transcription-PCR assays,we identified seven circular RNAs from the human BOULE gene in human sperm.We observed that the expression level of circEx3-6 was significantly reduced in asthenozoospermia,while the expression levels of both circEx2-6 and circEx2-7 were decreased in terato-zoospermia,compared with the controls.Furthermore,we demonstrated that the expression level of circEx2-6 was negatively correlated with the sperm DNA fragmentation index,and the expression level of circEx2-7 was correlated with both fertilization and cleavage rates in those treated with the assisted reproductive technologies.Further functional analyses in a transgenic fly model supported the roles of circBOULE RNAs in sperm development and human male fertility.Collectively,our findings support that sperm circBOULE RNAs may serve as diagnostic biomarkers for assessing sperm motility and DNA quality.Therefore,clinical application and significance of sperm circBOULE RNAs in the assisted reproductive technologies warrant further investigation.

Antioxidant therapy in male infertility： fact or fiction？

Infertile men have higher levels of semen reactive oxygen species （ROS） than do fertile men. High levels of semen ROS can cause sperm dysfunction, sperm DNA damage and reduced male reproductive potential. This observation has led clinicians to treat infertile men with antioxidant supplements. The purpose of this article is to discuss the rationale for antioxidant therapy in infertile men and to evaluate the data on the efficacy of dietary and in vitro antioxidant preparations on sperm function and DNA damage. To date, most clinical studies suggest that dietary antioxidant supplements are beneficial in terms of improving sperm function and DNA integrity. However, the exact mechanism of action of dietary antioxidants and the optimal dietary supplement have not been established. Moreover, most of the clinical studies are small and few have evaluated pregnancy rates. A beneficial effect of in vitro antioxidant supplements in protecting spermatozoa from exogenous oxidants has been demonstrated in most studies; however, the effect of these antioxidants in protecting sperm from endogenous ROS, gentle sperm processing and cryopreservation has not been established conclusively.

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.

The relationship between DNA fragmentation and the intensity of morphologically abnormal human spermatozoa

Objective:To determine the relationship between teratozoospermia and sperm DNA fragmentation(SDF)in the human ejaculate.Methods:This retrospective study included 100 normozoospermic men as a control cohort(abnormal forms>14%),210 patients with a high level of abnormal forms(≤4%)and 65 patients presenting with a moderate level of abnormal forms(>4%to≤14%)based on the World Health Organization definitions.Sperm morphology was assessed using bright field microscopy.Sperm DNA fragmentation was assessed using the sperm chromatin dispersion assay.Non-parametric analyses were conducted to examine the relationship between abnormal sperm morphology and sperm DNA fragmentation;receiver operating characteristic(ROC)analyses were conducted to assess sensitivity and specificity of this relationship.Results:A correlation analysis revealed that the higher the proportion of abnormal spermatozoa in the ejaculate,the higher the level of SDF(Spearman's Rho=-0.230;P<0.001).Significant differences in the proportion of SDF were found when all cohorts were compared(P<0.001);these significant differences were also retained when the different cohorts were compared pairwise.ROC analysis showed a moderate but significant predictive value for SDF to differentiate patients with different levels of teratozoospemia.Conclusions:Although analysis of a more continuous range of values for teratozoospermia would help further clarify any causal relationship with SDF,there is clearly a synergistic or coincident affiliation between these variables that needs to be acknowledged by the clinician when interpreting the spermiogram.

The Influence of Sperm DNA Damage and Semen Homocysteine on Male Infertility

Background:To explore the relationship of sperm DNA fragmentation index(DFI),serum and seminal plasma homocysteine(Hcy),and semen parameters in patients with severe spermatogenetic dysfunction.Methods:A total of 77 infertile males treated in our hospital for severe spermatogenetic dysfunction from January 2016 to November 2017 were recruited.The involved patients were divided into two groups:oligozoospermia(SOM group,35 cases)and asthenozoospermia(OAT group,42 cases).The control group(NM group)contained 31 healthy males without reproductive dysfunctions.All the participants involved were tested in the items below:spermatozoa parameters,spermatozoa DFI,serum Hcy level and seminal plasma Hcy level,concentration of seminal plasma malondialdehyde(MDA),and total antioxidant capacity(TAC).Results:Between the SOM group and NM group,there were significantly difference in sperm concentration,motility and vitality,concentration of MDA,and TAC.The spermatozoa DFI and Hcy levels in SOM group were significantly higher than those of the NM group.Sperm DFI was positively correlated with serum Hcy level(r=0.083,P<0.05).Serum Hcy level was negatively correlated with sperm concentration(r=−0.186,P<0.05)and sperm vitality(r=−0.216,P<0.05).The serum Hcy level was not correlated with sperm Hcy level(r=0.103,P>0.05).Conclusions:The elevated Hcy level and spermatozoa DFI may be important factors of the severe spermatogenetic dysfunction,which can be used as semen index to evaluate sperm quality and male fertility.

Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic male patients

Objective:To know whether sperm DNA fragmentation(SDF)affects the clinical outcomes in the cumulative transfers of an intracytoplasmic sperm injection(ICSI)cycle along with blastocyst transfers in couples with normozoospermic males.Methods:The study included 252 couples who underwent their first ICSI cycles along with blastocyst transfer and whose male partner semen samples were normozoospermic according to the World Health Organization 2010 criteria.All the couples were classified into two groups based on the SDF:the low SDF group(SDF≤30%,n=162)and the high SDF group(SDF>30%,n=90).Clinical as well as laboratory outcomes were correlated between the two groups.Sperm DNA fragmentation was assessed on the post-wash semen samples by acridine orange test.The main outcome measures were the live birth rate and miscarriage rate.Results:A significant decrease in the live birth rates was observed in the high SDF group compared to the low SDF group in fresh embryo transfer cycles(P<0.05).However,no significant difference was observed in the clinical outcomes either in the frozen embryo transfer cycles or in the overall cumulative transfer cycles(P>0.05).No significant difference was observed in the laboratory outcomes between the two SDF groups.A remarkable decrease in sperm motility was observed in the high SDF group compared to the low SDF group(P<0.05).Conclusions:Sperm DNA fragmentation does not affect the clinical outcomes in the cumulative transfers of an ICSI cycle along with blastocyst transfers in couples with normozoospermic males.

Frequency of Monthly Ejaculation at Sexual Intercourse, DNA Fragmentation Index and Fertilization Rate among Sperm Donors and Fertility-Challenged Men in Sub-Saharan Africa: Paper 1

Introduction: In humans, the ideal ejaculation frequency depends on age, exercise and sexual potential. Natural ejaculation frequency balances the testosterone levels in the body. Materials and Methods: Semi-structured questionnaire was used to collect information from subjects. Semen samples were collected from sperm donors and sub-fertile men who presented for infertility challenges. Processing and analysis of semen samples were done according to World Health Organization guidelines. Sperm DNA fragmentation was evaluated using the Halosperm&#174;?kit. Results: A total of 114 subjects, including 19 sperm donors and 95 sub-fertile males were studied. There was a significant difference (t =?&#8722;5.96, P-value = 0.00001) in the mean [±sd] age of sperm donors (30.8 [8.1]) and that of sub-fertile men (42.3 [76]). There was a significant difference (t=?&#8722;4.10, P-value = 0.0005) in the mean monthly ejaculation during sexual intercourse (MESI) among sperm donors with DNA fragmentation index &#8722;2.20, P-value = 0.02) in MESI among sub-fertile men aged ≥40 years (8.9 [4.6]) than among those aged &#8722;0.67, SE = 0.28, t = &#8722;2.40, P-value = 0.02, 95% CI: &#8722;1.24,?&#8722;0.10). Conclusion: In men < 40 years, fewer MESI did not worsen the DFI. A higher number of professionals such as doctors, lawyers and engineers, reported lower monthly frequency of sexual ejaculations compared to entrepreneurs. Entrepreneurs and non-smokers had the highest frequencies of MESI.

Frequency of Monthly Ejaculation at Sexual Intercourse, DNA Fragmentation Index and Fertilization Rate among Sperm Donors and Fertility-Challenged Men in Sub-Saharan Africa: Paper 2

Introduction: Heterogenous sexual intercourse often produces a powerful orgasm that stimulates the pituitary function. Studies have suggested ejaculation frequency based on age. Materials and Methods: Semi-structured questionnaires were used to collect information from subjects. Semen samples were collected from sperm donors and sub-fertile men who presented for infertility challenges. Processing and analysis of semen samples were done according to World Health Organization (WHO) guidelines. Sperm deoxyribonucleic acid (DNA) fragmentation was evaluated using the Halosperm kit. Results: Among sperm donors, those aged χ2 = 0.09, P-value = 0.81, OR = 3.2, 95% CI: 0.23, 45.19) while among sub-fertile men those aged ≥40 years were approximately 2.3 times more likely to have very low frequency of MESI compared to aged χ2 = 2.11, P-value = 0.51, OR = 2.27, 95% CI: 0.74, 9.92). The frequency of all categories of MESI was highest among sub-fertile men aged χ2 = 0.03, P-value = 0.57, OR = 2.42, 95% CI: 0.41, 14.46). Sub-fertile men aged ≥40 with diastolic hypertension (≥90 mmHg) were approximately 6 times more likely to have a low (6 - 10) frequency of MESI compared to those aged χ2 = 1.97, P-value = 0.16, OR = 6.22, 95% CI: 0.69, 55.77). Overall mean fertilization rate was significantly higher (t-test = 2.44, P-value = 0.01) among sub-fertile men aged Conclusion: Cigarette smoking, more than alcohol consumption, appears to be a major factor that significantly affects the frequency of MESI among sub-fertile men in all age groups. Frequency of MESI negatively but insignificantly correlated with systolic blood pressure.

时差成像胚胎培养系统观察精子DNA碎片化指数对卵胞浆内单精子显微注射的胚胎发育及临床结局的影响

目的使用时差成像(time-lapse imagining,TLI)胚胎培养系统观察精子DNA碎片化指数(DNA fragmentation index,DFI)对卵胞浆内单精子显微注射(intracytoplasmic sperm injection,ICSI)的胚胎发育指标及临床结局的影响。方法选取2023年1月至6月在上海交通大学医学院附属国际和平妇幼保健院辅助生殖科接受ICSI技术助孕的392对夫妇为研究对象,分为常规培养组284周期和TLI组108周期,再根据DFI≤15%、>15%~<30%、≥30%进一步分为正常组、临界组、异常组。比较各组的临床资料以及临床妊娠结局。统计学方法采用t检验、单因素方差分析、χ^(2)检验或Fisher确切概率法。结果6组的女方年龄、基础促卵泡激素(follicle stimulating hormone,FSH)、身体质量指数(body mass index,BMI)及获卵数比较,差异均无统计学意义(P值均>0.05);男方精液常规指标中,浓度和正常形态率比较,差异均无统计学意义(P值均>0.05);常规正常组、常规临界组、常规异常组、TLI正常组、TLI临界组和TLI异常组的前向运动精子率分别为(46.5±16.5)%、(31.0±14.2)%、(14.8±8.4)%、(41.6±16.2)%、(32.5±14.4)%、(19.3±11.1)%,常规异常组和TLI异常组的前向运动精子率分别低于常规正常组、常规临界组、TLI正常组和TLI临界组(P值均<0.05)。6组的卵裂率和囊胚形成率比较,差异无统计学意义(P>0.05)。常规正常组、常规临界组、常规异常组、TLI正常组、TIL临界组和TLI异常组的受精率分别为(77.3±18.6)%、(78.6±17.1)%、(68.3±22.7)%、(77.4±14.5)%、(74.5±13.1)%、(63.1±25.4)%;常规异常组的受精率低于常规正常组、常规临界组、TLI正常组(P值均<0.05);TLI异常组的受精率低于常规正常组、常规临界组、TLI正常组、TLI临界组(P值均<0.05)。常规正常组、常规临界组、常规异常组的妊娠率分别为57.4%(39/68)、54.5%(24/44)、27.3%(6/22),异常组低于正常组和临界组(P值均<0.05)。TLI正常组、TLI临界组和TLI异常组3组的妊娠率比较,差异无统计学意义(P>0.05)。常规组3组之间以及TLI 3组之间的早期流产率比较,差异无统计学意义(P>0.05)。结论精子DFI值的升高会影响精子前向运动率,还会影响胚胎的受精率,高DFI精子进行ICSI助孕时使用TLI胚胎培养系统可以获得稳定的妊娠率。

Early apoptotic changes in human spermatozoa and their relationships with conventional semen parameters and sperm DNA fragmentation

Aim： To investigate whether early apoptotic changes in spermatozoa can be significant markers for sperm quality. Methods： Two early apoptotic changes in the semen of 56 men were assessed using Annexin V （AN）/propidium iodide （PI） staining for phosphatidylserine externalization and JC-1 staining for mitochondrial membrane potential （MMP）. The results were compared with conventional semen parameters and DNA fragmentation identified using the TUNEL assay. Results： The different labeling patterns in the bivariate Annexin V/PI analysis identified four distinctive spermatozoa populations. The percentage of AN^-/PI^- spermatozoa positively correlated with conventional semen parameters and MMP, but negatively correlated with TUNEL （＋） spermatozoa. As for the AN^-/PI^＋ fraction, we found an opposite result in comparison to AN^-/PI^- spermatozoa. The level of early apoptotic AN^＋/PI^- spermatozoa negatively correlated with MMP and sperm motility. The level of late apoptotic AN^＋/PI^＋ spermatozoa negatively correlated with conventional semen parameters and MMP, and positively correlated with TUNEL （＋） spermatozoa. MMP positively correlated with conventional semen parameters, but negatively correlated with TUNEL （＋） spermatozoa. Conclusion： Although early apoptotic AN^＋/PI^- spermatozoa only negatively correlates with sperm motility, the differences in proportion of each subpopulation of spermatozoa （especially, the percentage of AN^-/PI^- spermatozoa）, and decreased MMP might be significant markers for diagnosing male infertility. They possibly bring additional information to predict the outcome of in vitro fertilization. （Asian J Androl 2008 Mar; 10： 227-235）

Can DNA fragmentation of neat or swim-up spermatozoa be used to predict pregnancy following ICSI of fertile oocyte donors？

This study compared the potential of assessing sperm DNA fragmentation （SDF） from neat semen and the subsequent swim-up （SU） procedure to predict pregnancy when conducting ICSI of fertile donor oocytes. Infertile females （n=81） were transferred embryos resulting from intracytoplasmic sperm injection （ICSI） of their partner＇s spermatozoa and proven donor oocytes. This model normalized the impact of female factor in putative sperm DNA repair. Semen was blindly assessed for SDF using Halosperm immediately following ejaculation （NS） and after swim-up at the time of ICSI fertilisation. There was a decrease in SDF values of the ejaculated semen sample following the swim-up protocol （P=0.000）. Interestingly, pregnancy could be equally predicted from SDF values derived from either neat or swim-up semen samples. Receiver operator curves and the derived Youden＇s indices determined SDF cutoff values for NS and SU of 24.8% and 17.5%, respectively. Prediction of pregnancy from NS SDF had a sensitivity of 75% and a specificity of 69%, whereas for SU SDF was 78% and 73%, respectively. While increased levels of SDF negatively impact reproductive outcome, we have shown that a reduction in SDF following sperm selection using ICSI with proven donor oocytes is not mandatory for achieving pregnancy. This suggests that a certain level of DNA damage that is not detectable using current technologies could be impacting on the relative success of assisted reproductive technology （ART） procedures. Consequently, we propose a modification of the so called ＇iceberg model＇ as a possible rationale for understanding the role of SDF in reproductive outcome.

精子核DNA完整性测定方案的优化及其在辅助生殖技术中的应用价值

目的:对现有精子核DNA完整性测定方案进行优化,并探讨其在辅助生殖技术(ART)中的应用价值。方法:选择2021年1月1日至2022年12月8日于江西中医药大学附属生殖医院就诊的拟接受体外受精-胚胎移植(IVF-ET)助孕的194对夫妇作为研究对象。采集男方的精液作为对照组(n=194),同一精液经双层密度梯度离心法优化处理后精子混合液作为观察组(n=194)。根据精子核DNA碎片率(DFI)测定结果将对照组及观察组各分为3个亚组,对照A组和观察A组:DFI<15%,对照B组和观察B组:DFI 15%~30%,对照C组和观察C组:DFI≥30%。对观察组与对照组的DFI值及各亚组间的助孕及妊娠情况进行比较。结果:(1)观察组DFI明显低于对照组,差异有统计学意义[(13.55±10.17)%vs.(18.56±11.54)%,P<0.05]。(2)6个亚组间的受精率、卵裂率及优胚率两两比较,差异无统计学意义(P>0.05)。(3)6个亚组的妊娠率和着床率比较,差异有统计学意义(P<0.05);其中,对照A组、对照B组、观察A组、观察B组4组的临床妊娠率(均在65.00%以上)及着床率(均在50.00%)两两比较,差异均无统计学意义(P>0.05),但均高于对照C组(43.24%、31.67%)及观察C组(13.64%、8.82%),差异有统计学意义(P<0.05);对照C组的临床妊娠率及着床率明显高于观察C组,差异有统计学意义(P<0.05)。结论:精液经优化处理后精子核DNA完整性可明显改善。两种不同检测方案在ART中均有较好的应用价值,当精液经优化处理后DFI≥30%时,对ART的不良妊娠结局具有更好的预测价值。

精子DNA碎片检测在男性不育症患者临床评估和治疗中的研究进展

近年来,我国人口呈现出生率降低和老龄化进程加快的国情,改善和提高男性生育力问题引发社会关注。精子DNA碎片指数(DNA fragmentation index,DFI)作为一种新的精子质量评价标志物,目前广泛应用于临床不育症患者精液样本检测中。随着2023年《精子DNA碎片检测的临床专家共识》发布,为精子DFI应用于不育症患者临床评估和治疗提供了依据和标准。本文将对近年来国内外报道的精子DFI与辅助生殖技术(assisted reproductive technique,ART)治疗结局关系、精子DFI与精子参数一致性关系、精子DFI检测方法评价等研究进行综述。

基于浊邪理论探讨仙方活命饮加减方修复不育症患者精子DNA完整结构的机制研究

目的探讨基于浊邪理论的仙方活命饮加减方修复不育症患者精子DNA完整结构(DFI)的作用机制。方法选取2021年9月至2022年12月南昌市生殖医院生殖男科门诊收治的符合男性不育症伴有精子DFI偏高的94例患者作为研究对象,采用掷硬币法分为观察组(51例)和对照组(43例),观察组采用仙方活命饮加减中药制成膏方,对照组采用左卡尼汀口服溶液治疗,治疗3个月,观察治疗后两组患者的精子DFI水平、前向运动精子活率、总活率以及中医症状积分。结果观察组治疗后DFI指标低于对照组,差异有统计学意义(P<0.05)。观察组前向运动精子活率、精子总活率高于对照组,中医症状积分低于对照组,差异有统计学意义(P<0.05)。结论仙方活命饮加减方能有效提高不育症患者前向运动精子活率、总活率,修复精子DFI,还能有效缓解中医症状,为临床治疗男性不育症提供新的治疗思路。

精子DNA碎片率的影响因素及与常规体外受精早期胚胎发育的关系研究

目的探讨精子DNA碎片率(DFI)与精液常规参数的相关性及影响因素,研究精子DFI对常规体外受精(IVF)早期胚胎发育的影响。方法选取2022年5月至2023年5月在武汉大学人民医院生殖医学中心就诊的150例男性患者作为研究对象,进行问卷调查,分析精子DFI与精液常规参数、年龄、生活方式及职业的相关性。回顾性分析行IVF治疗的178个周期的临床资料,分析精子DFI及精液常规参数与早期胚胎发育的相关性。结果精子DFI与精子浓度、活力、正常形态率及劳动型职业呈负相关,与年龄及辐射/放射暴露呈正相关(P<0.05)。DFI-B组(15%≤DFI<30%)的受精率为76.39%(64.40%,86.65%),DFI-C组(DFI≥30%)的受精率为67.34%(48.89%,75.00%),均显著低于DFI-A组(DFI<15%)的80.63%(70.26%,90.41%)(P<0.01)。精子DFI与IVF受精率呈显著负相关(P<0.01)。结论精子DFI与精液常规参数存在显著负相关,年龄、辐射/放射暴露会显著负向影响男性精子DFI,体力劳动会显著正向影响男性精子DFI。精子DFI升高可导致IVF受精率降低。

性激素水平、精液质量与不育症患者精子DNA碎片指数的相关性

目的:分析性激素指标水平、精液质量与不育症患者精子DNA碎片指数(DFI)的相关性。方法:回顾性分析2022年1—12月于该院就诊的80例不育症患者的临床资料,设为观察组,另回顾性分析同期该院80名男性健康体检者的临床资料,设为对照组。统计两组DFI,依据DFI将观察组患者分为异常患者(DFI≥30%)和正常患者(DFI<30%),比较两组及异常患者、正常患者性激素指标[睾酮、卵泡刺激素(FSH)、促黄体生成素(LH)]水平和精液质量,分析性激素指标水平、精液质量与DFI的相关性。结果:观察组DFI为(18.93±2.10)%,高于对照组的(15.38±2.05)%,差异有统计学意义(P<0.05);观察组DFI≥30%有58例,占72.50%(58/80);DFI<30%有22例,占27.50%(22/80);观察组LH、FSH水平均高于对照组,睾酮水平和精子总数、精子浓度、精子总活力、精子前向运动比例均低于对照组,差异有统计学意义(P<0.05);异常患者睾酮水平和精子总数、精子浓度、精子总活力、精子前向运动比例均低于正常患者,LH、FSH水平均高于正常患者,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,睾酮水平和精子总数、精子浓度、精子总活力、精子前向运动比例均与不育症患者精子DFI呈负相关(r<0,P<0.05);LH、FSH水平均与不育症患者精子DFI呈正相关(r>0,P<0.05)。结论:精液质量、睾酮水平均与不育症患者精子DFI呈负相关,LH、FSH水平均与不育症患者精子DFI呈正相关。

Resolution of sperm quality impairment following SARS-CoV-2 infection:A prospective study

Objective:To investigate the length of time required to resolve COVID-19 effects on semen quality and DNA integrity.Methods:A prospective cohort study was conducted among 42 men who tested positive for SARS-CoV-2 and underwent semen analysis at baseline and four months’post-recovery.Semen samples were collected and evaluated for macroscopic and microscopic parameters,sperm chromatin maturation,and DNA fragmentation.Results:The mean age of participants was 37(±7)years,and 14%had normozoospermia at baseline.After a four-month recovery from COVID-19,48%of patients had normozoospermia.Sperm count,motility,and morphology increased significantly,while sperm DNA fragmentation and sperm chromatin maturation decreased significantly post-recovery from COVID-19.Conclusions:Sperm parameters improve after a four-month recovery from COVID-19.The findings indicate significant improvements in sperm count,motility,morphology,DNA fragmentation,and chromatin maturation after a four-month recovery period.

男性免疫性不育患者精子参数与DNA完整性的交互作用及支原体感染对其的影响

目的研究男性免疫性不育患者精子参数与DNA完整性的交互作用及支原体感染对其的影响。方法回顾性选取四川锦欣西囡妇女儿童医院2022年1月至12月诊断的120例男性免疫性不育患者作为研究组,根据是否有支原体感染分为感染组(n=33)和未感染组(n=87)。另选取同期同一医院进行健康体检的120例正常男性作为对照组。比较研究组和对照组、感染组和未感染组的精液质量、DNA完整情况,研究精子DNA完整情况与精液质量的相关性。结果研究组患者的精液液化时间长于对照组,精子活率、精子浓度、前向运动精子百分率及正常形态率低于对照组;感染组患者的精液液化时间长于非感染组,精子活率、精子浓度、前向运动精子百分率及正常形态精子百分率低于非感染组。研究组患者的无光晕、小光晕、中光晕、大光晕、DNA碎片率显著高于对照组,感染组患者的无光晕、小光晕、中光晕、大光晕、DNA碎片率显著高于对照组。相关性分析显示,精液液化时间与大光晕、DNA碎片率呈负相关,与精子活率、精子浓度、前向运动精子百分率、正常形态精子百分率呈正相关。结论男性免疫性不育患者精子参数、支原体感染与DNA完整性呈显著相关性,支原体感染可能会造成DNA完整性下降,进而影响精子质量。

Evaluation of Sperm DNA Fragmentation amongst Infertile Black Africans. A Nigerian Study

Background: Male infertility is approaching an epidemic proportion. Almost 50% of all cases of infertility may be associated with a male factor. The diagnostic usefulness of sperm DNA integrity is now accessible as an additional tool to Seminal Fluid Analysis. Objective: To assess sperm DNA fragmentation index (SDFI) in male infertility and its relationship with obesity, alcohol consumption and cigarette smoking among infertile Nigerians. Patients and Methods: Patients who presented for infertility at three health facilities of Nordica Fertility Center in Lagos, Asaba and Abuja cities in Nigeria. STATA 13 was used for student’s t-test to compare the means of continuous variables among smokers and non-smokers and among alcohol consumers and non-consumers. Linear regression analysis was employed to assess the correlation between SDFI as dependent variable and some independent variables. Results: There was no significant difference in the SDFI of men aged &#8722;1.80, P-value = 0.04) than that of obese men (30.2%). Obese men were 2.12 times as likely to have SDFI ≥25% compared to normal weight men (χ2&#45;2.16, P-value = 0.14, OR = 2.12, 95% CI: 0.77, 5.80). Mean SDFI of men who consume alcohol (37.1%) was significantly higher (t = &#8722;1.97, P-value = 0.03) than that of those who did not consume alcohol. Although Pearson’s correlation matrix (r) indicated that sperm DNA fragmentation index was positively correlated with history of infertility (r = 0.01), groin surgery (r = 0.04), mumps (r = 0.04) and sexually transmitted illness (r = 0.04), however the degree of correlation was not significant (P-value ≥ 0.5) in each case. Conclusion: This is the first report in Black Africa that describes a correlation between sperm DNA integrity, as measured by the halo test and age, BMI and alcohol consumption. Men with normal BMI were more likely to have excellent to good SDFI and hence good fertility potential. Data from this study indicate that the infertile men had significantly higher sperm DNA fragmentation. Obese men and those engaged in alcohol consumption also had higher sperm DNA fragmentation indices.

Varicocele and DNA Fragmentation in Senegalese Infertile Males—A Study of 95 Cases

Varicocele is the first etiology of infertility in men worldwide and affects almost half of the men dealing with infertility in Senegal. Varicocele is associated with a high rate of sperm DNA fragmentation so this test is being more and more recommended especially when patients have to benefit from an ART (Assisted Reproductive Technology) procedure. The aim of our study was to assess if our patients with varicocele are concerned by higher DNA fragmentation rate in spermatozoon. Sperm samples were collected (95 cases of varicocele and 30 controls) and analyzed between January 2013 and June 2016 in a prospective study. Sperm DNA damage, characterized by the rate of DNA fragmentation was evaluated by TUNEL assay using fluorescence microscopy. There was a significant higher percentage of DNA fragmentation in patients with varicocele (p < 0.001), compared to controls. We plan to study a bigger cohort to assess this tendency and study the benefits of surgery in varicocele by evaluating DNA fragmentation after the procedure.