Association between microRNA expression and risk of male idiopathic infertility in Iraq

SUMMARY OBJECTIVE: The World Health Organization defines infertility as the inability to get pregnant after 12 months of unprotected sexual activity. This study was conducted to estimate the levels of gene expression for two mature miRNAs (i.e., miR-122 and miR-34c-5p) to evaluate susceptibility to male infertility. METHODS: This study included 50 male patients with idiopathic infertility who were admitted to hospital from the period November 2021 to May 2022 and another group consisting of 50 apparently healthy individuals used as controls. RESULTS: miR-122 level was significantly highest in azoospermia and followed by oligospermia, 39.22 (31.88) versus 37.34 (20.45), respectively. In addition, there was a very significant difference in miR-34c-5p levels between the study groups (p<0.05). CONCLUSION: Two miRNAs, namely, miR-34c-5p and miR-122, can be used as predictive and diagnostic biomarkers for infertility.

AYURVEDIC MANAGEMENT OF OLIGOSPERMIA: A CASE STUDY

The condition known as oligoasthenozoospermia occurs when the two parameters, sperm count and sperm motility, are changed. It is assessed by semen analysis and shows a decrease in the concentration and proportion of motile spermatozoa in a sperm sample. Research indicates that conditions or causes affecting male reproduction account for roughly 50% of infertility cases in India. According to a research by the WHO from 1982 to 1985 in many locations, 20% of cases of infertility are caused by male factors. About 23% of Indian couples receiving infertility treatment blamed male factors for their infertility. It is possible to correlate oligoasthenozoospermia to the Sukra kshaya Lakshanas stated in Ashta sukra dushtis. A 31-year-old man with 1.5 years of marriage was diagnosed with oligospermia, which is characterised by a low sperm count and a lack of motile spermatozoa. Shodhan (Virechan) and Shamanchikitsa demonstrated an improvement in seminal parameters following Deepan/Pachan. This demonstrates the effectiveness of Ayurvedic medicine in the treatment of male infertility

Severe Oligospermia Treatment with Testicular Sperm Using 揑CSI�

Introduction: Assisted reproductive technology has been developed significantly throughout the past few years, particularly diagnosing and treating male infertility. Many studies have been performed showing that Intracytoplasmic Sperm Injection (ICSI) is a successful method to attain clinical pregnancy and live birth through impaired spermatozoa characteristics or low sperm count, such as severe oligospermia. Severe oligospermia indicates low sperm count, which in some cases leads to azoospermia. Severe oligospermia can be caused by several factors such as genetics or medication. In search of efficient treatment for couples with Severe oligospermia, numerous retrospective and prospective researches have reported high pregnancy and live birth rates through testicular sperm for men with severe oligospermia and cryptozoospermia with or without high sperm DNA damage. The research showed that the use of testicular sperm in combination with ICSI yielded a high pregnancy rate and live births over another source of sperm, such as ejaculated sperms. Moreover, the use of ICSI in severe oligospermia has shown successful fertilization and pregnancy. Methods: In search for effective treatment for couples with severe male factor, a number of small retrospective and prospective studies have reported high pregnancy and live birth rates using testicular sperm for men with necrozoospermia, cryptozoospermia and oligozoospermia with or without elevated sperm DNA damage. Although the data suggest that there may be some benefit in performing testicular sperm retrieval (TSR)-ICSI in select groups of non-azoospermic infertile men, there are potential risks involved with TSR. Clinicians should balance these risks prior to the recommendation of TSR-ICSI on the result of a semen analysis or sperm DNA test alone. Careful evaluation and management of male factor infertility is important. The use of TSR-ICSI in the absence of specific sperm DNA defects is still experimental. Discussion: In 1992 and subsequently, several reports indicated that ICSI was a successful technique to achieve clinical pregnancy and live birth using spermatozoa with severely impaired characteristics. The initial optimism over the ability of ICSI to overcome significant sperm abnormalities was later tempered by the findings of more recent publications suggesting that some sperm deficits may not be as effectively treated with ICSI. Conclusion: Severe oligospermia indicates low sperm count, which can lead to male infertility; severe oligospermia which can be overcome through ICSI. Genetic factors like microdeletions of the Y chromosome (Yq) can cause severe oligospermia or chemotherapy molecules, affecting the sperm count directly.

Investigation of the genetic etiology in male infertility with apparently balanced chromosomal structural rearrangements by genome sequencing / 亚洲男科学杂志(英文版)

Apparently balanced chromosomal structural rearrangements are known to cause male infertility and account for approximately 1% of azoospermia or severe oligospermia. However, the underlying mechanisms of pathogenesis and etiologies are still largely unknown. Herein, we investigated apparently balanced interchromosomal structural rearrangements in six cases with azoospermia/severe oligospermia to comprehensively identify and delineate cryptic structural rearrangements and the related copy number variants. In addition, high read-depth genome sequencing (GS) (30-fold) was performed to investigate point mutations causative of male infertility. Mate-pair GS (4-fold) revealed additional structural rearrangements and/or copy number changes in 5 of 6 cases and detected a total of 48 rearrangements. Overall, the breakpoints caused truncations of 30 RefSeq genes, five of which were associated with spermatogenesis. Furthermore, the breakpoints disrupted 43 topological-associated domains. Direct disruptions or potential dysregulations of genes, which play potential roles in male germ cell development, apoptosis, and spermatogenesis, were found in all cases (n = 6). In addition, high read-depth GS detected dual molecular findings in case MI6, involving a complex rearrangement and two point mutations in the gene DNAH1. Overall, our study provided the molecular characteristics of apparently balanced interchromosomal structural rearrangements in patients with male infertility. We demonstrated the complexity of chromosomal structural rearrangements, potential gene disruptions/dysregulation and single-gene mutations could be the contributing mechanisms underlie male infertility.

Clinical Efficacy on Yishen Tongluofang for Treatment of Male Infertility with Deficiency and Stasis of Kidney / 中国实验方剂学杂志

Objective:To observe the clinical efficacy of Yishen Tongluofang in treating oligosperm type male infertility with kidney deficiency and blood stasis syndrome and explore its effect on serum sex hormones and seminal plasma microenviro. Method:One hundred and four patients were randomly divided into observation group and control group with 52 cases each. Patients in control group took compound Xuanju capsules orally， 3 capsules/time， 3 times/day. Patients in observation group took Yishen Tongluofang， 1 dose/day. Treatment courses continued three months and followed up for three months in both groups. The pregnancy situations of spouses within six months were recorded. Examination of semen parameters before and after treatment and score of kidney deficiency and blood stasis syndrome were conducted. The levels of seminal plasma zinc， fructose， elastase， acid phosphatase and <italic>α</italic>-glucosidase， serum follicle stimulating hormone （FSH）， luteinizing hormone （LH）， prolactin （PRT） and testosterone （T） were detected before and after treatment. Result:During the observation period of six months， the pregnancy rate of spouses in the observation group was 22.00%， higher than 10.00% in the control group， but the difference was not statistically significant （<italic>χ</italic>²=2.678，<italic>P</italic>>0.05）. The clinical efficacy in the observation group was better than that of the control group （<italic>Z</italic>=2.326，<italic>P</italic><0.01）. Sperm concentration， sperm motility， sperm motility， normal morphological sperm and linear movement speed of the observation group were all superior to those of the control group<italic> </italic>（<italic>P</italic><0.01）. The levels of zinc and fructose in seminal plasma of the observation group were higher than those of the control group （<italic>P</italic><0.01）， and the score of kidney deficiency and blood stasis syndrome was lower than that of the control group （<italic>P</italic><0.01）. Serum FSH， LH and PRT levels in the observation group were lower than those in the control group （<italic>P</italic><0.01）， and the T level was higher than that in the control group （<italic>P</italic><0.01）. The seminal plasma elastase of the observation group was lower than that of the control group， while the levels of acid phosphatase and <italic>α</italic>-glucosidase were higher than those of the control group （<italic>P</italic><0.01）. Conclusion:Yishen Tongluofang can significantly improve sperm parameters， regulate the level of sex hormones and seminal plasma environment in patients with oligosperm type male infertility， and improve the tendency of spouse pregnancy. Its clinical efficacy is better，so it is worthy of further research and application.

Clinical observation of herb-separated moxibustion on segmental conception vessel combined with low-frequency TEAS for asthenospermia and oligospermia / 中国针灸

OBJECTIVE@#To observe the clinical effect of herb-separated moxibustion on segmental conception vessel combined with low-frequency transcutaneous electrical acupoint stimulation (TEAS) for asthenospermia and oligospermia.@*METHODS@#A total of 105 patients with asthenospermia and oligospermia were randomly divided into a combination group, a TEAS group and a medication group, 35 cases in each one. In the medication group, vitamin E capsules, coenzyme Q10 capsules，@*RESULTS@#Compared before treatment, except for the sperm morphology 2 months into treatment in the medication group, the semen routine indexes 2, 3 months into treatment were improved in the 3 groups (@*CONCLUSION@#Herb-separated moxibustion on segmental conception vessel combined with low-frequency TEAS can improve semen routine, reduce sperm oxidative stress damage for patients with asthenospermia and oligospermia, and the clinical efficacy is better than the medication and TEAS.

Effects of clomiphene citrate on seminal parameters in idiopathic oligospermia: a single blinded prospective randomized controlled trial

Background: About 15% married couples face problem of infertility of which male factor is implicated in 20% of them. In about 30% infertile men no causative factor is found and the condition is termed “Idiopathic”. They are often treated by empirical medications or Assisted Reproductive Technologies (ART) although success in few; our present study is carried on effects of clomephene citrate on seminal parameters in idiopathic oligospermia.Methods: This single blinded prospective randomized controlled trial was conducted at the infertility clinic with 200 idiopathic oligospermic men (sperm count <15 millions/ ml of ejaculate) after fulfilling inclusion and exclusion criteria and were alternately allocated into two equal groups - “Group C” receiving clomephene citrate tablets and “ Group P” receiving placebo after concealment. Semen analysis data were collected at baseline and every month and three months of completion of treatment and were summarized by routine descriptive statistical analysis.Results: The demographic characteristics like mean age is comparative in both groups but duration of infertility of >2 years is more in group C than group p (4.3±3.06 versus 4.1±2.57). The semen volume, spermatozoa count, sperm motility and not normal form are all increased after three months of treatment in group C as are biochemical parameters like total testosterone and serum FSH, LH and as also pregnancy rate (22% versus 4%).Conclusions: This study showed clomiphene citrate treatment protocol is inexpensive, relatively safe and easy to administer and improves semen volume, sperm count and sperm motility but not sperm morphology by increasing serum testosterone, FSH and LH in male and resulting in improved pregnancy rate in female partners.

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.

Karyotype Analysis In Cases Of Primary Male Infertility

Introduction: Infertility is a major health problem in 10-15% Indian couples affecting their psychological andsocial wellbeing. There is increasing recognition to the contribution of genetic abnormalities to the causation ofmale infertility. Genetics play a important role in infertility by controlling the physiological processes includinghormonal factors, spermatogenesis, and sperm quality. The aim of the study was to find out the Chromosomalabnormalities that play a major role in male infertility cases with non-obstructive azoospermia and oligospermia.The timely investigation to detect genetic abnormality gives better understanding about prognosis to the patientsand helps in providing genetic counseling with early intervention, management and also understanding risksinvolved in transmission of abnormality to future generations.Materials and methods: In present study total 30 male cases of primary infertility clinically diagnosed andconformed by semen analysis as unobstructed azoospermia and oligospermia were selected. Their karyotypeswere prepared and studied for chromosomal abnormalitiesResult: The Numerical chromosomal abnormality was found in 2 (6.66%) cases of azoospermic group in the formof Klinefelter syndrome (47,XXY). In cases of oligospermia 1 (3.34%) case had an abnormality in the form ofRobertsonian translocation involving 14:15 chromosome. The total 3 cases (10%) were found to have grosschromosomal abnormality by conventional cytogenetic method.Conclusion: In cases of Klinelfelter syndrome (47,XXY) due to altered karyotype or due to meiotic non-disjunction,the residual gametes may be extracted through Testicular / Epididymal Sperm Aspiration (TESA). It is necessarythat the diagnosis be made as soon as possible, so as to guarantee the cryopreservation of the semen beforecomplete infertility sets in.

Effect on sperm quality of asthenospermia and oligospermia treated with grain-moxibustion combined with medicine therapy / 中国针灸

OBJECTIVE@#To observe the clinical effect of grain-moxibustion combined with medicine therapy for asthenospermia and oligospermia.@*METHODS@#A tatal of 60 patients were randomized into an observation group (30 cases) and a control group (30 cases) according to 1︰1 ratio. In the control group, vitamin E capsules were taken orally one capsule each time, twice a day, and pills 6 g each time, three times a day for a total of 3 months. In the observation group, grain-moxibustion was applied at Guanyuan (CV 4)，Shenshu (BL 23) and Zusanli (ST 36) based on the control group, once a week for 3 months, with a total of 12 times. The sperm concentration and sperm progressive motility were measured by automatic sperm quality analysis system in the two groups, and the clinical effects were compared. Sperm DNA fragmentation index (DFI) in the observation group was measured by sperm nucleus chromosome structure assay (SCSA).@*RESULTS@#①The sperm concentrations and sperm progressive motilities after 1-month, 2-month and 3-month of treatment were increased compared with those before treatment in the two groups (<0.01), and they were increased with time. In the two groups, 2-month and 1-month of treatment, 3-month and 2-month of treatment were compared, the sperm concentrations and sperm progressive motilities were significantly increased (<0.01). The sperm concentrations after 1-month, 2-month and 3-month of treatment in the observation group were higher than those in the control group (<0.01), the sperm progressive motility after 3-month of treatment in the observation group was higher than that in the control group (<0.05). ②After 3-month of treatment，the DFI in the observation group was significantly reduced compared with that before treatment (<0.01). ③The total effective rate in the observation group after 3-month of treatment was 86.7% (26/30), which was superior to 63.3% (19/30) in the control group (<0.05).@*CONCLUSION@#Grain-moxibustion combined with medicine therapy can improve sperm concentration and sperm progressive motility, enhance the integrity of sperm DNA.

Efficacy Of Dhathu Bushti Chooranam In The Management Of Male Infertility With Special Reference To Oligospermia - An Open Pilot Study

Infertility is a common problem of new age couples. It is affecting them psychologically and also affecting the harmony of the family. Among infertility couples, 40% was caused by male partner particularly by oligospermia. Literally oligospermia means insufficient number of spermatozoa in semen, but significantly, it means that oligospermia is a medical condition characterized by the total sperm count less than 20 million/ml of ejaculate. Extensive clinical researches are going on worldwide to treat oligospermia by utilizing various natural sources like plants, mineral and animal origin. Siddha medicine is having many formulations to treat oligospermia, one among them is Dhathu bushti chooranam described in Noigalukku Siddha Parigaram –a Sasthiric siddha literature. 10 male partners of infertility couples attending Sool mahalir maruthuvam OPD of the Ayothidoss Pandithar Hospital, National Institute of Siddha, Tambaram sanatorium, Chennai-47 were recruited for this pilot study. All patients were treated with 10 gm of Dhathu bushti chooranam twice a day with milk for 90 days. All patients were subjected to complete semenogram on 0th and 90th day of treatment. Results were observed by analyzing the semenogram parameters. The ingredients of Dhathu bushti chooranam are Salamisiri, Nilapanai kizhangu,Thaneervittan kizhangu, Poonaikaali vidhai, Boomisarkkarai kizhangu and most of them are having good spermatogenesis and aphrodiasic activities, hence the author selected this drug for this study. The efficacy of the trial drug Dhathu bushti chooranam was appreciable and the drug may be taken for clinical trial in large number of population.

Effect of Erxian Decoction on cyclophosphamide-induced oligospermia in mice / 中华男科学杂志

<p><b>Objective</b>To study the effect of Erxian Decoction (EXD) on oligospermia (OS) induced by cyclophosphamide in mice.</p><p><b>METHODS</b>Eighty 6-week-old male Kunming mice were randomly divided into five groups of equal number, normal control, OS model control, and low-, medium- and high-dose EXD, the former two groups treated intragastrically with normal saline and the latter three with EXD at 3, 6 and 12 g per kg of the body weight qd for 30 days. From the 21st day of administration, the mice of the normal control group were injected intraperitoneally with saline and those of the other four groups with cyclophosphamide at 80 mg per kg of the body weight qd for 5 consecutive days. At 24 hours after the last gavage, the bilateral epididymides of the mice were collected and sperm suspension prepared for determination of the sperm count and motility, and the bilateral testes were harvested for histomorphological observation and measurement of the concentrations of superoxide dismutase (SOD), malondialdehyde (MAD) and glutathione (GSH) in the testis tissue.</p><p><b>RESULTS</b>Compared with the normal controls, the mice of the OS model control group showed significant decreases in epididymal sperm concentration (［9.31 ± 1.32］ vs ［3.32 ± 1.13］×107/ml, P <0.01) and motility (［44.75 ± 8.12］% vs ［25.95 ± 11.41］， P<0.01) and the concentrations of SOD (［37.27 ± 0.99］ vs ［14.23 ± 1.99］ U/mg prot, P <0.01) and GSH (［101.55 ± 8.74］ vs ［58.77 ± 8.93］ μmol/L, P <0.01) but an obvious increase in the MDA level (［2.21 ± 0.65］ vs ［2.61 ± 0.15］ nmol/mg prot, P <0.05) in the testis tissue. In comparison with the OS model controls, the mice treated with low-, medium- and high-dose EXD exhibited significantly increased epididymal sperm concentration (［8.34 ± 2.59］, ［8.59 ± 1.10］ and ［8.41 ± 1.47］×107/ml) (P <0.01) and motility (［36.04 ± 12.33］%, ［38.87 ± 13.13］% and ［41.90 ± 8.09］%) (P <0.01) and concentrations of SOD (［22.99 ± 1.11］, ［20.82 ± 1.81］ and ［21.33 ± 1.66］ U/mg prot) (P <0.01) and GSH (［104.74 ± 2.47］, ［98.61 ± 12.98］ and ［108.89 ± 5.85］ μmol/L) (P <0.01) but decreased level of MDA (P <0.05).</p><p><b>CONCLUSIONS</b>Erxian Decoction can improve cyclophosphamide-induced reduction of sperm concentration and motility, which might be associated with its abilities of resisting oxidation and reducing oxidative stress injury.</p>

Therapeutic effect of Jinghuosu on oligospermia and asthenospermia / 中华男科学杂志

Objective@#To investigate the effects of the compound preparation Jinghuosu on oligospermia and asthenospermia.@*METHODS@#This multi-centered clinical study included 120 cases of mild to moderate idiopathic oligospermia or asthenospermia, all treated with oral Jinghuosu once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we detected sperm concentration, total sperm motility, progressive sperm motility and normal sperm morphology of each ejaculate, and recorded whether the patients had any adverse reactions.@*RESULTS@#After 3 months of treatment, all the patients showed obvious improvement in semen parameters, most significantly in sperm concentration, total sperm motility, and the percentages of progressive motile sperm and morphologically normal sperm (P <0.05). No significant adverse reactions were observed during the 3 months of medication.@*CONCLUSIONS@#Jinghuosu has a significant efficacy and no obvious adverse effect in the treatment of mild to moderate oligospermia and asthenospermia.

Genetic genes associated with oligospermia, asthenospermia and teratospermia: Advances in studies / 中华男科学杂志

Approximately 2,300 genes are found to be associated with spermiogenesis and their expressions play important roles in the regulation of spermiogenesis. In recent years, more and more attention has been focused on the studies of the genes associated with oligospermia, asthenospermia and teratospermia and their molecular mechanisms. Some genes, such as GSTM1, DNMT3L, and CYP1A1, have been shown to be potentially associated with oligospermia; some, such as CATSPER1, CRISP2, SEPT4, TCTE3, TEKT4, and DNAH1, with asthenospermia; and still others, such as DPY19L2 and AURKC, with teratospermia. These findings have provided a molecular basis for the studies of the pathogenesis of oligospermia, asthenospermia and teratospermia, as well as a new approach to the exploration of new diagnostic and therapeutic techniques.

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.

Effect of low dose clomiphene in treatment of idiopathic oligoasthenospermia and therapeutic effect on sperm epididymal protein 4 levels / 中国生化药物杂志

Objective To investigate therapeutic effect of the low dose clomiphene treatment of idiopathic oligoasthenospermia and effect on sperm epididymal protein level 4.Methods183 cases of idiopathic oligoasthenospermia were divided into three groups, vitamin group of 61 patients were given vitamin E,clomiphene group(61 cases)treated with low dose clomiphene, combined group of 61 patients were given low dose clomiphene and vitamin E, lasted for 12 weeks.Semen volume, sperm density, sperm motility, sperm survival rate and sperm reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), human epididymis protein 4 (HE4), follicle stimulating hormone, luteinizing hormone, testosterone concentration were observed before and after treatment.After treatment, the patients were followed up for 1 year, the observation of the natural pregnancy rate after treatment.ResultsSperm density, sperm survival rate and sperm and a A+B grade sperm in the clomiphene group were significantly higher comparedwith the vitamin group (P< 0.05), sperm density, sperm survival rate and sperm and a A+B grade sperm in the combined group were significantly increasedcompared with clomiphene group and vitamin group (P< 0.05),levels of HE4 after treatment was significantly lower compared with before treatment (P< 0.05), And the difference between the three groups were statistically significant (P< 0.05).Follicle stimulating hormone, luteinizing hormone, testosterone in clomiphene group and combined group after treatment, were significantly increased compared with before treatment (P< 0.05), and the combined group had no statistically difference compared with clomiphene group.The pregnancy rate in 1 year of vitamin group, clomiphene group and combined group were 24.59%, 42.62% and 62.29% (P< 0.05).ConclusionClomiphene treatment of idiopathic asthenospermia is better than vitamin E, the combination of the two has a synergistic effect.

Clinical correlation analysis of placenta growth factor expression in human seminal plasma and oligoasthenospermia / 第二军医大学学报

Objective To explore the correlation between placental growth factor (P1GF) expression and sperm quality in seminal plasma, and to evaluate its clinical significance in patients with oligoasthenospermia and azoospermia. Methods A total of 88 patients undergoing seminal fluid detection were enrolled from the Department of Reproductive Medicine Center of Changhai Hospital of Second Military Medical University fromSep. 2014 to Nov. 2014. The patients were divided into three groups according to the test results: ten cases with normal semen (normal group), 68 cases with oligoasthenospermia (oligoasthenospermia group), and ten cases with azoospermia (azoospermia group). Semen samples from five patients with normal semen and 5 patients with oligoasthenospermiawere collected and assayed for cytokine-related proteinmicroarray. The contents of P1GF in seminal plasma were detected by ELISA. The correlations between P1GF concentration and the sperm concentration and activity in seminal plasma and the age of patients were analyzed by Pearson correlation analysis. Results The contents of P1GF in seminal plasma in the normal group were significantly higher than that in the oligoasthenospermia and azoospermia groups (P<0. 05). The level of P1GF in seminal plasma was related to the concentration and activity of sperm (r=0.362, 0.253; P<0.05), but not to the age of patients. Conclusion The levll of P1GF in seminal plasma is correlated with the sperm concentration, providing reference for diagnosis and treatment of oligoasthenospermia and azoospermia in clinic.

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.

Effect of Environmental Factors, Lifestyle, Lipid Profile and Previous Medical Conditions on Semen Quality in Male Partners of Infertile Couples; Evidence from Kumasi Metropolis.

Introduction: Infertility among men is a major public health problem that has mainly been linked to semen abnormalities due to certain background or environmental characteristics, disease and surgical conditions as well as lifestyle. The purpose of this study was to assess the effects of environmental factors, lifestyle, lipid profile and previous medical conditions on semen quality of male infertile couples in the Kumasi metropolis. Methods: The study was a cross-sectional study conducted between February 2012 and May 2013. The study involved 150 men whose female partners reported to the Obstetrics and Gynaecology Department of Komfo Teaching Hospital (KATH) in Ashanti Region of Ghana for infertility treatment. Semen of the respondents were examined for various characteristics including sperm viability, motility and concentration. The demographic, behavioral and anthropometric data of clients were also taken with the use of structured questionnaires. Associations between the various explanatory factors and semen quality were tested using correlation and regression at significant levels of p<0.05. Results: About half of the respondents had very low sperm counts (oligospermia), 36.7% had normal sperm concentration whereas 10.7% had no sperm in the semen. The mean sperm motility among the males of infertile couples was 51.0 (SD=30.12). Mumps had significant association with Log of sperm concentration (p=0.025) but not with motility (p=0.333). Extensive use of marijuana was associated with 1.69X106 increase in the log sperm concentration (p=0.020). Extensive use of heroine also had a significant association sperm concentration (p=0.05). Lipid levels had no significant association with sperm quality. Conclusion: Although the lipid profile showed no significant association with semen quality, positive lifestyles targeted at improving lipid profile might help improve semen concentration since BMI and triglyceride negatively affected sperm concentration and motility though the effects were not significant. The effects of marijuana and heroin use may arise may be due the small number of users in the study group.