Male infertility

Agarwal, Ashok; Baskaran, Saradha; Parekh, Neel; Cho, Chak‐Lam; Henkel, Ralf; Vij, Sarah C.; Arafa, Mohamed; Selvam, Manesh Kumar Panner; Shah, Rupin

doi:10.1016/s0140-6736(20)32667-2

Cited by 706 publications

(487 citation statements)

References 175 publications

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“…Infertility is an important medical and social problem, which has a huge impact on health (Agarwal et al, 2020). Among them, the treatment of idiopathic male infertility is still controversial, and most of the clinical treatment still depends on empirical methods (Agarwal et al, 2020). In recent years, the application of LC/LAC in the treatment of oligoasthenoteratozoospermia of unknown origin has been proposed.…”

Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of the Efficacy of L-Carnitine/L-Acetyl-Carnitine or N-Acetyl-Cysteine in Men With Idiopathic Asthenozoospermia

et al. 2021

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The meta-analysis was performed to access efficacy of L-carnitine/L-acetyl-carnitine (LC/LAC) and N-acetyl-cysteine (NAC) in men with idiopathic asthenozoospermia. We researched PubMed, EMBASE, and Cochrane Library databases and references to related articles. Finally, seven articles including 621 patients were analyzed. The results indicated that LC/LAC and NAC had a considerable improvement in sperm motility ( p = .03 and p < .0001, respectively) and normal morphology ( p = .006, p = .0002, respectively) compared with the placebo group. Besides, NAC had a significantly greater increase in sperm concentration ( p < .00001) and ejaculate volume ( p = .002) compared with the placebo group, and there was no significant difference in LC/LAC. For the analysis of serum hormones, NAC had no obvious differences in improving the serum testosterone, luteinizing hormone, follicle-stimulating hormone, and prolactin compared with non-treatment group. Conclusively, LC/LAC and NAC showed a greater improvement in sperm motility and normal morphology. Moreover, NAC has a positive effect on sperm concentration and ejaculate volume, whereas no obvious effect was observed in serum hormones.

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Section: Discussionmentioning

confidence: 99%

A Meta-Analysis of the Efficacy of L-Carnitine/L-Acetyl-Carnitine or N-Acetyl-Cysteine in Men With Idiopathic Asthenozoospermia

et al. 2021

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“…Globally, infertility impacts 15% of couples trying to conceive. The incidence of male infertility has been increasing over the past several decades, ranging from 20% to 70% worldwide [ 1 2 ]. The male partner is found to be solely responsible in 20%–30% of cases, and contributes to couple infertility in approximately 50% of cases [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility

Agarwal

Finelli

Selvam

et al. 2021

World J Mens Health

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Purpose The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. Materials and Methods Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the clinical utility of oxidative stress (OS) testing and antioxidant prescriptions to treat male infertility. Results Responses from 1,327 participants representing 6 continents, showed the largest participant representation being from Asia (46.8%). The majority of participants were attending physicians (59.6%), with 61.3% having more than 10 years of experience in the field of male infertility. Approximately two-thirds of clinicians (65.7%) participated in this survey did not order any diagnostic tests for OS. Sperm DNA fragmentation was the most common infertility test beyond a semen analysis that was prescribed to study oxidative stress-related dysfunctions (53.4%). OS was mainly tested in the presence of lifestyle risk factors (24.6%) or sperm abnormalities (16.3%). Interestingly, antioxidants were prescribed by 85.6% of clinicians, for a duration of 3 (43.7%) or 3–6 months (38.6%). A large variety of antioxidants and dietary supplements were prescribed, and scientific evidence were mostly considered to be modest to support their clinical use. Results were not influenced by the physician's age, geographic origin, experience or training in male infertility. Conclusions This study is the largest online survey performed to date on this topic and demonstrates 1) a worldwide understanding of the importance of this therapeutic option, and 2) a widely prevalent use of antioxidants to treat male infertility. Finally, the necessity of evidence-based clinical practice guidelines from professional societies is highlighted.

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“…The assessment of these two parameters is fully justified because one of the reasons for the decrease in the integrity of sperm DNA is oxidative stress in the male reproductive system. The SCD is a recommended diagnostic test, while currently the ORP measurement is recognized as a novel biomarker of male infertility and is also widely recommended [ 1 , 3 , 22 ]. In addition, in this study, an in-depth statistical analysis of the obtained data was performed, going beyond comparative analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Medical data from past decades have clearly shown that infertility is a growing challenge for public health, with increased numbers of reproductive failures. Currently, it is estimated that a male factor is present in half of infertility cases, but some data suggest that in the Middle East, the proportion of cases attributable to male factors is increased up to 70% [ 1 , 2 , 3 ]. In this aspect, varicocele, defined as an abnormal venous dilation of the pampiniform plexus, usually with blood reflux, is of exceptional importance because, according to European Association of Andrology (EAU) Guidelines from 2020, varicocele is the second most common cause of male infertility.…”

Section: Introductionmentioning

confidence: 99%

The Negative Impact of Varicocele on Basic Semen Parameters, Sperm Nuclear DNA Dispersion and Oxidation-Reduction Potential in Semen

Gill

Kupś

Harasny

et al. 2021

IJERPH

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Since varicocele is so common in infertile men, this study intends to analyse the relationships between varicocele and conventional semen characteristics, sperm nuclear DNA dispersion and oxidation-reduction potential (ORP) in semen. Varicocele-positive and varicocele-negative infertile men (study groups) showed significantly lower standard sperm parameters and higher sperm DNA fragmentation (SDF) and ORP in semen than healthy volunteers and subjects with proven fertility (control groups). A lower proportion of low SDF levels (0–15% SDF) and higher incidence of high SDF levels (>30% SDF), as well as a higher prevalence of high ORP values (>1.37 mV/106 sperm/mL), were found in the study groups vs. the control groups. Moreover, infertile men had significantly lower odds ratios (ORs) for low SDF levels and significantly higher ORs for high SDF levels and high ORP. SDF and ORP were negatively correlated with sperm number, morphology, motility and vitality. Furthermore, a significant positive correlation was found between SDF and ORP. The obtained results suggest that disorders of spermatogenesis may occur in varicocele-related infertility. These abnormalities are manifested not only by reduced standard semen parameters but also by decreased sperm DNA integrity and simultaneously increased oxidative stress in semen.

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Male infertility

Cited by 706 publications

References 175 publications

A Meta-Analysis of the Efficacy of L-Carnitine/L-Acetyl-Carnitine or N-Acetyl-Cysteine in Men With Idiopathic Asthenozoospermia

A Meta-Analysis of the Efficacy of L-Carnitine/L-Acetyl-Carnitine or N-Acetyl-Cysteine in Men With Idiopathic Asthenozoospermia

A Global Survey of Reproductive Specialists to Determine the Clinical Utility of Oxidative Stress Testing and Antioxidant Use in Male Infertility

The Negative Impact of Varicocele on Basic Semen Parameters, Sperm Nuclear DNA Dispersion and Oxidation-Reduction Potential in Semen

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