Impact of clinical varicocele and testis size on seminal reactive oxygen species levels in a fertile population: a prospective controlled study

Cocuzza, Marcello; Athayde, Kelly S.; Agarwal, Ashok; Pagani, Rodrigo; Sikka, Suresh C.; Lucon, Antônio Marmo; Hallak, Jaime Eduardo Cecílio

doi:10.1016/j.fertnstert.2007.07.1377

Cited by 56 publications

(40 citation statements)

References 27 publications

(39 reference statements)

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“…No correlation with Hcy, folate and cobalamin seminal plasma concentrations was found. This is also in line with the study of varicocele and reactive oxygen species [23] and current varicocele management [24].…”

Section: Discussionsupporting

confidence: 89%

Seminal plasma homocysteine, folate and cobalamin in men with obstructive and non-obstructive azoospermia

Crha

Králíková

Melounová

et al. 2010

J Assist Reprod Genet

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Purpose The aim of this study was to analyze homocysteine, folate and cobalamin in men with normozoospermia, obstructive and non-obstructive azoospermia. Methods Analysis of plasma and seminal plasma homocysteine, folate and cobalamin in 72 azoospermic and 62 normozoospermic men. Evaluation of the azoospermic patient included testicular biopsy, endocrine, urological and ultrasound examination. Results Homocysteine (1.2 μmol/l) and cobalamin (322.05 pmol/l) concentrations (median values) in seminal plasma were significantly lower (p<0.001) in men with azoospermia than in men with normozoospermia (2.5 μmol/ l and 579.0 pmol/l). Folate and cobalamin concentrations were significantly higher in obstructive than in nonobstructive azoospermia. Significant correlations were determined between testis volume and seminal plasma homocysteine in azoospermic men. Conclusion Lower concentrations of homocysteine and cobalamin (but not folate) were found in azoospermic seminal plasma than normozoospermic. Folate and cobalamin were higher in seminal plasma from obstructive azoospermia than in non-obstructive azoospermia patients.

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Section: Discussionsupporting

confidence: 89%

Seminal plasma homocysteine, folate and cobalamin in men with obstructive and non-obstructive azoospermia

Crha

Králíková

Melounová

et al. 2010

J Assist Reprod Genet

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“…In contrast, in a study of ROS levels in fertile men with and without clinical varicoceles, Cocuzza et al [20] found no difference in ROS levels between these groups, and ROS levels were not correlated with varicocele grade or testis volume. Their study population was limited to fertile men, and the authors explained that such a population may have more efficient defense mechanisms to protect themselves against varicocele.…”

Section: Pathophysiology Of Varicocelesmentioning

confidence: 83%

Role of varicocele repair for male infertility in the era of assisted reproductive technologies

Kimura

Nagao

2014

Reprod Medicine & Biology

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Varicocele is an abnormal condition characterized by dilatation of the pampiniform plexus veins draining the testis and is present in 15 % of men. Varicoceles have an adverse effect on spermatogenesis and are the most common cause of male infertility. Approximately 35 % of infertile men and more than 70 % of men with secondary infertility were reported to have varicoceles. Although data on methods of varicocele repair are accumulating, there remains controversy regarding the indications and techniques for varicocele repair. In addition, the role of varicocele repair in this era of assisted reproductive technologies continues to be debated. In this study, we performed a comprehensive PubMed search in order to review the current status of varicocele repair for male infertility. We reviewed English-language studies published from 1992 through 2013. After reviewing the articles, we identified a recent meta-analysis of four randomized controlled trials, which found that varicocele repair for oligozoospermic men was associated with better pregnancy rates as compared with observation. Our review of prospective studies showed that all semen parameters, including sperm concentration, motility, and progressive motility, were significantly improved after varicocele repair. We also summarize the findings of recent studies reporting beneficial effects of varicocele repair, i.e., decreased oxidative stress and sperm DNA fragmentation after varicocele repair and superior cost effectiveness versus in vitro fertilization/intracytoplasmic sperm injection alone, which may be important in the era of assisted reproductive technologies. Varicocele repair is a widespread, well-established procedure that can improve semen parameters in men with infertility. The effect of such treatment on the pregnancy rate is unclear because evidence is limited due to difficulties in recruiting patients for studies. Among the repair techniques, microsurgical repair using a subinguinal approach is potentially the best practice, although this procedure requires training in microsurgery. All these topics require further research in studies with sufficient patient enrollment and follow-up.

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“…Elevated ROS levels have also been reported in some clinical conditions (e.g., varicocele and reproductive tract infections) as well as in association with lifestyle choices (e.g., smoking) [14][15][16][17][18]. Similarly, low fertilization and pregnancy rates were achieved in couples in which the male partner had elevated seminal ROS levels [19,20].…”

Section: Introductionmentioning

confidence: 91%

Reference values of reactive oxygen species in seminal ejaculates using chemiluminescence assay

Agarwal

Ahmad

Sharma

2015

J Assist Reprod Genet

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Purpose A physiological balance exists between seminal reactive oxygen species (ROS) and antioxidant capacity. An overproduction of ROS which exceeds the seminal plasma antioxidant capacity results in oxidative stress (OS). The aim of the present study was to describe a detailed protocol to measure ROS in a diagnostic laboratory and revise our previous cutoff value of ROS in seminal ejaculates in a larger cohort of infertile men and controls with proven and unproven fertility. Methods A total of 258 infertile men and 92 controls were enrolled in the study. Following initial semen analysis, ROS measurement in whole ejaculates was carried out using l u m i n o l -b a s e d c h e m i l u m i n e s c e n c e a s s a y . Chemiluminescence was measured for 15 min with a Berthold luminometer. Results were expressed as relative light units (RLU/s/10 6 sperm). The test's specificity, sensitivity, and cutoff values were calculated using the receiver operating characteristic (ROC) curve. Results Significantly higher ROS levels were seen in infertile men compared to controls (p<0.001). The optimal cutoff value to differentiate between controls and infertile men was 102.2 RLU/s/10 6 sperm. At this cutoff value, the test was 76.4% sensitive and 53.3% specific. The positive and negative predictive values of the test were 82.1% and 44.5%, respectively. A total of 76.4% infertile population was above this cutoff value compared to 46.7% of controls. Conclusions The luminol-based chemiluminescence assay can be used in routine diagnostic screening to test for male infertility diagnosis in a clinical setting. The current ROS cutoff value substantially distinguishes infertile from normal controls. Patients with elevated ROS must be evaluated for the underlying cause of ROS production.

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Impact of clinical varicocele and testis size on seminal reactive oxygen species levels in a fertile population: a prospective controlled study

Cited by 56 publications

References 27 publications

Seminal plasma homocysteine, folate and cobalamin in men with obstructive and non-obstructive azoospermia

Seminal plasma homocysteine, folate and cobalamin in men with obstructive and non-obstructive azoospermia

Role of varicocele repair for male infertility in the era of assisted reproductive technologies

Reference values of reactive oxygen species in seminal ejaculates using chemiluminescence assay

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