1.Comprehensive Review on Kisspeptin and Its Role in Reproductive Disorders.
Holly CLARKE ; Waljit S DHILLO ; Channa N JAYASENA
Endocrinology and Metabolism 2015;30(2):124-141
Kisspeptin has recently emerged as a key regulator of the mammalian reproductive axis. It is known that kisspeptin, acting centrally via the kisspeptin receptor, stimulates secretion of gonadotrophin releasing hormone (GnRH). Loss of kisspeptin signaling causes hypogonadotrophic hypogonadism in humans and other mammals. Kisspeptin interacts with other neuropeptides such as neurokinin B and dynorphin, to regulate GnRH pulse generation. In addition, a growing body of evidence suggests that kisspeptin signaling be regulated by nutritional status and stress. Kisspeptin may also represent a novel potential therapeutic target in the treatment of fertility disorders. Early human studies suggest that peripheral exogenous kisspeptin administration stimulates gonadotrophin release in healthy adults and in patients with certain forms of infertility. This review aims to concisely summarize what is known about kisspeptin as a regulator of reproductive function, and provide an update on recent advances within this field.
Adult
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Dynorphins
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Fertility
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Gonadotropin-Releasing Hormone
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Humans
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Hypogonadism
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Hypothalamus
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Infertility
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Kisspeptins
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Mammals
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Neurokinin B
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Neuropeptides
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Nutritional Status
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Axis, Cervical Vertebra
2.Impact of Antioxidant Therapy on Natural Pregnancy Outcomes and Semen Parameters in Infertile Men: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Ashok AGARWAL ; Rossella CANNARELLA ; Ramadan SALEH ; Ahmed M. HARRAZ ; Hussein KANDIL ; Gianmaria SALVIO ; Florence BOITRELLE ; Shinnosuke KURODA ; Ala’a FARKOUH ; Amarnath RAMBHATLA ; Armand ZINI ; Giovanni COLPI ; Murat GÜL ; Parviz KAVOUSSI ; Taha Abo-Almagd Abdel-Meguid HAMODA ; Edmund KO ; Gokhan CALIK ; Tuncay TOPRAK ; Germar-Michael PINGGERA ; Hyun Jun PARK ; Ramy Abou GHAYDA ; Suks MINHAS ; Gian Maria BUSETTO ; Mustafa Emre BAKIRCIOĞLU ; Ates KADIOGLU ; Eric CHUNG ; Giorgio Ivan RUSSO ; Aldo E. CALOGERO ; Rafael F. AMBAR ; Channa N. JAYASENA ; Rupin SHAH
The World Journal of Men's Health 2023;41(1):14-48
Purpose:
Seminal oxidative stress (OS) is a recognized factor potentially associated with male infertility, but the efficacy of antioxidant (AOX) therapy is controversial and there is no consensus on its utility. Primary outcomes of this study were to investigate the effect of AOX on spontaneous clinical pregnancy, live birth and miscarriage rates in male infertile patients. Secondary outcomes were conventional semen parameters, sperm DNA fragmentation (SDF) and seminal OS.
Materials and Methods:
Literature search was performed using Scopus, PubMed, Ovid, Embase, and Cochrane databases.Only randomized controlled trials (RCTs) were included and the meta-analysis was conducted according to PRISMA guidelines.
Results:
We assessed for eligibility 1,307 abstracts, and 45 RCTs were finally included, for a total of 4,332 infertile patients.We found a significantly higher pregnancy rate in patients treated with AOX compared to placebo-treated or untreated controls, without significant inter-study heterogeneity. No effects on live-birth or miscarriage rates were observed in four studies.A significantly higher sperm concentration, sperm progressive motility, sperm total motility, and normal sperm morphology was found in patients compared to controls. We found no effect on SDF in analysis of three eligible studies. Seminal levels of total antioxidant capacity were significantly higher, while seminal malondialdehyde acid was significantly lower in patients than controls. These results did not change after exclusion of studies performed following varicocele repair.
Conclusions
The present analysis upgrades the level of evidence favoring a recommendation for using AOX in male infertility to improve the spontaneous pregnancy rate and the conventional sperm parameters. The failure to demonstrate an increase in live-birth rate, despite an increase in pregnancy rates, is due to the very few RCTs specifically assessing the impact of AOX on live-birth rate. Therefore, further RCTs assessing the impact of AOX on live-birth rate and miscarriage rate, and SDF will be helpful.
3.Male Oxidative Stress Infertility (MOSI): Proposed Terminology and Clinical Practice Guidelines for Management of Idiopathic Male Infertility
Ashok AGARWAL ; Neel PAREKH ; Manesh Kumar PANNER SELVAM ; Ralf HENKEL ; Rupin SHAH ; Sheryl T HOMA ; Ranjith RAMASAMY ; Edmund KO ; Kelton TREMELLEN ; Sandro ESTEVES ; Ahmad MAJZOUB ; Juan G ALVAREZ ; David K GARDNER ; Channa N JAYASENA ; Jonathan W RAMSAY ; Chak Lam CHO ; Ramadan SALEH ; Denny SAKKAS ; James M HOTALING ; Scott D LUNDY ; Sarah VIJ ; Joel MARMAR ; Jaime GOSALVEZ ; Edmund SABANEGH ; Hyun Jun PARK ; Armand ZINI ; Parviz KAVOUSSI ; Sava MICIC ; Ryan SMITH ; Gian Maria BUSETTO ; Mustafa Emre BAKIRCIOĞLU ; Gerhard HAIDL ; Giancarlo BALERCIA ; Nicolás Garrido PUCHALT ; Moncef BEN-KHALIFA ; Nicholas TADROS ; Jackson KIRKMAN-BROWNE ; Sergey MOSKOVTSEV ; Xuefeng HUANG ; Edson BORGES ; Daniel FRANKEN ; Natan BAR-CHAMA ; Yoshiharu MORIMOTO ; Kazuhisa TOMITA ; Vasan Satya SRINI ; Willem OMBELET ; Elisabetta BALDI ; Monica MURATORI ; Yasushi YUMURA ; Sandro LA VIGNERA ; Raghavender KOSGI ; Marlon P MARTINEZ ; Donald P EVENSON ; Daniel Suslik ZYLBERSZTEJN ; Matheus ROQUE ; Marcello COCUZZA ; Marcelo VIEIRA ; Assaf BEN-MEIR ; Raoul ORVIETO ; Eliahu LEVITAS ; Amir WISER ; Mohamed ARAFA ; Vineet MALHOTRA ; Sijo Joseph PAREKATTIL ; Haitham ELBARDISI ; Luiz CARVALHO ; Rima DADA ; Christophe SIFER ; Pankaj TALWAR ; Ahmet GUDELOGLU ; Ahmed M A MAHMOUD ; Khaled TERRAS ; Chadi YAZBECK ; Bojanic NEBOJSA ; Damayanthi DURAIRAJANAYAGAM ; Ajina MOUNIR ; Linda G KAHN ; Saradha BASKARAN ; Rishma Dhillon PAI ; Donatella PAOLI ; Kristian LEISEGANG ; Mohamed Reza MOEIN ; Sonia MALIK ; Onder YAMAN ; Luna SAMANTA ; Fouad BAYANE ; Sunil K JINDAL ; Muammer KENDIRCI ; Baris ALTAY ; Dragoljub PEROVIC ; Avi HARLEV
The World Journal of Men's Health 2019;37(3):296-312
Despite advances in the field of male reproductive health, idiopathic male infertility, in which a man has altered semen characteristics without an identifiable cause and there is no female factor infertility, remains a challenging condition to diagnose and manage. Increasing evidence suggests that oxidative stress (OS) plays an independent role in the etiology of male infertility, with 30% to 80% of infertile men having elevated seminal reactive oxygen species levels. OS can negatively affect fertility via a number of pathways, including interference with capacitation and possible damage to sperm membrane and DNA, which may impair the sperm's potential to fertilize an egg and develop into a healthy embryo. Adequate evaluation of male reproductive potential should therefore include an assessment of sperm OS. We propose the term Male Oxidative Stress Infertility, or MOSI, as a novel descriptor for infertile men with abnormal semen characteristics and OS, including many patients who were previously classified as having idiopathic male infertility. Oxidation-reduction potential (ORP) can be a useful clinical biomarker for the classification of MOSI, as it takes into account the levels of both oxidants and reductants (antioxidants). Current treatment protocols for OS, including the use of antioxidants, are not evidence-based and have the potential for complications and increased healthcare-related expenditures. Utilizing an easy, reproducible, and cost-effective test to measure ORP may provide a more targeted, reliable approach for administering antioxidant therapy while minimizing the risk of antioxidant overdose. With the increasing awareness and understanding of MOSI as a distinct male infertility diagnosis, future research endeavors can facilitate the development of evidence-based treatments that target its underlying cause.
Antioxidants
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Classification
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Clinical Protocols
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Diagnosis
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DNA
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Embryonic Structures
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Female
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Fertility
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Health Expenditures
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Humans
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Infertility
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Infertility, Male
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Male
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Membranes
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Ovum
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Oxidants
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Oxidation-Reduction
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Oxidative Stress
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Reactive Oxygen Species
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Reducing Agents
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Reproductive Health
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Semen
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Spermatozoa
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Subject Headings