Glutathione S-transferase polymorphisms (GSTM1, GSTT1, GSTP1) and male factor infertility risk: a pooled analysis of studies.

PURPOSE: To determine the role of glutathione S-transferases (GSTs; GSTM1, GSTT1, and GSTP1) gene polymorphisms in susceptibility to male factor infertility. MATERIALS AND METHODS: We report a pooled analysis of 11 studies on the association of GSTM1, GSTT1, and GSTP1 polymorphisms and male factor infertility, including 1323 cases and 1054 controls. RESULTS: An overall significant association was determined between the GSTM1 null genotype [odds ratio (OR), 2.74; 95% confidence interval (CI), 1.72 to 3.84; P = .003], GSTT1 null genotype (OR, 1.54; 95% CI, 1.43 to 3.47; P = .02), and male factor infertility. The GSTP1 Ile/Val genotype had overall protective effect against development of infertility (OR, 0.48; 95% CI, 0.27 to 0.77), while there was significant heterogeneity between studies. In sensitivity analysis, two studies were excluded; the association and direction between GSTM1 and GSTT1 null genotypes and GSTP1 Ile/Val genotype and male infertility remained unchanged. There was no significant interaction between smoking status and studied genotypes on male infertility risk (P = .26). CONCLUSION: These results demonstrated that amongst populations studied to date, GSTM1 and GSTT1 null genotypes are associated with strong and modest increase in the risk of male infertility, respectively. On the contrary, GSTP1 Ile/Val genotype has protective effect.

RETRACTED: The effect of the mode of delivery on the quality of life, sexual function, and sexual satisfaction in primiparous women and their husbands.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief. Following the retraction of Dr. Safarinej ad's work by other journals, The Journal of Sexual Medicine has undertaken an extensive re-review of all papers Dr. Safarinejad published with the journal. Following an intensive re-evaluation and close scrutiny of the manuscripts, our expert reviewers raised multiple concerning questions about the methodology, results, and statistical interpretation as presented in this article. Dr. Safarinejad was contacted to provide his original data and offer explanations to address the concerns expressed by the reviewers. Dr Safarinejad chose not to respond. The co-authors of the article have also been contacted and did not respond either. Consequently, we can no longer verify the results or methods as presented and therefore retract the article.

Safety and efficacy of sildenafil citrate in treating erectile dysfunction in patients with combat-related post-traumatic stress disorder: a double-blind, randomized and placebo-controlled study.

OBJECTIVE: To evaluate the safety and efficacy of sildenafil citrate for treating erectile dysfunction (ED) in patients with combat-related post-traumatic stress disorder (PTSD). PATIENTS AND METHODS: In all, 266 combat-exposed war veterans with ED (aged 37-59 years) were recruited. They met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria for PTSD according to the Structured Clinical Interview for Patients, Investigator Version. The patients were also evaluated with the Clinician-Administered PTSD Scale, both to establish the diagnosis of PTSD and to measure symptom severity. Only patients with psychogenic ED were included in the study. Patients with comorbid conditions (diabetes mellitus, hypercholesterolaemia, hypertension, Peyronie's disease) and smokers of more than five cigarettes daily were excluded. The patients were randomly divided into a group of 133 who received 100 mg of on-demand sildenafil 0.75-2 h before sexual stimulation, and 133 who received placebo. Patients were asked to use > or =16 doses or attempts at home. The efficacy of the treatments was assessed every four attempts during treatment, and at the end of the study, using responses to the 15-question International Index of Erectile Function (IIEF), Sexual Encounter Profile diary questions 2 and 3, Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire, patients' event logs of sexual activity, and a Global Assessment Question about erections. RESULTS: Sildenafil did not produce significantly and substantially greater improvement than placebo in each of the primary and secondary outcome measures (P = 0.08). A normal EF domain score (> or =26) at endpoint was reported by 13 (9.8%), and 11 (8.3%) of patients on the sildenafil and placebo regimens, respectively (P = 0.09). Patients treated with sildenafil had no statistically significantly greater improvement in the five sexual function domains of the IIEF questionnaire than those treated with placebo (P = 0.08). The incidences of treatment-emergent adverse events were significantly greater in the sildenafil arm than in the placebo group (P = 0.01). CONCLUSIONS: Sildenafil is no better than placebo in treating PTSD-emergent ED. Further randomized clinical trials are warranted in combat veterans and other populations with PTSD to better elucidate the role of phosphodiesterase type 5 inhibitors in treating PTSD-emergent ED.

The effects of intensive, long-term treadmill running on reproductive hormones, hypothalamus-pituitary-testis axis, and semen quality: a randomized controlled study.

Effects of intensive exercise on hypothalamus-pituitary-testis (HPT) axis remain controversial. Our aim was to determine the effects of intensive, long-term treadmill running on reproductive hormones, HPT axis, and semen quality. A total of 286 subjects were randomly assigned to moderate-intensity exercise (approximately 60% maximal oxygen uptake (VO(2max)); group 1, n=143) and high-intensity exercise (approximately 80% VO(2max); group 2, n=143) groups. The two groups exercised for 60 weeks in five sessions per week, each session lasting 120 min. This was followed by a 36-week low-intensity exercise recovery period. All subjects underwent routine semen analysis. Blood samples were drawn for the determination of the levels of the following hormones: LH, FSH, prolactin, testosterone (T), free testosterone (fT), inhibin B, and sex hormone-binding globulin (SHBG). The HPT axis was assessed using GnRH and human chorionic gonadotropin tests. After 24 weeks of exercise, the subjects exercising with high intensity demonstrated significantly declined semen parameters compared with those exercising with moderate intensity (P=0.03). Serum T and fT began to decrease, and serum SHBG began to increase at the end of 12 weeks with both moderate- and high-intensity exercises. The serum LH and FSH concentrations decreased below the baseline level at 12 weeks in both groups (P=0.07 in group 1 and 0.03 in group 2). Both groups had blunted LH and FSH responses to GnRH. These parameters improved to their pre-exercise level during the recovery period. Long-term strenuous treadmill exercises (overtraining syndrome) have a deleterious effect on reproduction.

Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie's disease: a double-blind, placebo controlled, randomized study.

PURPOSE: We compared the efficacy and safety of oral vitamin E and propionyl-L-carnitine, separately or in combination, for the treatment of Peyronie's disease. MATERIALS AND METHODS: A total of 236 men (mean age 43.4 years) with Peyronie's disease were randomly assigned to 4 groups. Group 1 (58 men) received 300 mg vitamin E orally twice daily. Group 2 (59) received 1 gm propionyl-L-carnitine orally twice daily, and group 3 (60) received 300 mg vitamin E and 1 gm propionyl-L-carnitine orally twice daily. Group 4 (control group, 59 men) received a similar regimen of placebo during the 6-month treatment period. The efficacy of the 4 treatments was assessed using responses to the International Index of Erectile Function, visual analog scale for pain evaluation, mean intercourse satisfaction domain, mean weekly coitus episodes, penile curvature, plaque size and adverse drug effects. RESULTS: Pain decreased in 60.4%, 63%, 62.3% and 59.2% of the patients treated with vitamin E, propionyl-L-carnitine, vitamin E plus propionyl-L-carnitine and placebo, respectively (p = 0.1). After therapy a reduction in penile curvature was observed by 18.9%, 20.4%, 22.6% and 18.4% of the patients in groups 1, 2, 3 and 4, respectively (p = 0.09), and a decrease in plaque size was noted in 11.3%, 12.9%, 13.2% and 11.1%, respectively (p = 0.1). CONCLUSIONS: This study did not show significant improvement in pain, curvature or plaque size in patients with PD treated with vitamin E, propionyl-L-carnitine, or vitamin E plus propionyl-L-carnitine compared with those treated with placebo.