Male partners of subfertile couples in which the spouse is obese display adverse weight and lifestyle associated with reduced sperm quality.

OBJECTIVES: To assess: 1-the spousal concordance of lifestyle and anthropometric characteristics between partners of infertile couples in which the woman is obese; and 2-in men, the influence of these characteristics on their conventional seminal parameters. DESIGN: Cross-sectional study. SETTING: Fertility clinic of the Centre hospitalier universitaire de Sherbrooke, Canada, between January 2012 and February 2015. PATIENTS: 97 infertile heterosexual couples in which women were obese and seeking fertility treatments. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Weight and percentage of fat mass were evaluated using a scale with foot-to-foot bio-impedance. Abdominal obesity was estimated with waist circumference and lifestyle habits, by a self-reported questionnaire. Seminal parameters were analysed and collected according to the WHO guidelines (Kruger's strict criteria for seminal morphology). RESULTS: There was a significant spousal concordance for the percentage of fat mass, leisure activities and overall nutritional quality. Accordingly, male participants displayed anthropometric and lifestyle characteristics at higher risk than Canadian men of similar age. Moreover, BMI, daily consumption of fruits & vegetables and sleeping hours in men were independently associated to the total motile sperm count. CONCLUSION: This is the first study to report concordance for anthropometric and lifestyle characteristics between partners of infertile couples in which the woman is obese. These characteristics in men were more adverse than in the general population and were associated with reduced sperm quality. Altogether, our results suggest that male partners of infertile couples could benefit from participating in the lifestyle intervention that is already recommended for their spouse affected by obesity. CAPSULE: Because partners of subfertile couples in which the woman is obese share adverse anthropometric and lifestyle characteristics, male partners should be implicated in lifestyle interventions already indicated for their spouse.

Polybrominated diphenyl ethers and sperm quality.

BACKGROUND: Polybrominated diphenyl ethers are known to be endocrine disruptors and may affect male reproduction. This exploratory study investigated semen parameters and serum thyroid hormones in relation to serum PBDE, PCBs and p-p' DDE in adult men. METHODS: Fifty-two men were recruited in a fertility clinic. Semen counts were done for each participant. Serum thyroid hormone and PBDE, PCB and p-p' DDE levels were measured. Sociodemographic questionnaire were administered to each participant and all medical data were obtained from medical record. RESULTS: Semen mobility was negatively related to BDE-47, BDE-100 and ΣBDE. No relations were observed with other semen parameters. Thyroxin levels were negatively associated to serum BDE-47, BDE-99, ΣBDE and p-p' DDE and positively related to ΣPCB. No relations were observed between T3, TSH and any of the chemicals measured. CONCLUSION: These findings increased the evidence that PBDE may interfere with semen quality and thyroid status in general population.

Comparison of two continuous combined estrogen progestogen regimens in postmenopausal women: a randomized trial.

OBJECTIVE: To compare two different continuous regimens of estrogens: conjugated estrogens or estrone sulfate with medroxyprogesterone acetate (MPA). To evaluate the impact of these two regimens on bleeding pattern, endometrial histology, lipid metabolism, and climacteric symptoms. DESIGN: Prospective, open label, single center, randomized trial. SETTING: The menopause clinic, Centre Universitaire de Santé de l'Estrie, Université de Sherbrooke, Quebec, Canada. PATIENT(S): Fifty-nine postmenopausal women seeking treatment for symptomatic menopause. INTERVENTION(S): Patients were randomized to two groups. Both groups received 2.5 mg/d MPA plus 0.625 mg/d conjugated estrogens (group A: 31 patients) or 0.625 mg/d estrone sulfate (group B: 28 patients). Lipid metabolism, endometrial biopsies, and endometrial thickness (measured by vaginal ultrasound) were determined at 52 and 104 weeks. RESULT(S): Six women (10%) withdrew from the study (irregular bleeding and side effects). Fifty-three patients completed the study. Amenorrhea was produced in 92.6% and 96.1% by 52 weeks, and 100% by 104 weeks for groups A and B, respectively. Endometrial atrophy was observed by histology in 92.4% by 52 weeks and in 100% by 104 weeks in both groups. The correlation between an endometrial thickness (vaginal ultrasound) of < or = 4 mm and histologic diagnosis of endometrial atrophy was found in 41 of 53 patients. In both groups the climacteric symptoms were improved and the lipid profile showed a beneficial effect. CONCLUSION(S): No significant difference was found between the two continuous regimens. Amenorrhea and atrophic endometrium occurred in 92.4% after 52 weeks of treatment. A favorable change in lipid metabolism even with the addition of MPA to estrogens was noted. Irregular bleeding was reduced and the long-term compliance with the continuous regimen was high (90%).

Tamoxifen citrate therapy in male infertility.

A prospective, randomized, double-blind study with crossover, using tamoxifen (TAM) (Nolvadex, ici Pharma, Missisauga, Canada) 20 mg/day and placebo (p) for 6 months each, was conducted in 16 infertile men with idiopathic oligozoospermia. Baseline sperm count was 17.092 +/- 3.09 (10(6)/ml). Hormonal profile was performed and included follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), testosterone (T), prolactin (PRL), thyroid-stimulating hormone (TSH), and luteinizing hormone-releasing hormone (LH-RH) stimulation tests. The sperm analysis and hormonal profile were repeated at 6 and 12 months of the study. A sperm penetration assay (SPA) was performed on zona-free hamster egg. Compared with the placebo group, the TAM group showed a significant increase in plasma FSH, LH, E2, and T levels (P less than 0.001), but not in PRL and TSH levels. However, LH-RH stimulation tests and SPA were found to be comparable in the two treatment groups, and there was no significant effect on sperm analysis. Tamoxifen appeared to be no more effective than the placebo in the treatment of idiopathic oligozoospermia.

Bromocriptine therapy in oligozoospermic infertile men.

A prospective, randomized double-blind study with crossover using bromocriptine and placebo was performed on a group of 17 infertile males with idiopathic oligozoospermia. Twelve patients completed the duration of this study of eight months by receiving 5 mg of bromocriptine per day for four months followed by four months of placebo or vice versa. Prior to treatment, the sperm count was 8.76 +/- 1.32 (10(6)/ml). The hormonal profile was performed prior to treatment and included estimation of prolactin, T3, T4, thyroid stimulating hormone (TSH), testosterone, follicle stimulating hormone (FSH), and plasma LH. Stimulation studies using LHRH and TRH were also performed. All hormonal estimations were within normal limits. Compared to placebo, bromocriptine had no significant effect on sperm analysis, or basic hormonal profile. The stimulation test with luteinizing hormone releasing hormone (LHRH) was unchanged except for the basic plasma testosterone, which increased. The prolactin decreased following the thyrotropin releasing hormone (TRH) stimulation. Two pregnancies were noted four to six weeks following the end of treatment. Bromocriptine did not seem to be more effective than placebo in the treatment of idiopathic oligozoospermia.

Primary infertility: correlation between sperm migration test and humoral immunity.

Eleven couples with unexplained primary infertility were studied. The only abnormality appeared to be a poor sperm migration test (P.S.M.T.). The importance of circulating immune factors in these couples was assessed using a modified Kibrick test. Control sera included four provided by the WHO, four of our known positive samples, 49 sera obtained prevasectomy, and 17 sera collected from infertile couples with organic female pathology. A positive titer was found in one out of 49 control sera before vasectomy and in four out of 17 control coupled with organic female factors. In the 11 couples with poor sperm migration test, the titer was positive in two female and three male subjects. The wives of two of these male subjects with a positive titer became pregnant without any therapy. These results cast some doubts about the predictive value of such a test.

Ovarian hyperthecosis: in vivo and in vitro correlations of the androgen profile.

A 36-year-old patient with secondary amenorrhea and progressive frank virilization was found by histologic examination to have ovarian hyperthecosis. Baseline androgenic investigation revealed a selective increase in testosterone (T) production rate (3.1 mg/day), which was associated with an increase in both plasma T concentration (total and unbound) and metabolic clearance rate (MCR) of T (2156 liters/day). There was a marked concentration gradient for circulating plasma T between each ovarian vein and the peripheral veins (right ovarian, 50 ng/ml; left ovarian, 21 ng/ml). After bilateral wedge resection there was a rapid decrease in the total and unbound T levels as well as in the MCR of T, which remained normal for at least 6 months. By then the patient had stopped shaving and was menstruating normally. In vitro incubation studies of fragments from each ovary revealed incorporation of [3H]-dehydroepiandrosterone and [3H]-progesterone into [3H]-T in the range reported for normal human ovarian stroma, and short-term cellular culture suggested a normal morphology and steroidogenesis. It is concluded that in this patient with ovarian hyperthecosis, the observed ovarian T production resulted more from an increase in the amount of stromal-thecal tissue than from a functional biochemical defect in the latter.