Spinal cord injury (SCI) commonly affects males in their reproductive years. After spinal cord injury, most men experience fertility related problems including erectile and ejaculatory dysfunction, impaired spermatogenesis, abnormal sperm viability, motility, and morphology, genitourinary infection and endocrine abnormalities. In this article we will review the pathophysiology, evaluation and management of infertility in spinal cord injury. The impact of spinal cord injury on seminal plasma and the contribution of seminal oxidative stress to the poor sperm quality of men with spinal cord injury will be presented. Success with sperm retrieval techniques and assisted reproductive technology in SCI men with spinal cord injury will be discussed.
Ejaculation ; Humans ; Infertility, Male ; etiology ; Male ; Reproductive Techniques ; Semen ; Spinal Cord Injuries ; complications ; physiopathology ; Testis ; physiopathology

OBJECTIVETo evaluate the current status of penis and testicular development in boys and the effects of overweight/obesity on their development in the Zhengzhou area of Henan Province.

METHODSHeight, weight, waist circumference, hip circumference, penis length and testicular volume were measured in 3 546 4 to 12-year-old boys. The penis length and testicular volume were compared between the overweight/obesity and normal weight groups.

RESULTSBefore 9 years of age, the testicular volume was progressively smaller, and after 9 years old, it gradually increased. By the age of 11, it increased rapidly. The penis length increased gradually between 4 and 11 years of age, and after the age of 11 it increased rapidly. Phimosis was found in 144 cases (4.01%) and cryptorchidism was found in 18 cases (0.51%). A total of 639 (18.02%) boys were overweight or obese among 3 546 boys. At the ages of 6 and 7 years, the testicular volume in the overweight/obesity group was greater than in the normal control group (P<0.05). The penis length in the overweight/obesity group was significantly shorter than in the normal control group (P<0.05) by the age of 11 years. The correlation analysis showed that the testicular volume at the ages of 4 and 5 years was positively correlated with height, weight, BMI, waist circumference and hip circumference in overweight/obese boys. The penis length at the ages of 7 and 8 years was negatively correlated with weight, waist circumference and hip circumference. By the age of 12 years, the penis length was positively correlated with the height.

CONCLUSIONSThe development of penis and testicles in boys in the Zhengzhou area is in line with the level of sex development of Chinese boys. Overweight/obesity adversely affects the development of penis and testicles.

Child ; Child, Preschool ; China ; Humans ; Male ; Obesity ; epidemiology ; physiopathology ; Overweight ; epidemiology ; physiopathology ; Penis ; growth & development ; Testis ; growth & development

OBJECTIVETo study the mechanism of male infertility caused by varicocele by evaluating the effects of hyperbaric oxygenation (HBO) therapy on the testicular tissue morphology and function of rabbit model with varicocele(VC).

METHODSTwenty-four mature male rabbits were randomly divided into three groups: pseudo-operation, VC model and VC model administered by HBO. Experimental varicocele was induced by partial ligation of the left "lumbotesticular" trunk vein in rabbits. HBO was administered to one of the two groups of VC model rabbits after the operation. Weight and volume of both testes, parameters of seminal fluid, histological changes of testicular tissues, MTDs, TFI, and Sertoli cell index (SI) of seminiferous tubules were studied.

RESULTSThe average weight and volume of the left testes significantly increased in the rabbits treated by HBO. The semen quality was improved, and MTDs increased significantly compared with VC group(P < 0.0001). The testicular tissue morphology became nearly normal in VC + HBO group.

CONCLUSIONS1. Both the structure and spermatogenetic function of testes can be damaged by the presence of varicocele; 2. Chronic ischemia, anoxia and microcircular dysfunction may be the key process and essential factor that make varicocele contributive to testicular damage and spermatogenetic dysfunction; 3. HBO can effectively alleviate, even eliminate, chronic ischemia, anoxia and microcircular dysfunction in testicular tissues with varicocele, and thus protect the structure and functions of testes.

Animals ; Hyperbaric Oxygenation ; Male ; Rabbits ; Testis ; blood supply ; pathology ; Varicocele ; pathology ; physiopathology ; therapy

OBJECTIVETo determine the effect of high power microwave (HPM) radiation on the structure and function of blood-testis barrier (BTB) in rats.

METHODSOne hundred and sixty-six male Wistar rats were treated by heart perfusion of lanthanum-glutaraldehyde solution and tail vein injection of evans blue (EB) at 6 h, 1, 3, 7 and 14 d after exposed to 0, 10, 30 and 100 mW/cm2 HPM radiation for 5 minutes, the structural change of BTB and distribution of lanthanum or EB observed through the light microscope, electron microscope and laser scanning confocal microscopy (LSCM).

RESULTSTesticular interstitial edema, vascular congestion or hyperemia with accumulation of plasma proteins and red blood cells in the inner compartment of seminiferous tubules were observed after exposure to HPM. The above-mentioned pathological changes were aggravated at 1-7 d and relieved at 14 d after radiation, obviously more severe in the 30 and 100 mW/cm2 exposure groups than in the 10 mW/cm2. Both lanthanum precipitation and EB were deposited in the inner compartment.

CONCLUSIONHPM radiation may damage the structure and increase the permeability of BTB.

Animals ; Blood-Testis Barrier ; pathology ; physiopathology ; radiation effects ; Male ; Microwaves ; adverse effects ; Rats ; Rats, Wistar

ObjectiveTo explore the effects of ischemic preconditioning on the level of serum testosterone (T) and apoptosis of spermatogenic cells in rabbits with testicular ischemia-reperfusion injury induced by testicular torsion.

METHODSA total of 15 New Zealand male rabbits were randomly divided into groups A (control), B (ischemia-reperfusion), and C (ischemic preconditioning). The animals of group A were subjected to exposure of the right spermatic cord without ischemia, those of group B received 60-minute non-invasive occlusion of the right spermatic cord followed by 3 days of reperfusion, and those of group C underwent 5-minute occlusion plus 5-minute reperfusion of the right spermatic cord followed by the same procedure as that for group B. Then the rabbits were narcotized with 3% barbital sodium, the whole blood collected for examination of the serum T content and the testis tissues obtained from both the ischemic and healthy sides for HE and TUNEL staining.

RESULTSAfter operation, the body weight was significantly increased as compared with the baseline in groups A (［2.65±0.07］ vs ［2.45±0.07］ kg, P<0.05) and C (［3.03±0.11］ vs ［2.92±0.07］ kg, P<0.05), but not in group B (［3.05±0.07］ vs ［3.05±0.07］ kg, P>0.05). The serum T level showed no statistically significant difference in group A before and after operation (［139.59±9.39］ vs ［140.19±9.47］ ng/L, P>0.05), but was remarkably lower after operation than the baseline in groups B ［148.06±3.31］ vs ［74.12±4.00］ ng/L, P<0.01) and C (［133.75±6.48］ vs［94.76±3.13］ ng/L, P<0.01) as well as than the postoperative index in group A (P<0.01). In comparison with group A and the healthy side of group B, the testis tissue of the ischemic side in group B exhibited structural damage of most of the seminiferous tubules with disappearance of spermatogenic cell structures, apoptosis of spermatogenic cells, and exudation of light-eosin edema fluid in the mesenchyme and lumen, with a markedly increased apoptosis index (P<0.01) and a significantly decreased Johsen's score (P<0.01). Compared with ischemic side of group B, The testis tissue of the ischemic side in group C was restored to normal as compared with that in group B, with a dramatically decreased apoptosis index (P<0.01) and a remarkably increased Johnsen's score (P<0.01).

CONCLUSIONSIschemic preconditioning can raise the decreased serum T level and reduce the apoptosis of spermatogenic cells in rabbits with testicular ischemia-reperfusion injury, which could be applied as a potential option for the clinical treatment of testicular ischemia-reperfusion injury.

Animals ; Apoptosis ; Germ Cells ; In Situ Nick-End Labeling ; Ischemia ; physiopathology ; Ischemic Preconditioning ; Male ; Rabbits ; Random Allocation ; Reperfusion Injury ; blood ; physiopathology ; Spermatic Cord Torsion ; Testis ; physiopathology ; Testosterone ; blood

OBJECTIVETo investigate the influence of varicocele on the volume discrepancy of bilateral testes, and the relationship between testicular volume discrepancy and semen parameters.

METHODSThis study included 181 varicocele patients and 102 normal fertile men without varicocele. We retrospectively analyzed their clinical data, including the grades and locations of varicocele, testis volume and semen parameters.

RESULTSBilateral testicular volume discrepancy was found in 132 (72.9%) of the varicocele patients (including 117 cases of left testicular hypotrophy [88.6%]), and 35 (34.3%) of the non-varicocele fertile men. The rates of bilateral testicular volume discrepancy were 61.3%, 3.5%, 20.9% and 14.3% in the grade-III, grade-II, grade-I and non-varicocele groups, respectively (P < 0.05), with statistically significant differences among different age groups (P < 0.05). The percentage of morphologically normal sperm and sperm motility were reduced differently with different degrees of testicular volume discrepancy (P <0.05).

CONCLUSIONTesticular volume discrepancy is more common in men with left varicocele, and its prevalence and degree are correlated with the grade of varicocele. Semen quality decreases with the increase of testicular volume discrepancy.

Adult ; Humans ; Male ; Organ Size ; Retrospective Studies ; Semen Analysis ; Sperm Count ; Sperm Motility ; Testis ; pathology ; Varicocele ; pathology ; physiopathology ; Young Adult

OBJECTIVETo investigate the abnormal changes in the testes and semen parameters in patients with varicose veins and analyze the possible relationship between clinical varicocele and infertility.

METHODSWe retrospectively reviewed the records of 172 male patients consulting for varicocele in our hospital since 2003. All these patients were examined for the size of the testes with scrotal ultrasound. The semen samples of the patients with varicocele except for 5 under the age of 17 years were collected and analyzed, using the data of semen analyses of 163 healthy young male volunteers (aged 18-29 years) as control.

RESULTSAll the 172 patients had left-sided varicose veins. Sixty-three patients were found to have bilateral varicocele, and in most of them, the clinical grades of the left-sided varicose veins were higher than those of the right-sided ones. The mean volume of the left testis of the patients was 10.99∓3.71 ml, significantly smaller than that of the right one (11.86∓4.05 ml, P<0.01). The physiochemical indices of the patients, including the voiding volume, semen pH, liquefaction time and sperm concentration, were normal or similar with those of the healthy volunteers (P>0.05). Almost all the patients sperm motility and viability were significantly lower than those of the healthy volunteers (P<0.05). In addition, no significant difference was found in the sperm density, motility or viability between the patients with unilateral and bilateral varicocele (P>0.05).

CONCLUSIONVaricocele may decrease the testicular volume. Both unilateral and bilateral varicocele may have an effect on the bilateral testes to cause possible functional impairment of the testes manifested by decreased sperm motility and viability.

Adolescent ; Adult ; Child ; Humans ; Infertility, Male ; etiology ; Male ; Middle Aged ; Retrospective Studies ; Semen ; Sperm Count ; Sperm Motility ; Testis ; physiopathology ; Varicocele ; complications ; physiopathology ; Young Adult

OBJECTIVETo compare the outcomes of intracytoplasmic sperm injection (ICSI) with retrieved epididymal and testicular sperm for obstructive azoospermia and with ejaculated sperm for severe oligozoospermia and asthenospermia.

METHODSWe retrospectively analyzed 431 ICSI cycles, which were divided according to sperm sources into Groups A (n=287 in patients with severe oligozoospermia or asthenospermia using ejaculated sperm), B (n=109 in obstructive azoospermia patients with sperm retrieved by percutaneous epididymal sperm aspiration, PESA) and C (n=35 in obstructive azoospermia patients with sperm retrieved by testicular sperm extraction, TESE). Comparisons were made among the three groups in the rates of embryo implantation, fertilization, pregnancy, cleavage, and miscarriage.

RESULTSGroup A showed statistically significant differences from Groups B and C in the rates of embryo implantation and pregnancy (18.46% vs. 25.23% and 28.76%, 31.23% vs. 42.16% and 39.39%, P < 0.05). But no significant differences were seen in the rates of fertilization, cleavage and miscarriage among the three groups (P > 0.05).

CONCLUSIONThe rates of embryo implantation and clinical pregnancy are higher in patients with obstructive azoospermia than in those with severe oligozoospermia or asthenospermia after ICSI with ejaculated sperm.

Azoospermia ; therapy ; Epididymis ; cytology ; physiopathology ; Female ; Humans ; Male ; Oligospermia ; therapy ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Sperm Injections, Intracytoplasmic ; methods ; Spermatozoa ; Testis ; cytology ; physiopathology

OBJECTIVETo explore the effects of testis murine cytomegalovirus (MCMV) infection on mature sperm viability in mice.

METHODSBALB/c mice without MCMV infection, screened by ELISA, were randomly divided into two groups: an experimental group (n = 64) and a control group (n = 40). The former were directly inoculated with MCMV into the testis, while the latter treated by inoculation of DMEM without MCMV. The mice in both of the groups were sacrificed respectively at 1, 2, 4, 6, 9, 14, 21, 38 d postinoculation (D1, 2, 4, 6, 9, 14, 21, 38 PI), the testis was examined histopathologically, and meanwhile the viability of mature sperms in the epididymis cauda was measured.

RESULTSMCMV basophil inclusion bodies were found in the Leydig cells in the experimental group, and spermatogenic cells were vacuolated and arranged disorderly. Compared with the control group, the sperm viability in the experimental group was decreased significantly by 71.42% to 56.04% (P < 0.05) on D1 PI.

CONCLUSIONThe sperm viability in mice might be descended significantly by MCMV infection in the early period, but restored to normal with time. This shows that MCMV infection might influence procreation transiently.

Animals ; Cell Line ; Cell Survival ; physiology ; Cytomegalovirus Infections ; pathology ; physiopathology ; Male ; Mice ; Mice, Inbred BALB C ; Random Allocation ; Spermatozoa ; physiology ; Testicular Diseases ; pathology ; physiopathology ; virology ; Testis ; pathology

Objective: To investigate the influence of different procedures of testicular sperm retrieval on the levels of serum inhibin B (INHB), antisperm antibodies (AsAb), follicle-stimulating hormone (FSH), and testosterone (T) in patients with azoospermia. METHODS: We randomly assigned 210 azoospermia patients to receive testicular sperm extraction (TESE, n = 50), testicular sperm aspiration (TESA, n = 56), testicular fine needle aspiration (TEFNA, n = 64), or microscopic TESE (micro-TESE, n = 40). We measured the levels of serum INHB, FSH, and T and the positive rate of AsAb before and at 1 and 3 months after surgery. RESULTS: Compared with the baseline, the levels of serum FSH at 1 and 3 months after surgery showed no statistically significant differences in the TESE (［8.51 ± 4.34］ vs ［8.76 ± 3.07］ and ［7.24 ± 3.32］ IU/L, P >0.05), TESA (［7.70 ± 2.72］ vs ［7.90 ± 4.57］ and ［8.04 ± 3.65］ IU/L, P >0.05), TEFNA (［6.04 ± 3.17］ vs ［6.08 ± 2.70］ and ［6.10 ± 3.32］ IU/L, P >0.05), or micro-TESE group (［6.59 ± 2.74］ vs ［6.89 ± 1.78］ and ［6.75 ± 2.57］ IU/L, P >0.05); the positive rate of AsAb (IgM) was significantly increased at 1 month in the TESE (0.00 vs 14.00%, P <0.05) and micro-TESE groups (2.50% vs 15.00%, P <0.05), while the serum T level markedly decreased in the two groups (［16.52 ± 6.25］ vs ［9.25 ± 5.76］ nmol/L and ［14.16 ± 5.45］ vs ［8.23 ± 4.12］ nmol/L, P <0.05); the levels of serum INHB were remarkably reduced at 1 and 3 months in the TESE (［70.56 ± 23.17］ vs ［42.63 ± 15.34］ and ［44.05 ± 18.47］ pg/ml, P <0.05), TESA (［68.71 ± 14.74］ vs ［40.55 ± 20.51］ and ［42.11 ± 19.34］ pg/ml, P <0.05), TEFNA (［76.81 ± 27.04］ vs ［46.31 ± 19.28］ and ［48.32 ± 20.54］ pg/ml, P <0.05), and micro-TESE groups (［74.74 ± 28.35］ vs ［45.27 ± 18.83］ and ［47.64 ± 28.34］ pg/ml, P <0.05), but with no statistically significant differences among the four groups (P >0.05). CONCLUSIONS Different procedures of testicular sperm retrieval have different impacts on the testicular function and AsAb in patients with azoospermia.
Antibodies ; blood ; Azoospermia ; blood ; physiopathology ; Follicle Stimulating Hormone ; blood ; Humans ; Inhibins ; blood ; Male ; Sperm Retrieval ; Spermatozoa ; immunology ; Testis ; metabolism ; physiopathology ; Testosterone ; blood