Purpose
The functional role of the
FSHR
promoter −29G/A polymorphism (rs1394205) in men is not clear. Some studies failed to find a relationship between the
FSHR
−29G/A and follicle-stimulating ...hormone (FSH) levels and did not associate the SNP with male infertility. Only one study showed that the
FSHR
−29 SNP modulates serum FSH levels in Baltic young male cohort. Because the SNP −29G/A has to be shown to have a strong effect on in vitro transcription activity of the
FSHR
promoter and the activation of
FSHR
is necessary for a normal FSH function, this study was undertaken to assess whether the
FSHR
-29G/A SNP modulates the gonadal endocrine function in men.
Methods
A total of 200 men with alteration of conventional sperm parameters or normozoospermia (according to the parameters WHO 2010), were genotyped by TaqMan Assay. Hormone levels were measured by immunoassay, and sperm analysis was performed according to the World Health Organization criteria.
Results
A significant gradient of increasing FSH levels across the
FSHR
−29G/A genotypes was observed (
p
< 0.01). Among normozoospermic men (
n
= 110), those with
FSHR
−29A-allele carriers (GA + AA and AA) had higher serum FSH (
p
< 0.01) and LH levels (
p
< 0.05) and higher body mass index (BMI) (
p
< 0.01) compared to men with the GG genotype. The carrier status of rs1394205 genotypes did not affect the other endocrine parameters neither in men with altered sperm parameters nor in normozoospermic men.
Conclusions
The
FSHR
−29G/A polymorphism modulates FSH and, for the first time, LH serum levels and BMI in normozoospermic men. These findings underline the importance to pay close attention to the studies of genetic variations associated with clinical-endocrine parameters.
Introduction
Since varicocele is often associated with other venous abnormalities, this study was undertaken to evaluate the frequency of dilation of the periprostatic venous plexus (DPVP) in these ...patients and the effects of this association on sperm parameters before and after varicocelectomy.
Materials and Methods
Sperm parameters were evaluated using the conventional WHO criteria, and seminal fluid viscosity was further evaluated by quantitative viscometry, in 50 patients (aged 20–38 years) who underwent surgical treatment for grade III bilateral varicocele.
Results
Thirty patients with varicocele had also DPVP (DPVP+) (60 %). Sperm concentration and the percentage of spermatozoa with normal morphology did not differ significantly in patients with DPVP− or DPVP+ before or after surgical repair. On the other hand, sperm progressive motility was low in all patients and increased significantly after varicocele repair, but only in DPVP− patients. Before varicocele treatment, a significantly higher number of DPVP+ patients (25/30 = 83.3 %) had seminal fluid hyperviscosity compared to DPVP− patient (2/20 = 10.0 %). Viscosity quantitative measurement was significantly higher in DPVP+ patients both before and after varicocele repair compared to DPVP− patients. These latter showed a statistically significant reduction of sperm viscosity after varicocele surgical repair compared to pretreatment values. Finally, periprostatic venous plexus diameter and seminal fluid viscosity correlated directly in DPVP+ patients.
Conclusions
In conclusion, these results showed that a large number of patients with varicocele had a concomitant DPVP. This subset of patients did not take advantage from varicocele surgical repair since only DPVP− varicocele patients showed a significant improvement of sperm progressive motility and seminal fluid viscosity. These findings suggest the evaluation of the periprostatic venous plexus and seminal fluid viscosity before patients with varicocele undergo surgical repair for asthenozoospemia.
Genetic causes can be directly responsible for various clinical conditions of male infertility and spermatogenic impairment. With the increased use of assisted reproduction technologies our ...understanding of genetic basis of male infertility has large implications not only for understanding the causes of infertility but also in determining the prognosis and management of such couples. For these reasons, the genetic investigations represent today an essential and useful tool in the treatment of male infertility. Several evidences are available for the clinical practice regarding the diagnosis; however, there are less information relative to the treatment of the genetic causes of male infertility. Focus of this review is to discuss the main and more common genetic causes of male infertility to better direct the genetics investigation in the treatment of spermatogenic impairment.
Pathophysiological externalization of specific substances belonging to the vessel wall (after endothelial injury), usually not in contact with the blood (subintimal area) is the signal which is ...captured by surface receptor platelet's results in their adhesion. There are no studies that have so far examined the expression of these receptors in patients with arterial erectile dysfunction (ED). The aim of this study was to assess by flow cytometry, serum concentration of apoptotic endothelial microparticles (EMPa) and vitronectin receptor (VR) in a selected series of patients with arterial ED and without apparent other sistemic arterial involvement.
Evaluated consecutively 50 selected patients with arterial ED-based (mean IIEF-5 score of 6.3±0.3 and mean peak systolic velocity of 24.5±0.6 cm/s). Evaluation of EMPa and VR was conducted using a flow cytometer. The events CD45neg-CD144pos-annexinVpos were defined EMPa, while events CD51pos-CD61pos-CD41neg were defined VR.
Patients with arterial ED had a serum baseline concentrations of circulating EMPa (12.2±2.2% vs. 1.8±0.4%) and VR (7.4±1.2% vs. 1.2±0.2%) significantly higher than control group.
The present study shows that patients with arterial ED had an increased expression of endothelial apoptosis and initial platelet adhesion.
Abstract The frequency of human papillomavirus (HPV) infection in the semen of patients with male accessory gland infection (MAGI) was evaluated. One hundred infertile patients with MAGI were ...classified into group A: patients with an inflammatory MAGI ( n = 48) and group B: patients with a microbial form ( n = 52). Healthy age-matched fertile men (34.0 ± 4.0 years) made up the control group ( n = 20). Amplification of HPV DNA was carried out by HPV-HS Bio nested polymerase chain reaction for the detection of HPV DNA sequences within the L1 ORF. Ten patients in group A (20.8%) and 15 patients in group B (28.8%) had a HPV infection; two controls (10.0%) had HPV infection. Patients with MAGI had a significantly higher frequency of HPV infection compared with controls; patients with a microbial MAGI had significantly higher frequency of HPV infection compared with patients with an inflammatory form (both P < 0.05). Patients with MAGI and HPV had a slight, but significantly lower sperm progressive motility and normal morphology compared with patients with MAGI HPV-negative ( P < 0.05). Elevated frequency of HPV infection occurred in patients with MAGI, suggesting that HPV should be investigated in the diagnostic work-up of these patients.
Summary
This study was undertaken to evaluate conventional and some of the main bio‐functional spermatozoa parameters, serum gonadal hormones and didymo‐epididymal ultrasound features in patients ...with type 1 diabetes mellitus (DM1). DM1 affects an increasing number of men of reproductive age. Diabetes may affect male reproduction by acting on the hypothalamic–pituitary–testicular axis, causing sexual dysfunction or disrupting male accessory gland function. However, data on spermatozoa parameters and other aspects of the reproductive function in these patients are scanty. Thirty‐two patients with DM1 27.0 (25.0–30.0 years) and 20 age‐matched fertile healthy men 28.0 (27.25–30.75 years) were enrolled. Patients with diabetic neuropathy, other endocrine disorders or conditions known to alter spermatozoa parameters were excluded. Each subject underwent semen analysis, blood withdrawal for fasting and post‐prandial glycaemia, hormonal analysis and didymo‐epididymal ultrasound evaluation before and after ejaculation. Patients with DM1 had a lower percentage of spermatozoa with progressive motility 10.0 (7.0–12.75) vs. 45.0 (42.0–47.75) %; p < 0.01 and a higher percentage of spermatozoa with abnormal mitochondrial function than controls 47.0 (43.0–55.0) vs. 2.0 (1.0–5.0) %; p < 0.01. Patients also had greater post‐ejaculatory diameters of cephalic 11.5 (10.2–13.6) vs. 6.0 (4.0–7.0) mm; p < 0.01 and caudal epididymis 5.5 (4.00–7.55) vs. 3.0 (2.0–4.0) mm; p < 0.01 compared to controls, suggesting a lack of the physiological post‐ejaculation epididymal shrinkage. Correlation analysis suggested that progressive motility was associated with fasting glucose (r = −0.68; p < 0.01). The other parameters did not show any significant difference. Patients with DM1 had a lower percentage of spermatozoa with progressive motility, impaired mitochondrial function and epididymal post‐ejaculatory dysfunction. These findings may explain why patients with DM1 experience fertility disturbance. Larger multi‐centric studies are necessary to confirm these results.
Circulating endothelial progenitor cells (EPCs) and endothelial microparticles (EMPs) increase, respectively, in the attempt to repair the damaged endothelium and in response to endothelial ...dysfunction. Erectile dysfunction (ED) of arterial origin recognizes endothelial dysfunction as one of its main determinants and shares risk factors and physiopathological evolution with the metabolic syndrome (MetS). Tadalafil, selective inhibitor of phosphodiesterase V, long half-life, is used to treat erectile dysfunction, and several studies have already documented the beneficial effects on endothelial dysfunction. The aim of this paper was to evaluate the concentrations of EPCs and EMPs in patients with arterial ED and MetS, before and after tadalafil administration, and in healthy men.
Thirty patients (47-54 years) with ED and MetS (ATP III 1999 criteria) and 17 healthy men (44-57 years) were selected. EPCs (CD45neg/CD34pos/CD144pos) and EMPs (CD45neg/CD34neg/CD144pos) blood concentrations were evaluated by flow cytometry before and after administration of tadalafil (20 mg) on demand for 3 months. After treatment, the patients were divided into responders and poor responders, according to their IIEF-5 score.
Blood EPCs and EMPs.
Before treatment, the percentage of EPCs and EMPs was significantly higher in patients with ED and MetS compared to healthy men. Treatment with tadalafil increased significantly EPCs in both responders and poor responders. The latter had significantly higher EPCs compared to responders, both before and after tadalafil. Before tadalafil, EMPs were higher, but not significantly, in poor responders vs. responders. No significant change occurred after tadalafil administration in both responders and poor responders. A significant positive correlation was found between EPCs and age, Body Mass Index (BMI), acceleration time, IMT and EDV; whereas a negative correlation was found with IIEF-5 score, PSV and resistance index. EMPs correlated positively with BMI, acceleration time and IMT and negatively with the IIEF-5 score.
Tadalafil increased the percentage of EPCs in both responders and poor responders, suggesting the persistence of an adequate bone marrow response. The unchanged EMP concentrations after tadalafil suggest a reduction of the dysfunctional mechanism.
Purpose
The
FSHB
gene -211G/T polymorphism has been reported to modulate gene expression and to cause inter-individual differences in FSH serum levels in men. This study was undertaken to assess the ...functional relevance of this polymorphism on gonadotropin and total testosterone serum levels and sperm parameters in men from Eastern Sicily (Italy).
Methods
To accomplish this, 200 men with abnormal conventional sperm parameters or normozoospermia (according to the parameters of WHO 2010) were genotyped by TaqMan Assay.
Results
The frequency of
FSHB
-211 T allele was significantly higher (
p
< 0.005) in patients with altered conventional sperm parameters (18.9% of chromosomes) compared to that observed in men with normozoospermia (10.9% of chromosomes). Decreasing serum levels of FSH and LH were observed across the three
FSHB
-211 genotype subgroups (
p
< 0.001 and
p
< 0.05, respectively). In addition, the FSHB -211G/T polymorphism showed a total testosterone downward trend that became more evident in men with the TT genotype compared to subjects with the GG genotype (
p
= 0.05). Furthermore, we found a trend towards decreased sperm concentration, total sperm count, sperm forward motility and testicular volume in men with GT and TT genotypes.
Conclusions
These findings showed that the
FSHB
-211 G/T polymorphism modulates male gonadal function with a clear influence on hormonal levels and sperm parameters.
Capsule
The present study was undertaken to evaluate the distribution of the
FSHB
-211 G/T in men with normal or abnormal sperm parameters from Southern Italy to assess its functional relevance on the serum levels of reproductive hormones and on sperm parameters in men.
To address the severity of erectile dysfunction (ED) in consecutive sexually active men seeking a prostate health screening through a multivariable risk stratification including comorbidities and ...lower urinary tract symptoms (LUTS). Four hundred and twenty five consecutive subjects with stable sexual relationship with normal testosterone levels were enrolled. The International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) questionnaires were collected and health-significant comorbidities were scored with the Charlson comorbidity index (CCI). All the independent predictors of ED were combined to form four different risk categories of ED: low (age⩽65 years and IPSS<8 and CCI=0), intermediate (one of the following: age>65 years, IPSS⩾8 or CCI⩾1), high (two of the following: age>65 years, IPSS⩾8 or CCI⩾1) and very high (age >65 years, IPSS⩾8 and CCI⩾1). The prevalence of ED increased with increase of CCI (χ(2) likelihood ratio: 40.85, P=0.001). The median of the IIEF-5 significantly reduced with the increase of the CCI (P<0.001) and with the worsening of our risk group stratification (P<0.001). At univariate logistic regression analysis very high risk was significantly associated with of ED (odds ratio: 26.85, P<0.001). Very high-risk group predicted ED with 88% and 56% of specificity and sensitivity, respectively. Combining these risk factors through our risk stratification may be usefulness in revealing an underling ED.
Subclinical hypothyroidism (SH) is characterized by normal serum free T
4
and free T
3
levels and increased serum TSH levels. The relationship between SH and cardiovascular diseases has been one of ...the most popular topics recently. There is still some controversy concerning the cardiovascular impact of SH and management protocols. The vast majority of the studies published so far, suggests that SH accelerates endothelial dysfunction through traditional effects on risk factors that promote atherosclerosis and non-traditional effects on vasculature. In particular, SH is associated with increased of LDL-cholesterol, diastolic blood pressure, and markers of chronic inflammation (C reactive protein) and simultaneously reduces the bioavailability of nitric oxide to blood vessels and increases the expression of angiotensin receptor. Furthermore, replacement therapy seems to improve all these aspects.
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