Decreased total sperm counts in habitants of highly polluted areas of Eastern Sicily, Italy.

Air pollution has been suggested to affect semen quality, but the evidence is still contradictory. To assess whether any differences occur in conventional sperm parameters of men life-long resident in low, middle-low, middle, and high industrial density zones in the province of Messina. We retrospectively analyzed the conventional sperm parameters of patients to whom the sperm analysis was requested during their female partner counseling for infertility in an assisted reproductive technique (ART) center. A total of 184 men were enrolled. Total sperm count was higher in patients living in low and middle-low industrial density areas compared with that of men living in middle and high ones (123.5 ± 146.8 vs. 80.7 ± 92.7 mil/ejaculate, p < 0.05). No difference was found for sperm concentration (37.2 ± 49.7 vs. 30.5 ± 37.2 mil/mL), progressive motility (15.4 ± 19.8% vs. 14.2 ± 18.4%), total motility (62.3 ± 20.5 vs. 58.4 ± 19.9 mil/mL), and normal forms (2.7 ± 1.5 vs. 2.3 ± 3.0 mil/mL). These results add further evidence to findings from Sicilian population. Effective control of air pollution should be accomplished to prevent its negative impact on human reproductive health.

Prevalence of asymptomatic lower limb venous thrombosis in infertile women with thrombophilic disorders.

OBJECTIVE: We sought to assess the prevalence of asymptomatic venous thrombosis in infertile women with thrombophilic disorders (TDs). METHODS AND RESULTS: A total of 73 infertile women with TDs underwent duplex ultrasound scan to evaluate superficial and deep venous circulation of lower limbs. A control group of 35 infertile women without TDs was included. A single TD was found in 13 (17.8%) subjects, and 40 (54.8%) women presented a combined defect (more than three alterations). No residual mural thrombosis (RT) was noted in any deep veins. We found RT in 48 (65.8%) patients of TD group, while no RT was found in the control group (p < 0.0001). None of the clinical and prothrombotic factors were predictors of RT (all p > 0.20), and frequency of TD did not correlate with multi-vessel RT (p = 0.252). CONCLUSIONS: No signs of deep vein thrombosis but high prevalence of superficial RT is present in infertile women with TDs. Further studies are needed to assess the prognostic value of our findings.

Persistence of ultrasound alterations after antibiotic treatment with levofloxacin in patients with male accessory gland infection.

No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection (MAGI) according to the microbiological outcomes of bacterial cultures (absent, partial or complete) following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin (a common quinolone antibiotic), in patients with infections caused by Escherichia coli (a Gram-negative bacterium) according to the Naber's classification, which includes the following categories: eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 25±8 years (range: 20-40 years) with bacterial MAGI and bacterial cultures positive only for E. coli (colony forming units ≥10(6) per ml). Retrospective analysis was conducted only on patients treated with oral levofloxacin (500 mg) administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis (PV) (30.2% and 36.0%, respectively) or prostato-vesiculo-epididymitis (PVE) (60.2% and 70.0%, respectively) compared with patients with microbiological eradication (PV=10.2% and PVE=8.2%, respectively) or eradication with superinfection (PV=18.8% and PVE=21.2%, respectively). In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI (PV and PVE), compared with patients with microbiological eradication or eradication with superinfection.

Myoinositol: does it improve sperm mitochondrial function and sperm motility?

OBJECTIVE: To evaluate whether an improvement in mitochondrial membrane potential was associated with sperm motility amelioration and greater sperm recovery after the swim-up procedure. A second purpose was to evaluate the effects of myoinositol (MYO) on sperm apoptosis, quality of chromatin compaction, and DNA integrity. METHODS: Spermatozoa from 20 normozoospermic men and 20 patients with oligo-astheno-teratozoospermia were incubated in vitro with 2 mg/mL of MYO or phosphate-buffered saline as a control for 2 hours. After this incubation period, sperm motility was evaluated. Flow cytometry was used to analyze the mitochondrial membrane potential, phosphatidylserine externalization, chromatin compactness, and DNA fragmentation. We also evaluated the total number of motile spermatozoa recovered after swim-up after incubation with MYO or phosphate-buffered saline. RESULTS: MYO significantly increased the percentage of spermatozoa with progressive motility in both normozoospermic men and patients with oligo-astheno-teratozoospermia. Motility improvement in the latter group was associated with a significant increase in the percentage of spermatozoa with high mitochondrial membrane potential. MYO had no effects on mitochondrial function in spermatozoa from normozoospermic men. Sperm phosphatidylserine externalization, chromatin compactness, and DNA fragmentation were unaffected by MYO in both groups. After incubation with MYO, the total number of spermatozoa recovered after swim-up had improved significantly in both groups. CONCLUSION: These data show that MYO increases sperm motility and the number of spermatozoa retrieved after swim-up in both normozoospermic men and patients with abnormal sperm parameters. In patients with oligo-astheno-teratozoospermia, the improvement in these parameters was associated with improved sperm mitochondrial function. These findings support the use of MYO in both in vivo- and in vitro-assisted reproductive techniques.

Prevalence of Ureaplasma urealyticum and Mycoplasma hominis infection in unselected infertile men.

In this study, we investigated the prevalence of Ureaplasma urealyticum and Mycoplasma hominis infection among 250 unselected infertile men, the presence of urogenital symptoms in infected men and the effects of these microorganisms on the conventional sperm parameters. Urethral samples were obtained using a swab inserted 3-4 cm into the urethral meatus. Ureaplasma urealyticum and Mycoplasma hominis were detected by the kit Mycofast R evolution 3 Elitech Microbiology (Elitech Microbiology, Signes, France). Ureaplasma urealyticum was detected in 15.6% of the cases and Mycoplasma hominis in 3.6%. One patients had a co-infection with both pathogens. About 41% of the infertile patients with mycoplasma infection had urogenital symptoms. A lower number of patients with mycoplasma infection had normal sperm parameters compared with non-infected infertile men, but this frequency showed only a trend compared to non-infected patients (Chi-square=3.61; P=0.057), and a significantly higher percentage of patients with oligo-astheno-teratozoospermia (Chi-square=127.3; P<0.0001), or asthenozoospermia alone (Chi-square=5.74; P<0.05) compared to non-infected infertile patients. In conclusion, this study showed an elevated prevalence of Ureaplasma urealyticum and Mycoplasma hominis infection in unselected men attending an infertility outpatient clinic and that the presence of these microorganisms is associated with a higher percentage of patients with abnormal sperm parameters.

Chlamydia trachomatis prevalence in unselected infertile couples.

Chlamydia (C.) trachomatis, an obligate intracellular bacterium, is responsible for the most common sexual transmitted disease and infertility. The purpose of this study was to evaluate: a) the frequency of chlamydial infection in unselected infertile couples and b) whether chlamydial infection could be identified in the semen sample as effectively as in the urethral swab of infertile patients. To accomplish this, 73 unselected, consecutive infertile couples were enrolled. Both male and female partners underwent a complete work-up to identify the cause of their infertility. A PCR method was used to detect C. trachomatis in urethral swabs and the semen samples of the male partners and in the cervical swabs of the female partners. C. trachomatis infection was found in 6 couples (8.2%). Three couples had both partners infected, 2 couples had only the male partner infected, and 1 only the female partner. C. trachomatis infection was found in the urethral swab of all 5 men infected, whereas the bacterial DNA was found in the semen sample of 2 of them. These findings suggest that C. trachomatis infection is present in about 8% of unselected infertile couples and that the bacterium should be searched in the male partner urethral swab which has a higher sensitivity.

Candida albicans experimental infection: effects on human sperm motility, mitochondrial membrane potential and apoptosis.

Studies suggest Candida albicans infection has a negative effect on sperm function, including fertilizing ability. Assisted reproduction treatment using spermatozoa from a patient with unrecognized C. albicans infection did not result in fertilization. Preliminary evidence suggested an effect on sperm motility and apoptosis. This study was undertaken to evaluate the effects of experimentally induced C. albicans infection on motility, membrane mitochondrial potential (MMP), chromatin packaging and apoptosis [membrane phosphatidylserine (PS) externalization and DNA fragmentation] of spermatozoa isolated from normozoospermic healthy men. Motile spermatozoa were isolated by swim-up from 13 normal volunteers and exposed to increasing concentrations (0, 1000, 10,000, and 100,000 cfu/ml) of the fungus for 3 and 24 h. C. albicans was isolated from vaginal swabs, after identification, freshly prepared for experiments. Following incubation, sperm motility decreased significantly (P < 0.05 from 10,000 cfu/ml) and spermatozoa with reduced MMP or PS externalization, an early sign of apoptosis, increased in a time- and concentration-dependent manner. Sperm DNA fragmentation and chromatin integrity increased slightly after exposure to C. albicans, but the increase did not reach statistical significance. This study showed that C. albicans infection may decrease the functional competence of spermatozoa by reducing motility and MMP and by promoting molecular apoptosis mechanisms.