Andrology最新文献

Couple infertility is a very ancient medical condition. One of the first descriptions of familial infertility/subfertility is contained in the first book of the Bible, Genesis, written in the 10th century BC and reporting tales from the oral tradition even occurred about 800 years earlier. Genesis reports the peculiar case of Abraham and his descendants, Isaac and Jacob, the three patriarchs of Israel. The (favorite) wife of the three of them suffered from primary infertility and, according to Genesis, could reach pregnancy only in late age and for divine intervention. In this paper, we reconstruct the pedigree of Abraham's family on the basis of the biblical narration, which is rich enough of medical details to allow to reconstruct a plausible medical/genetic reason for the cases of infertility reported therein.

Background: Previous observational studies investigating the association between shift work and male fecundity employed retrospective designs and reported inconsistent findings. The distinction between rotating and fixed shift work has been noticed but not often taken into consideration in the field of reproductive health. Whether semen parameters played a role in this relationship was also unclear.

Objective: This study aimed to prospectively evaluate the association between male rotating shift work and achieving a successful pregnancy, and to assess the contribution of semen parameters to this relationship.

Materials and methods: Men reported their work type (rotating shift workers, fixed day workers, and fixed shift workers) and seven semen parameters (semen volume, sperm concentration, total sperm count, progressive motility, total motility, vitality, and normal morphology) were measured. Participants were contacted every 3 months for pregnancy status for up to 24 months or until conception. The rates of achieving a successful pregnancy within 1 year and 2 years were calculated to estimate male fecundity. Cox regression and linear regression were applied to compare the hazard of achieving a pregnancy within 1/2 year and semen parameters among rotating shift workers, fixed day workers, and fixed shift workers. Mediation analysis was applied to examine the contributions of semen parameters to the shiftwork-fecundity association.

Results: (1) After adjusting confounders, rotating shift workers had a 16% (HR = 0.84, 95% CI, 0.70-0.99, p = 0.04) and 14% (HR = 0.86, 95% CI, 0.74-1.01, p = 0.06) lower hazard of achieving a pregnancy within 1 year and 2 years, respectively, compared to fixed day workers. (2) Of the seven semen parameters, the rotating shift workers were significantly associated with lower sperm concentration (β = -10.77%, 95% CI, -18.89% to -2.55%, p = 0.01), total sperm count (β = -11.63%, 95% CI, -21.25% to -2.02%, p = 0.02), and vitality (β = -3.86%, 95% CI, -7.00% to -0.72%, p = 0.02) compared to the fixed day workers. No significant difference was found between fixed day workers and fixed shift workers. (3) Sperm concentration accounted for 33.46% and 31.12% of the total effect of the relationship between rotating shift work and lower hazard of achieving a pregnancy within 1 and 2 years. Vitality also mediated this association by 30.79% and 23.59%, respectively.

Conclusions: Male rotating shift work was associated with reduced fecundity, primarily attributed to reduced sperm concentration and vitality. The study emphasizes the need for occupational protection and provision of medical care for male workers with rotating shifts.

Background: Despite being the only approved oral therapy for premature ejaculation (PE), dapoxetine faces high discontinuation rates because of its suboptimal efficacy. Given that the role of gut microbiota in PE treatment has remained unexplored, we aim to investigate gut microbiota that may reflect the efficacy of dapoxetine.

Methods: Clinical data and fecal samples were collected from patients with lifelong PE before treatment. Gut microbiota was profiled via 16S rDNA sequencing, and differential microbiota between effective and ineffective groups were identified with the LEfSe method. To explore potential links between gut dysbiosis and efficacy, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway functional predictions were performed with the PICRUSt2 method. Efficacy was assessed using the Clinical Global Impression of Change (CGIC) scale, with scores ≥1 defined as the effective group.

Results: In the effective group, Erysipelotrichaceae_UCG_003, Parabacteroides_distasonis, and Prevotella_7_unclassified were significantly more prevalent, while Collinsella aerofaciens was less abundant. Their abundance was significantly correlated with CGIC scores, with correlation coefficients of 0.331, 0.250, 0.288, and ‒0.345, respectively. The discriminatory abilities of the four differential microbiota were 0.654, 0.669, 0.701, and 0.615, respectively. Incorporating them significantly improved the accuracy of the model predicting efficacy (0.796 vs. 0.738), which further suggests that modulating microbiota could be a novel strategy for PE treatment. The predicted gene abundance in the arachidonic acid metabolism pathway was significantly elevated in the effective group, indicating that dapoxetine's mechanism may also involve modulating this pathway.

Conclusions: This study identified gut microbiota associated with the efficacy of dapoxetine for the first time. Targeted modulation of specific gut microbiota may provide a novel strategy for PE treatment.

Background: Long-acting gonadotropin-releasing hormone (GnRH) agonists are commonly used for fertility control in male dogs. Their effect on testicular histomorphology has not been clarified.

Objectives: To elucidate the mechanisms underlying androgen withdrawal in response to long-acting GnRH agonist deslorelin 4.7 mg treatment on testicular histomorphology and key extracellular matrix (ECM) and cytoskeletal components.

Materials and methods: Testes of deslorelin-treated dogs (n = 5) were evaluated at maximum downregulation of germinative and steroidogenic function, and compared with untreated (control) adult (n = 7) and prepubertal immature (n = 8) dogs. Morphological analysis was performed with Crossman's triple staining and periodic-acid-Schiff (PAS). Localization of smooth muscle α-actin (αSMA/ACTA2), desmin (DES), elastin (ELN), collagen type I (COL1A1), collagen type IV (COL4A1) was detected by immunohistochemistry.

Results: Deslorelin treatment resulted in complete absence of germ cells except for spermatogonia. Crossman's triple staining identified thickening of peritubular connective tissue characterized by small infoldings toward the lumen of atrophied seminiferous tubules, and the expansion of interstitial area. PAS staining revealed a thickened basement membrane and phagosome-like particles within the seminiferous tubules. In control dogs, αSMA/ACTA2, DES, ELN, COL1A1, and COL4A1 were localized to blood vessels and the peritubular wall of seminiferous tubules. ELN, COL1A1, and COL4A1 were also found in stromal compartments. A similar localization pattern with signals within a thickened peritubular area was found in deslorelin-treated dogs. Prepubertal dogs had similar distribution but weaker signal intensity in the peritubular wall of seminiferous tubules. Positive area percentages of αSMA/ACTA2, DES, ELN, and COL4A1 were the highest in deslorelin-treated dogs, while COL1A1 was the lowest in control, intermediate in deslorelin-treated, and highest in prepubertal dogs.

Conclusion: Deslorelin treatment caused infertility with accumulation of collagen (COL4A1, COL1A1) and deposition of αSMA/ACTA2, DES, and ELN within the thickened lamina propria surrounding seminiferous tubules. Peritubular myocytes maintained their smooth muscle phenotype despite androgen withdrawal. The immature testis had lower abundance of most cytoskeletal and ECM proteins.

Background: End-stage renal disease (ESRD) is reported to be associated with the impairment of sex hormones, including decreased testosterone levels and increased follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin levels. Additionally, patients with ESRD often experience impaired spermatogenesis, leading to infertility. However, variations in study methodologies and reported outcomes make it challenging to draw definitive conclusions. Therefore, this study aims to evaluate the effects of kidney transplantation (KT) on these issues, which can be useful in counseling male patients with ESRD.

Methods: A systematic search was conducted in Web of Science, Medline (via PubMed), and Embase (via Scopus) to identify peer-reviewed studies evaluating the impact of KT on sex hormones and reproductive parameters. A systematic review (SR) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review included English-language articles published between January 1975 and December 2024. Excluded from this search were reviews, editorials, book chapters, conference abstracts, case reports, and case series with up to four patients were excluded.

Results: A total of 2939 publications were initially identified, and 23 studies met the inclusion criteria, comprising 738 patients for analysis. Most studies reported a significant increase in testosterone levels 3, 6, and 12 months post-KT. LH and prolactin levels exhibited a trend parallel to that of testosterone. A statistically significant decrease in LH levels was observed at both 1 and 12 months post-KT, while prolactin levels showed a significant reduction at all evaluated time points from 1 to 12 months. In contrast, FSH levels fluctuated over time and did not demonstrate statistical significance at any assessment point. Additionally, KT led to improvements in testis biopsy findings, and all categories of sperm parameters.

Conclusion: This SR demonstrates that KT improves sex hormone levels, sperm parameters, and sexual function in male kidney recipients. However, to gain a more comprehensive understanding of the sexual health of male kidney recipients, the establishment of an international database with prospectively collected data is warranted.