Poor semen quality and ROS-TAC scores in patients with idiopathic infertility.

INTRODUCTION: To compare the semen quality score and the seminal oxidative stress reactive oxygen species (ROS) and total antioxidant capacity (ROS-TAC score) in men with idiopathic infertility with normal donors and to a known group of fertile and infertile men. MATERIAL AND METHODS: Principal component analysis was applied to provide a standardized score in 36 men with idiopathic infertility and 19 controls attending our infertility clinic. A logistic regression analysis comparing the fertile and infertile men was used. RESULTS: Compared to controls, patients with idiopathic infertility had significantly lower sperm concentration, sperm motility and normal morphology (p < 0.05) and lower semen quality scores (83.0 +/- 14.5 vs. 100.0 +/- 10.0; p < 0.001). Compared to controls, the ROS levels were higher in the idiopathic infertility group (2.3 +/- 0.21 vs. 1.3 +/- 0.3; p = 0.006), whereas the TAC levels were lower in the idiopathic infertility (1,014.75 +/- 79.22 vs. 1,653 +/- 115.29; p = 0.001). Idiopathic infertility patients had lower ROS-TAC scores (32.8 +/- 14.2) than controls (50.0 +/- 10.0) (p < 0.001). 64% of men with idiopathic infertility will remain infertile during 1-year follow-up. CONCLUSIONS: Patients with idiopathic infertility have lower scores of semen quality and ROS-TAC.

Cigarette smoking is related to a decrease in semen volume in a population of fertile men.

OBJECTIVE: To evaluate the semen quality and hormonal levels in fertile men according to their level of cigarette smoking. SUBJECTS AND METHODS: We evaluated 889 fertile men who came for a vasectomy for sterilization purposes. The men included 522 non-smokers, 143 mild smokers (<10 cigarettes/day), 154 moderate smokers (11-20/day), and 70 heavy smokers (>20/day). We evaluated sperm concentration, motility, motion variables and hormonal levels in these men. RESULTS: There were no significant differences among the groups in sperm concentration or motility, or in levels of follicle-stimulating hormone, luteinizing hormone, or serum total testosterone. Also, sperm motion characteristics did not differ across the groups. Semen volume was the only semen variable which tended to decrease according to the number of cigarettes smoked. CONCLUSIONS: Cigarette smoking had no apparent effect on sperm concentration, motility or reproductive hormonal levels, but tended to reduce semen volume.

Sperm concentration and normal sperm morphology decrease and follicle-stimulating hormone level increases with age.

OBJECTIVE: To assess hormone levels, testicular volume, and semen characteristics of fertile men of various age groups. PATIENTS AND METHODS: The records of 889 men who sought a vasectomy between September 1999 and March 2003 were reviewed. Patients were divided into five groups by age; we evaluated semen volume, sperm concentration, motility, morphology and complex sperm motion variables. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone levels and both testicular volumes were compared. RESULTS: There were no differences among the groups in the levels of LH, testosterone, or right and left testicular volumes. There were differences among the five groups in FSH levels, semen volume, sperm concentration and motility. Normal morphology according to the World Health Organisation criteria was significantly lower in patients aged > 45 years. From a linear regression analysis, semen volume, sperm concentration and motility decreased by 0.01 mL, 2.1%, and 0.27%, respectively, per year, and the FSH level increased by 0.27%. CONCLUSIONS: Sperm concentration and motility decrease and FSH levels increase with age. Normal sperm morphology decreases from 45 years old. Thus, the ageing effect should be considered when proposing standard values for semen characteristics in routine semen analysis.

Female sexual dysfunction: the important points to remember.

Media exposure regarding male sexual dysfunction and the growing number of viable treatment alternatives for erectile dysfunction has resulted in increasing numbers of men seeking clinical appointments and treatment for the condition, which has previously been considered taboo. Because these problems usually arise within the context of relationships, some investigators have alluded to increased rates of sexual dysfunction among the partners of these men. Also, since general practitioners, gynaecologists, geriatrists, and urologists are also seeing female patients for evaluation of various types of dysfunction, certain groups of these women with underlying chronic conditions have been noted to have high rates of concomitant sexual dysfunction. Physicians who have good rapport with these patients are in a privileged position to help with these intimate problems, which are often difficult for patients to discuss. Therefore, it is of extreme importance that these professionals become knowledgeable about and comfortable with the initial evaluation and possible treatment of female sexual dysfunction.

Female sexual dysfunction: the important points to remember

A intensa exposição pela mídia do tema disfunção sexual masculina e o número crescente de tratamentos disponíveis para a disfunção erétil têm resultado num número crescente de homens que procuram consulta e tratamento clínico para este problema, antes considerado como "tabu". Uma vez que o problema geralmente surge no contexto do relacionamento, alguns investigadores aludem às taxas crescentes de disfunção sexual nas parceiras destes homens. Além disso, clínicos, ginecologistas, geriatras e urologistas igualmente estão avaliando pacientes do sexo feminino quanto a vários tipos de disfunção. Em alguns grupos de mulheres com condições crônicas subjacentes, também têm sido observado um aumento nas taxas de disfunção sexual concomitante. Médicos que tenham estabelecido uma boa relação médico-paciente estão em posição única para ajudar com este problema, que em virtude de sua própria característica de intimidade, geralmente é de difícil abordagem para os pacientes. Desta forma, é de extrema importância que estes profissionais tenham conhecimento e sintam-se à vontade para iniciar a avaliação e possivelmente o tratamento da disfunção sexual feminina.

Effect of oxidative stress in follicular fluid on the outcome of assisted reproductive procedures.

OBJECTIVE(S): To measure levels of lipid peroxidation (LPO) and total antioxidant capacity (TAC) in the follicular fluid from patients undergoing IVF and to examine the association among LPO and TAC and oocyte maturity, embryo quality, fertilization, cleavage, and pregnancy rates. DESIGN: Prospective study. SETTING: Tertiary care medical center. PATIENT(S): Forty-one patients undergoing IVF. INTERVENTION(S): Clear follicular fluid specimens were collected at oocyte retrieval. MAIN OUTCOME MEASURE(S): Follicular fluid LPO and TAC levels measured by the thiobarbituric acid and the chemiluminescence method, respectively. RESULT(S): The mean LPO level was 0.95 micromol malonaldehyde/L, and the mean TAC level was 819.16 Trolox equivalents. No correlation was seen among LPO or TAC levels and oocyte maturity, fertilization, cleavage, and embryo quality. The pregnancy rate was 31.7%. Pregnant patients were significantly younger than the patients who did not become pregnant (30.53 +/- 3.5 years vs. 34.32 +/- 3.98 years). After adjusting for age, a positive correlation was seen between pregnancy rate and LPO and between pregnancy rate and TAC. CONCLUSION(S): Both LPO and TAC levels were positively correlated with the pregnancy rate. Lipid peroxidation may be a good marker of metabolic activity within the follicle, and some amounts may be necessary to establish a pregnancy.