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Tissue & Cell May 2024Varicocele (VC) refers to expansion and tortuosity of spreading venous plexus in spermatic cord due to poor blood flow. This study aimed to investigate effects of Shugan...
Varicocele (VC) refers to expansion and tortuosity of spreading venous plexus in spermatic cord due to poor blood flow. This study aimed to investigate effects of Shugan Tongluo Qiangjing recipe (SGTL) on sperm DNA damage and oxidative stress in experimental VC (EVC) rats. EVC model was established by partial ligation of left renal vein. Spermatic vein diameter, testicular weight, sperm DNA fragmentation index (DFI) were evaluated. Telomere reverse transcriptase (TERT) expression, telomere gene transcription, and testicular tissue morphology were determined·HO, catalase, SOD, T-AOC were measured with colorimetry. SGTL significantly decreased spermatic vein diameter (P=0.000) and increased testicular weight (P=0.013) of rats compared those of EVC rats. SGTL maintained testicular tissue morphology in EVC rats. SGTL markedly reduced sperm DFI value in sperm of rats compared to EVC rats (P=0.000). SGTL significantly enhanced TERT expression and telomere gene transcription (P=0.028) in testis of rats compared to EVC rats. SGTL reduced HO levels (P=0.001) and promoted CAT activity (P=0.016), SOD activity (P=0.049), and T-AOC activity (P=0.047) of rats, compared to EVC rats. In conclusion, SGTL could reduce pathogenic process of EVC by reducing sperm DNA damage and regulating telomere length in EVC rats, which may be related to oxidative stress regulation.
PubMed: 38865824
DOI: 10.1016/j.tice.2024.102414 -
Human Genomics Jun 2024The prevalence of infertility among couples is estimated to range from 8 to 12%. A paradigm shift has occurred in understanding of infertility, challenging the notion... (Review)
Review
BACKGROUND
The prevalence of infertility among couples is estimated to range from 8 to 12%. A paradigm shift has occurred in understanding of infertility, challenging the notion that it predominantly affects women. It is now acknowledged that a significant proportion, if not the majority, of infertility cases can be attributed to male-related factors. Various elements contribute to male reproductive impairments, including aberrant sperm production caused by pituitary malfunction, testicular malignancies, aplastic germ cells, varicocele, and environmental factors.
MAIN BODY
The epigenetic profile of mammalian sperm is distinctive and specialized. Various epigenetic factors regulate genes across different levels in sperm, thereby affecting its function. Changes in sperm epigenetics, potentially influenced by factors such as environmental exposures, could contribute to the development of male infertility.
CONCLUSION
In conclusion, this review investigates the latest studies pertaining to the mechanisms of epigenetic changes that occur in sperm cells and their association with male reproductive issues.
Topics: Humans; Male; Epigenesis, Genetic; Infertility, Male; Spermatozoa; DNA Methylation; Animals
PubMed: 38835100
DOI: 10.1186/s40246-024-00626-4 -
Urology Annals 2024Varicocele is the dilatation of the scrotal veins and may affect sperm count and infertility. It is caused by congenital vein insufficiency or absence of venous valve.... (Review)
Review
Varicocele is the dilatation of the scrotal veins and may affect sperm count and infertility. It is caused by congenital vein insufficiency or absence of venous valve. The main treatment is by surgery, and currently, there are two minimally invasive choices: laparoscopic and microsurgical varicocelectomy. This systematic review aimed to record randomized clinical trials from various sources using all qualified studies up to June 2022. The assessed outcomes were operation time, hydrocele, hospital stay, change in semen parameter, recurrence rate, and pregnancy rate. The essential data extracted were Jadad score, publication year, age, and sample size. This systematic review consisted of 509 and 512 patients in the laparoscopic and microsurgery group, respectively, taken from 12 out of 281 studies. The result of this systematic review was significant difference in operation time between patients from two groups (weighted mean difference [WMD] -21.40, 95% confidence interval [CI]: -28.90--13.89); length of hospitalization (WMD: 0.38, 95% CI: 0.02-0.74); laparoscopic could significantly increase the risk of hydrocele by 3.30-fold (risk ratio [RR]: 3.30, 95% CI: 1.07-10.12); laparoscopic could significantly increase the recurrence rate by 6.98-fold (RR: 6.98, 95% CI: 3.46-14.08); no significant difference in spontaneous pregnancy between patients in both groups (RR: 0.81, 95% CI: 0.57-1.16); and laparoscopic surgery decreased the occurrence of sperm parameter changes by 40% (RR = 0.40, 95% CI: 0.25-0.62).
PubMed: 38818427
DOI: 10.4103/ua.ua_3_23 -
Clinical Case Reports Jun 2024Because of the complex embryonic origin of the abdominal venous structures, IVC and azygous systems can show numerous and even previously unreported anatomical...
KEY CLINICAL MESSAGE
Because of the complex embryonic origin of the abdominal venous structures, IVC and azygous systems can show numerous and even previously unreported anatomical variations and anomalies. Also, evaluating major vascular structures should not be dismissed in non-contrast-enhanced CT as it can provide valuable information about these structures.
ABSTRACT
Double IVC is a rare occurrence of IVC anatomical variations and congenital anomalies. Herein, we discuss a case of a very rare type of double IVC that has not been reported in the literature before. A non-contrast-enhanced CT study was performed for a 34-year-old patient who visited our ER to evaluate for urolithiasis, during which two IVCs were noted. Each renal vein joined the ipsilateral IVC at a perpendicular angle. Unusually, the right IVC was formed from the confluence of both left and right common iliac veins (CIV), and the left IVC-Instead of crossing the midline at the renal veins level and reuniting the right IVC-cranially contributed to the azygos vein formation and caudally joined the left CIV. Also, there were some small communicating veins between the two IVCs and the left gonadal vein was slightly dilated before suggesting a reflux from the left renal vein (LRV). A complimentary doppler ultrasound exam confirmed the diagnosis and revealed a left-side varicocele. Although rare cases of hemiazygos continuation and interiliac connections of left-side IVC in the cases of double-IVC have been reported previously, a complete confluence of CIVs is rare. The main differential diagnosis is retro-aortic left renal vein (RLRV) type IV which seems to have an oblique course. Radiologists and surgeons should expect previously unreported variations in the vena cava system. Furthermore, reviewing the main abdominal vasculature should not be dismissed in non-contrast CT exams.
PubMed: 38799539
DOI: 10.1002/ccr3.8981 -
Journal of Clinical Medicine May 2024Varicocele still today represents a common cause of infertility in young men. The treatment strategy remains a surgical approach such as scleroembolization; however,...
Varicocele still today represents a common cause of infertility in young men. The treatment strategy remains a surgical approach such as scleroembolization; however, the complete restoration of spermatic parameters afterward requires an average of six or more months to fully regain optimal seminal parameters. Recently, many studies have demonstrated the beneficial effects of Resveratrol in male fertility, given its potential anti-inflammatory, antiapoptotic, and mitochondrial effects. Therefore, Resveratrol-based nutraceuticals could be promising as an adjuvant to mitigate subfertility in patients with varicocele. In the present study, we retrospectively analyzed the effects of the administration of a Resveratrol-based nutraceutical after the scleroembolization procedure. The improvement of sperm quality in terms of number, motility, and morphology were considered to be the study's main endpoints. A spreadsheet program was used for data analysis, and a -value of <0.05 was considered significant. We found a statistically significant improvement in the spermatic parameters (sperm count and total motility) and an increase in normal sperm after only 4 months of treatment. The supplementation with a Resveratrol-based nutraceutical associated with the surgical procedure showed encouraging results if compared to data from a control group and the results reported in the literature linked to scleroembolization practice alone. In fact, there was a clear improvement in the seminal parameters at 4 months. This suggests the positive impact of the Resveratrol-based nutraceutical in synergizing with scleroembolization in reducing the time needed to fully recover sperm function.
PubMed: 38792465
DOI: 10.3390/jcm13102925 -
Journal of Clinical Medicine May 2024Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the... (Review)
Review
Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the prevalence of male factor infertility is about 7%. Among numerous other causes, the prevalence of male genital tract infections reportedly ranges between 10% and 35%. Leukocytospermia is found in 30% of infertile men and up to 20% in fertile men. Bacterial infections cause an inflammatory response attracting leukocytes, which produce reactive oxygen species (ROS) and release cytokines, both of which can cause damage to sperm, rendering them dysfunctional. Although leukocytospermia and bacteriospermia are both clinical conditions that can negatively affect male fertility, there is still debate about their impact on assisted reproduction outcomes and management. According to World Health Organization (WHO) guidelines, leukocytes should be determined by means of the Endtz test or with monoclonal antibodies against CD15, CD68 or CD22. The cut-off value proposed by the WHO is 1 × 10 peroxidase-positive cells/mL. For bacteria, Gram staining and semen culture are regarded as the "gold standard", while modern techniques such as PCR and next-generation sequencing (NGS) are allowing clinicians to detect a wider range of pathogens. Whereas the WHO manual does not specify a specific value as a cut-off for bacterial contamination, several studies consider semen samples with more than 10 colony-forming units (cfu)/mL as bacteriospermic. The pathogenic mechanisms leading to sperm dysfunction include direct interaction of bacteria with the male germ cells, bacterial release of spermatotoxic substances, induction of pro-inflammatory cytokines and ROS, all of which lead to oxidative stress. Clinically, bacterial infections, including "silent" infections, are treatable, with antibiotics being the treatment of choice. Yet, non-steroidal antiphlogistics or antioxidants should also be considered to alleviate inflammatory lesions and improve semen quality. In an assisted reproduction set up, sperm separation techniques significantly reduce the bacterial load in the semen. Nonetheless, contamination of the semen sample with skin commensals should be prevented by applying relevant hygiene techniques. In patients where leukocytospermia is detected, the causes (e.g. infection, inflammation, varicocele, smoking, etc.) of the leukocyte infiltration have to be identified and addressed with antibiotics, anti-inflammatories or antioxidants in cases where high oxidative stress levels are detected. However, no specific strategy is available for the management of leukocytospermia. Therefore, the relationship between bacteriospermia and leukocytospermia as well as their specific impact on functional sperm parameters and reproductive outcome variables such as fertilization or clinical pregnancy must be further investigated. The aim of this narrative review is to provide an update on the current knowledge on leukocytospermia and bacteriospermia and their impact on male fertility.
PubMed: 38792382
DOI: 10.3390/jcm13102841 -
International Urology and Nephrology May 2024To delve into the relationship between mean platelet volume (MPV) and semen quality in patients with varicocele.
OBJECTIVE
To delve into the relationship between mean platelet volume (MPV) and semen quality in patients with varicocele.
MATERIALS AND METHODS
A total of 246 varicocele patients and 120 healthy adult males were enrolled. Physical examinations and the color Doppler ultrasonography were conducted on patients with varicocele to confirm the diagnosis. Venous blood samples and semen samples were collected from all participants for subsequent analysis. A series of statistical analyses were conducted to assess the relationship between their MPV levels and semen quality. A series of statistical analyses were performed to assess the relationship between MPV and semen quality.
RESULTS
No statistically significant differences were found between body mass index (BMI), sexual hormones, semen volume, platelet count, and right testicular volume in all three groups (health subjects, varicocele without symptoms, and varicocele with infertility). When conducting regression analysis on two groups with varicocele, the results indicated that a lower MPV is associated with a reduced risk of varicocele accompanied by infertility (OR = 0.557 95% CI: 0.432-0.719, P < 0.001). Further correlation analysis in varicocele patients revealed that high MPV had a statistically negative impact on the occurrence of poor semen quality, affecting sperm concentration, progressive motility, and morphology (all P < 0.001). More importantly, when predicting varicocele associated with infertility, MPV demonstrated high diagnostic sensitivity (AUC = 0.745, P < 0.001).
CONCLUSION
Our results indicate that MPV is higher in varicocele with infertility and is closely related to semen quality, which may suggest an accompanying decline in semen quality associated with varicocele. However, these conclusions require further experimental validation.
PubMed: 38789870
DOI: 10.1007/s11255-024-04089-3 -
International Braz J Urol : Official... 2024Varicocele is a condition known to cause damage to seminal parameters and sperm function. Furthermore, it has been hypothesized that the varicocele effect on fertility...
PURPOSE
Varicocele is a condition known to cause damage to seminal parameters and sperm function. Furthermore, it has been hypothesized that the varicocele effect on fertility is time-dependent; however, little is known about the consequences of its establishment time on reproductive organs and/or sperm function. This study aimed to evaluate the effect of the duration of experimental varicocele on reproductive organs, sperm parameters, and sperm function.
MATERIALS AND METHODS
Varicocele induction surgeries were performed in Wistar rats aged 40 or 100 days old. At 160-day-old, analyses were performed, including biometry of reproductive organs (prostate, seminal vesicles, epididymis, and testis), sperm parameters (vitality, morphology, and motility), and sperm function tests (nuclear DNA integrity, acrosome integrity, and mitochondrial activity).
RESULTS
The analysis of the biometry of reproductive organs showed no differences between distinct ages in which varicocele was induced. The total abnormal sperm morphology was bigger in animals with varicocele induced to 100 days old than in animals with varicocele induced to 40 days old. Regarding nuclear DNA integrity, animals of varicocele induced to 100 days old showed worse results compared to animals of varicocele induced to 40 days old. Other parameters analyzed showed no differences between varicocele groups.
CONCLUSION
In this study conducted on rats, we conclude that varicocele adversely affects sperm, particularly its function. However, we did not observe a negative progressive effect on sperm.
Topics: Animals; Male; Varicocele; Rats, Wistar; Semen Analysis; Spermatozoa; Sperm Motility; Time Factors; Disease Models, Animal; Testis; Rats; Age Factors; Epididymis
PubMed: 38787514
DOI: 10.1590/S1677-5538.IBJU.2023.0412 -
Asian Journal of Andrology May 2024Varicocele has a prevalence of 15% in the population and represents a primary cause of infertility in 40% of cases and a secondary cause in approximately 80% of cases....
Varicocele has a prevalence of 15% in the population and represents a primary cause of infertility in 40% of cases and a secondary cause in approximately 80% of cases. It is considered the major correctable cause of male infertility. Despite its high prevalence in the infertile population, a large number of patients with varicocele do not experience reproductive difficulties. For this reason, it is still highly debated which parameters could be used to predict which patients with varicocele will be most likely to benefit from its repair. The main international and European guidelines state that treatment should only be considered in infertile patients with abnormal sperm quality. However, these guidelines do not help physicians to identify which of these patients may benefit from the treatment. Therefore, this narrative review collects the evidence in the literature on the usefulness of some factors as predictors of improvement, highlighting how some of them may be effective in an initial selection of patients to be treated, while others are promising but further studies are needed. Finally, a brief consideration on the possible role of artificial intelligence is proposed.
PubMed: 38783663
DOI: 10.4103/aja202420 -
International Urology and Nephrology May 2024To evaluate the clinical efficacy of microscopic internal spermatic-inferior epigastric vein anastomosis in the treatment of left varicocele and compare it with...
OBJECTIVE
To evaluate the clinical efficacy of microscopic internal spermatic-inferior epigastric vein anastomosis in the treatment of left varicocele and compare it with microscopic spermatic vein ligation for the same condition.
METHODS
A retrospective analysis of 74 patients with left varicocele between July 2020 and July 2022 was performed. The patients were divided into two groups based on the surgical method used. Group A consisted of 37 patients who underwent microscopic internal spermatic-inferior epigastric vein anastomosis, while Group B consisted of 37 patients who underwent microscopic spermatic vein ligation. Comparison of preoperative and postoperative semen quality, reproductive hormone levels, scrotal ultrasound results, duration of surgery, length of hospital stay, postoperative recurrence rate, and occurrence of complications with a follow-up time of 12 mo between two groups.
RESULTS
Both groups showed significant improvements in semen quality and serum reproductive hormone levels. The Group A demonstrated significantly improved sperm forward motility compared to Group B, but had longer operation times and hospital stays (P < 0.05). After 1 year of follow-up, 8 partners in Group A and 6 partners in Group B achieved natural conception, with no significant difference between the two groups. There were no recurrences observed in either group during the follow-up period, and no significant statistical differences were found in other postoperative observation indicators.
CONCLUSIONS
Both microscopic internal spermatic-inferior epigastric vein anastomosis and microscopic spermatic vein ligation are effective surgical methods for treating left varicocele. Anastomosis surgery provides greater improvement in sperm motility, although it is associated with longer operation times and hospital stays.
PubMed: 38782814
DOI: 10.1007/s11255-024-04090-w