Associations of sex hormone levels with body mass index (BMI) in men: a cross-sectional study using quantile regression analysis / 亚洲男科学杂志(英文版)

Body mass index (BMI) has been increasing globally in recent decades. Previous studies reported that BMI was associated with sex hormone levels, but the results were generated via linear regression or logistic regression, which would lose part of information. Quantile regression analysis can maximize the use of variable information. Our study compared the associations among different regression models. The participants were recruited from the Center of Reproductive Medicine, The First Hospital of Jilin University (Changchun, China) between June 2018 and June 2019. We used linear, logistic, and quantile regression models to calculate the associations between sex hormone levels and BMI. In total, 448 men were included in this study. The average BMI was 25.7 (standard deviation [s.d.]: 3.7) kg m-2; 29.7% (n = 133) of the participants were normal weight, 45.3% (n = 203) of the participants were overweight, and 23.4% (n = 105) of the participants were obese. The levels of testosterone and estradiol significantly differed among BMI groups (all P < 0.05). In linear regression and logistic regression, BMI was associated with testosterone and estradiol levels (both P < 0.05). In quantile regression, BMI was negatively associated with testosterone levels in all quantiles after adjustment for age (all P < 0.05). BMI was positively associated with estradiol levels in most quantiles (≤80th) after adjustment for age (all P < 0.05). Our study suggested that BMI was one of the influencing factors of testosterone and estradiol. Of note, the quantile regression showed that BMI was associated with estradiol only up to the 80th percentile of estradiol.

Effect of endometrial thickness on the day of hCG administration on pregnancy outcome in the fresh IVF/ICSI cycle-a retrospective multicenter study / 中国实用妇科与产科杂志

OBJECTIVE: To investigate the effect of endometrial thickness(EMT)on the day of hCG administration on preg⁃nancy outcome in the fresh in vitro fertilization/intracytoplasmic sperm injection(IVF/ICSI)cycle.METHODS:A retrospec⁃tive analysis was conducted of 3601 IVF/ICSI-ET cycles between January 1,2015 and December 31,2015 in eight repro⁃ductive centers.The endometrial thickness was measured on hCG injection day and the distribution of endometrial thick⁃ness and pregnancy outcome was drawn.Patients were divided into two groups based on the EMT:group A(289 cycles,EMT<8 mm),group B(3312 cycles,EMT≥duration of pregnancy and birth weight of single gestation were compared.RESULTS:Group A had significantly lower clini⁃cal pregnancy rate(46.0% vs.55.9%,P=0.001),live birth rates(35.3% vs. 47.0%,P=0.000)and higher pregnancy loss rate(23.3% vs.15.8%,P=0.024)compared with group B,while there was no significant difference in duration of pregnan⁃cy or birth weight of single gestation.Logistic regression analyses showed that clinical pregnancy rate(aOR=1.492,P=0.001)and live birth rate(aOR=1.621,P=0.000)increased in group B compared with group A,when correcting for the women age,BMI and transfer embryo numbers.CONCLUSION:The endometrial thickness on the day of hCG administra⁃tion affects the pregnancy outcome in the fresh IVF/ICSI cycle.When EMT<8 mm,the clinical pregnancy rate and live birth rate of IVF-ET are lower,and the patient should be well informed before making the decision of em⁃bryo transfer.However,endometrial thickness on the day of hCG administration does not affect the duration of preg⁃nancy and the birth weight of the fetus.

Prevalence and patterns of Y chromosome microdeletion in infertile men with azoospermia and oligzoospermia in Northeast China

In some cases infertile men showed small deletions of specific genes in the Y chromosome. It had been confirmed, these deleted genes are greatly associated with spermatogenic failure. However, the frequency and the patterns of such microdeletions among infertile men are not clearly clarified. We sought to determine the frequency and the patterns of Y chromosome microdeletions in azoospermic and oligozoospermic infertile men in Northeast China, and try to optimize the selection of sequence tagged sites [STSs] of AZF microdeletions in multiplex polymerase chain reaction [PCR]. 720 azoospermic and 330 oligozoospermic infertile men, from Northeast China were included in this retrospective study during May 2008 to November 2012. Semen analysis was performed according to the World Health Organization guidelines. Y chromosome microdeletions were detected by polymerase chain reaction assays. G-banding method was used for chromosome Karyotype analysis. Chi-square tests were used to compare patterns of Y chromosome microdeletions in azoospermic and oligozoospermic patients. Of 1050 infertile men, 12.95% cases had shown Y chromosome microdeletions, and 19.43% of cases showed abnormal chromosomal karyotype. Deletions in AZFc region was the most frequent 75.00%, followed by deletions in AZFb region 13.33%, AZFbc region 09.62%, and AZFa region 2.22%. All oligozoospermic patients showed presence of sY84, sY86, sY127, and sY134. Deletion of sY127 [p=0.0101] and sY157 [p=0.0043] showed significant difference between azoospermic group and oligozoospermic group. Deletions of sY127 may relate to azoospermia while sY84, sY86, sY127 can be ignored in AZF screening for oligozoospermic patients

Culturing surplus poor-quality embryos to blastocyst stage have positive predictive value of clinical pregnancy rate

Clinical reproductive centers produce large amounts of surplus poor-quality embryos annually, how to maximize the use of these embryos, and which of them have the potential to develop into blastocyst stage and influencing factors were lack of systematic research. To investigate the fate of surplus poor-quality embryos which were cultured to obtain blastocyst, determine the factors which may influence the blastulation, and discuss their application in predicting of the pregnancy outcomes. Day 3 [D3] after embryo transfer and freezing, surplus poor-quality embryos from IVF/ICSI cycles were cultured to blastocyst by the sequential method, then the blastulation outcomes were observed. Focusing on the blastulation rate of those embryos with different number cells and different embryonic grade; and last the relationship between the pregnancy outcomes of remained poor-quality embryos with successful blastulation or failed blastulation groups were studied. Of 127 patients with 569 poor-quality in vitro cultured embryos, there were formation of 248 blastocysts from 91 patients [43.59%], which lead to development of 138 high-quality blastocysts [24.25%]. With the increase in cells number of D 3 blastomeres, the blastulation rate gradually increased, that, 7-cell blastomeres blastulation rate was the highest [70.59%], and 8-cell blastomeres is a little below [70.37%]; while the embryonic levels and blastulation rate did not show this positive relationship. The clinical pregnancy rate and implantation rate of those who had successful blastulation [67.03% and 42.39%] were higher than of those who failed to develop to blastocyst [p=0.039]. Day 3 poor-quality embryos with successful blastulation or with failed blastulation had predictive value on pregnancy outcomes. For embryo transfer 7-8 cells grade III-IV embryo is better than 4-5 cells grade I-II embryo, in case of lack good-quality embryos

Clinical and cytogenetic analysis of 45,X/46,XY individuals / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze main clinical manifestations and cytogenetic characteristics of patients with a 45,X/46,XY karyotype.</p><p><b>METHODS</b>G-banding karyotype analysis was carried out. PCR was performed to detect azoospermia factor (AZF) microdeletion in adult male patients and sex-determining region on Y chromosome (SRY) gene in all patients. Clinical phenotype and genetic characteristics were summarized.</p><p><b>RESULTS</b>Among the 9 individuals with 45,X/46,XY, there have been 7 males and 2 females. Six out of the 7 males have manifested primary infertility, which included 5 with azoospermia, 1 with oligospermia, and 1 with hypospadia. Three of the 6 infertile patients were found to have AZF microdeletions. Two females showed typical Turner syndrome. All of the 9 cases were SRY-positive.</p><p><b>CONCLUSION</b>The 45,X/46,XY karyotype may result in a range of phenotypes. No correlation has been found between clinical manifestations and proportion of mosaicism cells for their peripheral blood karyotypes. As phenotypically normal male patients may produce sperm, infertile patients should undergo further examination at the molecular level.</p>

Molecular genetic mechanisms of teratozoospermia / 中华男科学杂志

Teratozoospermia is one of the important factors contributing to male infertility, and its pathogenesis is not yet clear. Recent years have witnessed some progress in the researches on sperm morphology, and some genes have been confirmed to be correlated with spermatogenesis. Aiming to provide some evidence for the pathogenesis of teratozoospermia, this paper reviews the relevant literature in the past five years addressing such special teratozoospermia as globozoospermia, nuclear vacuoles, decapitated spermatozoa, excessive residual cytoplasm, dysplasia of the fibrous sheath, and primary ciliary dyskinesia, and elaborates on the molecular genetic mechanisms of DPY19L2, AR, PRM1, GBA2, PCI, CREM, TH2A, TH2B, ODF1, Cntrob, OAZ-t, HOOK1, SPEM1, GAT1, PRSS21, 15-LOX, Sptrx, AKAP3, AKAP4, DNAI1, DNAH5, RSPH4A, TXNDC3, CCDC39, LRRC6, LRRC50, KTU and so on. Meanwhile, this review also presents an overview on the latest advances in assisted reproductive technology and its outcomes in the treatment of teratozoospermia patients in order to provide a theoretical basis for the diagnosis and treatment of male infertility.

Decline of semen quality and increase of leukocytes with cigarette smoking in infertile men

Previous researches about the effect of smoking on semen quality are contradictory, and the mechanism behind the harmful effect of smoking on semen quality still remains unclear until today. The objectives of this study are evaluation of the relationship between smoking and fertility, investigation of the effects of cigarette smoking on sperm parameters and detection of presence of leukocytes within the semen of idiopathic infertile men from Northeastern China. A retrospective study of 1512 infertile patients who visited affiliated hospitals of Jilin University from 2007-2010 were enrolled in this study. Patients were assigned into one non-smoking and one smoking group which was divided into mild, moderate and heavy subgroups. Sperm parameters [including leukocytes] and sperm morphology analysis were performed using standard techniques. Compared with non-smokers, smokers had a significant decrease in semen volumes [p=0.006], rapid progressive motility [p=0.002] and sperm viability [p=0.019]; moreover, smokers had a significant increase in the levels of immotile sperms [p=0.005] and semen leukocytes [p=0.002]; pH and sperm concentration were not statistically significant [p=0.789 and p=0.297 respectively]. Sperm motion parameters were all lower in the smokers except for beat-cross frequency [Hz] [BCF]. Further, the percentage of normal morphology sperm was decreased significantly in smokers [p=0.003], the sperm morphology was worse with increasing degree of smoking. These findings suggest that smoking leads to a significant decline in semen quality and higher levels of leukocytes, thus smoking may affects the fertilization efficiency

AZF deletions and male infertility / 中华男科学杂志

The Y chromosome contains genes closely related to male gonadal development and spermatogenesis. The azoospermia factor (AZF) is a gene on the long arm of the Y chromosome that regulates spermatogenesis, and its deletion can induce spermatogenic arrest and consequently male infertility. Most researchers subdivide AZF into AZFa, AZFb and AZFc, and some believe there to be another region, AZFd, between AZFa and AZFb. Different AZF deletions lead to different phenotypes. AZFc deletion, as the commonest type that attracts widespread attention of researchers, includes complete AZF deletion and partial AZF deletion, and the latter mainly consists of gr/gr deletion and b2/b3 deletion. The gr/gr deletion can cause infertility in some areas or in human species. The influence of b2/b3 deletion on spermatogenesis has not been confirmed, but its wide spread in haplogroup N has distribution scientists' attention. This review outlines the structures, candidate genes and deletions of AZF, especially AZFc, along with their relationship with spermatogenesis, so as to provide a theoretical basis for clinical prenatal diagnosis and treatment of infertility.

Y chromosome microdeletions in severe oligospermia men with varicocele / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate Y chromosome microdeletions in severe oligospermia men with varicocele.</p><p><b>METHODS</b>We randomly selected 100 cases of severe oligospermia with left varicocele (sperm concentration <5 x 10(6)/ml, group 1), 100 cases of mild oligospermia with left varicocele (sperm concentration 10 -20 x 10(6)/ml, group 2), 100 cases of idiopathic infertility with severe oligospermia (group 3), 100 cases of idiopathic infertility with moderate oligospermia (group 4) and 30 normal fertile men as controls (group 5). We used polymerase chain reaction (PCR) technology to screen 9 sequence tagged sites (STS) of the AZF a, b and c regions and detect Y chromosome microdeletions.</p><p><b>RESULTS</b>AZF microdeletions were found in 19 patients in group 1 (19%) and 11 in group 3 (11%), with a higher rate in the former than in the latter, but not in the other three groups.</p><p><b>CONCLUSION</b>Screening of Y chromosome microdeletions should be performed before the treatment of severe spermatogenesis with varicocele.</p>

Mutation of the KAL1 gene in 30 male patients with idiopathic hypogonadotropic hypogonadism / 中华男科学杂志

<p><b>OBJECTIVE</b>To analyze the mutation of the KAL1 gene in male patients with idiopathic hypogonadotropic hypogonadism (IHH).</p><p><b>METHODS</b>We analyzed the exon mutation of the KAL1 gene in 30 IHH patients using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) combined with the PCR product direct sequencing technique.</p><p><b>RESULTS</b>Three cases of the KAL1 gene mutation were found among the total number of patients, including 1 case of nonsense mutation (c. 1270C > T,p. R424X), and 2 cases of frameshift mutation, (c. 279_280delAG,p. G94fs) and (c. 1886_1887delTT,p. L629fs).</p><p><b>CONCLUSION</b>Of the 3 cases of the KAL1 gene mutation we detected, 2 are new and 1 already reported in the literature. The results of our study have provided valuable information on the molecular genetics of the IHH syndrome.</p>

Molecular genetics of Kallmann syndrome: an update / 中华男科学杂志

Kallmann syndrome (KS) is a clinically and genetically heterogeneous disorder that occurs in either an inherited or a sporadic manner. KS results from failed embryonic migration of GnRH-1 neurons from the nasal placode to the hypothalamus, due to the abnormal development of olfactory nerves and bulbs. Hypogonadotropic hypogonadism is related to GnRH deficiency, and anosmia is associated with the absence or hypoplasia of olfactory bulbs and tracts. KS patients can also present some non-reproductive or non-olfactory anomalies in addition to the above typical symptoms. For the high complexity of the molecular genetic mechanism of KS, to date, only 6 KS-related genes have been identified. The KAL1 gene is responsible for the X chromosome-linked recessive form of KS, while the fibroblast growth factor receptor 1 (FGFR1/KAL2) and fibroblast growth factor 8 (FGF8/KAL6) genes are related to the autosomal dominant form of the disease. However, the mutations in these 6 genes account for only about 25 - 30% of all KS cases, which suggests that other pathogenic genes involved in KS remain to be discovered. This article presents an overview on the studies of the pathogenic genes, clinical diagnosis and treatment of KS.

Novel t[10; 13] [q24; q14] in a female with recurrent miscarriage

This case report presents a novel finding of 46, XX, t[10;13] [q24; q14] in a 35-year-old female with five spontaneous abortions. The only other abnormal finding was a low testosterone level. This report provides further information on the influence of balanced reciprocal translations in recurrent miscarriage

Updated esoteric causation of sperm oxidative stress / 中华男科学杂志

The incidence of infertility is on the rise worldwide. Statistically, infertility affects approximately 15% of couples and 50% of males, which can be attributed to the decreased sperm quantity and quality and consequently male eugenesis induced by such esoteric factors as quickened pace of life, polluted environment, unhealthy behaviors, and so on. With the establishment and development of the free radical theory, active oxygen-mediated oxidative stress has been found to play a significant role in the pathogenesis of male infertility. This review presents an overview of the esoteric factors responsible for sperm oxidative stress.

Influence of sperm DNA damage on reproductive outcomes and its clinical significance / 中华男科学杂志

Many factors are responsible for sperm DNA damage, which may lead to fertilization failure and embryo maldevelopment. At present, sperm DNA damage can be detected by more and more methods, which are considered to be superior to the conventional measures. There are some clinical indications for tests of sperm DNA damage in IVF/ICSI, but additional studies are still needed to fully define the clinical value of testing sperm DNA damage.

Assessment of released acrosin activity as a measurement of the sperm acrosome reaction / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To develop a method for assessing sperm function by measuring released acrosin activity during the acrosome reaction (AR).</p><p><b>METHODS</b>Human semen samples were obtained from 24 healthy donors with proven fertility after 3-7 days of sexual abstinence. After collection, samples were liquefied for 30 min at room temperature. Standard semen parameters were evaluated according to World Health Organization (WHO) criteria. Calcium ionophore A23187 and progesterone (P4) were used to stimulate the sperm to undergo AR. After treatment, sperm were incubated with the supravital dye Hoechst33258, fixed in a glutaraldehyde-phosphate-buffered saline solution, and the acrosomal status was determined by fluorescence microscopy with fluorescein isothiocyanate-labeled Pisum sativum agglutinin (FITC-PSA). The percentage of sperm undergoing AR (AR%) was compared to sperm acrosin activities as assessed by spectrocolorimetry. The correlation between AR% and acrosin activity was determined by statistical analysis.</p><p><b>RESULTS</b>The AR% and released acrosin activity were both markedly increased with A23187 and P4 stimulation. Sperm motility and viability were significantly higher after stimulation with P4 versus stimulation with A23187 (P < 0.001). There was a significant positive correlation between released acrosin activity and AR% determined by FITC-PSA staining (r=0.916, P < 0.001).</p><p><b>CONCLUSION</b>Spectrocolorimetric measurement of released acrosin activity might serve as a reasonable alternative method to evaluate AR.</p>

Update of the relationship between sperm morphology and sperm function / 中华男科学杂志

This article reviews the recent literature on sperm morphology and attempts to illuminate the important value of sperm morphology for evaluating man fertility, with a survey of the present status of sperm morphology analysis techniques and the relationship between sperm morphology and sperm function tests. Sperm morphology analysis, although its techniques need to be further improved, is proved of great value for its significant correlation with sperm function and as a predictor in assisted reproduction.

Cryopreservation of spermatozoa / 中华男科学杂志

Sperm cryopreservation has revolutionized the field of assisted reproduction. However, it causes cryodamage to the structure and function of spermatozoa during the freezing-thawing process. Optimization of sperm cryopreservation is necessary for the preservation of male fertility. Cryodamage can be reduced effectively by such methods as improvement of semen quality before freezing, spermatozoal selection, addition of optimal cryoprotectants and application of appropriate thawing techniques. Recent studies focus on cryobiology, improvement of freezing-thawing methods, especially for poor quality semen, and evaluation criteria for post-thaw spermatozoa.

Relationship between sperm motility parameters and sperm morphology / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the relationship between sperm motility parameters and sperm morphology.</p><p><b>METHODS</b>Seven hundred and eighty-three semen samples were tested. Sperm motility parameters were analyzed by computer-aided sperm analysis (CASA) , and sperm morphology assessed by automated sperm morphology analyzer (ASMA). The cases were classified based on the World Health Organization criteria. Morphologically 241 of the samples were normal and the other 542 abnormal.</p><p><b>RESULTS</b>VCL, WOB, VAP of the morphologically abnormal group were significantly higher than those of the normal group (P < 0.05, P < 0.001), while MAD, LIN, STR of the abnormal group were significantly lower (P < 0.05, P < 0.001). There were significant positive correlations between the morphologically normal sperm rates and MAD, LIN, WOB, STR, and a significant negative correlation between the morphologically normal sperm rate and ALH.</p><p><b>CONCLUSION</b>Morphological abnormality of sperm is often accompanied with weak motility, which is probably attributed more to some factors that coact on both sperm motility and morphology than to the influence of sperm morphological abnormality on sperm motility.</p>

Progress in leukocytospermia research / 中华男科学杂志

Leukocytospermia is a most common cause of male infertility, but the distribution, origin and role of leukocytes in semen are still controversial. Some reports on leukocytospermia have indicated its negative effects on semen parameters and even in vitro fertilization (IVF). Recent literature has made it clear that the most deleterious effect of leukocytospermia is that the increased reactive oxygen species (ROS) may cause sperm damage, leading to significantly increased male infertility. The treatment and prevention of leukocytospermia have been proven of help for improving semen parameters.

Ca2+ and sperm function / 中华男科学杂志

Ca2+ is an important positive ion in the living body. Recently, there have been quite a few reports about the function of Ca2+ in sperm. Calcium is considered as a regulator of sperm motility, a participant in sperm capacitation, and an essential second messenger for acrosome reaction. This paper reviews the relationship of Ca2+ with sperm function.