Association between semen collection time and semen parameters: an observational study / 亚洲男科学杂志(英文版)

The process of semen collection plays a key role in the quality of semen specimens. However, the association between semen collection time and semen quality is still unclear. In this study, ejaculates by masturbation from 746 subfertile men or healthy men who underwent semen analysis were examined. The median (interquartile range) semen collection time for all participants was 7.0 (5.0-11.0) min, and the median time taken for semen collection was lower in healthy men than that in subfertile men (6.0 min vs 7.0 min). An increase in the time required to produce semen samples was associated with poorer semen quality. Among those undergoing assisted reproductive technology (ART), the miscarriage rate was positively correlated with the semen collection time. After adjusting for confounders, the highest quartile (Q4) of collection time was negatively associated with semen volume and sperm concentration. A longer time to produce semen samples (Q3 and Q4) was negatively correlated with progressive and total sperm motility. In addition, there was a significant negative linear association between the semen collection time and the sperm morphology. Higher risks of asthenozoospermia (adjusted odds ratio [OR] = 2.06, 95% confidence interval [CI]: 1.31-3.25, P = 0.002) and teratozoospermia (adjusted OR = 1.98, 95% CI: 1.10-3.55, P = 0.02) were observed in Q3 than those in Q1. Our results indicate that a higher risk of abnormal semen parameter values was associated with an increase in time for semen collection, which may be related to male fertility through its association with semen quality.

Clinical Observation on Herb-partitioned Moxibustion on Navel Combined with Yishen Tongluo Prescription in Treatment of Infertility Induced by Idiopathic Asthenozoospermia with Kidney-Yang Deficiency and Collateral Obstruction Syndrome / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription in the treatment of infertility induced by idiopathic asthenozoospermia （iAZS） with kidney-Yang deficiency and collateral obstruction syndrome and its effect on sperm DNA damage and superoxide dismutase （SOD） in the seminal plasma. MethodsA total of 112 eligible patients who met the inclusion criteria were randomly divided into an observation group （56 cases） and a control group （56 cases）. The patients in the observation group were treated with herb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription，while those in the control group received levocarnitine oral liquid. The primary observation indicators included spouse pregnancy rate，progressive motility （PR），and total sperm motility，and the secondary observation indicators included sperm DNA fragmentation index （DFI），SOD in the seminal plasma， and improvement of TCM syndromes. The treatment cycle was 12 weeks. Before and after treatment，the PR，total sperm motility，sperm DFI，SOD in the seminal plasma， and TCM syndrome scores were recorded. The patients were followed up for 12 weeks and the pregnancy status of spouses within 24 weeks （half a year） was recorded. The clinical efficacy of the two groups was evaluated. ResultThe pregnancy rate of spouses in the observation group was 15.69% （8/51）， higher than 3.85% （2/52） in the control group （χ2=4.118，P<0.05）. The total effective rate of the observation group was 88.24%（45/51）， superior to 69.23% （36/52）in the control group （Z=-3.402，P<0.01）. After treatment， PR， total sperm motility，sperm DFI， SOD in the seminal plasma， and TCM syndromes of the two groups were improved compared with those before treatment （P<0.05）， and the observation group was superior to the control group （P<0.05）. ConclusionHerb-partitioned moxibustion on the navel combined with Yishen Tongluo prescription in the treatment of iAZS-induced infertility patients with kidney-Yang deficiency and collateral obstruction syndrome can increase PR，total sperm motility， and SOD level in the seminal plasma， reduce sperm DFI，improve the TCM symptoms of patients， and improve the pregnancy rate of spouses. The mechanism may be attributed to the fact that this treatment can increase the SOD level in the seminal plasma of patients，enhance the body's antioxidant function，protect sperm from oxidative stress damage，and reduce sperm DFI.

Abnormal semen parameters among males in infertile couples: a cross sectional study from a tertiary care centre

Background: In India, the prevalence of primary infertility ranges from 3.9% to 16.8%. Male factor contributes 40-50% of this. Male factor infertility is indicated by decreased sperm concentration, reduced motility, vitality or abnormal sperm morphology. Semen analysis is the single most important investigation to detect male factor infertility. The aim of this study was to analyse the prevalence of abnormal semen parameters among males in infertile couples and their association with contributing factors.Methods: This cross-sectional hospital-based study was carried out in the Department of Pathology at Lady Hardinge Medical College and Smt. Sucheta Kriplani Hospital. A total of 400 cases were analyzed during a period of 6 months. Detailed history of the couple was taken. Semen analysis was done using automated semen analyzer (SQA-vision) after 3 days of abstinence according to the WHO 5th edition 2010 guidelines. The results were analysed using excel sheet and SPSS software.Results: In the present study, 122 cases (30.5%) out of 400 cases had abnormal semen parameters. Most common abnormality detected was asthenozoospermia (14.3%) followed by oligozoospermia (13.8%), azoospermia (10.5%) and teratozoospermia (10.5%). There was significant association of alcohol intake, obesity and trauma with abnormal semen parameters.Conclusions: Asthenozoospermia was the most common abnormality noted in this study. Lifestyle modifications along with timely medical attention in male partners of infertile couples can improve the semen quality.

Gene transcription profiling of astheno- and normo-zoospermic sperm subpopulations / 亚洲男科学杂志(英文版)

Spermatozoa contain a repertoire of RNAs considered to be potential functional fertility biomarkers. In this study, the gene expression of human sperm subpopulations with high (F1) and low (F2) motility from healthy normozoospermic (N) and asthenozoospermic (A) individuals was evaluated using RNA microarray followed by functional genomic analysis of differentially expressed genes. Results from A-F1 versus N-F1, A-F2 versus N-F2, N-F1 versus N-F2, and A-F1 versus A-F2 comparisons showed a considerably larger set of downregulated genes in tests versus controls. Gene ontology (GO) analysis of A-F1 versus N-F1 identified 507 overrepresented biological processes (BPs), several of which are associated with sperm physiology. In addition, gene set enrichment analysis of the same contrast showed 110 BPs, 36 cellular components, and 31 molecular functions, several of which are involved in sperm motility. A leading-edge analysis of selected GO terms resulted in several downregulated genes encoding to dyneins and kinesins, both related to sperm physiology. Furthermore, the predicted activation state of asthenozoospermia was increased, while fertility, cell movement of sperm, and gametogenesis were decreased. Interestingly, several downregulated genes characteristic of the canonical pathway protein ubiquitination were involved in asthenozoospermia activation. Conversely, GO analysis of A-F2 versus N-F2 did not identify overrepresented BPs, although the gene set enrichment analysis detected six enriched BPs, one cellular component, and two molecular functions. Overall, the results show differences in gene transcription between sperm subpopulations from asthenozoospermic and normozoospermic semen samples and allowed the identification of gene sets relevant to sperm physiology and reproduction.

Transurethral seminal vesiculoscopy in treatment of oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction: A report of 8 cases / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the utility of transurethral seminal vesiculoscopy with a slender ureteroscope in the treatment of severe oligoasthenozoospermia secondary incomplete ejaculatory duct obstruction (EDO).@*METHODS@#From March 2018 to September 2018, the clinical data of 8 patients with severe oligoasthenozoospermia secondary incomplete EDO treated by the technique of transurethral seminal vesiculoscopy in the Peking University Third Hospital Reproductive Center were analyzed. Preoperative routine included semen analysis, hormone determination, transrectal ultrasonography, pelvic magne-tic resonance examination and other examinations. All the patients were diagnosed with severe oligoasthenozoospermia secondary to incomplete EDO. All the patients were operated by the same surgeon with multiple cases of experience in transurethral surgery, and 1 year follow-up was conducted to evaluate the surgical effect.@*RESULTS@#The average age of the 8 patients was 29 years, and the average operation time was 32 min. Preoperative transrectal ultrasound indicated 6 cases of ejaculatory duct cyst or Mullerian cyst, 1 case of prostate calcification and bilateral seminal vesicle dilatation. The average maximum transverse diameter of the right seminal vesicle in pelvic MRI was 33.60 mm (24.63-42.28 mm), the average maximum transverse diameter of the left seminal vesicle was 32.85 mm (25.91-44.89 mm), the ave-rage maximum antero-posterior diameter was 27.99 mm (21.36-33.12 mm), the average maximum width of the seminal vesicle duct was 10.53 mm (5.93-19.39 mm). There were 5 cases of ejaculatory duct cyst, 2 cases of seminal vesicle hemorrhage, and 1 case of Mullerian cyst. The semen volume [(2.64±0.80) mL], the sperm concentration [(49.76±8.50)×106/mL], and the motility (grade a+b) [(25.76±6.48)%] in postoperation were significantly higher than those in preoperation [(1.46±0.50) mL, (28.78±5.17)×106/mL, and (2.88±0.93)%, P < 0.05]. Two patients conceived naturally during the follow-up of 6 months after surgery. There were no severe complications, such as retrograde ejaculation, urinary incontinence or rectal injury.@*CONCLUSION@#The technique of transurethral seminal vesiculoscopy is safe and effective for treating severe oligoasthenozoospermia secondary to incomplete EDO. However, due to the small sample size of this study, short follow-up time, and the uncertainty in seminal vesicle surgery, it still needs to be further confirmed by long-term follow-up studies with large samples.

Clinical effect of acupuncture combined with traditional Chinese medicine in treatment of oligozoospermia/asthenozoospermia: a meta-analysis / 针刺研究

OBJECTIVE: To evaluate the clinical effect of acupuncture combined with Chinese medicine in the treatment of oligozoospermia/asthenozoospermia. METHODS: Randomized controlled trials (RCTs) of acupuncture combined with traditional Chinese medicine (TCM) in the treatment of oligozoospermia/asthenozoospermia published up to February 15, 2019 were searched from databases of CNKI, CBM, Wanfang Data, VIP, PubMed, Embase, and The Cochrane Library. Two reviewers independently performed quality assessment and data extraction of the studies, and RevMan5.3 was used to perform the meta-analysis. RESULTS: A total of 13 articles with 12 RCTs were included, with a total of 1 183 patients. The meta-analysis showed that acupuncture combined with TCM achieved a significantly higher pregnancy rate than TCM alone in the treatment of oligozoospermia/asthenozoospermia(risk ratio [RR] ＝1.46, 95% confidence interval [CI]: 1.13－1.90，P＝0.004). The patients treated with acupuncture combined with TCM had a significantly higher effective rate than those treated with TCM alone (RR＝1.17, 95% CI：1.10－1.24, P<0.000 01). Compared with TCM alone, acupuncture combined with TCM achieved significantly better improvements in sperm survival rate (mean difference [MD]＝8.28, 95% CI: 6.48－10.08, P<0.000 01), sperm motility (MD＝17.01, 95%CI：11.06－22.96, P<0.000 01), sperm concentration (MD＝8.71, 95%CI：5.92－11.50, P<0.000 01), and number of grade A sperms (MD＝6.39, 95%CI：5.27－7.50, P<0.000 01). CONCLUSION: Acupuncture combined with TCM has a better clinical effect than TCM alone in the treatment of oligozoospermia/asthenozoospermia. Due to the low methodological quality of the studies included in this analysis, acupuncture combined with TCM in the treatment of oligozoospermia/asthenozoospermia should be used based on patients' conditions in clinical practice.

Effectiveness and Safety Evaluation of Qixiong Zhongzi Decoction () in Idiopathic Asthenozoospermia Treatment: A Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To evaluate the clinical effectiveness and safety of the Chinese medicine (CM) Qixiong Zhongzi Decoction (, QZD) in the treatment of patients with idiopathic asthenozoospermia.@*METHODS@#A total number of 66 patients with idiopathic asthenozoospermia were included and randomly divided into treatment and control groups by SAS-generated code from January 2015 to August 2016, 33 patients in each group. Patients in the treatment group were administered with 150 mL of QZD twice a day, whereas those in the control group were given 1 g of levocarnitine oral liquid twice a day. The two groups received the indicated medication for 12 weeks and were then followed up for 4 weeks. The primary outcome was sperm motility, and the secondary therapeutic indices were sperm volume, density, pregnancy probability, and CM syndrome score. The comparison between groups was carried out at 4, 8 and 12 weeks, respectively. The safety was determined before and after treatment.@*RESULTS@#(1) Drop-off: 5 cases (7.58%) were lost after treatment (2 from the treatment group and 3 from the control group). (2) Primary outcomes: after 8- and 12-week treatment, the progressive sperms in the two groups were significantly higher than the baseline (all P0.05), however, the CM syndrome score of the treatment group significantly declined compared with baseline level at each time points (all P<0.05). (4) Safety: no obvious side reactions were found during the treatment in both groups.@*CONCLUSION@#QZD could improve the progressive and non-progressive grade sperm in the treatment of idiopathic asthenozoospermia. It is safe with no obvious side effects.

Polymorphism of the testis-specific serine/threonine kinase 2 gene and risk of asthenozoospermia in Côte d'Ivoire

Background: The testis-specific serine/threonine protein kinase (TSSK2) is an indispensable protein responsible for the mobility of spermatozoa expressed specifically in the germ cells during spermatogenesis and present in the mature spermatozoa. Its gene mutation could constitute a risk of infertility. The aim of this study is to investigate the polymorphism of this TSSK2 gene in men with asthenozoospermia.Methods: The ejaculates were obtained from patients attending the reproductive biology unit of Institut Pasteur of Côte d’Ivoire for their spermiological evaluations. The semen analyses are performed with the automatic sperm analyzer SQA-Vision. 30 sperms, including 20 asthenozoosperms and 10 normosperms, were selected from their spermiological results and the spermatozoa DNA was extracted by the phenol/chloroform method. Direct Sequencing of the spermatozoa DNA fragments was done using the Sanger method. The frequencies of mutation were analysis with the Fisher and Mann-Whitney tests.   Results: It was revealed 17 mutations in 22 ejaculates. The frequent mutations are c.839C>T (T280M), c.816G>C (L372L), c.1026G>A (R342R), c.785A>C (H262P) and c.80A>G (K27R) with respectively frequencies of 50.0%, 26.67%, 16.67%, 13.33% and 10.0%. The analysis of these mutations indicated a significant difference in the frequency of occurrence of mutations between normosperms and asthenozoosperms (p-value = 0.01).Conclusions: This study shows that mutations in the TSSK2 gene are more common in asthenozoosperm ejaculates than normosperm ejaculates. This fact suggests the probable association of mutations in the TSSK2 gene with asthenozoospermia.

Seminal Cell-Free DNA Test for the Management of Male Infertility

The use of extracellular or circulating nucleic acids (Cfs), as a diagnostic or prognostic tool in oncology, has been broadly documented. However, their use in gynecology-obstetrics as non-invasive biomarkers in the management of infertility has become a recurring fact. The circulating nucleic acids are constituted by: free DNA which can be long or short DNA strands resulting from the apoptotic or necrotic processes, the free RNA containing: micro-RNAs (miRNAs) which are short single-stranded ribonucleic acids (RNA) that are able to deter the production of protein from a gene, Piwi-interacting RNAs (PiRNAs) that are small RNAs expressed in germ cells or even early embryos and small interfering RNAs (siRNAs) that are small RNAs that can bind specifically to a messenger RNA sequence and prevent gene expression by cleaving that RNA. The presence of circulating nucleic acids in many biological fluids such as: urine, seminal plasma and serum, the fact that they are easy to detect, the variation of their level according to the physiopathological conditions of the body and their implication in many biological processes such as folliculogenesis, steroidogenesis and spermatogenesis make nucleic acids circulating important biomarkers of interest in the management of male infertility. They compose a real complementary help for practitioners of medically assisted procreation. As a result, circulating nucleic acids are a promising avenue in the prevention of implantation failures. In this article, we will seek to affirm further, their importance in the management of male infertility, by highlighting their different uses.

Asthenozoospermia is not correlated with 3' UTR polymorphisms of the GRP78 gene / 中华男科学杂志

<p><b>Objective</b>To investigate the correlation of the single nucleotide polymorphisms (SNPs) rs12009, rs1140763 and rs16927997 in the 3'-untranslated region (3'UTR) of the glucose-regulated protein 78 (GRP78) gene with the risk of male asthenozoospermia (AZS).</p><p><b>METHODS</b>We included 400 AZS patients in the AZS group and another 400 fertile men as normal controls. Using the SNaPshot technique, we genotyped the rs12009, rs1140763 and rs16927997 polymorphisms in the 3'UTR of the GRP78 gene in all the male subjects and analyzed the association of the three SNPs with AZS.</p><p><b>RESULTS</b>The percentage of progressively motile sperm was significantly lower in the AZS group than in the normal controls (［20.09 ± 8.18］ % vs ［57.16 ± 13.45］ %, P <0.01). Three genotypes of CC, CT and TT and 2 alleles of C and T were found in rs12009 and rs1140763 of the GRP78 gene, and another three genotypes of GG, GA and AA and two alleles of G and A were observed in rs16927997. There were no statistically significant differences between the control and AZS groups in the frequencies of the C and T alleles in rs12009 (44.3% vs 47.3% and 55.7% vs 52.7%, P >0.05) or rs1140763 (50.0% vs 52.0% and 50.0% vs 48.0%, P >0.05) or those of the G and A alleles in rs16927997 (6.0% vs 4.4% and 94.0% vs 95.6%, P >0.05), nor in the genotypes and allele frequencies of the 3 polymorphisms (P >0.05). Furthermore, three haplotypes of C-C-A, T-C-G and T-T-A were observed in the male subjects but showed no evident correlation between the AZS and normal control groups.</p><p><b>CONCLUSIONS</b>The polymorphisms in the 3'UTR of the GRP78 gene are not correlated with the risk of male asthenozoospermia.</p>

The expression of the new epididymal luminal protein of PDZ domain containing 1 is decreased in asthenozoospermia / 亚洲男科学杂志(英文版)

Spermatozoa are not mature until they transit the epididymis where they acquire motility and the ability to fertilize an egg through sequential modifications. The epididymis has three functional regions, caput, corpus, and cauda, and the luminal proteins of the epididymis play important roles in the above modifications. However, the proteins with differential enrichment between the caput and cauda are still largely unknown. To reveal the functions of the caput and cauda during sperm maturation, luminal proteins from caput and cauda of mice were analyzed by isobaric tag for relative and absolute quantitation (iTRAQ). Overall, 128 differentially enriched proteins were found, of which 46 were caput enriched and 82 were cauda enriched. Bioinformatic analysis showed that lipid metabolism was active in the caput; while anion- and cation-binding activity and phosphorus and organophosphate metabolism were active in the cauda. A new epididymal luminal protein, the caput-enriched PDZ domain containing 1 (Pdzk1), also named Na+/H+ exchange regulatory cofactor 3 (NHERF3), which plays a critical role in cholesterol metabolism and carnitine transport, was found in the lipid metabolism. Western blotting and immunofluorescence analyses showed that Pdzk1 was expressed in the epididymis but not in the testis, and localized at the middle piece of the sperm tail. Pdzk1 protein level was also reduced in the spermatozoa in case of asthenozoospermic patients compared with that in normozoospermic men, suggesting that Pdzk1 may participate in sperm maturation regulation and may be associated with male infertility. These results may provide new insights into the mechanisms of sperm maturation and male infertility.

Effects of fufangxuanju capsule combined with tamoxifen citrate tablet on seminal plasma biochemistry in patients with asthenospermia / 中国医师进修杂志

Objective To study the effect of fufangxuanju capsule combined with tamoxifen citrate tablet on seminal plasma biochemistry in patients with asthenospermia.Methods One hundred and fifty patients with asthenospermia were divided into group A(treated with tamoxifen citrate tablet,45 cases),group B(treated with fufangxuanju capsule,45 cases)and group C(treated with tamoxifen citrate tablet and fufangxuanju capsule, 60 cases) according to random digits table method.All patients were treated for 2 months.The semen parameters and semen biochemical parameters were detected, and the pregnancy rate was followed up for 6 months.Results The semen volume,sperm density,sperm survival rate, grade a sperm percentage and grade a+b sperm percentage after treatment in group C were significantly higher than those in group A and group B: (4.41 ± 1.21) ml vs.(4.01 ± 0.87) and(3.97 ± 1.10)ml,(24.63 ± 4.44)×109/L vs.(20.45 ± 4.69)and(18.04 ± 3.05)×109/L,(64.05 ± 7.98)% vs.(45.15 ± 8.87)% and(51.47 ± 10.01)%,(26.05 ± 5.62)% vs.(15.01 ± 3.67)% and(18.31 ± 2.21)%, (55.30 ± 9.65)% vs.(38.07 ± 8.26)% and (44.35 ± 9.03)%, and there were statistical differences (P<0.05).There were no statistical differences between group A and group B (P>0.05).The fructose, a-glucosidase and acid phosphatase levels after treatment in group C were significantly higher than those in group A and group B:(30.36 ± 5.30)mmol/L vs.(24.01 ± 6.32)and(26.03 ± 5.53)mmol/L,(60.61 ± 8.86) U/L vs.(45.46 ± 8.87)and(50.56 ± 5.56)U/L,(140.12 ± 10.25)U/L vs.(98.36 ± 8.36)and(100.36 ± 8.36) U/L,and there were statistical differences(P<0.05);there were no statistical differences between group A and group B(P>0.05).The zinc after treatment in group C was significantly higher than that in group A and group B:(2 406.96 ± 187.60)μmol/L vs.(1 508.30 ± 135.87)and(2 001.30 ± 130.26)μmol/L,the zinc after treatment in group B was significantly higher than that in group A, and there were statistical differences(P<0.05).The pregnancy rate within 6 months in group C was significantly higher than that in group A and group B: 51.6% (31/60) vs.37.8% (17/45) and 33.3% (15/45), and there was statistical difference (P<0.05).There was no statistical difference between group A and group B (P>0.05).Conclusions Fufangxuanju capsule combined with tamoxifen citrate tablet can increase the concentration of fructose, a-glycosidase, zinc and acid phosphatase in seminal plasma, and improve the semen quality of patients with asthenospermia so as to increase the woman pregnancy rate.

Expressions of SLC22A14 and SPAG6 proteins in the ejaculated sperm of idiopathic asthenozoospermia patients / 中华男科学杂志

Objective@#To investigate the expressions of solute carrier family 22 member 14 (SLC22A14) and sperm-associated antigen 6 (SPAG6) in the sperm of idiopathic asthenospermia men.@*METHODS@#We collected semen samples from 50 idiopathic asthenozoospermia patients and another 50 normal sperm donors, purified the sperm by discontinuous density centrifugation on Percoll gradients, and then determined the mRNA and protein expressions of SLC22A14 and SPAG6 by RT-PCR and Western blot, respectively.@*RESULTS@#Compared with the normal controls, the idiopathic asthenozoospermia patients showed significantly decreased mRNA expressions of SLC22A14 (0.77 ± 0.08 vs 0.53 ± 0.10, P<0.01) and SPAG6 (0.78 ± 0.09 vs0.52 ± 0.10 , P<0.01) and protein expressions of SLC22A14 (0.80 ± 0.09 vs 0.55 ± 0.10 , P<0.01) and SPAG6 (0.78 ± 0.09 vs 0.56 ± 0.09, P<0.01).@*CONCLUSIONS@#T The expressions of SLC22A14 and SPAG6 are reduced in the sperm of the patients with idiopathic asthenospermia, which may be one of the important causes of asthenospermia.

Huangjing Zanyu Capsule enhances sperm mitochondrial membrane potential in asthenozoospermia patients / 中华男科学杂志

Objective@#To observe the effect of Huangjing Zanyu Capsule (HZC) on sperm mitochondrial membrane potential (MMP) in asthenozoospermia patients.@*METHODS@#We assigned 70 asthenozoospermia patients to a treatment group (n = 39) and a control group (n = 31), the former treated with oral HZC at the dose of 4 capsules tid for 3 months while the latter left untreated. We obtained semen parameters from the patients and detected their sperm mitochondrial membrane potentials (MMP) by JC-1 staining and flow cytometry before and after medication, followed by comparison between the two groups.@*RESULTS@#The total effectiveness rate was 71.05% in the treatment group and natural pregnancy was achieved in 3 cases during the medication. A total of 35 patients in the treatment group and 30 controls completed all the laboratory examinations after a 3-month observation. Compared with the controls, the patients treated with HZC exhibited significant improvement after medication in MMP (variation value: ［1.19 ± 10.36］% vs ［20.28 ± 14.21］%, P <0.01), total sperm motility (variation value: ［3.46 ± 8.67］% vs ［20.68 ± 14.12］%, P <0.01), the percentage of progressively motile sperm (variation value: ［2.26 ± 8.29］% vs ［17.58 ± 12.73］%, P <0.01), and the percentage of morphologically normal sperm (variation value: ［0.23 ± 3.48］% vs ［3.37 ± 3.99］%, P <0.01). MMP was significantly correlated with total sperm motility (r = 0.69, P <0.01), progressive sperm motility (r = 0.75, P <0.01) and normal sperm morphology (r = 0.26, P <0.01).@*CONCLUSIONS@#Huangjing Zanyu Capsule can enhance sperm mitochondrial membrane potential and sperm mitochondrial function, thus improving total sperm motility, progressive sperm motility and normal sperm morphology. It is safe and effective for the treatment of asthenospermia.

Transcutaneous electrical acupoint stimulation for asthenozoospermia / 中华男科学杂志

Objective@#To study the effect of transcutaneous electrical acupoint stimulation (TEAS) in the treatment of asthenozoospermia.@*METHODS@#We randomly divided 72 asthenozoospermia patients into a 2 Hz TEAS (n = 29), a 100 Hz TEAS (n = 20), and a blank control group (n = 23), those in the former two groups treated by 30 minutes of TEAS at 2 Hz and 100 Hz respectively, applied to the acupoints of bilateral Shenshu, left Zusanli, and Guanyuan, once a day for 60 days, while those in the blank control group left untreated. Using computer-assisted sperm analysis (CASA), we examined sperm concentration and motility as well as the percentages of grade a and grade a+b sperm in different groups of the patients.@*RESULTS@#Compared with the baseline, 2 Hz TEAS significantly increased sperm motility (［12.76 ± 1.39］ vs ［18.89 ± 2.46］%, P<0.05) and the percentage of grade a+b sperm ( ［10.68 ± 1.22］ vs ［16.32 ± 2.10］%, P<0.05) in the asthenozoospermic patients, while 100 Hz TEAS improved not only sperm motility (［12.32 ± 2.21］ vs ［23.81 ± 3.42］%, P<0.01) and the percentage of grade a+b sperm (［10.45 ± 1.98］ vs ［20.25 ± 2.82 ］%, P<0.01), but also the percentage of grade a sperm (［6.44 ± 1.16］ vs ［13.31 ± 2.30］%, P<0.05). Moreover, in comparison with the blank control group, 2 Hz TEAS also remarkably increased sperm motility (［9.57 ± 1.60］ vs ［18.89 ± 2.46］%, P<0.05) and the percentage of grade a+b sperm (［7.81 ± 1.31］ vs ［16.32 ± 2.10］%, P<0.05) in the asthenozoosperma patients, while 100 Hz TEAS improved not only sperm motility (［9.57 ± 1.60］ vs ［23.81 ± 3.42］%, P<0.01) and the percentage of grade a+b sperm (［7.81 ± 1.31］ vs ［20.25 ± 2.82］%, P<0.01) but also the percentage of grade a sperm (［4.87 ± 1.01］ vs ［13.31 ± 2.30］%, P<0.01). Meanwhile, the rate of clinical effectiveness was significantly higher in the 100 Hz TEASthan in the blank control group either in intention-to-treat (ITT) analysis (100% vs 18.18%) orper-protocol (PP) analysis (90% vs 0%), and so was it than in the 2 Hz TEAS group based on the data of ITT (100% vs 33.33%).@*CONCLUSIONS@#Both 2 Hz and 100 Hz TEAS are effective for the treatment of asthenozoospermia by improving sperm motility and vitality.

In vitro culture medium for sparse spermatozoa improves human sperm motility / 中华男科学杂志

Objective@#To investigate whether in vitro culture medium (IVCM) for sparse spermatozoa can improve human sperm motility for the purpose of helping clinicians, laboratorians and patients choose a better strategy of assisted reproduction.@*METHODS@#Semen samples were obtained from 178 males for routine semen examination from March to August 2016, including 151 cases of asthenozoospermia and 27 cases of normal sperm motility. A total of 200 μl was collected from each sample and divided into two equal portions and equal volumes of IVCM (experimental group) and F10 (1×) (control group) were added to the two portions, respectively, followed by 30-minute incubation at 37℃ in an incubator with 5% CO2. Sperm concentration, motility and viability and the percentages of progressively motile, non-progressively motile and immotile sperm were recorded before and after incubation.@*RESULTS@#After activated with IVCM, neither the samples with asthenozoospermia nor those with normal sperm motility showed any statistically significant difference in sperm viability from the baseline or the control group (P>0.05). The rates of progressively and non-progressively motile sperm from the asthenozoospermia males were increased by 14.02% and 4.86% respectively, while that of immotile sperm decreased by 19.01% in the experimental group (P >0.01), and similar results were observed in the semen samples from the men with normal sperm motility. The percentage of reduced immotile viable sperm was positively correlated with that of immotile viable sperm in both the asthenozoospermia patients (r = 0.260, P <0.01) and the men with normal sperm motility (r = 0.679, P <0.01).@*CONCLUSIONS@#IVCM can increase sperm motility without affecting sperm viability in men with either asthenozoospermia or normal sperm motility. The larger the proportion of immotile viable sperm, the higher the percentages of progressively and non-progressively motile sperm in the semen after IVCM activation, and this correlation is more significant in men with normal sperm motility than in asthenozoospermia patients.

Clinical study of Wuzi-Yanzong pill combined with compound Xuanju capsule for the male patients with infertility oligoasthenozoospermia / 国际中医中药杂志

Objective To assess the clinical effect of Wuzi-Yanzong pill combined with compound Xuanju capsule for treatment of male infertility oligoasthenozoospermia. Methods 136 cases of infertility with less, weak spermatozoa patients who meet the inclusion criteria were divided into two groups using random number table, 68 cases in each group. The control group was treated with Wuzi-Yanzong Pills and Vitamin E orally, and the study group was treated with compound Xuanju capsules on the basis of the control group. Both groups were treated for 3 months. The changes of semen quality and male hormone were observed before and after treatment, and the clinical curative effect was evaluated. Results The total effective rate of the study group was 89.7% (61/68), the control group was 73.5% (50/68), there was significant difference between two groups (χ2=5.930, P=0.015). After treatment, in study group, the sperm of a grade and b grade were (68.5% ± 15.5 % vs. 52.5% ± 15.6 %, t=2.607), the sperm of a grade was (35.3% ± 15.3% vs. 26.5% ± 13.4%, t=2.688), sperm motility rate was (73.3% ± 22.5% vs. 56.8% ± 20.5%, t=2.780), sperm density was [(28.7 ± 15.5)×107/ml vs. (20.5 ± 13.2)×107/ml, t=2.612], and the sperm volume was (2.9 ± 1.7 ml vs. 2.2 ± 1.3 ml, t=2.667), higher than those of the control group (P<0.05 or P<0.01). The level of testosterone in study group (816.5 ± 135.6 ng/dl vs. 768.5 ± 118.5 ng/dl, t=2.728). Conclusions Wuzi-Yanzong pills combined with compound Xuanju capsule can effectively improve the quality of spermatozoa for patients with oligospermia, and improve the clinical efficacy.

Chloride channels are involved in sperm motility and are downregulated in spermatozoa from patients with asthenozoospermia / 亚洲男科学杂志(英文版)

Human spermatozoa encounter an osmotic decrease from 330 to 290 mOsm l-1 when passing through the female reproductive tract. We aimed to evaluate the role of chloride channels in volume regulation and sperm motility from patients with asthenozoospermia. Spermatozoa were purified using Percoll density gradients. Sperm volume was measured as the forward scatter signal using flow cytometry. Sperm motility was analyzed using computer-aided sperm analysis (CASA). When transferred from an isotonic solution (330 mOsm l-1 ) to a hypotonic solution (290 mOsm l-1 ), cell volume was not changed in spermatozoa from normozoospermic men; but increased in those from asthenozoospermic samples. The addition of the chloride channel blockers, 4,4'-diisothiocyanatostilbene-2,2'- isulfonic acid (DiDS) or 5-nitro-2-(3-phenylpropylamino) benzoic acid (NPPB) to the hypotonic solution caused the normal spermatozoa to swell but did not increase the volume of those from the asthenozoospermic semen. DiDS and NPPB decreased sperm motility in both sets of semen samples. The inhibitory effect of NPPB on normal sperm motility was much stronger than on spermatozoa from the asthenozoospermic samples. Both sperm types expressed ClC-3 chloride channels, but the expression levels in the asthenozoospermic samples were much lower, especially in the neck and mid-piece areas. Spermatozoa from men with asthenozoospermia demonstrated lower volume regulating capacity, mobility, and ClC-3 expression levels (especially in the neck) than did normal spermatozoa. Thus, chloride channels play important roles in the regulation of sperm volume and motility and are downregulated in cases of asthenozoospermia.

Needle Aspiration Biopsy of Seminiferous Tubules (NABST) as a Diagnostic Method in Korea / 전남의대학술지

To evaluate the diagnostic efficacy of needle aspiration biopsy of seminiferous tubules (NABST) and to represent the redistributed diagnostic results corresponding to testicular volumes and follicle-stimulating hormone (FSH) levels. In this retrospective study, we investigated 65 infertile men with either azoospermia or oligoasthenoteratozoospermia. Following NABST, specimens were stained with hematoxylin and eosin and classified into five histological types. With pre-procedure FSH levels and testicular volumes, we evaluated the probabilities of detecting sperms within biopsy specimens. NABST led to the classification of normal spermatogenesis in 31 cases (47.7%), hypospermatogenesis in 23 cases (35.4%), maturation arrest in 4 cases (6.2%), and Sertoli cell only syndrome in 4 cases (6.2%). The success rate of reaching a histological diagnosis using NABST was 95.4% (62 out of 65 cases). Fourteen patients (21.5%) had a testicular volume <15 cc; of these, 8 patients (57.1%) had normal spermatogenesis, 2 patients (14.3%) had hypospermatogenesis, 2 patients (14.3%) had maturation arrest and 2 patients (14.3%) had Sertoli cell-only syndrome (SCO). Twelve patients (18.5%) had an FSH level ≥10 IU; of these, 6 (50%) had normal spermatogenesis, 2 patients (16.7%) had maturation arrest and 4 patients (33.3%) had SCO. Cases with an FSH level <10 IU were positively associated with a probability of detecting sperm using NABST (p<0.001). NABST is a reliable tool for the histological diagnosis of azoospermic and oligoasthenoteratozoospermic patients. The diagnostic success rate was high and associated with pathological accuracy. NABST is a convenient procedure with few complications.

Needle Aspiration Biopsy of Seminiferous Tubules (NABST) as a Diagnostic Method in Korea / 전남의대학술지

To evaluate the diagnostic efficacy of needle aspiration biopsy of seminiferous tubules (NABST) and to represent the redistributed diagnostic results corresponding to testicular volumes and follicle-stimulating hormone (FSH) levels. In this retrospective study, we investigated 65 infertile men with either azoospermia or oligoasthenoteratozoospermia. Following NABST, specimens were stained with hematoxylin and eosin and classified into five histological types. With pre-procedure FSH levels and testicular volumes, we evaluated the probabilities of detecting sperms within biopsy specimens. NABST led to the classification of normal spermatogenesis in 31 cases (47.7%), hypospermatogenesis in 23 cases (35.4%), maturation arrest in 4 cases (6.2%), and Sertoli cell only syndrome in 4 cases (6.2%). The success rate of reaching a histological diagnosis using NABST was 95.4% (62 out of 65 cases). Fourteen patients (21.5%) had a testicular volume <15 cc; of these, 8 patients (57.1%) had normal spermatogenesis, 2 patients (14.3%) had hypospermatogenesis, 2 patients (14.3%) had maturation arrest and 2 patients (14.3%) had Sertoli cell-only syndrome (SCO). Twelve patients (18.5%) had an FSH level ≥10 IU; of these, 6 (50%) had normal spermatogenesis, 2 patients (16.7%) had maturation arrest and 4 patients (33.3%) had SCO. Cases with an FSH level <10 IU were positively associated with a probability of detecting sperm using NABST (p<0.001). NABST is a reliable tool for the histological diagnosis of azoospermic and oligoasthenoteratozoospermic patients. The diagnostic success rate was high and associated with pathological accuracy. NABST is a convenient procedure with few complications.