The role of the prostate in male fertility, health and disease

Abstract

Ejaculation is a synchronized cascade of events that has the ultimate goal of activating sperm and enabling them to reach an egg for fertilization. The seminal plasma contains a complex mixture of fluids that is secreted from the testes, epididymis and male accessory glands. The prostate gland has a pivotal role in this process, as prostatic fluid enriched in Zn(2+), citrate and kallikreins is crucial for the molecular synchronization of the functional cascade triggered by ejaculatory stimuli. The prostate is the target of a number of common diseases that can affect male fertility at different ages. In both young and aged men, prostatic diseases or an unhealthy prostate can affect spermatozoa functioning and, therefore, male fertility. Consideration of prostate physiology emphasizes a number of points: the central role of Zn(2+) and citrate in the regulation of prostate epithelium homeostasis and in ejaculation; the influence of bacteria-related prostatic inflammation on male fertility; and the potential role of prostatic inflammation in promoting the development of prostatic hyperplastic growth and carcinogenesis.

Patients with chronic prostatitis/chronic pelvic pain syndrome show T helper type 1 (Th1) and Th17 self‐reactive immune responses specific to prostate and seminal antigens and diminished semen quality

“…In addition, they have shown that prostate inflammation induces chronic pelvic pain development and has deleterious effects on semen quality compromising male fertility [6,25]. However, compelling available data from studies in patients are limited [6,25,26]. In the present study, we provide novel evidence indicating that Th1 and Th17 self-reactive immune responses specific to PAg are detected in a considerable proportion of patients with CP/CPPS, which may be responsible for the observed inflammation of the male genital tract.…”

“…Such animal models mirror most features of human CP/CPPS and have shown that prostate inflammation induction is mediated by T-cell responses specific to PAg. In addition, they have shown that prostate inflammation induces chronic pelvic pain development and has deleterious effects on semen quality compromising male fertility [6,25]. However, compelling available data from studies in patients are limited [6,25,26].…”

“…The prostate is the major male accessory gland and secretes several factors that exert crucial functions for human reproduction [25,36]. Therefore, it is reasonable to hypothesise that inflammation of the prostate could alter male fertility potential [36].…”

Physiological function of seminal vesicle secretions on male fecundity

“…At copulation, a mixture of cauda epididymal spermatozoa and accessory gland secretions is ejaculated into the female reproductive tract. The accessory gland secretions mainly come from the seminal vesicles (SV), prostates, bulbourethral gland (also known as “Cowper's gland”), and urethral glands . Specifically, men ejaculate 3–3.5 mL of semen into the female reproductive tract, which is mainly composed of secretions from SV (1.5–2.0 mL), prostates (0.5 mL), and bulbourethral gland and urethral glands (0.1 mL) .…”

Characterization of seminal plasma proteomic alterations associated with the IVF and rescue‐ICSI pregnancy in assisted reproduction

“…Among them, the seminal vesicles, prostate, testes, and epididymides are the major secretory origins and account for approximately 65%, 25%, and 10%, respectively, of the semen volume (Drabovich et al, 2014). Some seminal proteins have tissue specificity: Seminal vesicles mainly secrete semenogelins and fibronectin (Lilja et al, 1987), the epididymis secretes clusterin (Han et al, 2012), the prostate secretes kallikreins (Verze et al, 2016), and the bulbourethral glands secrete mucinous proteins (Boursnell et al, 1970).…”