Retentissement de l’infection genitale a chlamydia trachomatis sur le sperme chez les hommes consultant pour infertilite du couple

Chlamydia trachomatis (CT) genital infection is one of the most frequent causes of infertility. Its repercution on semen parameters and male infertility is controversial. The objective of this study was to evaluate the impact of CT genital infection on semen parameters in male partners of infertile couples. Ninety-seven infertile couples were studied. Semen, urethral and cervical samples were tested for CT by means of direct fluorescence antibodies assay (DFA), cell culture, polymerase chain reaction (PCR) and FLISA. Sera from both parteners were tested for immunoglobulin M, A and G antibodies to Chlamydia by means of the microimmunofluorescence MIF). For all mens, standard semen parameters were analysed according to the guidlines of the word health organisation. CT infection was identified in 34% of the male partners. In 76% of cases, the infection was asymptomatic. 60,6% of infected patients’s wives were also infected by CT. There was no significant difference between the mean values of concentration, motility and morphology of spermatozoa in both groups of male patients, infected by CT (CT+ group) and lacked infection (CT-group). The mean values of motility, vitality, concentration and normal forms of spermatozoa, in both CT+ and CT- groups were respectively: 39,6%±17,5% vs 40,4% ± 14,9%, 61,9% ±18,1% vs 62,4% ± 18,5%, 80,7×10⁶±67,5×10⁶ vs 67,1×10⁶ ±65,2×10⁶ and 34,7% ± 16,7% vs 33% ± 0,1%. Oligospermia was significantly more frequent in CT+ group (54,9%) than in CT-group (26,9%). High levels of coiled flagella (≥20) were more frequently observed in CT+ group (18,5%) than in CT-group (7,4%), but the difference was not significant. We found in this study a high prevalence of genital chlamydial infection into infertile couples. This infection has no repercution on sperm quality, suggesting that there is no effect of CT upon the spermatozoa. But, we can not exclude any impact on fertilisation ability and/or ultrastructure of these gametes. The finding that oligospermia was more frequent in CT+group, leds us to suggest thas chlamydial infection has a repercution on the gametogenesis or on genital ducts permeability. Another hypothesis would be that oligospermia, reflect of spermatogenesis disorder would be associated with reduction of local immunity. Other studies with wide exploration of spermatic functions and of different parts of genital tract are needed to specify the real impact of genital chlamydial infection upon men reproduction function.     

Association between the JC Polyomavirus Infection and Male Infertility

In recent years the incidence of male infertility has increased. Many risk factors have been taken into consideration, including viral infections. Investigations into viral agents and male infertility have mainly been focused on human papillomaviruses, while no reports have been published on polyomaviruses and male infertility. The aim of this study was to verify whether JC virus and BK virus are associated with male infertility. Matched semen and urine samples from 106 infertile males and 100 fertile males, as controls, were analyzed. Specific PCR analyses were carried out to detect and quantify large T (Tag) coding sequences of JCV and BKV. DNA sequencing, carried out in Tag JCV-positive samples, was addressed to viral protein 1 (VP1) coding sequences. The prevalence of JCV Tag sequences in semen and urine samples from infertile males was 34% (72/212), whereas the BKV prevalence was 0.94% (2/212). Specifically, JCV Tag sequences were detected in 24.5% (26/106) of semen and 43.4% (46/106) of urine samples from infertile men. In semen and urine samples from controls the prevalence was 11% and 28%, respectively. A statistically significant difference (p<0.05) in JCV prevalence was disclosed in semen and urine samples of cases vs. controls. A higher JC viral DNA load was detected in samples from infertile males than in controls. In samples from infertile males the JC virus type 2 strain, subtype 2b, was more prevalent than ubiquitous type 1. JCV type 2 strain infection has been found to be associated with male infertility. These data suggest that the JC virus should be taken into consideration as an infectious agent which is responsible for male infertility.     

Indications de la recherche des anticorps anti-spermatozoïdes

The clinical significance of antisperm antibodies (ASA) is highly controversial. A significant percentage of infertile men and women present immunity to spermatozoa, suggesting that ASA may interfere with the fertilizing capacity. ASA can act negatively on sperm parameters, sperm-cervical mucus interaction, gamete fusion and possibly also on the first step of embryonic development. ASA are present in approximately 2.8% to 26% of the male population and 0.2% to 1.6% of women. The pathogenesis of immunity to spermatozoa had not been fully elucidated: breakdown of normal protective mechanisms, i.e. blood-testis barrier, or epithelial barrier in women, and other mechanisms of immunological sperm tolerance, such as regulation of suppressor T lymphocytes. The indication for antisperm antibody testing is based on clinical and laboratory findings of infertile patients. In men, indictions for ASA testing include a history of genital disease, surgery for genital abnormalities, vasectomy, obstruction or injuries of the male genital tract, infection of accessory glands, long-standing infertility, alteration of semen parameters (agglutination, motility), mucus penetration, and reduced fertilizing capacity in IVF. In many cases, no etiological cause of autoimmunity is found and a genetic predisposition has been suggested. A majority of women do not develop antisperm antibodies, despite repeated contact with spermatozoa during their sexual life. Upper genital tract infection is the main cause of isoimmunization in females, although sexual practices, endometriosis, surgery for cervical neoplasia, recurrent spontaneous abortion and long-term infertility may also be involved. Sperm-cervical mucus impairment is the most obvious effect of immunization in women associated with IVF failure. Autoantibodies are frequently associated with antisperm antibodies. One of the consequences of the success of ICSI has been a decreased research effort to further the understanding of the origin and relevance of antisperm antibodies and specific antibody-antigen interactions. A better understanding of the natural history of immunological infertility would be useful for patient conseiling and to develop the most effective, efficient and safest management strategies. Such data could also be useful for the development of new tests and immunological methods of male contraception.     

Prévalence de la pyospermie et retentissement sur la qualite du sperme chez les hommes infertiles

There are numerous controverses concerning the relationship between the presence of leukocytes in semen and male infertility. In the aim to determine the impact of pyospermia on sperm quality, we have realised a retrospective study in which we analysed and compared semen parameters and abnormalities frequencies between pyospermic and non pyospermic infertile patients. 833 spermiograms were included in this study. They were done in accord with WHO method. Leucocytes identification was performed by cyto-enzymologic method that reveals myelo-peroxydase in polymorphonuclear granulations. Pyospermia was considered when number of leucocytes was more than one million per millititre of sperm. The non pyospermic group was composed by sperm with leucocytospermia less than 50.000 per millilitre. The prevalence of pyospermia was 5.88%. There was not significative difference of semen parameters (volume, motility, morphology, number of spermatozoa and viability) between pyospermic and non pyospermic groups. In the other hand, no correlation was found between leucospermia and semen parameters. However, oligospermia was significantly more frequent in pyospermic group (40.8%) than in non pyospermic group (20,3%). Inversly, the frequence of teratospermia was significantly higher in non pyospermic group (47.2% vs 34.1%, p<0,05). These results suggest that inflammation and/or infection associated with pyospermia is complicated by reduction of spermatic ducts permeability. Although, the leucocytes would act in removing amorphous gametes by phagocytosis. No relationship was established between pyospermia and infection. In future, a prospective study would be done with exhaustive exploration of pyospermia etiology, with hopes to clarify the true link with infection and autoimmune reaction and to determine the effect of pyospermia on glandular activities in male genital tract and on functional properties of spermatozoa.     

Relationship between clinical phenotype, semen parameters and aneuploidy frequency in sperm nuclei of 50 infertile males

The purpose of this study was to analyse the frequency of disomy for chromosomes 1, 13, 14, 18, 21, 22, X and Y in sperm nuclei of 50 infertile men and 10 healthy probands of proven fertility. Semen parameters (sperm count, global motility and morphology), urological clinical examination, genital ultrasound and lymphocyte karyotyping were performed for each patient. Disomy frequency was established by fluorescence in situ hybridization by using whole chromosome paint probes. The mean rate of disomy for the various autosomes studied was higher in infertile males than in subjects of proven fertility. Interchromosomal and interindividual differences in the disomy frequency were observed between the 50 patients. The mean frequency of homodisomy YY and heterodisomy XY was increased in spermatozoa of patients with low semen quality parameters (0.24% and 0.54%, respectively). The disomy frequency in infertile males was directly correlated with the severity of oligospermia. However, no relationship was established between aneuploidy rate, sperm motility, morphology or clinical phenotype. These results support the hypothesis that, during spermatogenesis of males with sperm parameter alterations, a decreased frequency of meiotic chromosome pairing and crossing over may lead to spermatogenesis arrest at the meiosis stage and/or to an increase of meiotic nondisjunctions. Meiotic arrest in some germ cells may be responsible for oligospermia and nondisjunctions in other cells for aneuploidy in mature male gametes.     

Effect of trace elements on the seminal oxidative status and correlation to sperm motility in infertile Saudi males

The impact of trace elements, especially zinc, selenium, copper, and magnesium, on male fertility has gained great interest and significance. Increased oxidative stress and altered trace element levels are probable etiological factors underlying male reproductive dysfunction and infertility. The present study focused on the evaluation of seminal oxidative markers, such as reactive oxygen species (ROS), malondialdehyde (MDA), and total antioxidant capacity (TAC), and trace element levels in the normozoospermic fertile control group (n = 40) and asthenozoospermic infertile group (n = 30). Semen from infertile men exhibited significantly higher ROS and MDA levels accompanied with significant decline in TAC and trace element (zinc and magnesium) levels. Furthermore, a significant correlation was observed between trace elements and oxidative markers with sperm motility. The current study revealed increased lipid peroxidation and oxidant-reductant imbalance that leads to deterioration of semen quality and male infertility. Thus, oxidative stress and trace elements can be considered important biomarkers of male infertility. Measurement of seminal oxidative stress with conventional seminological parameters must be integrated in fertility assessment from early stages to ensure healthy semen characteristics and fertility in men.     

Approche clinique d'une OAT

The clinical approach of the male partner of infertile couples seems to be still a problem. Indeed, clinical history and examination are too often lacking. Such an attitude induces that the treatment of male infertility tends to be based for most part on the examination of seminal fluid alone. With the consequence that the treatment of the semen rather the man is the focus of attention. Oligozoospermia (OAT) is a common finding among infertile men. This OAT can be due to factors that may be found through anamnesis, clinical examination and semen analysis. Anamnesis indicates history of cryptorchidism, urogenital infections, surgery for inguinal hernia. One of the most studied factors that can be found during clinical examination is varicocele, and recent data indicate that the surgical treatment of varicocele when associated with OAT could be beneficial to fertility of infertile men. Semen infection, a difficult diagnosis mainly based on bacteriospermia and leukospermia, could benefit from other diagnosis tools such as echography of the male reproductive tract and biochemical markers of the seminal plasma. Finally, when no potential factors responsible for an OAT are found, such an OAT is named “idiopathic”. However, some of these “idiopathic OAT” are false idiopathic OAT, as shown through three examples, such as unilateral testicular obstruction, partial ejaculatory duct obstruction and thermal pathologies of the testes, when anamnesis and clinical examination are adequately associated with semen analysis.     

Aspects cliniques et biologiques de l’azoospermie chez l’homme infertile en Tunisie

Objective

It is now very important to investigate azoospermia because the introduction of the intracytoplasmic sperm injection technique during the last decade has allowed many infertile men to achieve their dreams of fatherhood. The purpose of this study was to define the characteristics of infertile men with azoospermia, and to analyse the clinical and laboratory features and the causes of infertility in Tunisia. The authors also discuss various aspects that they consider to be very important in the diagnosis of male fertility.

Material and Methods

This retrospective study analysed the parameters of physical examination, laboratory tests, semen analysis, radiographic examinations, testicular biopsy, karyotype and AZF microdeletions.

Results

Based on the results of endocrinological and cytogenetic examinations, the aetiology of azoospermia was considered to be secretory in 43 cases of azoospermia. Physical examination revealed a high percentage of hypotrophic/atrophic testes (43.9%). Serum follicle stimulating hormone levels were high in 58.5% of cases. The overall incidence of chromosomal abnormalities was 31.4%. The most frequent anomaly was Klinefelter syndrome (9 cases). Seven out of 28 patients (25%) with nonobstructive azoospermia had AZF deletions. None of the patients with excretory azoospermia and severe oligospermia had an abnormal karyotype or AZF microdeletions. 48.8% of patients presented a varicocele, 13.9% had cryptorchidism and 13.0% had a history of genital tract infection.

Conclusion

In line with the literature, genetic abmormalities are the main causes of severe forms of impaired spermatogenesis in the Tunisian population.     

Using the PCR and Blood Agar in Diagnosis of Semen Bacterial Contamination of Fertile and Infertile Men

Background:One of the causes of male infertility is Genital tract infections (GTI). Considering the importance of GTI, widespread recognition of them seems necessary. we aimed to characterize and compare semen microbial populations in fertile and infertile men who referred to an infertility clinic in Yazd, Iran.Methods:Semen samples were collected from two groups of fertile (268) and infertile (210) men. Sperm analysis (concentration, morphology, viability and motility parameters) were performed according to the World Health Organization (WHO) 2010 guidelines laboratory manual. Bacterial isolation was performed in Sheep Blood Agar and Eosin Methylene Blue (EMB) agar plates. For PCR, samples were analyzed with genus specific primers.Results:All semen characteristics were poor in the infertile group compared to those in the fertile men (p-value< 0.05). Enterococcus spp. (18.7%, 17.1%; p= 0.814), E. coli (7.9%, 11.4%; p= 0.486), Staphylococcus aureus (6.4%, 2.9%; p= 0.398) and Proteus mirabilis (0%, 2.9%; p= 0.002) were the most common agents, respectively. Also, the results obtained from PCR were confirmed using culture-base method.Conclusion:Proteus mirabilis contamination was identified in the infertile group. While no significant association was observed between male infertility and semen microbial populations, p. mirabilis may be the leading cause of reproduction impairment in men.Key Words: Infertility, Microbial contamination, culture, PCR     

Evaluation of telomere length,reactive oxygen species,and apoptosis in spermatozoa of patients with oligospermia

50% of cases of infertility are caused by male factor, which acquired or congenital problems may bring on. Male infertility can be caused by oligospermia and asthenozoospermia, which are common. Since the same mutations that cause azoospermia in some people also cause oligozoospermia in others, oligozoospermia may be thought of as a less severe form of azoospermia. Studies have demonstrated telomere length, catalase activity, super oxide dismutase (SOD), and DNA fragmentation can be influential factors for male infertility. The amount of apoptosis, oxidative stress factors, telomere length, and DNA fragmentation were some aspects of healthy sperm that we chose to look into in this study and compare to oligospermia individuals. Oligospermia patients (n = 24) and fertile men (n = 27) semen samples were collected, and the apoptosis rate of sperms in both groups was analyzed (Flow cytometry). Also, gene expression of apoptotic and antiapoptotic markers and telomere length were examined (real-time polymerase chain reaction). The sperm DNA fragmentation kit was used to determine DNA fragmentation and to evaluate catalase and SOD activity; the specific kits and methods were utilized. Higher expression levels of caspase3 (p = .0042), caspase8 (p = .0145), caspase9 (p = .0275), and BAX (p = .0202) mRNA were observed in patients who had oligospermia. In contrast, lower mRNA expression of BCL-2 (p = .0009) was detected in this group. In addition, telomere length was decreased in the oligospermia group (p < .0001) compared to the health group. Moreover, the frequency of apoptosis is induced in patients (p = .0026). The catalase activity is low (p = .0008), but the SOD activity is high (p = .0015) in the patient group. As a result of our findings, we may list the sperm cell apoptosis rate, telomere length, the degree of sperm DNA fragmentation, and lastly, the measurement of significant and efficient oxidative stress markers like SOD and catalase in semen plasma among the principal diagnostic characteristics for oligospermia. Future studies will be better able to treat oligospermia by showing whether these indicators are rising or falling.     

Infection of semen-producing organs by HIV and role in virus dissemination

Despite semen being the main vector of human immunodeficiency virus (HIV) dissemination worldwide, the origin of the virus in this bodily fluid remains unknown. Of particular significance is the persistence of virus release in the semen of a subset of HIV-infected men under antiretroviral therapy, who otherwise show an undetectable blood viral load. It is therefore considered critical to identify the sources of virus shedding in semen for the more efficient control of HIV transmission. Our recent findings indicate HIV infection of several semen-producing organs, including the testis (which represents a pharmacological sanctuary for several antiretroviral drugs). This reinforces phylogenetic observations suggesting that the free viral particles and infected cells contaminating semen are produced within the male genital tract. The fact that HIV replicates within the male genital organs raises several questions: Is one or several of the male genital tract organs responsible for the persistence of HIV in semen despite efficient antiviral therapies? What is the nature of HIV interactions with spermatozoa and testicular germ cells? Recent results established that semen from HIV negative men modifies HIV infectivity: does the seminal fluid from HIV+ men enhance or inhibit the efficiency of HIV sexual transmission?     

不育男性患者和健康男性血液与精浆中微量元素含量的对比分析

目的:研究不育患者精浆和血液中微量元素的含量,为男性不育的诊断和治疗提供理论依据。方法:对73例正常生育组男性和265例男性不育患者的精浆和血液中的锌、铁、铜、钙、镁、镉进行检测分析,分析两组血液和精浆微量元素的差异。结果:不育组患者精浆和血液中锌的含量明显低于正常对照组,铜、镉离子含量明显高于正常对照组,与正常对照组比较均有显著性差异(P<0.01);而两组中的钙、铁、镁的含量接近,差异无统计学意义(P>0.05)。不育组患者精浆中的锌元素水平明显高于血液锌含量,而血液中的镉含量明显高于精浆中的镉含量,差异有明显的统计学意义(P<0.05)。结论:精浆和血液中锌、铜、镉的变化与男性不育密切相关。     

Obstructions des canaux éjaculateurs: diagnostic et traitements

The management of male factor infertility has been frustrated by the large group of men with idiopathic infertility in whom treatment options have been limited to either empiric medical thrapy,orassisted reproductive technologies or donor insemination. Therefore, the identification of reversible causes of infertility in these patients is extremely attractive to couples and physicians. Recent reports suggest that partial ejaculatory duct obstruction may be responsible for infertility in some men previously labelled as having idiopathic infertility. Complete ejaculatory duct obstruction is suspected in azoospermic or severely oligospermic patients with low ejaculate volume (less than 1 ml), absence of sperm from the post-ejaculatory urine, normal endocrine studies and normal testis size. Demonstration of dilatation of the seminal vesicles and/or ejaculatory ducts by transrectal ultrasonography is diagnostic of ejaculatory duct obstruction in patients with the afore-mentioned clinical features. However, in the absence of definitive transrectal ultrasonography findings, vasography remains the gold standard for the diagnosis of ejaculatory duct obstruction. Ejaculatory duct obstruction is diagnosed in approximately 5% of azoospermic infertile men and is treated by transurethral incision of the ducts. After the surgical procedure semen parameters can improve and pregnancies have been initiated. Although, the patient must be informed that surgical therapy can also fail and can be associated with significant complications.     

Peroxiredoxins: hidden players in the antioxidant defence of human spermatozoa

Spermatozoon is a cell with a precious message to deliver: the paternal DNA. Its motility machinery must be working perfectly and it should be able to acquire fertilizing ability in order to accomplish this mission. Infertility touches 1 in 6 couples worldwide and in half of the cases the causes can be traced to men. A variety of conditions such as infections of the male genital tract, varicocele, drugs, environmental factors, diseases, smoking, etc., are associated with male infertility and a common feature among them is the oxidative stress in semen that occurs when reactive oxygen species (ROS) are produced at high levels and/or when the antioxidant systems are decreased in the seminal plasma and/or spermatozoa. ROS-dependent damage targets proteins, lipids, and DNA, thus compromising sperm function and survival. Elevated ROS in spermatozoa are associated with DNA damage and decreased motility. Paradoxically, ROS, at very low levels, regulate sperm activation for fertilization. Therefore, the regulation of redox signaling in the male reproductive tract is essential for fertility. Peroxiredoxins (PRDXs) play a central role in redox signaling being both antioxidant enzymes and modulators of ROS action and are essential for pathological and physiological events. Recent studies from our lab emphasize the importance of PRDXs in the protection of spermatozoa as infertile men have significant low levels of PRDXs in semen and with little enzymatic activity available for ROS scavenging. The relationships between sperm DNA damage, motility and lipid peroxidation and high levels of thiol-oxidized PRDXs suggest the enhanced susceptibility of spermatozoa to oxidative stress and further support the importance of PRDXs in human sperm physiology. This review aims to characterize PRDXs, hidden players of the sperm antioxidant system and highlight the central role of PRDXs isoforms in the protection against oxidative stress to assure a proper function and DNA integrity of human spermatozoa.     

Influence of sexual intercourse on genital tract microbiota in infertile couples

Several studies have suggested the association of disturbed genital tract microbiota with infertility. Our aim was to clarify the influence of sexual intercourse on partner’s genital tract microbiota in infertile couples. Seventeen couples were studied, and in 5 men inflammatory prostatitis (IP) was diagnosed. Semen samples were collected during menstruation of the female counterpart, two self-collected vaginal samples were taken 3–5 days later – before intercourse and 8–12 h after intercourse. Ureaplasma parvum was found in 59% of women, its prevalence was higher in women whose partner had IP, as well as in half of their male partners. Sexual intercourse caused significant shifts in vaginal microbiota – increase of Nugent score and shifts in cultured microbiota (emergence and disappearance of several species). These changes were less expressed in the presence of normal vaginal microbiota but more prominent in the partners of IP men. These changes may interfere with fertilization.     

Should Seminal Oxidative Stress Measurement be Offered Routinely to Men Presenting for Infertility Evaluation?

ObjectiveTo determine if seminal oxidative stress measurement should be offered routinely to men presenting for infertility evaluation.MethodsWe performed an extensive review of the English-language literature by searching MEDLINE for studies published between 1980 and 2007.ResultsResearch conducted during the last decade has provided growing support for the concept that excessive production of reactive oxygen species (ROS) is related to abnormal semen parameters and sperm damage. Routine semen analysis remains the backbone of clinical evaluation in male infertility, but determining the levels and sources of excessive ROS generation in semen is currently not included in the routine evaluation of subfertile men. However, the diagnostic and prognostic capabilities of seminal oxidative stress measurement exceed the capabilities of conventional sperm quality tests. An oxidative stress test may accurately discriminate between fertile and infertile men and identify those with a clinical diagnosis of male factor infertility who are likely to initiate a pregnancy if they are followed over a period of time. In addition, such a test can help select subgroups of patients with infertility in which oxidative stress is an important factor and those who may benefit from antioxidant supplementation. Although consensus is still required about the type and dosage of antioxidants to be used, rationale and evidence exist supporting their use in infertile men with elevated oxidative stress.ConclusionConsensus is growing about the clinical utility of seminal oxidative stress testing in infertility clinics, but standardization of protocols to measure ROS is crucial before introducing these tests into routine clinical practice. (Endocr Pract. 2008;14:484-491)     

A Comparative Analysis of the Altered Levels of Human Seminal Plasma Constituents as Contributing Factors in Different Types of Male Infertility

(1) Background: The relationships between the biochemical and immunological components in seminal plasma and their physiological effects on male reproductive system have been underreported. In this study, we evaluated the potential of several seminal plasma biochemical and immunological markers in the pathophysiological developments of the infertile male patients. The study was designed to identify and assess different markers that may be associated with semen functions in different types of male infertility. (2) Methods: A total of 50 infertile male patients who underwent checkup for fertility assessment and 50 fertile controls were included in this study. The complete medical history of each recruited participant was reviewed. The infertile sub-groups (non-obstructive azoospermia (NOA), asthenozoospermia (AS), normozoospermic infertile (NI), and oligozoospermia (OZ)) were characterized based on sperm motility and concentration, while NI patients were included after a thorough check up of their female partners as well. We investigated each sample for 21 different analytes, enzymes, trace elements, and immunological markers to find crucial markers posing as contributing factors to a specific type of male infertility. (3) Results: The levels of 15 out of 21 markers, assayed from the seminal plasma of infertile males, were significantly altered in comparison to fertile controls (p < 0.05). For the first time, microprotein levels were also analyzed. The presence of monocytes, lymphocytes, and granulocytes was limited to semen from NOA patients, while a significant increase in the level of platelets was observed in AS. Hierarchical clustering and ROC-AUC analysis identified the three most significant markers (zinc, LDH, and TG) for the healthy control group and asthenozoospermic group (AUC, of 0.92 and 0.81, respectively). (4) Conclusions: The altered levels of biochemical and immunological markers in seminal plasma might be associated with the different male infertility profiles and could be required for the sperm metabolism and maintenance. However, a larger sample size and follow up analysis is required for establishing the hypothesized panel of markers as biomarkers at clinical stage.     

精子端粒长度与特发性男性不育相关

端粒是真核生物染色体末端的多功能特异性DNA-蛋白结构,覆盖在染色体末端,保护基因组的稳定性。端粒在减数分裂过程中起到了十分重要的作用,协助染色体配对、联会、同源重组和分离。精子中的端粒可能在精子的受精能力和胚胎发育中起到重要作用。近年来,端粒与生殖的相关性研究成为一个新的热点,但精子端粒与男性不育间的相关性并不明确。本文采用实时荧光定量PCR方法检测中国特发性男性不育人群(126例)和正常可育男性人群(138例)的精子相对端粒长度,结果发现,特发性男性不育病例的精子平均相对端粒长度(2.894±0.115)低于正常对照组(4.016±0.603),差异具有统计学意义(P=5.097×10^-5);并且精子相对端粒长度与精子密度、精子总数和精子活力都有显著的相关性：精子数量较多和/或精子活力较高,精子相对端粒长度较长。研究结果提示,在中国人群中,精子端粒长度与特发性男性不育具有相关性,精子的端粒长度可能影响精子发生和精子的功能,精子端粒的缩短导致精子数目及活力的降低从而导致男性不育。     

The relationship between anogenital distance, fatherhood, and fertility in adult men

Background

Anogenital distance (AGD), a sexually dimorphic measure of genital development, is a marker for endocrine disruption in animal studies and may be shorter in infant males with genital anomalies. Given the correlation between anogenital distance and genital development, we sought to determine if anogenital distance varied in fertile compared to infertile adult men.

Methods

A cross sectional study of consecutive men being evaluated for infertility and men with proven fertility was recruited from an andrology clinic. Anogenital distance (the distance from the posterior aspect of the scrotum to the anal verge) and penile length (PL) were measured using digital calipers. ANOVA and linear regression were used to determine correlations between AGD, fatherhood status, and semen analysis parameters (sperm density, motility, and total motile sperm count).

Findings

A total of 117 infertile men (mean age: 35.3±17.4) and 56 fertile men (mean age: 44.8±9.7) were recruited. The infertile men possessed significantly shorter mean AGD and PL compared to the fertile controls (AGD: 31.8 vs 44.6 mm, PL: 107.1 vs 119.5 mm, p<0.01). The difference in AGD persisted even after accounting for ethnic and anthropomorphic differences. In addition to fatherhood, on both unadjusted and adjusted linear regression, AGD was significantly correlated with sperm density and total motile sperm count. After adjusting for demographic and reproductive variables, for each 1 cm increase in a man''s AGD, the sperm density increases by 4.3 million sperm per mL (95% CI 0.53, 8.09, p = 0.03) and the total motile sperm count increases by 6.0 million sperm (95% CI 1.34, 10.58, p = 0.01). On adjusted analyses, no correlation was seen between penile length and semen parameters.

Conclusion

A longer anogenital distance is associated with fatherhood and may predict normal male reproductive potential. Thus, AGD may provide a novel metric to assess reproductive potential in men.     

Variants of the CLOCK gene affect the risk of idiopathic male infertility in the Han-Chinese population

Recent experimental animal studies suggested that the circadian locomotor output cycles kaput protein gene (CLOCK) has been reported to play a critical role in sperm function and male fertility. The aim of this study was to determine whether variants of the CLOCK gene are involved in idiopathic male infertility. The study included 478 idiopathic infertile men and 194 fertile controls who completed physical examinations. Each subject donated 5?ml of peripheral blood and a sample of semen in the ejaculate. An aliquot of each blood sample was used to separate the serum for the measurement of testosterone as well as follicular stimulating hormone (FSH) using the standard radioimmunoassay. The rest of the blood samples was used to extract the DNA for the assay of three tagging single-nucleotide polymorphisms of CLOCK gene, viz., rs1801260, rs3817444 and rs3749474, using the real-time fluorescence quantitative PCR. The ejaculate of each subject was used for semen analysis by computer-assisted semen analysis system. The results indicated: (a) the variant rs1801260 associated with normal semen parameters was linked to a significant increase in the risk of idiopathic infertility, (b) the variant rs3817444 associated with both normal and abnormal semen parameters also indicated an increased risk of idiopathic infertility, and (c) the variants rs3749474 associated with both normal and abnormal semen parameters, on the other hand, conferred no significant risk for male infertility. Furthermore, elevated serum testosterone and FSH levels were correlated with the three variants of CLOCK gene in idiopathic infertility. The findings demonstrate that the human subjects with variants of the CLOCK gene are associated with idiopathic male infertility and therefore may be applied as a risk factor of male infertility.