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Andrology Sep 2018Varicocele is the most common abnormality identified in men being evaluated for subfertility. In this comprehensive review of the pathophysiology of varicocele, we will... (Review)
Review
Varicocele is the most common abnormality identified in men being evaluated for subfertility. In this comprehensive review of the pathophysiology of varicocele, we will shed light on novel pathophysiological findings and their clinical implications that may direct future researches; we will shed light on the impact of transient scrotal hyperthermia and the roles of inflammation and differential protein expression and androgen expression in spermatozoa on inducing pathophysiological findings. Furthermore, we will clarify the linked processes contributing to the pathophysiology of varicocele and the impact of genetics on the induction of these processes. Spermatogenesis is a temperature-sensitive process, and heat stress of varicocele is considered the most plausible cause of impaired spermatogenesis. The three processes associated with the presence of varicocele - heat stress, excess reactive oxygen species, and increased apoptosis - appear to be linked; heat stress is associated with increased levels of reactive oxygen species and oxidative stress, which can induce apoptosis. The genetic role should not be overlooked as a contributing factor in the induction of heat stress, excess reactive oxygen species/oxidative stress, and apoptosis; this is evidenced by the association of varicocele with decreased expression of heat-shock proteins, higher polymorphism of glutathione S transferase and nitric oxide synthase genes, and increased BAX and decreased BCL2 genes and proteins. In this article, we will highlight the need of application of novel diagnostic techniques that can provide a precise pathophysiological diagnosis to guide potential specific innovative therapies. Innovative therapies can counteract the varicocele-induced stasis, suppress the degenerative effects of testicular hyperthermia, reduce the varicocele-induced apoptosis, and target the elevated-neutrophil products aiming at abrogating the testicular damage caused by the induced varicocele in rats/mice. In conclusion, on the basis of the novel scientific research, it may be possible to formulate new treatments and achieve the appropriate selection of patients who can benefit from these treatments.
Topics: Animals; Apoptosis; Body Temperature; Cadmium; DNA Damage; Humans; Infertility, Male; Inflammation; Male; Reactive Oxygen Species; Receptors, Androgen; Spermatogenesis; Testis; Varicocele
PubMed: 29978951
DOI: 10.1111/andr.12511 -
Asian Journal of Andrology 2016Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as... (Review)
Review
Post-vasectomy pain syndrome remains one of the more challenging urological problems to manage. This can be a frustrating process for both the patient and clinician as there is no well-recognized diagnostic regimen or reliable effective treatment. Many of these patients will end up seeing physicians across many disciplines, further frustrating them. The etiology of post-vasectomy pain syndrome is not clearly delineated. Postulations include damage to the scrotal and spermatic cord nerve structures via inflammatory effects of the immune system, back pressure effects in the obstructed vas and epididymis, vascular stasis, nerve impingement, or perineural fibrosis. Post-vasectomy pain syndrome is defined as at least 3 months of chronic or intermittent scrotal content pain. This article reviews the current understanding of post-vasectomy pain syndrome, theories behind its pathophysiology, evaluation pathways, and treatment options.
Topics: Anesthetics, Local; Anti-Inflammatory Agents, Non-Steroidal; Anticonvulsants; Antidepressive Agents, Tricyclic; Chronic Pain; Denervation; Disease Management; Epididymis; Humans; Male; Microsurgery; Orchiectomy; Pain, Postoperative; Pelvic Floor; Physical Therapy Modalities; Spermatic Cord; Testicular Diseases; Vasectomy; Vasovasostomy
PubMed: 26952956
DOI: 10.4103/1008-682X.175090 -
Pathophysiology : the Official Journal... Oct 2021According to global data, there is a male reproductive potential decrease. Pathogenesis of male infertility is often associated with autoimmunity towards sperm antigens... (Review)
Review
According to global data, there is a male reproductive potential decrease. Pathogenesis of male infertility is often associated with autoimmunity towards sperm antigens essential for fertilization. Antisperm autoantibodies (ASAs) have immobilizing and cytotoxic properties, impairing spermatogenesis, causing sperm agglutination, altering spermatozoa motility and acrosomal reaction, and thus preventing ovum fertilization. Infertility diagnosis requires a mandatory check for the ASAs. The concept of the blood-testis barrier is currently re-formulated, with an emphasis on informational paracrine and juxtacrine effects, rather than simple anatomical separation. The etiology of male infertility includes both autoimmune and non-autoimmune diseases but equally develops through autoimmune links of pathogenesis. Varicocele commonly leads to infertility due to testicular ischemic damage, venous stasis, local hyperthermia, and hypoandrogenism. However, varicocelectomy can alter the blood-testis barrier, facilitating ASAs production as well. There are contradictory data on the role of ASAs in the pathogenesis of varicocele-related infertility. Infection and inflammation both promote ASAs production due to "danger concept" mechanisms and because of antigen mimicry. Systemic pro-autoimmune influences like hyperprolactinemia, hypoandrogenism, and hypothyroidism also facilitate ASAs production. The diagnostic value of various ASAs has not yet been clearly attributed, and their cut-levels have not been determined in sera nor in ejaculate. The assessment of the autoimmunity role in the pathogenesis of male infertility is ambiguous, so the purpose of this review is to show the effects of ASAs on the pathogenesis of male infertility.
PubMed: 35366245
DOI: 10.3390/pathophysiology28040030 -
Andrologia Dec 2022To evaluate the changes in testicular stiffness and microcirculation caused by spermatic vein ligation in patients with varicocele, we conducted a case-controlled study....
To evaluate the changes in testicular stiffness and microcirculation caused by spermatic vein ligation in patients with varicocele, we conducted a case-controlled study. A total of 27 grade III left varicocele cases were enrolled. Testicular stiffness and perfusion were evaluated by shear wave elastography and contrast-enhanced ultrasound during subinguinal microscopic varicocelectomy. The external and the internal parenchyma of bilateral testes were selected to compare the shear wave velocity of bilateral testes during the spermatic vein ligation. We mapped and compared the intensity-time curves following bolus contrast injection three times in the same region of interest. Initially, the shear wave velocity of the left internal parenchyma was higher than the right side (1.10 ± 0.06 m/s vs. 1.00 ± 0.03 m/s). It decreased (1.09 ± 0.06 m/s) (p < 0.05) after ligation. Meanwhile, the left epididymis had the higher agent peak intensity (0.90 × 10E-5 AU), the largest area under the curve (80.20 × 10E-5 AU s), and the longest washout area (54.35 × 10E-5 AU s). In addition, the left internal parenchyma presented a sharper slope (0.18 × 10E-5 AU/s) (p < 0.05). In conclusion, the spermatic vein ligation improved the perfusion of the internal testicular parenchyma, but it could temporally deteriorate the stasis of the epididymis. These changes caused softer testicular parenchyma.
Topics: Male; Humans; Varicocele; Elasticity Imaging Techniques; Veins; Vascular Surgical Procedures; Testis
PubMed: 36217608
DOI: 10.1111/and.14586 -
Zhonghua Nan Ke Xue = National Journal... Dec 2023The occurrence of varicocele infertility can be attributed to the small and flexural spermatic plexus which constitutes the main structure of spermatic cord.Obstruction...
The occurrence of varicocele infertility can be attributed to the small and flexural spermatic plexus which constitutes the main structure of spermatic cord.Obstruction of blood circulation, stagnation of qi and blood, ultimately leading to infertility. The spermatic plexus ' physiological and pathological symptoms are consistent with the theory of visceral collateral. Based on the theory of visceral collaterals, the varicocele infertility caused by stagnation of liver collateral and deficiency of kidney collateral. And the acupuncture is used to directly act on the relevant points on the meridians, so as to dredge the meridians, strengthen the healthy and expel the evil, and harmonize the yin and yang of visceral, which is more in line with the therapeutic principle of " unblocking the meridians " for collateral diseases. For varicocele infertility caused by liver meridian stasis, it can regulate the liver meridian Chong Ren, eliminate blood stasis and promote stagnation, and be combined with LR3, LI4, GB34, SP6, CV3. For varicocele infertility caused by kidney deficiency and meridian syndrome, it can tonify the kidney meridian Du Yang, warm and disperse the essence, and mainly focus on GV4, CV4, KI3, BL23 and BL43.
Topics: Male; Humans; Varicocele; Acupuncture Therapy; Meridians; Infertility; Syndrome; Acupuncture Points
PubMed: 38639957
DOI: No ID Found -
Medicine Oct 2022The incidence of male infertility is increasing in recent years, and the semen routine examination of some patients is normal, but the semen pathological examination...
BACKGROUND
The incidence of male infertility is increasing in recent years, and the semen routine examination of some patients is normal, but the semen pathological examination shows that the sperm DNA fragmentation index (DFI) is high, and the patients' clinical manifestations are infertility or recurrent abortion of their spouses. At present, there is no special treatment for male infertility caused by high DFI, and traditional Chinese medicine compound prescription shows potential value in the treatment of male infertility. Wuwei Fuzheng Yijing formula (WFY) is an effective prescription for the treatment of sperm DNA damage in male infertility, but there is no strict clinical trial to support its application. Therefore, we designed a randomized controlled trial to evaluate the efficacy and safety of WFY in patients with sperm DNA damage in male infertility.
METHODS
In this randomized controlled study, 100 patients who met the inclusion criteria were randomly divided into WFY group and levocarnitine oral solution group. The treatment period was 12 weeks. The main observation index was sperm DFI, and the secondary observation index was sperm concentration, motility, survival rate, and TCM syndrome score. Safety observation indicators will include electrocardiogram, blood tests (including blood routine tests, liver and renal function), routine urine tests, and routine stool tests. All results were evaluated at the 4th and 8th week of the baseline, and the end of treatment.
DISCUSSION
This study will provide a basis for the efficacy and safety of WFY in the treatment of sperm DNA damage in male infertility with spleen and kidney qi deficiency and blood stasis.
Topics: Pregnancy; Female; Male; Humans; Semen; DNA Fragmentation; Infertility, Male; Spermatozoa; DNA Damage; Randomized Controlled Trials as Topic
PubMed: 36316921
DOI: 10.1097/MD.0000000000031226 -
Proceedings. Biological Sciences Sep 2020The bivalved crustacean ostracods have the richest fossil record of any arthropod group and display complex reproductive strategies contributing to their evolutionary...
The bivalved crustacean ostracods have the richest fossil record of any arthropod group and display complex reproductive strategies contributing to their evolutionary success. Sexual reproduction involving giant sperm, shared by three superfamilies of living ostracod crustaceans, is among the most fascinating behaviours. However, the origin and evolution of this reproductive mechanism has remained largely unexplored because fossil preservation of such features is extremely rare. Here, we report exceptionally preserved ostracods with soft parts (appendages and reproductive organs) in a single piece of mid-Cretaceous Kachin amber (approximately 100 Myr old). The ostracod assemblage is composed of 39 individuals. Thirty-one individuals belong to a new species and genus, gen. et sp. nov., exhibiting an ontogenetic sequence from juveniles to adults (male and female). Seven individuals are assigned to sp. (Cypridoidea, Candonidae, Paracypridinae) and one to sp. (Cytheroidea, Loxoconchidae). Our micro-CT reconstruction provides direct evidence of the male clasper, sperm pumps (Zenker organs), hemipenes, eggs and female seminal receptacles with giant sperm. Our results reveal that the reproduction behavioural repertoire, which is associated with considerable morphological adaptations, has remained unchanged over at least 100 million years-a paramount example of evolutionary stasis. These results also double the age of the oldest unequivocal fossil animal sperm. This discovery highlights the capacity of amber to document invertebrate soft parts that are rarely recorded by other depositional environments.
Topics: Amber; Animals; Arthropods; Crustacea; Female; Fossils; Genitalia; Genitalia, Male; Male; Reproduction; Spermatozoa; X-Ray Microtomography
PubMed: 32933445
DOI: 10.1098/rspb.2020.1661 -
Medicine Oct 2020The reproductive dilemma faced by men has always been the focus of the whole society. Idiopathic asthenozoospermia (AZS), as one of the common causes of male...
BACKGROUND
The reproductive dilemma faced by men has always been the focus of the whole society. Idiopathic asthenozoospermia (AZS), as one of the common causes of male infertility, lack of specific treatment. Traditional Chinese medicine has shown potential benefits in the management of male infertility. Yishentongluo decoction (YSTL) is a representative Chinese herbal formula; however, there is still no rigorous clinical trial supporting its application. Therefore, we designed a randomized controlled trial to evaluate the efficacy and safety of YSTL for patients with idiopathic AZS and explain the possible action mechanisms of YSTL in improving sperm motility.
METHODS
In this randomized controlled study, a total of 160 eligible patients will be assigned to YSTL group or the Levocarnitine oral solution group in a 1:1 ratio. The treatment period will be 12 weeks and the follow-up period will last 4 weeks. The primary outcome will be the the progressive (motility), sperm rate (%). Secondary outcomes will include the progressive (motility) + non-progressive (motility) sperm rate(%), total effective sperm count, inner mitochondrial membrane potential (MMP) in spermatozoa, and spouse pregnancy rate (%). Safety outcomes will cover electrocardiogram , blood tests (including blood routine test, hepatic function, and renal function), urine routine test, and stool routine test. The semen parameters, sperm MMP test, and all the safety outcomes will be performed at the baseline, 4th, 8th and 12th week. The pregnancy outcome will be evaluated at 4 weeks after treatment.
DISCUSSION
This study will provide initial evidence regarding the efficacy and safety of YSTL in the treatment of idiopathic AZS with kidney deficiency and blood stasis pattern. In addition, potential mechanisms of YSTL in improving sperm motility will be explored based on sperm MMP test.
TRIAL REGISTRATION
Chinese Clinical Trials Register identifier, ChiCTR2000033290, registered on 26 May 2020.
Topics: Asthenozoospermia; Drugs, Chinese Herbal; Humans; Male; Medicine, Chinese Traditional; Randomized Controlled Trials as Topic; Spermatozoa
PubMed: 33120757
DOI: 10.1097/MD.0000000000022662 -
Theriogenology Oct 2017This study investigated the effect of exposure to zearalenone (ZEN) and its metabolites on the characteristics of epididymal spermatozoa, testicular and epididymal...
This study investigated the effect of exposure to zearalenone (ZEN) and its metabolites on the characteristics of epididymal spermatozoa, testicular and epididymal biometry and histology, and the concentration of testosterone in blood plasma in male wild boars. The study was performed during more than one year on 18 clinically healthy male wild boars with initial and final body weight, of 39 ± 4 kg and 59 ± 3 kg, respectively. The animals were divided into two experimental groups (group I and group II) and one control group (group C) comprising 6 boars per group. Group I animals were administered per os pure zearalenone (ZEN) at 150 μg/kg BW for 7 consecutive days every two months, while group II animals received a dose of 50 μg/kg BW/day via feed that was naturally contaminated with ZEN. These male wild boars were exposed to ZEN over a period of 1 year. Control animals were fed a placebo. Testicles with epididymides of the boars were collected on the last day of the experiment within 3 min after slaughter. Blood samples were collected from each of the male wild boars. Testes and epididymides were measured and sampled for histological examination. Epididymides were dissected and epididymal spermatozoa were harvested. The spermatozoa were diluted with swine-specific BTS extender and stored at 17°C for 144 h. Sperm motility was analyzed with CASA, and other parameters including viability, acrosome integrity, DNA fragmentation index, lipid peroxidation and apoptosis were assessed with flow cytometry. In these wild boars, per os exposure to natural sources of ZEN or a combination of ZEN and its metabolites changed the testicular interstitium and led to modification of some epididymal sperm parameters. The interstitial glands in testes of experimental group I were markedly reduced and hyperemic with evident blood stasis in small capillaries. Also in group I were single degenerating seminiferous tubules. In both groups I and II, immediately after dilution of spermatozoa with BTS remarkable decreases in motility rate as well as in progressive motility and the subpopulation of cells with rapid movement were noted compared with the control group (P < 0.05). But unexpectedly, after 24 h incubation of boar semen in the BTS diluent, these sperm properties improved and were not significantly different from the control group. Thus, exposure to ZEN has no lasting but only a temporary, reversible effect on wild boar sperm motility. There was no influence of exposure to ZEN and its metabolites on the integrity of membranes, intensity of lipid peroxidation and apoptosis or on sperm chromatin structure. This study is the first using these direct measures of sperm motility and integrity to show a redundant adverse effect of ZEN exposure on wild boar sperm characteristics. There were no effects of exposure to ZEN and its metabolites on body weight, testicular and epididymal biometry, gonadosomatic index and the concentration of testosterone in blood plasma in the male wild boars.
Topics: Animals; Epididymis; Estrogens, Non-Steroidal; Lipid Peroxidation; Male; Spermatozoa; Sus scrofa; Testis; Testosterone; Zearalenone
PubMed: 28750295
DOI: 10.1016/j.theriogenology.2017.07.015 -
Medicine Mar 2021Sperm DNA fragmentation (SDF) may hinder embryonic development and growth, increasing the risk of spontaneous miscarriage, and is considered an important factor...
The effectiveness and safety of traditional Chinese herbal medicine for the treatment of male infertility associated with sperm DNA fragmentation: A protocol for systematic review and meta-analysis.
BACKGROUND
Sperm DNA fragmentation (SDF) may hinder embryonic development and growth, increasing the risk of spontaneous miscarriage, and is considered an important factor affecting male infertility (MI). Traditional Chinese herbal medicine is considered effective in the treatment of MI due to SDF by nourishing kidney essence or promoting blood circulation for removing blood stasis. The objective of this systematic review protocol is to evaluate the effectiveness and safety of traditional Chinese herbal medicine on the treatment of MI associated with SDF.
METHODS
We searched the PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP Chinese Science, Technology Journal Database, and Wanfang Database until the end of 2020 for English and Chinese published literature. Randomized controlled trials (RCTs) to evaluate the effectiveness and safety of traditional Chinese herbal medicine for the treatment of MI associated with SDF will be included. Study selection and data extraction were performed independently by 2 reviewers, and the quality evaluation and risk assessment were assessed by the Cochrane collaboration's tool, and use the RevMan 5.3 software for meta-analysis.
CONCLUSION
This study will evaluate the efficacy and safety of traditional Chinese herbal medicine for the treatment of MI due to SDF, which may provide some help for the clinician's decision.
PROSPERO REGISTRATION NUMBER
CRD42020221053.
Topics: DNA Fragmentation; Drugs, Chinese Herbal; Humans; Infertility, Male; Male; Medicine, Chinese Traditional; Spermatozoa; Meta-Analysis as Topic; Systematic Review as Topic
PubMed: 33655953
DOI: 10.1097/MD.0000000000024918