Varicocele is a prevalent condition in the infertile male population. However, to date, which patients may benefit most from varicocele repair is still a matter of debate. The purpose of this study was to evaluate whether certain preintervention sperm parameters are predictive of successful varicocele repair, defined as an improvement in total motile sperm count (TMSC). We performed a retrospective study on 111 patients with varicocele who had undergone varicocele repair, collected from the Department of Endocrinology, Metabolic Diseases and Nutrition, University of Catania (Catania, Italy), and the Unit of Urology at the Selcuk University School of Medicine (Konya, Türkiye). The predictive analysis was conducted through the use of the Brain Project, an innovative tool that allows a complete and totally unbiased search of mathematical expressions that relate the object of study to the various parameters available. Varicocele repair was considered successful when TMSC increased by at least 50% of the preintervention value. For patients with preintervention TMSC below 5 × 10 6 , improvement was considered clinically relevant when the increase exceeded 50% and the absolute TMSC value was >5 × 10 6 . From the preintervention TMSC alone, we found a model that predicts patients who appear to benefit little from varicocele repair with a sensitivity of 50.0% and a specificity of 81.8%. Varicocele grade and serum follicle-stimulating hormone (FSH) levels did not play a predictive role, but it should be noted that all patients enrolled in this study were selected with intermediate- or high-grade varicocele and normal FSH levels. In conclusion, preintervention TMSC is predictive of the success of varicocele repair in terms of TMSC improvement in patients with intermediate- or high-grade varicoceles and normal FSH levels.
Humans ; Varicocele/complications* ; Male ; Retrospective Studies ; Machine Learning ; Adult ; Treatment Outcome ; Sperm Count ; Infertility, Male/etiology* ; Sperm Motility ; Follicle Stimulating Hormone/blood* ; Young Adult

The adverse effects of obesity on male reproductive function are mainly manifested as the abnormal development of the reproductive system, decrease of testosterone level, decline of sperm quality, and impact on the health of offspring, while its regulatory mechanism is far from being clarified. This paper expounds the influence of obesity on the male reproductive system in the aspects of population epidemiology and animal experiments, presents an overview on the action mechanisms of obesity from the perspectives of the hypothalamus-pituitary-testis axis, blood-testis barrier, inflammatory reaction, oxidative stress, testicular germ cell apoptosis, and impact of paternal obesity on the health of offspring, aiming to shed some light on the clinical treatment and prevention of obesity-related male reproductive dysfunction.
Male ; Obesity/physiopathology* ; Humans ; Animals ; Hypothalamo-Hypophyseal System ; Testis/physiopathology* ; Oxidative Stress ; Infertility, Male/etiology* ; Reproduction ; Blood-Testis Barrier

We assessed the concomitant impact of cigarette smoking and alcohol consumption in men presenting for primary couple's infertility. Data from 189 infertile men were analyzed. Semen analysis, serum hormones, and sperm DNA fragmentation (SDF) were obtained. Smoking status was categorized as follows: current nonsmoker (-S), moderate smoker (+MS), and heavy smoker (+HS). Alcohol consumption was categorized as follows: abstainer (-D), moderate drinker (+MD), and heavy drinker (+HD). Descriptive statistics and logistic regression models were applied. Among all the participants, 132 (69.8%), 30 (15.9%), and 27 (14.3%) patients were -S, +MS, and +HS, respectively. In addition, 67 (35.4%), 77 (40.7%) and 45 (23.8%) men were -D, +MD and +HD, respectively. Regarding concomitant habits, 52 (27.5%) patients were nonsmokers and abstainers (-S/-D: Group 1), 91 (48.1%) had at least one recreational habit (-S/+D or +S/-D: Group 2), and 46 (24.3%) were both smokers and drinkers (+S/+D: Group 3). Sperm concentration and progressive motility were lower in +HS and +HD, compared with -S and -D (all P < 0.05), respectively. Similarly, both parameters were significantly lower in Group 3 than Groups 1 and 2 (all P < 0.05). SDF values were higher in Group 3 than Groups 1 and 2 (both P < 0.05). In multivariate analysis, follicle-stimulating hormone (FSH) levels and concomitant +S/+D status were independent predictors of impaired sperm concentration and progressive motility (all P < 0.05). Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/abstaining. When concomitant, +S/+D status has an even greater detrimental effect on semen parameters.
Adult ; Alcohol Drinking/adverse effects* ; Alcoholism/complications* ; Cigarette Smoking/adverse effects* ; Cohort Studies ; Female ; Follicle Stimulating Hormone/blood* ; Humans ; Infertility, Male/pathology* ; Male ; Middle Aged ; Semen Analysis ; Sperm Count ; Sperm Motility ; Spermatozoa/ultrastructure*

Anti-Müllerian hormone (AMH) is a functional marker of fetal Sertoli cells. The germ cell number in adults depends on the number of Sertoli cells produced during perinatal development. Recently, AMH has received increasing attention in research of disorders related to male fertility. This paper reviews and summarizes the articles on the regulation of AMH in males and the serum levels of AMH in male fertility-related disorders. We have determined that follicle-stimulating hormone (FSH) promotes AMH transcription in the absence of androgen signaling. Testosterone inhibits the transcriptional activation of AMH. The undetectable levels of serum AMH and testosterone levels indicate a lack of functional testicular tissue, for example, that in patients with anorchia or severe Klinefelter syndrome suffering from impaired spermatogenesis. The normal serum testosterone level and undetectable AMH are highly suggestive of persistent Müllerian duct syndrome (PMDS), combined with clinical manifestations. The levels of both AMH and testosterone are always subnormal in patients with mixed disorders of sex development (DSD). Mixed DSD is an early-onset complete type of disorder with fetal hypogonadism resulting from the dysfunction of both Leydig and Sertoli cells. Serum AMH levels are varying in patients with male fertility-related disorders, including pubertal delay, severe congenital hypogonadotropic hypogonadism, nonobstructive azoospermia, Klinefelter syndrome, varicocele, McCune-Albright syndrome, and male senescence.
Anti-Mullerian Hormone/metabolism* ; Follicle Stimulating Hormone/blood* ; Gene Expression Regulation ; Humans ; Infertility, Male/blood* ; Male ; Testosterone/blood*

ObjectiveTo screen out an effective substitute in the prescription of Shengjing Capsules (SJC), observe the effects of the redeveloped New SJC (NSJC) with cordyceps cephalosporium mycelia (CCM) substituted for the ingredient cordyceps sinensis in the treatment of spermatogenesis impairment (SI), and provide some experimental evidence for its application in the treatment of male infertility and sexual dysfunction.

METHODSWe equally randomized 192 male mice into 16 groups: normal saline control, SI model, high-, medium- and low-dose fermented cordycepin powder (FCP, 1.60, 0.80 and 0.40 g/kg), high-, medium- and low-dose CCM (1.60, 0.80 and 0.40 g/kg), high-, medium- and low-dose cordyceps mortierella mycelia (CMM, 1.60, 0.80 and 0.40 g/kg), high-, medium- and low-dose fermented cordyceps sinensis (FCS, 1.60, 0.80 and 0.40 g/kg), SJC (0.80 g/kg), and vitamin E (VE, 0.25 g/kg), with the SI model established in all the mice and the normal controls injected intraperitoneally with cyclophosphamide at 60 mg/kg qd for 5 consecutive days. After intragastrical medication with respective drugs, we obtained the body mass index (BMI), sexual organ coefficient, sperm count, sperm motility, and percentage of morphologically abnormal sperm (MAS) of the mice. We also randomly divided 70 male rats into 7 groups of equal number: normal control, SI model, high-, medium- and low-dose NSJC (1.12, 0.56 and 0.28 g/kg), SJC (0.56 g/kg), and VE (0.18 g/kg), the SI model constructed in the latter 6 groups of rats by gavage of adenine at 200 mg/kg qd for 5 consecutive days. After intragastrical medication with respective drugs, we examined the BMI, coefficients of sexual and renal organs, levels of reproductive hormones, testicular morphology, and fertility of the animals.

RESULTSAfter medication, the mice in different groups showed different degrees of improvement in the cyclophosphamide-induced slow growth, significant increases in the testicular and epididymal coefficients, sperm count, motility and viability (P < 0.05 or P < 0.01), and a remarkable reduction in the percentage of MAS (P < 0.05 or P < 0.01). The effect was particularly significant in the CCM group and therefore CCM was chosen as the best substitute ingredient in the redeveloped NSJC. Compared with the rats in other groups, those treated with NSJC exhibited significant increases in the BMI, coefficients of sexual and renal organs and levels of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and estradiol (E2) (P < 0.05 or P < 0.01), improvement of the pathologically damaged testicular morphology, elevation of the pregnancy rate and litter size, and recovery from adenine-induced SI.

CONCLUSIONSThe redeveloped New Shengjing Capsules with cordyceps cephalosporium mycelia substituted for the ingredient cordyceps sinensis can improve fertility and reverse spermatogenesis impairment in male rats. The new prescription may also be applied to the clinical treatment of male infertility and sexual dysfunction.

Acremonium ; Animals ; Capsules ; Cordyceps ; Cyclophosphamide ; Drugs, Chinese Herbal ; Epididymis ; Estradiol ; blood ; Fertility ; Follicle Stimulating Hormone ; blood ; Infertility, Male ; chemically induced ; therapy ; Luteinizing Hormone ; blood ; Male ; Mycelium ; Random Allocation ; Rats ; Species Specificity ; Sperm Count ; Sperm Motility ; Spermatogenesis ; Spermatozoa ; Testis ; anatomy & histology ; Testosterone ; blood

ObjectiveTo investigate the correlation of the levels of reproductive hormones and oxidative stress in the seminal plasma with semen parameters in obese males.

METHODSBased on the body mass index (BMI), we divided 138 infertile men into three groups: normal (BMI <24 kg/m2, n = 48), overweight (24 kg/m2≤BMI<28 kg/m2, n = 47), and obesity (BMI ≥28 kg/m2, n = 43). We determined the concentrations of follicle-stimulating hormone (FSH), luteotropic hormone (LH), prolactin (PRL), testosterone (T) and estradiol (E2) in the serum by electrochemiluminescence and measured the levels of superoxide dismutase (SOD), glutathione-S-transferases (GSTs), reactive oxygen species (ROS) and malondialdehyde (MDA) in the seminal plasma by ELISA, compared the above indexes among the three groups, and analyzed their correlation with the semen volume, sperm concentration, total sperm count, and percentage of progressively motile sperm (PMS).

RESULTSThe semen volume was significantly lower in the obesity than in the normal group (［2.63 ± 0.74］ vs ［3.37 ± 1.00］ ml, P < 0.05), and so was the percentage of PMS in the overweight and even lower in the obesity than in the normal group (［47.91 ± 12.89］ and ［41.27 ± 15.77］ vs ［54.04 ± 13.29］%, P < 0.05). Compared with the normal group, both the overweight and obesity groups showed markedly decreased levels of serum T (［4.83 ± 1.42］ vs ［3.71 ± 1.22］ and ［3.49 ± 1.12］ ng/ml, P<0.05), T/LH ratio (1.53 ± 0.57 vs 1.19 ± 0.54 and 0.97 ± 0.51, P<0.05), SOD (［112.05 ± 10.54］ vs ［105.85 ± 6.93］ and ［99.33 ± 8.39］ U/ml, P<0.05), and GSTs (［31.75±6.03］ vs ［29.54±5.78］ and ［29.02±4.52］ U/L, P<0.05), but remarkably increased seminal plasma ROS (［549.93±82.41］ vs ［620.61±96.13］ and ［701.47±110.60］ IU/ml, P<0.05) and MDA (［7.46 ± 2.13］ vs ［8.72 ± 1.89］ and ［10.47 ± 2.10］ nmol/L, P<0.05). BMI was correlated positively with ROS and MDA, but negatively with the semen volume, PMS, T, T/LH, SOD and GSTs (P<0.05); LH negatively with sperm concentration, total sperm count and GSTs (P<0.05); PRL negatively GSTs (P<0.05); E2 positively with SOD (P<0.05); T positively with SOD (P<0.05) but negatively with MDA (P<0.05); T/LH positively with PMS and SOD (P<0.05) but negatively with ROS and MDA (P<0.05); SOD positively with semen volume, PMS and GSTs (P<0.05) but negatively with ROS and MDA (P<0.05); GSTs negatively with sperm concentration; total sperm count and MDA (P<0.05); ROS positively with MDA (P<0.01) but negatively with PMS (P<0.05); and MDA negatively with semen volume (P<0.05). Multivariate logistic regression analysis showed that the independent factors influencing the semen volume were BMI and GSTs, those influencing the total sperm count were BMI and T, and those influencing PMS were BMI and MDA.

CONCLUSIONSIncreased BMI induces changes in the levels of male reproductive hormones and seminal plasma oxidative stress and affects semen quality, which may be associated with male infertility.

Body Mass Index ; Estradiol ; blood ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Male ; blood ; classification ; metabolism ; Luteinizing Hormone ; blood ; Male ; Malondialdehyde ; analysis ; Obesity ; blood ; metabolism ; Oxidative Stress ; Prolactin ; blood ; Reactive Oxygen Species ; analysis ; Reproduction ; Semen ; metabolism ; Semen Analysis ; Sperm Count ; Testosterone ; blood

Inhibin B, a glycoprotein produced predominantly by Sertoli cells and preferentially suppressing the production and secretion of follicle-stimulating hormone (FSH) in the pituitary, is closely related to spermatogenesis. Varicocele is the abnormal dilatation and tortuosity of the pampiniform plexus veins, which may contribute to spermatogenic dysfunction and male infertility. More and more evidence has shown that the level of serum inhibin B is negatively correlated with the severity of varicocele. Determination of the inhibin B level may help assess the severity of spermatogenic dysfunction of the patient and predict the outcomes of varicocele repair and therefore has a potential application value in the diagnosis and treatment of varicocele.
Follicle Stimulating Hormone ; metabolism ; Humans ; Infertility, Male ; blood ; etiology ; Inhibins ; blood ; Male ; Sertoli Cells ; Spermatogenesis ; Varicocele ; blood

Adult ; Azoospermia/parasitology* ; Hormones/blood* ; Humans ; Infertility, Male/parasitology* ; Male ; Polymerase Chain Reaction ; Testicular Diseases/parasitology* ; Trichomonas Infections/parasitology* ; Trichomonas vaginalis

PURPOSE: The aim of this study was to evaluate the relationship of seminal parameters with the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), which are inflammatory markers, in men with an abnormal semen analysis and men with normozoospermia. MATERIALS AND METHODS: Fifty-seven men with abnormal semen analyses and 59 men with normozoospermia were included in this cross-sectional study. A complete blood count was recorded, and the NLR and PLR were calculated from the hematologic parameters. RESULTS: The NLR was 1.84±0.78 in the normozoospermic group and 1.80±0.75 in the abnormal semen analysis group. The PLR was 95.32±35.47 in the normozoospermic group and 93.57±28.09 in the abnormal semen analysis group. No significant differences were found between the normozoospermic and the abnormal semen analysis group in the NLR (p=0.828) or the PLR (p=0.768). In addition, no seminal parameters were correlated with the NLR or the PLR (p>0.05). CONCLUSIONS: We do not recommend using the NLR or the PLR as markers to screen for abnormal semen parameters or male infertility.
Blood Cell Count ; Cross-Sectional Studies ; Humans ; Infertility ; Infertility, Male ; Lymphocytes ; Male ; Neutrophils ; Semen ; Semen Analysis

Objective: To investigate the correlation of the single nucleotide polymorphism (SNP) rs1042522 of the tumor protein p53 (TP53) gene with the risk of male infertility. METHODS: This casecontrol study included 380 male patients with idiopathic infertility and 398 normal fertile men as controls from the Nanjing area. We genotyped the SNP rs1042522 of the TP53 gene by Sequence Mass Array and analyzed the correlation of the SNP with male infertility using the logistic regression model. RESULTS: Compared with the normal controls, the patients with idiopathic infertility showed significantly decreased sperm concentration (［77.34±49.24］ vs ［13.13±24.96］ ×106/ml), percentage of progressively motile sperm (［42.55±9.57］ vs ［10.38±5.57］%), serum testosterone level (［14.07±5.36］ vs ［11.89±4.50］ nmol/L), and folliclestimulating hormone level (［16.80±18.20］ vs ［4.55±7.17］ U/L) (P < 0.05) but no statistically significant differences in other parameters. No correlation was observed between the SNP frequencies and male infertility and similar results were found in the subgroups of the cases. CONCLUSIONS SNP rs1042522 of the TP53 gene is not significantly correlated with the risk of male infertility.
Case-Control Studies ; Follicle Stimulating Hormone ; blood ; Gene Frequency ; Genes, p53 ; genetics ; Genetic Predisposition to Disease ; Genotype ; Humans ; Infertility, Male ; blood ; genetics ; Logistic Models ; Male ; Polymorphism, Single Nucleotide ; Sperm Count ; Sperm Motility ; Testosterone ; analogs & derivatives ; blood