Anogenital distance, male factor infertility and time to pregnancy

Abstract

Background: Anogenital distance (AGD), the distance between the anus and genitals, is in rodents a well-established marker of early androgen action and has been suggested to be so in humans as well. Thus, a link between human AGD and semen quality and potentially fecundity may exist. Objective:The aim of this study was to assess the association between AGD and male factor infertility and among proven fertile men also time to pregnancy (TTP).Material and methods: All included men were recruited from and examined at Copenhagen University Hospital -Rigshospitalet, Denmark (N = 388). Men with impaired semen quality were included from infertile couples (N = 128), and men with naturally conceived pregnant partners were invited to participate when their partners had their routine second trimester examination (N = 260). All men underwent a physical examination, completed a questionnaire (including TTP for the fertile men), delivered a semen sample and had a blood sample drawn. The primary exposure was AGD AS measured from the centre of the anus to the posterior base of the scrotum. Associations between AGD and fertility status as well as between AGD and TTP among the fertile men were calculated using multiple logistic regression adjusted for covariates.Results: AGD did not show a statistically significant association with fertility status.In adjusted logistic regression models, the odds of infertility per 1 cm increase in AGD AS were 1.02 (95% confidence interval [CI]: 0.88; 1.19). Among fertile men, a 1cm increase in AGD AS was associated with an 8% non-statistically significantly reduced odds of having a longer (>3months) TTP (adjusted odds ratio (OR) = 0.92, 95% CI: 0.76-1.11). Conclusion:Our study showed that the clinical application of AGD as a predictor of fertility and fecundity seems to be limited as no associations were observed between AGD and fertility status, nor was the decreased risk of experiencing a longer TTP with longer AGD AS statistically significant.

Effect of Aqueous Extract of Unripe Musa Paradisiaca Linn on Parameters Affecting Reproduction in Rats

“…Follicle stimulating hormone (FSH) and luteinizing hormone (LH) induce the secretion of estrogen and progesterone, which regulate sexual development, excitement, and conception. 21 Anything that hinders LH or FSH secretion or lowers LH or FSH level will eventually lead to infertility, and this may include hypothalamic suppression, hypopituitarism, hyperprolactinemia, gonadotropin deficiency, gonadal suppression therapies, etc. 21 The increase in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) following treatment with the extract suggests improved reproductive function in treated male and female rats.…”

“… 21 Anything that hinders LH or FSH secretion or lowers LH or FSH level will eventually lead to infertility, and this may include hypothalamic suppression, hypopituitarism, hyperprolactinemia, gonadotropin deficiency, gonadal suppression therapies, etc. 21 The increase in follicle-stimulating hormone (FSH) and luteinizing hormone (LH) following treatment with the extract suggests improved reproductive function in treated male and female rats. An increase in progesterone levels hinders ovulation by inhibiting LH production and enhancing the inhibitory effects of estrogen.…”

Altered DNA methylation in estrogen-responsive repetitive sequences of spermatozoa of infertile men with shortened anogenital distance

“…They exert their function in the genome either directly through binding to estrogen response elements (ERE) in the regulatory elements of target genes or through interference with co-regulating transcription factors, which may either act on ERE or on alternative regulatory elements in estrogen target genes. The anogenital distance (AGD) describes the distance from the anus to the scrotum and reflects exposure to endocrine disruptors during prenatal development [39,40], whereas the relationship between shortened AGD and reduced sperm count remains somewhat controversial [41][42][43], both testicular cancer and cryptorchidism occur more frequently in individuals with shortened AGD [44][45][46][47].…”