Gonad damage is one of the major complications of chemotherapy, radiotherapy or surgery in male cancer patients. For those who wish for childbearing after treatment, it is of great significance how to protect the reproductive function of the cancer patients. The main strategy for fertility protection is to optimize the treatment protocol, hormone therapy, antioxidant therapy, and the preservation of sperm and testicular tissue. This article presents an overview on the pathogenesis of gonadal damage induced by different treatments and protection of the reproductive function of the patient.
Fertility Preservation ; methods ; Humans ; Infertility, Male ; prevention & control ; Male ; Neoplasms ; therapy ; Risk ; Spermatozoa

Male infertility is a significant cause of psychosocial and marital distress in approximately 50% of couples who are unable to conceive, with male factors being the underlying cause. Guijiajiao (Colla Carapacis et Plastri, CCP) is a Traditional Chinese Medicine commonly used to treat male infertility. The present study aimed to investigate the potential mechanisms underlying the preventive effects of CCP on male infertility. An infertile male rat model was established using cyclophosphamide (CTX), and CCP was administered for both treatment and prevention. Fecal microbiota transplantation (FMT) was also performed to explore the role of gut microbiota in the CCP-mediated prevention of male infertility in rats. Sperm motility and concentration were determined using a semi-automatic sperm classification analyzer. Subsequently, histopathological analysis using HE staining was performed to examine the changes in the small intestine and testis. Moreover, the serum levels of lipopolysaccharide (LPS) and testosterone were measured by ELISA. In addition, immunohistochemistry was conducted to detect CD3 expression in the small intestine, while RT-qPCR was employed to assess the expressions of interleukin-1 beta (IL-1β), cluster of differentiation 3 (CD3), Monocyte chemoattractant protein-1 (MCP-1), and C-X-C motif chemokine ligand 10 (CXCL-10) in the small intestine and epididymis. Finally, gut microbiota was analyzed by 16S rRNA sequencing. CCP improved sperm motility, number, and concentration in CTX-induced infertile male rats. CCP increased the serum testosterone level, inhibited the immune cell infiltration of the intestinal lamina propria, and promoted the aggregation of CD3⁺ T cells in CTX-induced male infertility rats. CCP also inhibited the expressions of MCP-1, CXCL-10, and IL-1β in the epididymis of male infertility rats. At the genus level, CTX led to a reduction in the abundance of Lactobacillus, Clostridia_UCG.014, and Romboutsia in the intestinal tract of rats. In contrast, CCP decreased the abundance of Ruminococcus and increased the abundance of Romboutsia in infertile male rats. Additionally, FMT experiments proved that the gut microbiota of CCP-treated rats facilitated testicular tissue recovery and spermatogenesis while also reducing the serum LPS level in infertile male rats. CCP improves the spermatogenic ability of infertile male rats by restoring gut microbiota diversity and inhibiting epididymal inflammation.
Humans ; Rats ; Male ; Animals ; Gastrointestinal Microbiome ; Lipopolysaccharides/pharmacology* ; RNA, Ribosomal, 16S ; Semen ; Sperm Motility ; Infertility, Male/prevention & control* ; Testosterone

In recent years, the incidences of male infertility and recurrent abortion are increasing. The causes of the conditions are varied and complex, but the affected stability of the genetic material in the sperm is an important etiological factor. Environmental pollutants may invade the body through respiration, diet and other channels, resulting in infertility and abortion or even affecting the reproductive system development of the offspring by changing the epigenetics of sperm DNA. In this paper, we propose the idea of using traditional Chinese medicine to prevent environmental pollutant-induced epigenetic changes of sperm DNA, hoping to provide a new insight into the protection against genetic material damage, male infertility, and recurrent abortion caused by environmental pollutants.
DNA Damage ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Environmental Pollutants ; toxicity ; Epigenesis, Genetic ; Humans ; Infertility, Male ; chemically induced ; prevention & control ; Male ; Medicine, Chinese Traditional ; Spermatozoa ; drug effects

It is estimated that in 2010, 1 in every 250 adults will be a childhood cancer survivor. Today, oncological surgery, radiotherapy and chemotherapy achieve relatively high rates of remission and long-term survival, yet are often detrimental to fertility. Quality of life is increasingly important to long-term survivors of cancer, and one of the major quality-of-life issues is the ability to produce and raise normal children. Developments in the near future in the emerging field of fertility preservation in cancer survivors promise to be very exciting. This article reviews the published literature, discusses the effects of cancer treatment on fertility and presents the options available today thanks to advances in assisted-reproduction technology for maintaining fertility in male and female patients undergoing this type of treatment. The various diagnostic methods of assessing the fertility potential and the efficacy of in vitro fertilization (IVF) after cancer treatment are also presented.
Adult ; Child ; Female ; Fertility ; Humans ; Infertility ; prevention & control ; Male ; Neoplasms ; drug therapy ; radiotherapy ; surgery ; Ovarian Neoplasms ; pathology ; Ovary ; pathology ; Survivors ; Testicular Neoplasms ; pathology ; Testis ; pathology

Human papillomavirus (HPV) infection is one of the worldwide sexually transmitted diseases (STD), and the DNA of HPV can exist in the normal epithelium of reproductive organs of both men and women. Because the majority of HPV infections are asymptomatic, healthy HPV-carriers become the main source of the infection. Studies show that HPV infection in men is correlated with STD, infertility, tumor of reproductive organs, and infection in the sexual partners. Therefore, measures should be taken to reduce male HPV infection, including circumcision, fewer sexual partners, and condom use.
Adult ; Asymptomatic Infections ; Carrier State ; virology ; Circumcision, Male ; Female ; Humans ; Infertility, Male ; virology ; Male ; Papillomaviridae ; Papillomavirus Infections ; complications ; prevention & control ; transmission ; Reproductive Health ; Risk Factors ; Sexual Partners ; Sexually Transmitted Diseases ; virology

OBJECTIVETo investigate the protective action of Epimedium against chemotherapy-induced damage to rat epididymides.

METHODSFifty 60-day-old male rats were divided into a control, a model and a treatment group. Procarbazine was injected into the abdominal cavity of the model rats at the dose of 30 mg/(kg x d). In addition to procarbazine, Epimedium was given intragastrically to the treatment group. The changes in the ultrastructure of the epididymis were observed after 10 and 20 days.

RESULTSElectron microscopy showed that the chemotherapy-induced damages to the epididymal epithelia mainly included cell swelling, local cavitation of mitochondria, tumor-like change in nucleoli, agglutination of marginal translocation of heterochromatin and cell apoptosis. The damage to the epithelial ultrastructure was slight in the treatment group as compared with the model rats. Chemotherapy significantly affected sperm concentration, sperm viability and sialic acid (SA), which were (15.59 +/- 4.01) x 10(6)/ml, (76.71 +/- 10.11)% and (19.38 +/- 9.34) g/mg prot in the model group in comparison with (10.63 +/- 3.82) x 10(6)/ml (P < 0.01), (60.03 +/- 7.54)% (P < 0.01) and (13.62 +/- 7.81) g/g prot (P < 0.05) in the control. Epimedium significantly increased sperm viability in the treatment group (60.03 +/- 7.54)% as compared with the model rats (69.90 +/- 12.58)% (P < 0.05).

CONCLUSIONEpimedium can lessen chemotherapy-induced damage to the epididymis and protect the reproductive function of rats.

Animals ; Antineoplastic Agents ; toxicity ; Drugs, Chinese Herbal ; pharmacology ; Epididymis ; drug effects ; physiopathology ; ultrastructure ; Epimedium ; chemistry ; Infertility, Male ; chemically induced ; physiopathology ; prevention & control ; Male ; Microscopy, Electron, Transmission ; Phytotherapy ; Random Allocation ; Rats ; Rats, Sprague-Dawley

ObjectiveAutosomal dominant polycystic kidney disease (ADPKD) is one of the most common genetic renal diseases, which may cause oligoasthenospermia and azoospermia and result in male infertility. This study aimed to analyze the outcomes of preimplantation genetic diagnosis (PGD) in male patients with ADPKD-induced infertility.

METHODSWe retrospectively analyzed the clinical data on 7 male patients with ADPKD-induced infertility undergoing PGD from April 2015 to February 2017, including 6 cases of oligoasthenospermia and 1 case of obstructive azoospermia, all with the PKD1 gene heterozygous mutations. Following intracytoplasmic sperm injection (ICSI), we performed blastomere biopsy after 5 or 6 days of embryo culture and subjected the blastomeres to Sureplex whole-genome amplification, followed by haplotype linkage analysis, Sanger sequencing, array-based comparative genomic hybridization to assess the chromosomal ploidy of the unaffected embryos, and identification of the unaffected euploid embryos for transfer.

RESULTSOne PGD cycle was completed for each of the 7 patients. Totally, 26 blastocysts were developed, of which 12 were unaffected and diploid. Clinical pregnancies were achieved in 6 cases following 7 cycles of frozen embryo transplantation, which included 5 live births and 1 spontaneous abortion.

CONCLUSIONSFor males with ADPKD-induced infertility, PGD may contribute to high rates of clinical pregnancy and live birth and prevent ADPKD in the offspring as well. This finding is also meaningful for the ADPKD patients with normal fertility.

Abortion, Spontaneous ; genetics ; Biopsy ; Blastocyst ; Comparative Genomic Hybridization ; Embryo Transfer ; Female ; Humans ; Infertility, Male ; etiology ; genetics ; Male ; Mutation ; Polycystic Kidney, Autosomal Dominant ; complications ; diagnosis ; genetics ; prevention & control ; Pregnancy ; Pregnancy Outcome ; Preimplantation Diagnosis ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

PURPOSE: It is well known that testicular germ cell tumors arise with increased frequency in patients with cryptorchidism. In addition, intratubular germ cell neoplasia (ITGCN) is a precursor lesion to testicular germ cell tumor. Approximately 50% of patients with ITGCN will develop an invasive of testicular germ cell tumors within 5 years. Therefore, we evaluated that the incidence of ITGCN in postpubertal cryptorchidism. MATERIALS AND METHODS: Between January 2002 and August 2012, orchiectomy specimens from 31 postpubertalpatients (aged 12 or over) with cryptorchid testis were reviewed. The specimens were evaluated for ITGCN using immunohistochemical stains of placental-like alkaline phosphatase and Oct 3/4 with routine hematoxylin-eosin stain. Additionally, the degree of spermatogenesis was assessed using the Johnsen score. RESULTS: Mean age was 34 years (range, 17 to 74 years) at surgery. All patients were diagnosed as unilateral cryptorchidism. One patient (3.2%) of 20-year-old had ITGCN in surgical specimen with all positive markers. Histological assessment of spermatogenesis showed that mean Johnsen score was 3.42 (range, 1 to 9). Majority of patients (27 of 31) presented impaired spermatogenesis with low Johnsen score lesser than 5. CONCLUSIONS: Considering the risk of malignancy and low spermatogenesis, we should perform immunohistochemical stains and discuss preventative orchiectomy for the postpubertal cryptorchidism.
Adolescent ; Adult ; Aged ; Alkaline Phosphatase/metabolism ; Biomarkers, Tumor/metabolism ; Carcinoma in Situ/diagnosis/*etiology/pathology ; Cryptorchidism/*complications/surgery ; Disease Progression ; Humans ; Infertility, Male/etiology ; Isoenzymes/metabolism ; Male ; Middle Aged ; Neoplasms, Germ Cell and Embryonal/diagnosis/*etiology/pathology/prevention & control ; Orchiectomy ; Puberty ; Retrospective Studies ; Spermatogenesis ; Testicular Neoplasms/diagnosis/*etiology/pathology/prevention & control ; Young Adult