Proportion of Hypogonadism in Transfusion-Dependent Thalassemia Patients and Its Contributing Factors.

BACKGROUND: Beta thalassemia is a lifelong disease involving malformed red blood cells (RBC). One of the disease's complications is hypogonadism, in which adults tend to exhibit regression in sexual characteristics, experience sexual dysfunction, and therefore have a lower quality of life. Around 3-10% of the Indonesian population carries the beta-thalassemia gene. This study aimed to see the proportions of hypogonadism in transfusion-dependent thalassemia patients and its contributing factors. METHODS: This is a cross-sectional study involving 60 male patients admitted to three Indonesian general hospitals from July 2022 to July 2023. All patients were diagnosed with beta-thalassemia via chromatography hemoglobin analysis. We performed a single-time physical examination and laboratory examinations to determine FSH, LH, and free testosterone levels. The correlation between Hb and sexual hormone levels was analyzed using Spearman's rank correlation coefficient. ROC curve analysis was conducted afterward. All statistical analysis was done in SPSS version 29. RESULTS: 31 out of 60 thalassemia patients had hypogonadism. Pre-transfusion Hb count was found to be linearly correlated with FSH (r = 0.388, p = 0.049), LH (r = 0.338, p = 0.008), and free testosterone (r = 0.255, p = 0.049). ROC analysis indicated that pre-transfusion Hb was viable as a predictor for hypogonadism (AUC = 0.655, 65.5% sensitivity, 67.7% specificity). CONCLUSION: We confirmed the role of pre-transfusion Hb count as a potential predictor for hypogonadism due to the tissue hypoxia mechanism and transfusion-related iron overload in TDT patients. Decreased Hb is linearly correlated with FSH, LH, and testosterone levels. Decreased Hb also downregulates these factors.

The seahorse (Hippocampus comes L.) extract ameliorates sperm qualities, testosterone level, and serum biochemistry in rats induced by depo medroxyprogesterone acetate.

Objective: The percentage of infertility cases in this world is about 50%. Seahorses (Hippocampus spp.) are widely used in traditional medicine. Several studies suggest that seahorses have ethnopharmacological characteristics, such as fertility, antioxidants, and antifatigue. The purpose of this study was to determine whether seahorse extract (SE) (Hippocampus comes L.) has an effect on fertility and serum biochemistry in rats induced by depo medroxyprogesterone acetate (DMPA). Materials and Methods: All animals were induced with 1.25 mg/kg BW of DMPA. Animals were grouped into five groups: namely aquadest, 1% CMC, and SE doses of 150, 225, and 300 mg/kg BW. The rats were gavage every morning from week 7 until 18. At the end of our study, semen from the vas deferens and blood from the heart were analyzed. We analyzed with a one-way analysis of variance and Bonferroni's post hoc tests (α 95%). Results: The concentration of spermatozoa had a significant difference in dose of 150 mg/kg BW compared to other groups (p = 0.04). In contrast, the motility (p = 0.012) and viability of spermatozoa (p = 0.007) were highly significant differences (p < 0.05 and p < 0.01) at 300 mg/kg BW. Testosterone levels were not significantly (p = 0.162; p > 0.05), but tended to increase at 300 mg/kg BW (11.01%). Nevertheless, serum biochemistry was insignificant (p > 0.05) in all groups. Conclusion: SE (Hippocampus comes L.) ameliorates fertility and serum biochemistry in rats induced by DMPA.

Dietary Soybean (Glycine max (L.) Merr.) Improved the ZP2 Expression in Female Swiss Mice.

OBJECTIVE: This study aimed to determine the effects of soybean (Glycine max) administration on ZP2 expression in female mice. METHODS: This research used Mus musculus, six-week-old female SWISS strain mice divided into three groups (group without soybean administration and groups with mixed feed with soybeans and pelleted 50:50 and 25:75). Soybean feed for mice was 360 grams per kilogram of mouse body weight for 2 weeks. The percentage of follicles was measured and analyzed using Hematoxylin-Eosin staining, and the expression of ZP2 was analyzed using immunohistochemistry. We assessed the data using one-way ANOVA and paired t-test using the SPSS 17. RESULTS: Some of the follicles in the ovaries do not develop until their final stage of follicle maturation. The administration of soybean before and after treatment in all groups was not significantly different, but the numbers of atretic follicles in groups 1 and 2 were significantly different. Soybean administration at a ratio of 50:50 has the effect of increasing the percentage of the ZP2 expression in tertiary follicles (p=0.001), whereas soybean administration at a ratio of 25:75 was not able to maintain or increase the formation of ZP2 in tertiary follicles (p=0.77). CONCLUSION: Soybean administration with a ratio of 50:50 significantly increased the percentage of the ZP2 expression in tertiary follicles.

Acupuncture Therapy for Severe Oligoasthenoteratozoospermia.

Background: Infertility affects ∼15%-20% of couples. Of the 16.7% infertility rate reported based on Word Health Organisation questionnaire data, 6.4% of cases are associated with male factors. Male infertility can result from abnormal semen parameters; oligoasthenoteratozoospermia (OAT) is the most common diagnosis. Acupuncture is an ancient method that has been used for centuries to treat and prevent various conditions. In modern medicine, it is gaining popularity as a complementary infertility therapy. Case: A 41-year-old male presented to the Medical Acupuncture Department of Dr. Cipto Mangunkusumo Hospital (in Jakarta, Indonesia) because he wanted to have a child. His semen was analyzed, and he was diagnosed with severe OAT. Manual acupuncture therapy was performed at CV 3, CV 4, CV 5, CV 6, CV 7, ST 29, SP 6, SP 3, ST 36, and KI 3, alternating with KI 7 5 days per week and at LR 8 once per week, for a total of 28 sessions. Results: Semen analysis after 2 series of manual acupuncture treatments revealed improvement, especially in sperm motility, from 25% to 33% and then to 67% after the first and second serial therapies, respectively, changing the diagnosis from severe OAT to severe oligoteratozoospermia. Conclusions: Manual acupuncture combined with medication improves male fertility, especially sperm motility.

Sperm chromatin maturity and integrity correlated to zygote development in ICSI program.

UNLABELLED: This study aimed to evaluate sperm chromatin maturity and integrity of that injected into good-quality oocytes in an in vitro fertilization-intra cytoplasmic sperm injection (IVF-ICSI) program. A cut-off value of sperm chromatin maturity and integrity was developed as a function of their correlation to the zygote development, i.e., embryo formation and cleavage rate. The study assessed sperm chromatin maturity using aniline blue (AB) staining, whereas toluidine blue (TB) staining was used to assess sperm chromatin integrity. Ejaculates from 59 patients undergoing ICSI and 46 fertile normozoospermic donors for determination of normal values of sperm chromatin status were used in this study. Embryo formation and cleavage rates were observed for the period of 3 days after ICSI. There was a significant difference in the percentage of sperm with mature chromatin between ejaculate from ICSI patients and fertile donor (p=0.020); while there was no significant difference in sperm chromatin integrity of both samples (p=0.120). There was no significant correlation between sperm chromatin maturity and either embryo formation or cleavage rate; as well as sperm chromatin integrity to both parameters of zygote development (p>0.05). Furthermore, we found that the cut-off value of sperm chromatin maturity and integrity of the fertile normozoospermic ejaculates were 87.2% and 80.2%, respectively. Using the cut-offs, we found that low sperm chromatin maturity at the level of <87% correlated significantly with the cleavage rate of the zygote (p=0.022; r=0.371); whereas poor sperm chromatin integrity at the level of <80% correlated with embryo formation (p=0.048; r=0,485). In conclusion, this study showed that poor maturity and integrity of sperm chromatin (AB<87% and TB<80%, respectively), could affect zygote development following ICSI. ABBREVIATIONS: AB: aniline blue; CMA3: chromomycin A3; ICSI: intra cytoplasmic sperm injection; IVF: in vitro fertilization; PBS: phosphate buffer saline; SPSS: Statistical Package for Social Science; TB: toluidine blue; WHO: World Health Organization.