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Ceska Gynekologie 2024Reactive oxygen species play a significant role in male fertility and infertility. They are essential for physiological processes, but when their concentration becomes... (Review)
Review
Reactive oxygen species play a significant role in male fertility and infertility. They are essential for physiological processes, but when their concentration becomes excessive, they can be a cause of various sperm pathologies. Seminal leukocytes and pathologically abnormal sperm are the primary sources of oxygen radicals in ejaculate. They negatively affect sperm quality, including DNA fragmentation and sperm motility impairment. Addressing increased concentrations of reactive oxygen species involves various appropriate lifestyle modifications and measures, including the use of antioxidants, treatment of urogenital infections, management of varicocele, weight reduction, and others. In many cases, these interventions can lead to adjustments in the condition and improvement in sperm quality. Such improvements can subsequently lead to enhanced outcomes in assisted reproduction or even an increased likelihood of natural conception. In some instances, the need for donor sperm may be eliminated. However, a key factor is adhering to a sufficiently prolonged treatment, which requires patience on the part of both, the physician and the patient.
Topics: Humans; Male; Reactive Oxygen Species; Infertility, Male; Spermatozoa; Fertility
PubMed: 38704227
DOI: 10.48095/cccg2024139 -
Kardiochirurgia I Torakochirurgia... Mar 2024It has been previously proposed in numerous studies that chronic venous insufficiency (CVI) has similar pathogenesis to varicocele in males. Varicocele has been...
INTRODUCTION
It has been previously proposed in numerous studies that chronic venous insufficiency (CVI) has similar pathogenesis to varicocele in males. Varicocele has been identified as the most common cause of infertility in men, accounting for 40% of cases.
AIM
This study investigates whether varicocele screening should be conducted in patients with CVI and, if so, which patients should undergo such screening.
MATERIAL AND METHODS
The study included 102 adult male patients with venous insufficiency complaints who presented to the cardiovascular surgery clinic between January 2023 and June 2023. Data were prospectively collected through medical history interviews and Doppler ultrasound measurements performed by a single radiologist. The relationship between non-normally distributed measurement data of the two groups was evaluated using the Mann-Whitney test, while the association between categorical variables was assessed using the χ test. ROC analysis was employed for determining predictive value. A type 1 error level of α = 0.05 was adopted.
RESULTS
The mean left great saphenous vein (GSV) diameter of those with varicocele (6.6 ±2.3) was significantly larger compared to the mean left GSV diameter of those without varicocele (5.3 ±2.6) ( = 0.004). The area under the ROC curve for left GSV diameter was 67% ( = 0.005). When varicocele screening is performed in patients with a left GSV diameter of 5.35 cm and above, sensitivity is 71.4% and specificity is 61.2%.
CONCLUSIONS
There is a significant association between left GSV diameter and varicocele ( = 0.004). Varicocele screening can be carried out with 71.4% sensitivity in adult male patients with a left GSV diameter of 5.35 cm and above. Both cardiovascular surgeons and radiologists can conduct varicocele screening by measuring pampiniform veins in patients with a left GSV diameter of 5.35 cm and above. This approach has the potential to reduce the incidence of varicocele and associated infertility.
PubMed: 38693978
DOI: 10.5114/kitp.2024.138486 -
IJU Case Reports May 2024Sperm immobility is a condition in which sperm are viable but not motile. We reported three patients with sperm immobility, who underwent testicular sperm...
INTRODUCTION
Sperm immobility is a condition in which sperm are viable but not motile. We reported three patients with sperm immobility, who underwent testicular sperm extraction-intracytoplasmic sperm injection.
CASE PRESENTATION
In case 1, a 32-year-old patient with sperm immobility had previously undergone intracytoplasmic sperm injection with ejaculated sperm; however, pregnancy was unsuccessful. testicular sperm extraction-intracytoplasmic sperm injection was performed at our clinic, and pregnancy was achieved. In case 2, a 23-year-old patient with clinical varicocele whose semen analysis revealed sperm immobility underwent varicocelectomy, without improvement. Using the hypo-osmotic swelling test technique, testicular sperm extraction-intracytoplasmic sperm injection was performed; however, pregnancy was not achieved. In case 3, a 44-year-old patient with sperm immobility underwent testicular sperm extraction, and motile sperm were retrieved. testicular sperm extraction-intracytoplasmic sperm injection using these sperm resulted in pregnancy.
CONCLUSION
Although testicular sperm extraction-intracytoplasmic sperm injection is not considered a solution in patients with sperm immobility, pregnancies were achieved. testicular sperm extraction-intracytoplasmic sperm injection may be successful in some cases in which ejaculated sperm intracytoplasmic sperm injection is unsuitable.
PubMed: 38686059
DOI: 10.1002/iju5.12702 -
Molecular Biology Reports Apr 2024Mechanisms by which varicocele causes infertility are not clear and few studies have reported that some miRNAs show expression alterations in men with varicocele....
BACKGROUND
Mechanisms by which varicocele causes infertility are not clear and few studies have reported that some miRNAs show expression alterations in men with varicocele. Recently, sperm promoter methylation of MLH1 has been shown to be higher in men diagnosed with varicocele. This study aimed to assess the potential effects of miR-145, which was determined to target MLH1 mRNA in silico on sperm quality and function in varicocele.
METHODS
Sperm miR-145 and MLH1 expressions of six infertile men with varicocele (Group 1), nine idiopathic infertile men (Group 2), and nine fertile men (control group) were analyzed by quantitative PCR. Sperm DNA fragmentation was evaluated by TUNEL and the levels of seminal oxidative damage and total antioxidant capacity were analyzed by ELISA.
RESULTS
Our results have shown that sperm expression of miR-145 was decreased in Group 1 compared to Group 2 (P = 0.029). MLH1 expression was significantly higher in Group 2 than the controls (P = 0.048). Total antioxidant level and sperm DNA fragmentations of Group 1 and Group 2 were decreased (P = 0.001 and P = 0.011, respectively). Total antioxidant capacity was positively correlated with sperm concentration (ρ = 0.475, P = 0.019), total sperm count (ρ = 0.427, P = 0.037), motility (ρ = 0.716, P < 0.0001) and normal morphological forms (ρ = 0.613, P = 0.001) and negatively correlated with the seminal oxidative damage (ρ=-0.829, P = 0.042) in varicocele patients.
CONCLUSION
This is the first study investigating the expressions of sperm miR-145 and MLH1 in varicocele patients. Further studies are needed to clarify the potential effect of miR-145 on male fertility.
Topics: Humans; Male; MicroRNAs; Varicocele; Oxidative Stress; DNA Fragmentation; MutL Protein Homolog 1; Spermatozoa; Adult; Infertility, Male; Semen; Sperm Motility; Antioxidants
PubMed: 38683237
DOI: 10.1007/s11033-024-09534-1 -
Journal of Clinical Ultrasound : JCU Apr 2024The aim of this study was to investigate the relationship between left-sided varicocele and epididymitis or epididymo-orchitis.
OBJECTIVE
The aim of this study was to investigate the relationship between left-sided varicocele and epididymitis or epididymo-orchitis.
MATERIALS AND METHODS
The study included 72 patients with left side epididymitis (EP) or epididymo-orchitis (EPO) (Group 1) and a control group of 72 patients without EP or EPO (Group 2). Those with right EP-EPO were excluded due to possible other underlying retroperitoneal pathologies causing varicocele. Groups were evaluated for presence of left side varicocele, varicocele grade and pampiniform plexus vein diameter.
RESULTS
The average age was 38 ± 8.4 years (range, 18-50 years) in Group 1, and 36 ± 9.1 years (range, 16-47 years) in Group 2. Varicocele was significantly more common in patients with EP or EPO (p < .001). The rate of varicocele was 66.7% (48/72) in Group 1, and 22.3% (16/72) in Group 2. The median grade of varicocele was 2 in Group 1, and 0 in Group 2. Pampiniform plexus vein diameters were found to be significantly larger in patients with EP or EPO compare to patients without EP and EPO. The median vein diameter was 3.3 mm with the 25th and 75th percentiles at 2.7 and 3.8 mm, and was 1.9 mm with the 25th and 75th percentiles at 1.7 and 2.3 mm, respectively (p < .001).
CONCLUSIONS
Left-sided varicocele was significantly more common in patients with EP or EPO and it is an important cause for the development of EP/EPO because of chronic venous stasis.
PubMed: 38651691
DOI: 10.1002/jcu.23694 -
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 -
Zhonghua Nan Ke Xue = National Journal... Dec 2023Objective: To observe roproductive hormone levels in varicocele patients during a cycle (6 years) of Wu Yun Liu Qi, and explore whether the cycle had effect on the...
Objective: To observe roproductive hormone levels in varicocele patients during a cycle (6 years) of Wu Yun Liu Qi, and explore whether the cycle had effect on the roproductive hormone levels. Methods: Data of roproductive hormone levels in varicocele patients from 2015 to 2020 were analyzed retrospectively. FSH、LH、T、PRL、E2 levels and T/E2 ratio were compared among the six years. According to Chinese sexagenary cycle heavenly stems and earthly branches of each year from 2015 to 2020 its yunqi characteristics were determined. Results: Totally data of 848 cases of varicocele patients were collected from 2015 to 2020. Among which, in 2015 (Yiwei year) there were 57 cases, in 2016 (Bingshen year) 83 cases, in 2017 (Dingyou year ) 133 cases, in 2018(Wuxu year) 156 cases, in 2019(Sihai year) 274 cases, and in 2020(Gengzi year) 145 cases. The levels of FSH、LH、PRL、T were not diferrent statistically from the six years except individual year. However, the level of E2 in 2016 when the Yunqi was Shao Yang Xiang Huo Si Tian and Jue Yin Feng Mu Zai Quan obviously higher than other years excpet 2018( All P< 0.05). And T/E2 ratio was lower in 2016 than other years except 2018 and 2020( All P< 0.05). Conclusions: Shi Xiang factors of Wu Yun Liu Qi had effect on roproductive hormone levels in varicocele patients, showing by higher E2 level in Yinshen year when the Shi Xiang factors may have bad effect on human fertility.
Topics: Male; Humans; Qi; Varicocele; Retrospective Studies; Follicle Stimulating Hormone
PubMed: 38639955
DOI: No ID Found -
Urologia Apr 2024Varicocele is a condition in which the veins in the spermatic cord become enlarged and twisted. Varicocele is widely recognized as the leading cause of male infertility...
INTRODUCTION
Varicocele is a condition in which the veins in the spermatic cord become enlarged and twisted. Varicocele is widely recognized as the leading cause of male infertility due to its significant impact on reproductive health in men. The aim of this study was to investigate the relationship between the diameter of the varicose vein and the recovery rate of the spermogram after varicocelectomy. Also, the effect of body mass index (BMI) on sperm parameters after varicocelectomy.
METHODS
This descriptive and analytical cross-sectional study was conducted in Valiasr Hospital's urology clinic in Qaemshahr, Iran from August 2018 to August 2019 and involved 27 men with unilateral left varicocele who met the inclusion criteria for surgical repair. Before the operation, we recorded demographic information, the maximum diameter of varicose veins in the pampiniform plexus, and spermogram results. We repeated semen analysis 3 months after the operation and analyzed the data using Statistical Package for the Social Sciences version 21 software.
RESULTS
Our findings showed that the diameter of the varicose vein before varicocelectomy was not significantly associated with the improvement of main semen parameters after the operation. Furthermore, our study suggested that a lower body mass index might contribute to a greater improvement in sperm motility, as individuals with lower BMI showed more significant improvement.
DISCUSSION
There is a significant inverse relationship between BMI and sperm motility improvement after surgery. Patients with a lower BMI showed greater improvement in sperm motility.
PubMed: 38634553
DOI: 10.1177/03915603241247290 -
Cirugia Pediatrica : Organo Oficial de... Apr 2024Varicocele is the abnormal dilatation of the pampiniform plexus. It occurs in 15-20% of pre-adolescent/adult males. Varicocele diagnosis is important since it can induce... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Varicocele is the abnormal dilatation of the pampiniform plexus. It occurs in 15-20% of pre-adolescent/adult males. Varicocele diagnosis is important since it can induce testicular hypertrophy and fertility issues in adulthood. The objective of this study was to assess whether complications, including varicocele recurrence, depend on the vascular occlusion technique used -clipping + division vs. vascular sealer- in the laparoscopic Palomo technique used in our institution.
MATERIALS AND METHODS
A longitudinal, prospective study was carried out from 2017 to 2021. Two therapeutic groups were created according to the vascular occlusion method used during laparoscopic varicocelectomy -clipping + division vs. vascular sealer. Patients were randomly allocated to the groups in a systematic alternating consecutive manner. Variables -age, varicocele grade according to the Dubin-Amelar classification, postoperative complications, follow-up, and varicocele recurrence- were analyzed according to the method employed.
RESULTS
A total of 37 boys, with a mean age of 12 years (10-15 years) and a mean follow-up of 12 months, were studied. In 20 patients (54.1%), clipping + division was used, and in the remaining 17 (45.9%), the vascular sealer was employed. 24.3% had symptomatic Grade II varicocele and 75.7% had Grade III varicocele. 32.4% of the children had postoperative complications during follow-up. 29.7% of the patients had hydrocele following surgery -8 boys from the sealing group and 3 boys from the clipping group-, with 13.5% requiring re-intervention as a result of this. None of the patients had varicocele recurrence.
CONCLUSIONS
The laparoscopic Palomo technique is safe and effective, with good results in pediatric patients and few postoperative complications, regardless of the vascular occlusion device used. In our study, no statistically significant differences regarding the use of clipping or vascular sealer in this laparoscopic technique were found. However, further studies with a larger sample size are required to find potential differences.
Topics: Male; Adolescent; Humans; Child; Prospective Studies; Varicocele; Retrospective Studies; Laparoscopy; Postoperative Complications; Treatment Outcome
PubMed: 38623800
DOI: 10.54847/cp.2024.02.16 -
Zhonghua Nan Ke Xue = National Journal... Aug 2023Centipede is an important traditional Chinese medicine with a long history of clinical application and a wide range of effects, and its use in the field of andrology is...
Centipede is an important traditional Chinese medicine with a long history of clinical application and a wide range of effects, and its use in the field of andrology is also expanding.In this study, the drug experience and clinical research progress of centipede in erectile dysfunction, chronic prostatitis, prostate cancer, varicocele, chronic epididymitis, epididymal nodules, functional non-ejaculation, scrotal eczema and other diseases were reviewed.
Topics: Male; Animals; Humans; Chilopoda; Andrology; Epididymis; Epididymitis; Erectile Dysfunction
PubMed: 38619525
DOI: No ID Found