Basic and Clinical Andrology最新文献

Background: Psychogenic erectile dysfunction patients accounted for a substantial percentage of younger erectile dysfunction ones. This cross-sectional observational study investigated the correlation between a history of frequent masturbation and anxiety/depression symptoms in patients with psychogenic erectile dysfunction .

Results: Baseline characteristics showed significant between-group differences in age (the Frequent Masturbation History group younger, P < 0.05), but not in disease duration, residence, or lifestyle factors. The Frequent Masturbation History group demonstrated significantly higher anxiety (GAD-7: Z=-2.17, P = 0.030) and depression scores (PHQ-9: Z=-3.01, P = 0.003), alongside significantly lower psychological resilience (CD-RISC: Z=-2.53, P = 0.011) compared to the Non-Frequent Masturbation History group. These findings indicate that frequent masturbation history in psychogenic erectile dysfunction patients is associated with younger age, elevated anxiety/depression symptomatology, and reduced stress adaptability.

Conclusions: Clinical implications suggest incorporating behavioral pattern assessment and psychological screening into psychogenic erectile dysfunction evaluations. Targeted interventions should focus on cognitive-behavioral therapy to address maladaptive beliefs, mindfulness training to reduce performance anxiety, and partner-involved support to disrupt the observed "masturbation to anxiety/depression to erectile dysfunction" cycle. Future longitudinal studies integrating biopsychosocial assessments are warranted to elucidate temporal relationships.

Background: The axonemal co-chaperone gene DNAJB13 is essential for sperm motility and structural integrity. This study aimed to investigate the association between coding variants in DNAJB13 and idiopathic asthenozoospermia (IAZS) in a cohort from Sichuan, China.

Methods: Sanger sequencing of all DNAJB13 exons was performed in 130 patients with IAZS and 120 fertile controls with strictly normal semen parameters according to World Health Organization (WHO) 5th edition criteria. Detected variants were analyzed for genotype and allele frequencies. The potential impact of a novel missense variant was assessed using evolutionary conservation analysis across mammalian orthologs and in silico prediction tools for structural and splicing effects.

Results: Six coding variants were identified. Three variants (c.T279C, c.C882T, c.G927A) were common single nucleotide polymorphisms (SNPs ) with no significant differences between cases and controls. A novel missense variant, c.T272G (p.V91G), was detected exclusively in patients. Genotype distribution and allele frequency of this variant differed significantly between groups. Valine 91 was highly conserved, and computational modeling predicted that the p.V91G substitution would destabilize protein structure, disrupt hydrophobic core architecture, potentially interfere with RNA splicing regulatory elements, and impair DNAJB13 co-chaperone function in axonemal assembly.

Conclusions: The c.T272G (p.V91G) in DNAJB13 is significantly associated with IAZS in the studied cohort and represents a potential high-risk genetic factor. Predicted detrimental effects on protein structure and function suggest a novel genetic mechanism underlying impaired sperm motility. Functional validation and replication studies in diverse populations are necessary to confirm its pathogenic role.

Background: Empirical evidence indicates that high levels of sperm DNA fragmentation (SDF) negatively impact the results of both natural conception and assisted reproductive technology (ART). However, there is a notable absence of detailed guidelines for clinicians on which patient groups should be tested for SDF based on their semen analysis results. The goal of this study was to determine which sperm categorizations and morphological subcategorizations should be tested for sperm DNA integrity.

Results: Lowered sperm concentration, motility, progressive motility, and morphology, as well as a higher percentage of immature sperm, were linked to increased DNA Fragmentation Index (DFI) values. Higher DFI values were also found in semen samples from patients with two-sided varicoceles. The most significant intermediate correlation was identified between DFI and micro/partial head defects. Additionally, a low but significant correlation was observed in cases of combined oligo-astheno-teratozoospermia.

Conclusion: Targeted DFI assessment is especially valuable for patients who have a two-sided varicocele, micro/partial head sperm defects, or combined oligo-astheno-teratozoospermia. Incorporating this assessment may enhance the diagnostic accuracy of male infertility evaluations.

Background: The study aimed to evaluate the microbial content and diversity in semen samples of men with obesity, determine the differences between infertile and fertile groups, and investigate the effect of seminal microbiota on semen parameters, sperm DNA fragmentation, sperm chromatin condensation, and total antioxidant capacity.

Results: The study included thirteen infertile men with obesity as subjects and five fertile men with obesity as the control group (aged 18-55 years, body mass index > 30 kg/m²). The most abundant bacteria in both groups were seen to be belonging to the phylum of Bacillota, Pseudomonadota, Actinomycetota and Bacteroidota. The most common bacteria at the genus level were Pseudescherichia, Staphylococcus, Paenibacillus, Streptococcus, Klebsiella, and Moraxella, which had similar distributions in both groups. A negative correlation was observed between the percentage of aniline-positive sperm and motility (p < 0.0001), sperm concentration (p = 0.0001) and total sperm count (p = 0.001). It was found that Brevibacterium, Paenibacillus, Alistipes, Lactiplantibacillus, Rhizobacter, Sphingomonas and Venlonella genera were correlated with sperm DNA fragmentation; Pantoea, Devosia, Bacteroides, Acidovorax were correlated with total antioxidant capacity, Fusobacterium was correlated with the histone-rich sperm, and Corynebacterium, Hydrogenophaga, and Paenalcagenes were associated with body mass index.

Conclusion: Bacterial species in semen may play a role in male infertility by affecting semen quality, sperm DNA fragmentation or total antioxidant capacity.

Background: Chronic health conditions (CHC), both somatic and mental, increase the risk of sexual dysfunctions (SD) in men, which are associated with reduced quality of life. Despite existing guidelines, help-seeking remains low due to barriers such as shame and limited access, with many turning to anonymous sources. Representative data on care pathways and treatment preferences across SD domains and CHC subgroups is lacking. This study examines SD diagnoses, help-seeking, and treatment preferences in men with and without CHC meeting ICD-11 SD criteria to inform more tailored care.

Results: Of all N = 1815 (unweighted N = 1787) cis-men, n = 265 (16.6%) fulfilled positive ICD-11 SD criteria and were included in this study (mean age 49.2; SD = 16.9 years). CHC were present in 74.1% of men, of whom 23.2% had self-reported SD. While the internet remains the most used information source, urologists were the preferred information sources and dialogue partners for sexual health concerns. Men with mental health conditions (MH +) valued psychotherapists and psychiatrists more highly in this regard. Shame was the most cited barrier to help-seeking, particularly present in men with MH + , with 50.4%. Only 46.6% of men with SD symptoms meeting the ICD-11 criteria reported an SD diagnosis. Previous therapy was rare, with 3-4 months of waiting times. Medication was the most commonly used treatment in the past. As preferred treatment, men with CHC prioritized medication (42.6% vs. 36.7% in men without CHC), whereas men without CHC also favored relaxation methods (29.3%). Desired treatment goals included improved sexual and relationship satisfaction. Digital tools such as apps or websites were also of interest, with reimbursement considered essential.

Conclusion: Despite the high burden, SD diagnoses remain rare, and help-seeking behaviors vary, especially between men with somatic versus mental CHC. Regular healthcare contact may offer opportunities to address sexual health in trusted settings. Interventions should target both sexual and relationship satisfaction. Digital solutions can help close treatment gaps and improve access to specialized care. However, given low interest and adherence-particularly among men with CHC-tailored approaches are essential. Reimbursement within the German healthcare system is needed to lower financial barriers.

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women with potential familial and genetic components. Emerging evidence suggests that male first-degree relatives (fathers and brothers) may exhibit endocrine and metabolic abnormalities similar to a "male equivalent" of PCOS, although the condition remains without clear diagnostic criteria. We conducted a systematic review and meta-analysis to investigate whether male relatives of women with PCOS show consistent patterns of metabolic and hormonal dysregulation.

Results: A total of 21 studies met inclusion criteria, encompassing male first-degree relatives of women with PCOS with available data on metabolic, hormonal, and cardiovascular outcomes. Meta-analysis showed that male relatives had significantly higher fasting blood glucose (MD: 6.25; 95% CI: 1.36-11.14), body mass index (1.18; 0.35-2.02), triglycerides (17.82; 10.82-24.81), total cholesterol (18.63; 6.16-31.10), LDL-cholesterol (12.99; 1.27-24.71), and dehydroepiandrosterone sulfate (1.29; 0.66-1.92) compared with controls. They also exhibited higher prevalence of hypertension (OR: 1.88; 1.18-2.29), waist circumference > 90 cm (3.27; 1.18-9.08), and androgenetic alopecia (1.65; 1.04-2.60). Findings were consistent across studies, with low to moderate heterogeneity and minimal publication bias.

Conclusion: Male first-degree relatives of women with PCOS demonstrate increased rates of metabolic abnormalities, hormonal imbalances, and androgenic features, supporting the concept of a male PCOS of equivalent. These findings underscore the familial nature of PCOS and highlight the need for improved diagnostic criteria and higher clinical awareness. Screening male relatives for metabolic and hormonal risk factors may help identify at-risk individuals and inform preventive interventions.

Trial registration: IR.SBMU.ENDOCRINE.REC.1403.146.

Background: The objective of this study was to investigate potential causal associations between indicators of obesity and male reproductive disorders using Mendelian randomization (MR) analysis.

Methods: Based on summary data from the GWAS, we conducted MR analyses. Univariable MR analysis was performed to estimate the association between three obesity indicators and five male reproductive diseases. Multivariable MR analysis was conducted to account for pleiotropy observed in univariable MR analysis by including a set of covariates.

Results: Univariable MR analysis revealed suggestive associations between waist-to-hip ratio (WHR) and testicular dysfunction (OR = 0.32, 95% Cl: 0.11-0.99, P_IVW = 0.049), body mass index (BMI) and erectile dysfunction (OR = 1.28, 95%CI 1.12-1.45, P_IVW = 1.84 × 10^-4). Multivariate MR analysis indicated after controlling for potential confounders, waist-to-hip ratio was suggestively associated with the decreased risk of testicular dysfunction (OR = 0.23, 95% Cl: 0.08-0.67, P_IVW = 0.008). Nevertheless, multivariate MR analysis also showed that body mass index was suggestively associated with the increased risk of erectile dysfunction (OR = 1.22, 95% Cl: 1.06-1.40, P_IVW = 0.006). Sensitivity analyses confirmed that these results were reliable.

Conclusion: Our two-sample MR analysis suggests generalized obesity in was suggestively associated with the increased risk of erectile dysfunction, while central obesity obesity is associated with an decreased risk of testicular dysfunction.

Background: Hyperuricemia (HUA) impairs sperm function via oxidative stress and metabolic dysregulation. This retrospective cohort study aimed to investigate the therapeutic effect of density gradient centrifugation (DGC) on HUA-associated sperm dysfunction.

Results: A total of 490 couples undergoing their first intrauterine insemination (IUI) were stratified into the HUA group (200 cycles) and control group (290 cycles) based on male serum uric acid levels. At baseline, the percentage of progressively motile sperm (PR%) in the HUA group was significantly lower than that in the control group (39.55% ± 11.29% vs. 41.76% ± 11.89%, P = 0.040). Following DGC processing, PR% in both groups exceeded 90% with no significant intergroup difference; however, the increase in PR% (ΔPR%) was significantly greater in the HUA group (52.34% ± 10.62% vs. 50.29% ± 11.02%, P = 0.040). No significant difference was observed in the clinical pregnancy rate between the two groups (11.0% vs. 13.4%, P = 0.230).

Conclusions: DGC specifically improves sperm motility in patients with HUA. While direct measurement of mechanistic markers (e.g., oxidative stress, metabolic factors) was not performed in this study, this motility-improving effect may correlate with DGC's known capacity to scavenge reactive oxygen species and optimize energy supply-an inference supported by prior mechanistic studies. However, improving sperm motility alone is insufficient to significantly enhance clinical pregnancy rates. These findings provide insights to optimize semen preparation strategies in HUA-associated male infertility.