Comparison of spermiograms of infertile men before and during the COVID-19 pandemic

SUMMARY OBJECTIVE: Since the start of the COVID-19 pandemic, there has been interest in the impact of both SARS-CoV-2 infection and pandemic-induced social restrictions on male reproductive health. This study aimed to evaluate the spermiogram values of men who presented for infertility during the pandemic compared with the previous 2 years. METHODS: Patients who presented to a urology outpatient clinic for the first time due to infertility were included. The patients' age, semen volume, and spermiogram results were recorded. Based on the presentation date, the patients were divided into prepandemic group 1 (March 2018-February 2019), prepandemic group 2 (March 2019-February 2020), and pandemic group (March 2020-February 2021) for comparison. RESULTS: A total of 594 patients were included. There was no significant difference between the three groups in terms of the number of patients who presented for infertility (207, 190, and 197 patients, respectively; p=0.691). The mean age was 36.6±7.2 in the prepandemic group 1, 35.5±7.1 in the prepandemic group 2, and 33.1±6.3 in the pandemic group. Patients who presented during the pandemic were significantly younger (p<0.001). There were no differences between the groups in terms of semen volume (p=0.910) or rates of normospermia and pathological spermiogram findings (p=0.222). CONCLUSIONS: In the first year of the COVID-19 pandemic, there was no significant difference in the number of patients who presented for infertility or in their spermiogram results compared with 2018 and 2019. However, it is noteworthy that the patients were significantly younger during the pandemic than in the previous 2 years.

Laparoscopic Versus Open High Ligation for Adolescent Varicocele: A 6-year Single Center Study

Objective: The aim of this study was to compare the outcomes of high ligation in adolescentswith varicocele between open and laparoscopic surgical approaches. Design: Retrospectivestudy. Setting: The study was conducted from January 2012 to January 2018, with medianfollow-up of 36 months, in the division of pediatric surgery at tertiary-care hospital. Patients:Data of 537 adolescents who underwent varicocelectomy were classified into two groups,depending on surgical approach. Intervention: Open or laparoscopic varicocelectomy. Mainoutcome measures: Indications for surgery, complications, duration of surgery, hospitalstay, and recurrences rate. Results: The median age of the patients was 15 years. Themedian (IQR) duration of surgery was 12 (11,15.3) min in laparoscopic and 25 (10,30) min inopen group (P<0.001). The most common complication was hydrocele (n=29), which wasmore common in open group (6.8% vs 1.4%; P=0.01). A total of 16 recurrences wererecorded, all in open group (P=0.049). In both groups, sperm concentration (P<0.001),morphology (P<0.001) and motility (laparoscopy, P=0.001; P=0.02; open varicocelectomy,P=0.001; P=0.04) improved six months after surgery in patients with varicocele stage I and II.In stage III there was an improvement in sperm concentration (P=0.002; P=0.001) andmorphology (P=0.03; P=0.06), while sperm motility (P=0.15; P=0.2) did not significantlyrecover in either of the groups. Conclusions: Laparoscopic and open varicocelectomy areequally effective and result in significant improvement of testicular volume, disappearance ofpain, and sperm parameters in adolescents. Based on our findings laparoscopicvaricocelectomy is associated with shorter operating time, shorter hospitalization, fasterrecovery, and fewer complications and recurrences

Efecto de la hiperviscosidad seminal sobre la integridad acrosómica y la movilidad espermática antes y después de la criopreservación. / Effect of seminal hyperviscosity on acrosomal integrity and sperm motility before and after cryopreservation

La criopreservación del semen es una herramienta útil en la reproducción asistida, la cual puede tener impacto en las características espermáticas durante el congela miento y el descongelamiento. El objetivo de este estudio fue valorar la integridad del acroso ma y la movilidad de los espermatozoides criopreservados y descongelados provenientes de muestras hiperviscosas y no viscosas. Se realizó el espermograma, la integridad del acrosoma, el espermocultivo y los niveles de los marcadores de glándulas accesorias en 60 muestras de semen. Cada alícuota de semen fue inmersa en un crioprotector comercial para congelar a -196°C. Transcurridos 30 días, éstas fueron descongeladas y en el sedimento celular espermá ticesuspendido se evaluó la movilidad y la integridad acrosómica, disminuyendo significa tivamente la movilidad progresiva (p<0,05), la vitalidad espermática (p<0,005) y la integridad acrosómica (p<0,05); dicho descenso fue más evidente en las muestras hiperviscosas. La viscosidad del semen fresco se relacionó inversamente con la movilidad y la integridad del acrosoma antes y después del congelamiento (p<0,05). En veinte muestras de semen se iden tificó la presencia de microorganismos y de anticuerpos IgA anti C. trachomatis , de las cuales quince muestras en la reproducción hiperviscosas. El aumento de la viscosidad seminal y los niveles de ácido cítrico están asociados con disfunción prostática, baja movilidad espermática y reacción prematura del acrosoma, lo que puede reducir la capacidad fecundante de un esper matozoide. La etiología de la hiperviscosidad sigue siendo compleja; sin embargo, para pre servar la movilidad y la integridad del acrosoma, previamente deben investigarse sus causas en las muestras seminales que van a ser sometidas a la criopreservación.

Semen cryopreservation is a useful tool in assisted reproduction, which may have impact on sperm characteristics during freezing and thawing. The aim of this study was to assess the integrity of the acrosome and motility of cryopreserved and thawed spermatozoos in hyperviscous and no viscous samples. In semen samples spermiogram, glandular markers, acrosome integrity, culture and the levels markers accessory glands were measured. Each ali quot of semen was immersed in cryoprotectant and maintained in a commercial freezer at -196 ° C. After 30 days, these were thawed and in the cell pellet resuspended, spermatic motility and acrosomal integrity were evaluated. In thawed samples, there were significant decreases in progressive motility (p <0.05), vitality (p <0.005) and acrosome integrity (p <0.05) with respect to fresh sperm, this decline was most evident in hyperviscous samples. The viscosity of fresh semen was inversely related to motility and acrosome integrity before and after freezing (p <0.05). Twenty semen samples showed the presence of microorganisms and C. trachomatis IgA antibodies, of which fifteen showed hyperviscosity. Biochemical analysis demonstrated that semen samples with low levels of citric acid had less acrosomal integrity both before and after freezing (p <0.05). The viscoelasticity and citric acid levels are associated with prostate dys function, low sperm motility and premature acrosome reaction, which can reduce the fertilizing capacity of sperm. The etiology of hyperviscosity remains complex; however, to preserve mo tility and acrosome integrity, its causes must be investigated previously in the seminal samples to be subjected to cryopreservation.

Spermiogram and sperm head morphometry assessed by multivariate cluster analysis results during adolescence (12-18 years) and the effect of varicocele / 亚洲男科学杂志(英文版)

This work evaluates sperm head morphometric characteristics in adolescents from 12 to 18 years of age, and the effect of varicocele. Volunteers between 150 and 224 months of age (mean 191, n = 87), who had reached oigarche by 12 years old, were recruited in the area of Barranquilla, Colombia. Morphometric analysis of sperm heads was performed with principal component (PC) and discriminant analysis. Combining seminal fluid and sperm parameters provided five PCs: two related to sperm morphometry, one to sperm motility, and two to seminal fluid components. Discriminant analysis on the morphometric results of varicocele and nonvaricocele groups did not provide a useful classification matrix. Of the semen-related PCs, the most explanatory (40%) was related to sperm motility. Two PCs, including sperm head elongation and size, were sufficient to evaluate sperm morphometric characteristics. Most of the morphometric variables were correlated with age, with an increase in size and decrease in the elongation of the sperm head. For head size, the entire sperm population could be divided into two morphometric subpopulations, SP1 and SP2, which did not change during adolescence. In general, for varicocele individuals, SP1 had larger and more elongated sperm heads than SP2, which had smaller and more elongated heads than in nonvaricocele men. In summary, sperm head morphometry assessed by CASA-Morph and multivariate cluster analysis provides a better comprehension of the ejaculate structure and possibly sperm function. Morphometric analysis provides much more information than data obtained from conventional semen analysis.

CARACTERÍSTICAS SEMINALES DEL TITÍ GRIS (Saguinus leucopus) BAJO CONDICIONES DE CAUTIVERIO OBTENIDAS POR ESTIMULACIÓN VIBRATORIA DEL PENE (EVP) / SEMINAL CHARACTERISTICS OF WHITE-FOOTED TAMARIN (Saguinus leucopus) UNDER CAPTIVITY CONDITIONS OBTAINED BY PENILE VIBRATORY STIMULATION (PVS)

Se evaluó la eficacia de la técnica de estimulación vibratoria del pene (EVP) para obtener semen en quince especímenes de S. leucopus bajo condiciones de cautiverio, en cuatro diferentes sitios en Colombia. Adicionalmente, se estandarizó la técnica EVP y se determinaron algunas características seminales (color, viscosidad, volumen, pH, motilidad, morfología, viabilidad, concentración y morfometría espermática). Se empleó clorhidrato de ketamina a dosis entre 5 y 10 mg/kg I.M. para la sedación previa al muestreo a fin de disminuir el estrés de la captura y del procedimiento, ya que los especímenes no estaban acostumbrados o entrenados para procesos de obtención de muestras biológicas. En el uso de la técnica se logró un 52,6% de éxito en la combinación de 90 Hz de vibración y 1 mm de amplitud; el tiempo de eyaculación promedio fue de 12:35±6:42 minutos; el pH, 7,5±0,26; el volumen, 24±18,82 µl; la motilidad masal fue de 3,7/5,0±0,5; la motilidad individual progresiva, 97,1±45,4%; la concentración espermática fue de 87.617±21.327 x 10(4) spz/µl; la normalidad fue del 69,3±11,06% y la viabilidad del 93,7±4,9%. Las características seminales fueron similares a las reportadas en otras especies de callitríchidos y obtenidas por la misma técnica. Se empleó satisfactoriamente el diluyente Talp-Hepes y el cual no afectó las características antes descritas. La EVP es un método innovador, replicable, viable y seguro para la obtención de semen en S. leucopus y a otros callitríchidos bajo sedación con ketamina en condiciones de cautiverio.

The efficacy of the penile vibratory stimulation (PVS) for semen collection was evaluated in fifteen (15) specimens of white-footed tamarin (S. leucopus), held in captivity, at four different locations. Additionally the technique was standardized for semen collection in this species and seminal characteristics, color, viscosity, volume, pH, motility, morphology, viability, sperm concentration and morphometry were also evaluated. Ketamine hydrochloride was used at a dose between 5 to 10 mg/Kg for sedation and semen sampling. The technique was successful in 52.6% of the animals using the combination of 90 Hertz of vibration and 1 mm of amplitude; time of ejaculation was 12:3 ±6:42 minutes. Seminal characteristics were: pH of 7.5±0.26; volume of 24±18.82 µl; masal motility of 3.7/5.0±0.5; progressive motility of 97.1±45.4%; sperm concentration of 87,617±21,327 x 10(4)spz/µl; normal morphology 69.3±11.06% and viability of 93.7±4.9%. Talp-Hepes extender was satisfactorily used and it did not appear to affect seminal characteristics. The PVS is an innovating, replicable, viable and safe method for obtain semen in S. leucopus and perhaps in other callitrichids under ketamine sedation and in captivity.

Influencia de la abstinencia eyaculatoria en las características del espermiograma: revisión sistemática / Relationship between the duration of ejaculatory abstinence and sperm characteristics: systematic review of the literature

Antecedentes: La Organización Mundial de la Salud propone que el tiempo de abstinencia eyaculatorio óptimo para evaluar los parámetros seminales del espermiograma sea entre 2 y 7 días. Objetivo: Evaluar la evidencia científica para esta recomendación. Método: Se realizó esta revisión sistemática con el fin de evaluar la relación entre la duración de la abstinencia sexual y las características del espermiograma. Se realizó una búsqueda en las bases MEDLINE y PUBMED incluyendo artículos prospectivos y retrospectivos donde se informara la abstinencia eyaculatoria y que el informe del espermiograma cumpliera con los criterios de la OMS. Se descartaron aquellos que incluyera hombres con tratamientos hormonales o con diabetes mellitus. Resultados: Encontramos cuatro trabajos que cumplieron los criterios de selección. De su análisis se desprende que tanto el volumen seminal como la concentración espermática varió con el tiempo de abstinencia, pero no se encontraron diferencias significativas en los parámetros de motilidad ni en la frecuencia de morfologías normales. Conclusión: No encontramos evidencia que apoye la política actual de abstinencia eyaculatoria previo a la evaluación del espermiograma...

Background: The World Health Organization proposed an ejaculatory abstinence to evaluate seminal parameters of 2 to 7 days. Objective: Evaluate the scientific evidence for this recommendation. Methods: We performed a systematic review of the literature, in order to assess whether there is a relationship between the duration of ejaculatory abstinence and sperm characteristics. We performed a search in databases MEDLINE and PUBMED including articles reporting ejaculatory abstinence and that met the WHO criteria for seminal analysis. Exclusion criteria included hormonal treatment or diabetes mellitus. Results: Four articles met the inclusion criteria. They reported that both semen volume and sperm concentration differed significantly according to ejaculatory abstinence, however we found no evidence that neither motility parameters nor normal morphology depended on ejaculatory abstinence. Conclusion: We found no evidence to support 2-7 days ejaculatory abstinence prior to perform a semen analysis...

Evaluación y estandarización de la calidad del espermiograma: nuevos límites inferiores de referencia / Evaluation and standardization of the quality of semen: new lower reference limit

El análisis seminal o espermiograma es uno de los parámetros más usados en la evaluación de la fertilidad masculina. La OMS (WHO, 2010), presentó el 5 Manual para el examen y procesamiento del semen humano, documento que fue analizado durante el primer taller de estandarización del análisis seminal (PLEAS), realizado en Santiago de Chile, mayo del 2010. Posteriormente se aplicaron los nuevos valores indicados como "límite de referencia inferior" (LIR), en el estudio del análisis seminal realizados por varios autores (2003 al 2010). Los resultados obtenidos indican que el 81 por ciento de los investigadores latino americanos creen que el nuevo manual estandariza mejor la concentración espermática, un 96 por ciento está de acuerdo con la nueva subclasificación en la motilidad espermática en progresiva (A), no progresiva (B) e inmóviles (C). El 68 por ciento estima que el mejor instrumental de recuento es la cámara de Neubauer. Respecto a los controles de calidad solo el 18 por ciento realiza controles de calidad externa. El 100 por ciento de los investigadores estima conveniente realizar continuos talleres de estandarización. Respecto a la aplicación de los LIR en las poblaciones en estudio, todos ellos cumplirían con los estándares actuales para ser considerada una población con capacidad de fertilidad. Sin embargo varios autores opinan que una nueva versión del manual OMS, debe realizarse urgentemente para estandarizar mejor la concentración espermática (15 millones por mL) y la morfología según criterios estrictos (4 por ciento), valores de referencia que consideran muy bajos.

Spermogram or semen analysis is one of the most used parameters in the evaluation of male fertility. WHO (2010) presented the 5th Manual for review and processing of human semen, a document that was discussed during the first workshop of standardization of semen analysis (PLEAS), held in Santiago de Chile, May 2010. Subsequently applied the new values expressed in "lower referencelimit" (LRL) for semen in several analysis studies conducted by various authors (2003 to 2010). The results indicate that 81 percent of Latin American researchers believe the new manual standardizes best sperm concentration, 96 percent agree with the new subclassification in progressive sperm motility (A), non-progressive (B) and immobile (C). 68 percent determined that the best instruments for the sperm countis the Neubauer haemocytometerchamber. Regarding quality control only 18 percent performed external quality control. 100 percent of researchers believe it is appropriate to conducton going standardization workshops. Regarding the application of LRL in the study populations (2003-2010), 100 percent comply with the standards to be considered a population with fertility capacity. However, several authors argue that a new version of the WHO manual, must be re-done urgently to better standardize sperm concentration (15 million/mL) and morphology according to strict criteria (4 percent), reference values considered very low.

Spermiogram and Morphological Characteristics in Testicular and Epididymal Spermatozoa of Large White Boar in Nigeria / Espermiograma y Características Morfológicas de los Espermatozoides en el Testículo y Epidídimo del Verraco Grande Blanco en Nigeria

Ten healthy male (boar) of large white pigs aged between 6.0 and 18.0 months, were used for this study. Spermiogram and morphological characteristics were studied in testes and in the different parts of the epididymis of the boar. The objective was to study the changes that occur in testes and epididymis during epididymal transit. Progressive motile spermatozoa were first observed in the testes (6-10%) in the caput (20-30%), corpus (40-50%) and highest at the caudal epididymis (85%). Cytoplasmic droplets were lost as the spermatozoa moved up the epididymis. The caput epididymis had a value of 20.05% of abnormal sperm cell, which is different significantly (p<0.5) from 15 ­ 80 % of the caudal epididymis. The total abnormal sperm cells in corpus are also higher than in the caudal epididymis Percentage motility was 0.6 ± 2.0 % in the testis, which was lower (P< 0.5) than in caput with 23.0 ± 5.0%. This motility increases from caput to caudal epididymis. The caput epididymis also had 0.20% of spermatozoa with small head, which differed significantly (p<0.05) from corpus (0.05%) and the caudal (0.00%). The testicular and epididymal parameters were positively correlated (weight of testis and epididymis; weight of testis, scrotal circumference, testicular circumference, weight of epididymis and weight of testis (p<0.05), except the correlation values between testes and epididymis circumference (TEC) and other parameters (p<0.01).

Para la investigación se utilizaron 10 verracos de cerdos blancos de gran tamaño, con edades entre 6 y 18 meses. Se realizó el espermiograma y se observaron las características morfológicas, en los testículos y en las diferentes partes del epidídimo. El objetivo fue estudiar los cambios que ocurren en los espermatozoides a nivel de los testículos y del epidídimo durante el tránsito epididimal. Los espermatozoides mótiles progresivos se observaron primero en testículos (6-10%), en la cabeza (20-30%), cuerpo (40-50%) y en la cola de epidídimo (85%). Pierden gotas citoplásmicas, en la medida en que los espermatozoides se trasladan ascendiendo hasta el epidídimo. La cabeza del epidídimo presenta un valor de 20,05% de células anormales de espermatozoides, lo que es significativamente muy diferente (p<0.5) de 15-80% en la cola del epidídimo. El total de espermatozoides anormales en el cuerpo del epidídimo, es también más alto que en la cola del epidídimo. El porcentaje de motilidad fue de 0,6 ± 2,0% en el testículo, el cual era más bajo (p< 0.5) que en la cabeza del epidídimo, con 23.0 5 0%. Esta motilidad aumenta desde la cabeza a la cola del epidídimo. La cabeza del epidídimo también presenta 0,20% de espermatozoides con cabeza pequeña, lo que difiere significativamente (p<0.05) del cuerpo (0,05%) y de la cola (0,00%). Los parámetros testicular y epididimal estaban positivamente correlacionados (peso del testículo y del epidídimo; peso del testículo, circunferencia escrotal, circunferencia testicular (peso del epidídimo y peso del testículo (p<0.05), excepto los valores de correlación entre testículos y circunferencia epididimaria (TEC) y otros parámetros (p = 0.01).