Recent years have seen a rise incidence of male infertility, and mostly caused by the decline of sperm quality. The ratio of infertile males to infertile females has escalated from 3:7 in 2013 to today’s 5:5, which turning male infertility into the research focus of reproductive medicine. This study aimed to clarify the effect of reproductive tract infection by ureaplasma urealyticum (UU) and chlamydia trachomatis (CT) on the DNA integrity and routine semen parameters of infertile males. A retrospective study was performed. A total of 259 infertile males who were treated at the Andrological Laboratory Examination and Reproductive Medicine Center in our hospital were analyzed. qRT-PCR was used to examine the infection status of CT and UU. According to the eligibility criteria, we evaluated the semen parameters and biochemical data of 253 men. Based on the results of PCR, the subjects were divided into four groups: group I (CT positive, 63 cases), group II (UU positive, 60 cases), group III (CT positive and UU positive, 62 cases), and group IV (no infection, 68 cases). DNA fragmentation index (DFI), sperm count, vitality and morphology, elastinase level, seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) were assessed. Compared to group IV, three groups (group I, group II and group III) showed difference in semen volume, proportion of sperm with normal morphology, sperm motility, progressive motility, and vitality (P<0.05). Compared to group IV, group II and group III showed difference in DFI (P<0.05). Compared to group IV, group II and group III showed difference in elastase level (P<0.05). VCL, VSL, VAP, WOB,ROS,TM, HDS showed differences between groups of abnormal/normal WBC (*P<0.01) UU infection significantly increased the level of seminal leukocytes only in group II, but not in the other three groups, indicating that UU is an factor to increase the level of seminal leukocytes. Compared with the normal leukocyte group, there were significant differences in total motility, forward motility and normal sperm ratio between the two groups. The proportion of sperm with abnormal morphology (mostly in the head) showed obvious difference between groups of high and normal seminal leukocytic level. At the same time, in this study, SCGE and SCD verified that leukocytes could damage sperm DNA by increasing ROS, which ultimately affects male fertility.

BackgroundAccording to world Health Organization guidelines, semen analysis by testing routine parameters is the main method for assessing male fertility.In general, routine semen analysis makes only limited predictions about a man's reproductive potential and is not always able to explain why he is infertile. In fact, many male infertility cases are caused by sperm DNA defects ,which routine semen quality analyses fail to detect.The relationship between sperm DFI , sperm parameters and their diagnostic value were analyzed and evaluated by observing the seminal parameters of infertile patients without accessory gonadal infection.MethodsSpecimens of 151 cases were collected from infertile patients who visited the male department of STD and reproductive specialty clinic of our hospital from August 2018 to September 2019. SCD test was performed to measure the DNA fragmentation in native. The routine semen analysis was performed with a semen quality detection system (WLJY-9000, Beijing Weili New century Science & Tech Dev .Co.Ltd) and supporting reagents. Seminal plasma malondialdehyde (MDA), and total antioxidant capacity (TAC) were assessed. Fructose(Fru) 、a-glucosidase (,a-glu), and zinc (Zn) levels are quantitatively detected by kehua-310, a fully automated biochemical tester provided by Nanjing Xindibio.ResultsAccording to DFI level, there were 31 cases in group I (DFI≤15%), 81 cases in group II (15% < DFI < 30%), and 39 cases in group III (DFI≥30%). Compared with group II, there were significant differences in sperm survival rate, PR% and Fru by non-parametric test (Z = -2.16 -2. 43. - 2. 20,respectively,P < 0. 05). There were significant differences in sperm survival rate and PR% between group I and group III (t = 4. 32, 4.25, respectively, P< 0.01). Compared with group III, there were significant differences in sperm survival rate and PR% by non-parametric test (Z= -3. 26, -3. 50, respectively).Sperm DFI was negatively correlated with sperm survival rate and PR%(R=-0.56,-0.46,P<0.01). DFI was positively correlated with MDA content (R=0.42, P<0.01) and negatively correlated with TAC (r=-0.40, P<0.01).There was no correlation with age ,abstinence days, semen volume, sperm concentration, percentage of normal form sperm, Fru, a-Glu, Zn (R= 0. 15, 0. 05,0.03,-0.03, -0.2, -0.16,- 0.20, 0.03, 0.15, p > 0.05).ConclusionThe survival rate and PR% of sperm decreased significantly with the increase of DFI level, antioxidant can decrease the rate of DNA fragmentation, antioxidant can decrease the rate of DNA fragmentation. Semen volume and sperm concentration were mainly related to the secretion volume of accessory gonads and total sperm count, but no correlation was found between them and DFI.

BackgroundThere has been no systematic review and meta‐analysis to analyze and summarize the predictive factors of successful sperm extraction in salvage microdissection testicular sperm extraction.ObjectivesWe aimed to investigate the factors predicting the result of salvage microdissection testicular sperm extraction in patients with non‐obstructive azoospermia who failed the initial microdissection testicular sperm extraction or conventional testicular sperm extraction.Materials and methodsWe conducted a systematic literature search in PubMed, Web of Science, EMBASE, and the Cochrane Library for literature that described the characteristics of patients with non‐obstructive azoospermia who underwent salvage microdissection testicular sperm extraction after failing the initial microdissection testicular sperm extraction or conventional testicular sperm extraction published prior to June 2022.ResultsThis meta‑analysis included four retrospective studies with 332 patients with non‐obstructive azoospermia who underwent a failed initial microdissection testicular sperm extraction and three retrospective studies with 177 non‐obstructive azoospermia patients who underwent a failed conventional testicular sperm extraction. The results were as follows: among non‐obstructive azoospermia patients whose first surgery was microdissection testicular sperm extraction, younger patients (standard mean difference: −0.28, 95% confidence interval [CI]: −0.55 to −0.01) and those with smaller bilateral testicular volume (standard mean difference: −0.55, 95% CI: −0.95 to −0.15), lower levels of follicle‐stimulating hormone (standard mean difference: −0.86, 95% CI: −1.18 to −0.54) and luteinizing hormone (standard mean difference: −0.68, 95% CI: −1.16 to −0.19), and whose testicular histological type was hypospermatogenesis (odds ratio: 3.52, 95% CI: 1.30–9.53) were more likely to retrieve spermatozoa successfully, while patients with Sertoli‐cell‐only syndrome (odds ratio: 0.41, 95% CI: 0.24–0.73) were more likely to fail again in salvage microdissection testicular sperm extraction. Additionally, in patients who underwent salvage microdissection testicular sperm extraction after a failed initial conventional testicular sperm extraction, those with testicular histological type of hypospermatogenesis (odds ratio: 30.35, 95% CI: 8.27–111.34) were more likely to be successful, while those with maturation arrest (odds ratio: 0.39, 95% CI: 0.18–0.83) rarely benefited.ConclusionWe found that age, testicular volume, follicle‐stimulating hormone, luteinizing hormone, hypospermatogenesis, Sertoli‐cell‐only syndrome, and maturation arrest were valuable predictors of salvage microdissection testicular sperm extraction, which will assist andrologists in clinical decision‐making and minimize unnecessary injury to patients.