VEGF和Flt-1在精索静脉曲张大鼠附睾中的表达变化

目的研究血管内皮生长因子(VEGF)及其受体Flt-1在实验性左侧精索静脉曲张(ELV)大鼠附睾组织中的表达变化,探讨它们与精索静脉曲张(VC)的关系及致男性不育的病理生理学机制。方法建立青春期雄性SD大鼠ELV模型,采用免疫组化SP法检测ELV及对照组附睾中VEGF和Flt-1的表达。结果 VEGF和Flt-1蛋白在大鼠附睾中均有表达,并具有细胞和区域特异性。ELV4周时双侧附睾中VEGF蛋白的表达明显上调(P<0.01),8周时则显著下降(P<0.01);而Flt-1蛋白在ELV4周左侧显著下降(P<0.01),右侧未见明显差异(P>0.05),8周组均显著下降(P<0.01)。结论 ELV引起大鼠附睾中VEGF和Flt-1表达量发生变化,可能影响精子的成熟,是VC引起男性生育力下降甚至不育的原因之一。     

28例未婚青年精索静脉曲张的超声诊断分析

精索静脉曲张是临床中常见的疾病之一,在男性不育症患者中发病率高达10％～15％,WHO在不育症的研究中已将其列为首位,因此及时诊断和治疗显得尤为重要。本文应用高频彩色多普勒超声诊断未婚青年精索静脉曲张28例,并进行分析,以提高对本病的认识水平。     

精索静脉曲张对青春期大鼠睾丸中VEGF和Flt-1蛋白表达的影响

目的研究血管内皮生长因子(VEGF)及其受体Flt-1蛋白在实验性左侧精索静脉曲张(ELV)大鼠睾丸中的表达和定位,探讨它们在精索静脉曲张(VC)致男性不育中的作用。方法建立青春期大鼠ELV模型,采用免疫组化法检测VEGF及Flt-1在ELV4周、8周组及相应对照组大鼠睾丸中的表达变化。结果 VEGF和Flt-1蛋白在大鼠睾丸中定位具有细胞特异性。VEGF蛋白表达于生精细胞、精子细胞发育中的顶体、Sertoli和Leydig细胞胞质内;Flt-1表达于精子细胞发育中的顶体及Leydig细胞胞质中。ELV4周组睾丸中VEGF蛋白的表达显著增加(P<0.01),8周时其表达量下降(P<0.01);ELV4周组与8周组睾丸中Flt-1蛋白的表达均比相应对照组下降(P<0.01),ELV8周组比4周组显著减少(P<0.01)。结论 ELV可影响青春期大鼠睾丸中VEGF和Flt-1蛋白的表达量,可能会影响精子的发生、发育,因而该变化可能是VC引起男性不育的原因之一。     

ELV对青春期大鼠睾丸中VEGF与VEGFR2蛋白表达的影响

目的研究血管内皮生长因子(VEGF)及其受体2(VEGFR2)在实验性左侧精索静脉曲张大鼠睾丸中的表达和定位,探讨精索静脉曲张中VEGF和VEGFR2的可能作用。方法通过部分结扎左肾静脉建立大鼠实验性左侧精索静脉曲张模型,于术后2周和4周取材,采用免疫组化法检测VEGF、VEGFR2在睾丸上的表达变化。结果 ELV2周与4周组大鼠两侧睾丸中VEGF蛋白表达均上调,但ELV组间VEGF蛋白表达没有明显变化;ELV2周组大鼠睾丸中VEGFR2蛋白的表达与对照组比较增强,而4周组比对照组和2周组均显著增强。结论实验性左侧精索静脉曲张对VEGF、VEGFR2蛋白的表达有影响,说明它们与男性不育可能有一定的关系。     

彩色多普勒超声检测睾丸微石症合并精索静脉曲张患者睾丸动脉与精索静脉血流动力学的临床分析

目的:采用彩色多普勒超声检测睾丸微石症(TM)合并精索静脉曲张(VC)患者睾丸动脉与精索静脉血流动力学的情况,并分析VC分级与TM分型的关系。方法:选择2014年8月到2016年8月80例TM合并VC患者及80例健康男性分别作为研究组与对照组,均采用彩色多普勒超声检测睾丸动脉收缩期峰值血液速度(PSV)、阻力指数(RI)及精索静脉最高流速(VS-Vmax)、静脉返流时间(TR)、平静呼吸最大内径(DR)、Valsalva试验最大内径(DV)。用Spearman秩相关分析TM分类与VC评分的关系。结果:两组睾丸动脉RI比较无显著差异(P0.05)。研究组PSV明显小于对照组(P0.05),精索静脉DR、DV、VS-Vmax、TR均显著大于对照组(P0.05)。TM分类与VC分级呈正相关(P0.05)。结论:TM合并VC患者睾丸动脉、精索静脉血流动力学均存在不同程度的改变,VC严重程度与睾丸微小结石数量呈正相关。     

不同程度精索静脉曲张对不育男性精浆生化标志物及精子DNA完整性的影响

摘要 目的：探讨不同程度精索静脉曲张（varicocele,VC）对不育男性精浆生化标志物及精子DNA完整性的影响。方法：选取2017年8月至2020年9月至我院生殖医学中心男性专科门诊就诊并进行精浆生化及精子DNA完整性检查的不育患者138例,按照有无VC分为VC不育组62例,非VC不育组76例,选取同期就诊无VC的正常生育者60例作为本研究的对照组,根据精索静脉曲张程度将VC不育组患者分为VCⅠ度组、VCⅡ度组、VCⅢ度组。比较VC不育组、非VC不育组与正常生育组精浆生化标志物及精子DNA碎片率（DNA fragmentation index,DFI）,分析比较VC不育各亚组间精浆生化标志物及精子DFI变化情况。结果：精浆生化标志物分析：VC不育组精浆α-葡萄糖苷酶较非VC不育组及正常生育组明显减低（P＜0.05）,且VC不育各亚组间精浆α-葡萄糖苷酶水平依次减低,三组间两两比较有显著性差异（P＜0.05）;精浆锌、柠檬酸、果糖在VC不育组、非VC不育组与正常生育组比较无统计学差异（P＞0.05）,在VC不育各亚组间比较均无显著性差异（P＞0.05）;精子DFI分析：VC不育组精子DFI较正常生育组升高（P＜0.05）,非VC不育组精子DFI较正常生育组升高（P＜0.05）,VC不育组精子DFI较非VC不育组比较未见明显差异（P＞0.05）;VC不育各亚组间精子DFI逐渐升高,三组间两两比较精有显著性差异（P＜0.05）。结论：VC的发生与进展程度与精子DFI及精浆α-葡萄糖苷酶水平异常具有相关性,其二者可作为评价VC的有效指标,并为VC的分度提供一定的依据。     

青春期大鼠实验性精索静脉曲张对附睾超微结构的影响

目的：精索静脉曲张（VC）与男生不育密切相关,但其导致不育的确切机制尚不清楚。大量临床观察和实验研究证明VC可引起睾丸损害,但对附睾的影响研究较少,特别关于青春期动物VC对附睾影响的研究尚未见任何报道,为此,本研究在建立青春期大鼠实验性VC模型的基础上,试图通过实验性VC对附睾超微结构的影响。来阐明其在不育发生机理中的地位。方法：部分结扎青春期大鼠左肾静脉建立VC模型,分别于手术后4周和8周取左右侧附睾始段头,体,和尾部,在光镜研究的基础上,制作透射电镜标本并进行观察,结果：VC大鼠左右侧附睾各段上皮的超微结构都发生明显改变;如上皮基膜增厚;上皮微绒毛稀少且局部受损;主细胞内多形态溶酶体增加,内质网扩张,高尔基复合体空泡化,线粒体嵴模糊,胞质内出现大空泡;晕细胞数增加且胞质内含大量高电子密度的溶酶体;亮细胞内脂肪滴和溶酶体明显增多,细胞膨胀,常可见游离面突入官腔,此外,附睾官腔内精子残余体增多,精子头出现核大泡,精子尾线粒体,纤维柱排列紊乱等。结论：青春期可引起大鼠附睾超微结构受损,这可能也是VC导致不育的重要原因之一。     

腹腔镜精索静脉曲张高位结扎250例报告

目的:探讨腹腔镜精索静脉曲张高位结扎治疗精索静脉曲张的疗效与安全性.方法:回顾性分析行腹腔镜精索静脉曲张高位结扎250例患者的临床资料.结果:250例手术均成功,术后随访平均1年,无一例复发.结论:该术式对患者损伤小,恢复快,疗效确切,并发症少,特别适用双侧精索静脉曲张.     

SPANX蛋白的研究进展及其与男性生育力的相关性

男性不育症病因十分复杂,遗传、环境、内分泌等许多因素都会导致男性不育。而现今临床上多依据精液常规分析对男性不育做出诊断和治疗,但仅依赖精液常规参数存在一定局限性。探寻男性生育力的潜在生物标志分子是当前男性不育的迫切需求。精子X染色体核结合精子蛋白(The sperm protein associated with the nucleus on the X chromosome,SPANX)是在精子中表达的一类小分子蛋白,SPANX蛋白家族基因定位在X染色体上,它随精子的成熟而迁徙,参与精子结构的形成,在精子成熟的不同时期,蛋白定位和蛋白表达均存在差异。在精液参数正常的不育男性和自发弱精症的男性中,SPANX表达下调;同时在活性氧自由基(reactive oxygen species,ROS)阴性的精子中,SPANXC表达降低,在DNA碎片率低的精子中,SPANX表达增高;这些表明SPANX与男性生育力存在一定的相关性,但其与生育力的影响极其相关机制还需要进一步的研究。     

睾丸生殖细胞的凋亡及其调控

睾丸生殖细胞在分化过程中存在自发性和诱发性凋亡,这是清除过量或异常生殖细胞的一种重要途径。生殖细胞的凋亡涉及内分泌、细胞社会组成和基因等多因素的调控。深入了解生殖细胞凋亡的调控机制,明确决定睾丸生殖细胞（Ｇｅｒｍ ｃｅｌｌｓ,Ｇｃ）凋亡机制的分子组成,将为治疗男性不育和开发男性避孕药物奠定理论基础。     

De novo complex chromosomal rearrangement of 46, XY,t (3; 16; 8) (p26; q13; q21.2) in a non-obstructive azoospermic male

Complex Chromosomal Rearrangements (CCRs) are rare structural abnormalities that are usually associated with infertility or subfertility in male carriers. We described clinical and chromosomal features of a non-obstructive azoospermic male that has been referred for infertility. Cytogenetic analysis showed three chromosomes, i.e. 3, 8 and 16, which have been involved and caused spermatogenesis failure.     

Association of T/A polymorphism in miR-1302 binding site in CGA gene with male infertility in Isfahan population

Infertility occurs in 10–15% of couples worldwide and close to half of it is caused by male factors. One of the genes that can affect male infertility is CGA. Polymorphisms in CGA gene may affect gene expression, therefore affecting male infertility by disrupting the regulation of this gene. One of the polymorphisms is the substitution of T with A in the miR-1302 binding site in the 3′ untranslated region of the CGA gene. In this study, we explored this polymorphism in Isfahan population. In this case-control study, by the use of Tetra primer-ARMS–PCR technique, rs6631 has been investigated in 224 infertile men and 196 controls. Infertile men were recruited from Isfahan Fertility and Infertility Center. Analysis of genotype and allele frequencies indicated that the differences between case and control populations were significant for rs6631 because P?=?0.00 which is above the threshold. We found a significant relationship between this polymorphism and male infertility. This study which performed for the first time in Iran suggests that polymorphism in CGA gene can affect male infertility. Also, this polymorphism has high heterozygosity, so it can be used for further studies in different populations.     

Evaluation of <Emphasis Type="Italic">GPx1</Emphasis> Pro198Leu polymorphism in idiopathic male infertility

Infertility is defined as failure to conceive a child after 1 year of unprotected regular sexual intercourse. Approximately half of all cases of infertility are caused by factors related to the male. In nearly 50% of infertile men it is not possible to determine the cause of infertility and this situation has been defined as unexplained or idiopathic. Oxidative stress plays an important role in the pathophysiology of male infertility. Oxidative stress results from an imbalance in free radicals and antioxidant defense mechanisms of the body. Genetic variations in the antioxidant gene coding for GPx enzyme may lead to decreased or impaired regulation of its enzymatic activity and alter reactive oxygen species (ROS) detoxification. We have investigated the possible association between polymorphism GPx1 Pro198Leu and idiopathic male infertility. One hundred patients with idiopathic male infertility and one hundred fifty healthy volunteers were enrolled. Genomic DNA was extracted from blood samples. Genotyping for the GPx1 Pro198Leu polymorphism was done by PCR–restriction fragment length polymorphism (RFLP) using ApaI. The genotype frequencies were 11% (Leu/Leu), 76% (Pro/Leu) and 13% (Pro/Pro) in the patient group and 8.7% (Leu/Leu), 67.3% (Pro/Leu) and 24% (Pro/Pro) in the control group. The genotype and allele frequencies of GPx1 Pro198Leu did not differ between the patient group and the control group (P = 0.09 and P = 0.1, respectively). In conclusion, there is no correlation between idiopathic male infertility and the GPx1 codon Pro198Leu polymorphism. Further studies are needed to investigate other genetic factors that influence the development of idiopathic male infertility.     

Antifertility effects in rats actively immunized with 80 kDa human semen glycoprotein.

A 80 kDa human sperm antigen has been identified using the serum of an infertile woman having circulating antisperm antibodies. The antigen was then purified to homogeneity by gel permeation chromatography using HPLC (protein PAK-125 column) system and on FPLC (superose-12 column) system. The antigen was found to be a glycoprotein. The antigen was mainly localized in the postacrosomal region of the human sperm, while it was localized in the head region of the rat sperm as demonstrated by immunofluorescent staining. The presence of this antigen was also demonstrated in the human prostate and endometrium and in the rat testis; epididymis and the prostate by immunocytochemical staining. The purified protein upon active immunization in female rats caused infertility in 100 percent animals. While in male rats it caused infertility in 90 percent animals. On morphometric analysis of testicular tissue it was observed that there was no significant change in spermatogonia and spermatocytes, but significant decrease in spermatids and sperm number as well as daily sperm production in the immunized male rats. The epididymal spermatozoa were markedly reduced in number and were largely found to be agglutinated. The results suggest that 80 kDa human sperm antigen appears to be a suitable candidate for immunocontraception both in male and female.     

Detection of Y chromosome microdeletions and mitochondrial DNA mutations in male infertility patients

Infertility affects about 10-15% of all couples attempting pregnancy with infertility attributed to the male partner in approximately half of the cases. Proposed causes of male infertility include sperm motility disturbances, Y chromosome microdeletions, chromosomal abnormalities, single gene mutations, and sperm mitochondrial DNA (mtDNA) rearrangements. To investigate the etiology of decreased sperm fertility and motility of sperm and to develop an appropriate therapeutic strategy, the molecular basis of these defects must be elucidated. In this study, we aimed to reveal the relationships between the genetic factors including sperm mtDNA mutations, Y chromosome microdeletions, and sperm parameters that can be regarded as candidate factors for male infertility. Thirty men with a history of infertility and 30 fertile men were recruited to the study. Y chromosome microdeletions were analyzed by multiplex PCR. Mitochondrial genes ATPase6, Cytb, and ND1, were amplified by PCR and then analyzed by direct sequencing. No Y chromosome microdeletions were detected in either group. However, a total of 38 different nucleotide substitutions were identified in the examined mitochondrial genes in both groups, all of which are statistically non-significant. Fifteen substitutions caused an amino acid change and 12 were considered novel mutations. As a conclusion, mtDNA mutations and Y chromosome microdeletions in male infertility should be examined in larger numbers in order to clarify the effect of genetic factors.     

Y-haplotypes and idiopathic male infertility in an Indian population

Infertility being a multifactorial disorder, both genetic and environmental factors contribute to the etiology of infertile phenotype. Chromosomal anomalies and Y-microdeletion are the established genetic risk factors of male infertility. Y-haplotypes has been found as risk factor for male infertility in certain populations, though in certain others no association has been reported, suggesting a population-specific association of these variations with male infertility. In a case-control study, 165 azoo-/oligospermic patients and 200 controls were haplotyped for certain Y-haplogroups for a possible association with idiopathic male infertility in an Indian population. Analysed Y-haplogroups showed no association with infertile phenotype. Thus this genetic factor is not a risk for infertility in the studied Indian population but that does not rule out the possibility of any of them, to be a risk in other populations.     

Evaluation of the Fas/FasL signaling pathway in diabetic rat testis

We investigated the role of the Fas/Fas ligand (FasL) signaling pathway in diabetic male infertility. Male rats were divided into two groups: a control group and a streptozotocin induced diabetic group. Thirty days after induction of diabetes, samples of testes were harvested and fixed in 10% formalin for light microscopy. Germ cell apoptosis was determined using the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate in situ nick end-labeling (TUNEL) and immunostaining of caspase 8 and active caspase 3. We also investigated the expressions of Fas and FasL using immunohistochemistry. Streptozotocin-induced diabetes caused severe histopathological damage and increased apoptotic tubule and apoptotic cell indices, caspase 8 and caspase 3 expressions, and Fas and FasL-immunopositive cells in the rat testes. We suggest that the Fas/FasL signaling pathway may play a role in male infertility caused by diabetes.     

Anomalies génétiques de la spermatogenèse

The important role of genetic abnormalities in the causation of human male infertility is increasingly recognized. Considerable progress has been achieved over the past years both in the clinical delineation of genetic forms of male infertility and in the characterization of the responsible genes and their mutations. We review the current state of knowledge on genetic disorders where male infertility is a major and regular feature.     

Detection of oxidative DNA damage in human sperm and its association with sperm function and male infertility

The expanding research interest in the last two decades on reactive oxygen species (ROS), oxidative stress, and male infertility has led to the development of various techniques for evaluating oxidative DNA damage in human spermatozoa. Measurement of 8-hydroxydeoxyguanosine (8-OHdG) offers a specific and quantitative biomarker on the extent of oxidative DNA damage caused by ROS in human sperm. The close correlations of 8-OHdG level with male fertility, sperm function and routine seminal parameters indicate the potential diagnostic value of this technique in clinical applications. On the other hand, single cell gel electrophoresis (SCGE or comet assay) and terminal deoxynucleotidyl transferase (TdT) mediated dUTP nick end labeling (TUNEL) assay have also been demonstrated to be sensitive, and reliable methods for measuring DNA strand breaks in human spermatozoa. As certain technical limitations were inherent in each of these tests, it is believed that a combination of these assays will offer more comprehensive information for a better understanding of oxidative DNA damage and its biological significance in sperm function and male infertility.     

Towards an understanding of the genetics of human male infertility: lessons from flies

It has been argued that about 4–5% of male adults suffer from infertility due to a genetic causation. From studies in the fruitfly Drosophila, there is evidence that up to 1500 recessive genes contribute to male fertility in that species. Here we suggest that the control of human male fertility is of at least comparable genetic complexity. However, because of small family size, conventional positional cloning methods for identifying human genes will have little impact on the dissection of male infertility. A critical selection of well-defined infertility phenotypes in model organisms, combined with identification of the genes involved and their orthologues in man, might reveal the genes that contribute to human male infertility.