No abstract

ObjectiveTo assess seminal oxidation–reduction potential (ORP) and sperm DNA fragmentation (SDF) in male infertility and their relationships with sperm morphology in fertile and infertile men.Patients and methodsProspective case-control study comparing the findings of infertile men (n = 1168) to those of men with confirmed fertility (n = 100) regarding demographics and semen characteristics (conventional and advanced semen tests). Spearman rank correlation assessed the correlation between ORP, SDF, and different morphological indices. Means of ORP and SDF were assessed in variable levels of normal sperm morphology amongst all participants.ResultsInfertile patients had a significantly lower mean sperm count (32.7 vs 58.7 × 106 sperm/mL), total motility (50.1% vs 60.4%), and normal morphology (5.7% vs 9.9%). Conversely, infertile patients had significantly higher mean head defects (54% vs 48%), and higher ORP and SDF values than fertile controls. ORP and SDF showed significant positive correlations and significant negative correlations with sperm head defects and normal morphology in infertile patients, respectively. ORP and SDF were significantly inversely associated with the level of normal sperm morphology. Using receiver operating characteristic curve analysis, ORP and SDF threshold values of 1.73 mV/106 sperm/mL and 25.5%, respectively, were associated with 76% and 56% sensitivity and 72% and 72.2% specificity, respectively, in differentiating <4% from ≥4% normal morphology.ConclusionA direct inverse relationship exists between seminal ORP and SDF with various levels of normal sperm morphology. Using ORP and SDF measures in conjunction with standard semen morphology analysis could validate the result of the fertility status of patients.

Obesity has become a major health concern, with a prevalence rate approaching epidemic states. An inverse relationship between men's body weight and semen parameters has been observed, suggesting a favourable role for weight loss in improving fertility. This prospective study included 46 patients undergoing sleeve gastrectomy, who were investigated with semen analysis and serum hormone tests before and 12 months after surgery. Patients were divided into three groups according to their initial sperm concentration; median loss of body mass index was used as a cut-off to further classify patients according to extent of weight loss. Patients' preoperative seminal investigations revealed azoospermia in 13 (28.3%), oligospermia in 19 (41.3%) and normal sperm concentration in 14 (30.4%). Overall, only serum testosterone significantly increased after surgery (P < 0.001). Between study groups, the increase in sperm concentration was statistically significant in men with azoospermia and oligospermia (both P < 0.05), whereas serum testosterone was statistically significant in all groups (P < 0.001). Changes in semen and hormone tests were not affected by the extent of weight loss experienced by patients. Weight loss from bariatric surgery had a favourable effect on serum testosterone levels and semen parameters of patients with pre-existing azoospermia and oligospermia.

Standard analyses for evaluating semen quality require technical expertise and are interpretive in nature. Oxidative stress (OS) alters many of the semen parameters; thus, a measure of OS could be an indicator of semen quality. Static oxidation-reduction potential (sORP) is a universal measure of OS traditionally used in environmental applications but is increasingly used in biomedical studies. sORP was measured to determine how well it associates with semen quality and if it differentiates semen from infertile patients and fertile donors. All study participants (Infertile, n = 365 and Fertile, n = 50) underwent standard semen analyses, and sORP was measured in unprocessed semen. In infertile patients, sORP increased with decreased total sperm number, motility and morphology. sORP values were higher in samples with abnormal quality (low number, motility and/or normal morphology) compared with those of normal quality. Infertile patients had higher sOPR values compared to fertile donors. A sORP cut-off value of 1.38 mV/10 sperm/ml can differentiate normal from abnormal semen samples, while a cut-off value of 1.41 mV/10 sperm/ml, can differentiate between infertile and fertile semen samples. In conclusion, sORP provides a quick and unbiased indicator of semen quality that can be a beneficial addition to semen analysis to determine semen quality and fertility status.

Klinefelter syndrome (KS) is the most common chromosomal disorder associated with male hypogonadism and infertility. Parenthood can be achieved in men with KS by intracytoplasmic sperm injection (ICSI) using testicular spermatozoon. The aim of this study was to evaluate surgical sperm retrieval (SSR) rate in patients with KS and to investigate the approach associated with the highest SSR. This is a retrospective study where all medical records of patients with KS who underwent SSR for ICSI, in our centre in the past 14 years, were reviewed. Forty-three patients were included in this study. Twenty-three underwent conventional testicular sperm extraction (TESE), while 20 patients underwent microsurgical TESE (Micro-TESE). The SSR was significantly higher in the Micro-TESE group when compared with the TESE group (30% versus 0% respectively). In the Micro-TESE group, hormonal stimulation was given to 16 patients, while no treatment was given to four patients. SSR was only successful in hormonally treated patients (6/16). When the type of hormone stimulation was evaluated, SSR was higher in patients receiving aromatase inhibitors (27.8%). SSR in patients with KS is significantly higher when using hormonal stimulation by aromatase inhibitors followed by microsurgical testicular sperm extraction.