Revista Internacional De Andrologia最新文献

Background and objective

The high demand of assistance made by trans people in recent years has directed the focus of research towards the study of their clinical and sociodemographic aspects. The objective of this work was to compare and analyze some sociodemographic variables in trans people in two periods: the period when the unit began to operate and the most recent period.

Materials and method

A sample of 131 users who attended the Gender Identity Treatment Unit of the Principality of Asturias (UTIGPA) between 2015-2019 was compared with a sample of 33 who attended between 2007-2009. Data were extracted from medical records.

Results

Regarding 2007-2009, in 2015-2019 the ratio is inverted in favor of Trans Men (TM). Users of both genders request consultation at an earlier age (specially TM), come less from abroad, achieve higher educational and work qualifications, are less unemployed and request more name changes. And, although Trans Women (TW) continue to be those who are mostly engaged in prostitution and self-administration of hormones, in the most recent period they report it less and, furthermore, they live more accompanied tan in the past.

Conclusions

Changes are observed in the sociodemographic variables of UTIGPA users between 2007-2009 and 2015-2019, in the direction of a greater inclusion. However, the sociodemographic conditions of the TW are still at a disadvantage in comparison to those of the TM.

Introduction and objectives

It is necessary to be able to predict sperm retrieval before microdissection testicular sperm extraction (mTESE) in azoospermic men. This study established the importance of proliferating cell nuclear antigen (PCNA) and LIM15 gene expression levels in predicting the success of sperm retrieval by mTESE.

Materials and methods

One hundred and forty-three men who were diagnosed with non-obstructive azoospermia (NOA) were included in the study. Patients’ age, total testosterone and follicle stimulating hormone values, testicular volume and testicular histology were recorded by prospectively. PCNA and LIM15 gene expression levels were determined by real-time PCR in the materials from both ejaculate and testicular specimens.

Results

Testis volume and histology were the most important factors in predicting the sperm retrieval rate (SRR). The PCNA and LIM15 gene expression levels measured in testicular tissues and the LIM15 gene expression levels measured in ejaculate significantly correlated with the SRR in mTESE (p = 0.038, p = 0.022, and p = 0.004, respectively). Although the PCNA gene expression level measured in ejaculate was higher in men with successful sperm retrieval, the difference was not statistically significant (p = 0.061). According to the multivariate logistic regression analysis, testicular volume and LIM15 gene expression level in ejaculate were independent predictive parameters for sperm retrieval.

Conclusion

The data showed that LIM15 gene expression level in ejaculate is a useful molecular marker to predict the SRR before mTESE.

Background

There has been a decrease in sperm concentration in recent years. Concurrently, there were important dietary changes, including an increase in sugar-sweetened beverage intake (SSB). The relation between SSB and male reproduction functions in humans are barely described in the literature.

Methods

Cross-sectional study with 209 participants (18–23 years old) recruited during one year in Murcia, Spain. All men provided semen and blood samples the same day. SSB consumption was evaluated using a 101-item validated food frequency questionnaire. Reproductive hormones were analysed from serum samples, obtaining levels of follicle-stimulating hormone, inhibin B, luteinizing hormone, estradiol, and testosterone. The evaluation of semen analysis followed the WHO guidelines and consisted of seminal volume, sperm concentration, total sperm count, percentage of morphologically normal sperm, and percentage of motile sperm. SSB intake association with semen parameters and hormone levels were examined using multiple linear regression.

Results

Men in the highest quartile of the SSB intake had a higher percentage of morphologically normal sperm, 37.4% [6.1, 68.3] (p, trend = 0.047) and higher estradiol levels (9.5% [−3.5, 22.5] (p, trend = 0.047) than those in the first quartile. SSB intake was unrelated to other semen quality parameters or reproductive hormone levels.

Conclusions

Our results indicate that sperm morphology and estradiol levels may be associated with sugar-sweetened beverage intake. These findings might be explained by physiological metabolism homeostasis, though more studies are required to confirm these results and draw conclusions in other male populations.

Objective

To analyze existence of an association between methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism with male infertility.

Materials and methods

A case–control study was conducted from June 2017 to August 2018 in which 88 infertile and 40 fertile were recruited. Polymerase chain reaction (PCR) – restriction fragment length polymorphism (RFLP) assay was carried out to study the allelic frequency of C677T polymorphism. The differences in allelic and genotypic frequencies of C677T locus between fertile and infertile groups were evaluated by the Pearson chisquare test. A logistic regression model was used to calculate Odds ratios and 95% confidence intervals, p value < 0.05 was considered significant. The Hardy–Weinberg equilibrium was tested using HWE software.

Results

In infertile subjects, frequency distribution of CC allele was (60.2%), the CT allele was (30.7%) the TT allele was (9.1%) and in the fertile controls the frequency was CC allele (75%), CT allele (20%) and TT allele (5%) respectively. Analysis revealed MTHFR 677 CC genotype associated significantly with male infertility (p < .046, OR = 2.385; 95% CI = 1.014–5.608); Frequency of CT (30.7%) and TT (9.1) genotypes were higher in infertile men as compared to CT (20%) TT (5%) in fertile controls but statistically these were not significantly different (p = 0.097; OR = 0.455; CI = 0.179–1.153 and p = 0.431; OR = 0.526; CI = 0.107–2.599 respectively). Significant association of age and BMI with MTHFR genotypes and infertility was observed.

Conclusion

Our results showed that MTHFR C677T polymorphism is not a risk factor for male infertility in our Pakistani population.

Introduction and objectives

Advances in assisted reproductive techniques (ART) have caused an increase in requests for postmortem sperm retrieval (PMER). The use of these techniques is usually tied to legal, ethical and medical/casuistic problems. The objective of this work is to analyze technical and legal aspects of PMER in Spain using two real cases and to establish guidelines to help in decision-making after a PMER request.

Material and methods

Two real cases in which a PMER was requested and others published in Spain in recent years are presented. We proceed to an exposition of the techniques used in postmortem ART cases and specifically in PMER, and a detailed study of the current legal framework is carried out.

Results

In Spain we have a complete law on ART. Article 9 expressly requires an authorization from the deceased male partner for the use of his reproductive material in the following 12 months. Regarding the PMER, technical and logistical considerations require a quick and organized decision-making. The time until extraction should not exceed 24–36 hours from death and a good choice of biological material is essential.

Conclusions

Medical-scientific advances now allow PMER and the use of postmortem ART. A good knowledge of the technical, logistical and legal aspects is necessary for a fast and coordinated action.

Introduction and objectives

Premature ejaculation (PE) is characterized by shorter intravaginal ejaculation latency time than it is acceptable for the patient or partner. It is thought that lifelong PE is a neurobiological dysfunction associated with genetic predisposition and with central serotonin neurotransmission dysfunction in receptors. To contribute to the understanding the genetic etiology of lifelong PE, it was planned to compare the 5-HT2C receptor gene rs3813929, rs518147, 5-HT1A receptor gene rs6295, 5-HT1B receptor gene rs11568817 of lifelong PE patients to healthy controls.

Materials and methods

For this purpose, 100 patients with premature ejaculation and 100 healthy controls were included in the study. Blood samples for DNA extraction were obtained. Appropriate procedures were applied to the probes (rs3813929, rs518147, rs6295, rs11568817) suitable for the DNA studied.

Results

A statistically significant relationship was found between the rs11568817 polymorphism (p = 0.019) in the 5-HT1B receptor gene and the rs518147 polymorphism (p = 0.016) in the 5-HT2C receptor gene. Also, no statistically significant relationship was found between 5-HT1A receptor gene rs6295 polymorphism and 5-HT2C receptor gene rs3813929 polymorphism and lifelong PE.

Conclusions

The relationship between rs3813929 and rs11568817 polymorphisms with lifelong PE was confirmed. Repeating the study in larger sample groups could be useful in determining the genetic etiology of PE.

Introduction

Semen analysis is a clinical method aimed at determining the fertility of a male individual. The traditional subjective method lacks the reliability that can be achieved by computer-assisted sperm analysis (CASA) technology. Unfortunately, this technology has only been used when taking into consideration individually different sperm characteristics. The aim of this work is to present an integrative mathematical approach that considers different seminal variables to establish human sperm subpopulations.

Methods

Samples were obtained from thirteen volunteers via masturbation and were analyzed by the routine subjective method and two objective systems, CASA Motility (CASA-Mot) and CASA Morphology (CASA-Morph).

Results

Seminogram variables were reduced to three principal components (PC) showing two subpopulations. Kinematics and morphometric variables each rendered three PCs for four subpopulations.

Conclusions

These results lay the foundations for future studies including different geographical, social, ethnic and age range conditions with the aim of achieving a definitive view of the human semen picture.

There are multiple congenital structural abnormalities that affect male urogenital tract which could affect either the male external genitalia, internal genitalia or both. Congenital anomalies of the vas deferens may be unilateral or bilateral that could be complete or segmental and include (agenesis, atresia, duplication, ectopy or diverticulum). Anomalies of the vas deferens may be isolated or may be associated with other congenital anomalies especially in the male urogenital tract. These rare vas anomalies may be discovered during genital examination (either clinically or radiologically) or even accidentally during inguinal surgeries as in varicocelectomy, hernia repair, vasectomy or orchiopexy. We hereby reported the first case of triple vas deferens in a 35-year-old male that was felt on spermatic cord examination and confirmed by trans-rectal ultrasonography. Thus, proper evaluation should be made for the cases of multiple vas deferens to avoid the accidental injury during the operation and to exclude other associated congenital anomalies.

Introduction

Vasectomy is a safe and effective technique to achieve azoospermia, although the failure rate of the technique is less than 1%. Sterility is not immediate so the post-vasectomy seminogram continues o be essential to ensure the success of the technique. The aim of this trial is to establish the attitude when dealing with immobile residual sperm patients.

Material and methods

Cross-sectional analysis of 2,168 vasectomies performed between January 2010 and March 2017. The first post-vasectomy seminogram was performed at 3 months. Those patients with azoospermia did not undergo further controls. Patients with immobile sperm (<100,000/ml o >100,000/ml) were considered potentially fertile and were followed with monthly seminograms until azoospermia was obtained.

Results

Of a total of 1,807 patients were included; 1,297 of these had azoospermia at 3 months seminogram and 501 patients had immobile residual sperm. Only 24 patients of this last group showed more than 100.000 sperm/ml; 9 cases showed mobile sperm. All patients who presented immobile residual sperm underwent serial seminograms. Azoospermia was achieved in an average time of 4,5 months in a rage of 4-10 months, regardless of the initial sperm count. An average of 2,5 tests were performed on each patient. All of the patients with mobile sperm required a reintervention.

Conclusion

All patients with immobile sperm on the first post-vasectomy seminogram will achieve azoospermia regardless of the initial count. Therefore, serial controls until a negative seminogram is obtained are unnecessary.