Basic and Clinical Andrology最新文献

Background: Smoking impairs spermatogenesis by disrupting gene and miRNA expression profiles. This study aims to explore the protective effects of quercetin against nicotine-induced testicular damage, with a specific focus on its regulatory role on sperm miR-151a-5p and testicular Cep72 gene expression, as potential molecular mechanisms involved in male reproductive dysfunction. Male BALB/c mice (N = 32) were randomly divided into four groups of: control, nicotine, quercetin, and quercetin + nicotine combined groups. Treatments lasted 35 days. Spermatogenesis was evaluated through histopathological studies of the testicles. TAC and SOD levels were evaluated as markers of antioxidant activity using colorimetric methods in testicular homogenates. Sex hormones were measured using the ELISA method. Relative expression of Cep72 and miR-151a-5p genes in testicular tissue and epididymal sperm was assessed by real-time PCR. Androgen receptor (AR) and estrogen receptor alpha (ERα) expression in testicular tissue were evaluated by immunohistochemical methods.

Results: The combined treatment of quercetin and nicotine enhanced sperm quality, caused significant changes in LH and estradiol hormone levels, increased anti-oxidants in testicular homogenates, and increased AR expression in Sertoli cells without affecting ERα, compared to the nicotine group. In addition, the combined therapy improved spermatogenesis by increasing the number of germ cells and Leydig cells. Furthermore, combined therapy increased testicular Cep72 gene expression and reduced sperm miR-151a-5p.

Conclusions: This study demonstrates that quercetin may protect against nicotine-induced testicular damage by maintaining hormonal balance, enhancing AR expression, improving antioxidant enzyme activity, and normalizing the miR-151a-5p/Cep72 regulatory axis, ultimately supporting sperm quality and spermatogenesis. These results establish a foundation for future mechanistic and translational research.

Background: Asthenozoospermia is a major cause of male infertility, accounting for approximately 18% of infertility cases. L-Proline, a natural antioxidant and osmoprotectant, has gained attention for its potential applications in semen cryopreservation. This study aimed to evaluate the beneficial effects of L-proline on sperm quality in samples from asthenozoospermic patients during cryopreservation.

Results: This in vitro experimental study utilized semen samples from 30 men (aged 27-40 years) diagnosed with asthenozoospermia. Each sample was divided into three aliquots for cryopreservation: (1) a control group using a standard unsupplemented freezing medium; (2) a group supplemented with 2 mM L-proline; and (3) a group supplemented with 4 mM L-proline. Following thawing, samples were assessed for sperm count, motility, viability, morphology, and chromatin quality. Additionally, levels of malondialdehyde (MDA), total antioxidant capacity (TAC), and nitric oxide (NO) were assessed. Supplementation with 2 mM L-proline resulted in significantly higher post-thaw progressive motility, viability, and chromatin integrity compared to the control group (p < 0.05). These functional improvements were associated with a more favorable antioxidant status, evidenced by significantly lower levels of MDA and NO and higher levels of TAC (p < 0.05). While the 4 mM L-proline group showed some protection, the effects were less pronounced than those observed with the 2 mM concentration.

Conclusions: The results suggest that adding 2 mM L-proline into the freezing medium effectively protects human sperm quality and chromatin integrity in asthenozoospermic samples by mitigating cryopreservation-induced nitro-oxidative stress. This strategy holds promise for improving assisted reproductive technology (ART) outcomes in men with asthenozoospermia.

Male infertility, particularly asthenozoospermia (AZS), has become an increasingly severe global public health issue. Obesity induced by a high-fat diet (HFD) is considered a key factor in the development of AZS, although its exact molecular mechanisms remain unclear. This study employs bioinformatics analysis to explore the key genes and potential regulatory mechanisms of HFD-induced obesity in AZS, which were validated by animal experiments. First, on the basis of GEO transcriptomic data, we identified nine common differentially expressed genes (DEGs) between HFD-induced obesity and AZS. Using LASSO regression and support vector machine methods, we subsequently identified C1QBP and PPIL1 as critical genes associated with HFD-induced AZS. Furthermore, a core gene‒transcription factor coexpression network revealed that MYC is likely an upstream transcriptional regulator of these two core genes. According to single-cell RNA-seq data, C1QBP and PPIL1 are predominantly expressed in spermatogonia, whereas MYC is primarily localized in stromal cells and is closely correlated with AZS. Additionally, through genome-wide enrichment analysis, we identified several key pathways regulating both HFD-induced obesity and AZS, including cell proliferation and differentiation (MYC targets and mTOR signalling), energy metabolism, cellular stress and homeostasis, and immune and inflammatory responses. The results of animal experiments demonstrated that HFD-induced obesity significantly impaired sperm motility in male rats, accompanied by decreased testosterone levels and increased oxidative stress. At the molecular level, the expression of MYC and mTOR in the HFD obesity/AZS group was significantly reduced (P < 0.01), whereas PPIL1 expression was significantly increased (P < 0.01). Moreover, L-carnitine partially reversed these changes, indicating potential therapeutic value. In conclusion, our study suggests that HFD-induced obesity may lead to AZS through the upregulation of PPIL1 levels and the inhibition of the MYC and mTOR signalling pathways.

Background: Sleep quality has been increasingly recognized as an important determinant of overall health, yet its influence on male fertility remains underexplored. This study investigated the association between male sleep quality and reproductive outcomes, including semen characteristics, hormone profiles, and partner pregnancy success, in infertile couples.

Results: A total of 727 male partners from infertile couples were evaluated between October 2023 and February 2025. Sleep quality was assessed using Pittsburgh Sleep Quality Index and categorized as good or poor. Poor sleep quality was reported in 75.1 percent of participants. Men with poor sleep quality showed significantly lower sperm concentration (β = -1.39, 95% confidence interval = -2.11 to -0.67, p < 0.001), reduced progressive motility (β = -1.25, 95% confidence interval = -1.61 to -0.88, p < 0.001), and decreased total motility compared with those reporting good sleep. No significant associations were observed between sleep quality and hormone concentrations, including follicle-stimulating hormone, luteinizing hormone, estradiol, prolactin, and testosterone. Poor male sleep quality was also linked to a lower probability of achieving clinical pregnancy (odds ratio = 4.67, 95% confidence interval = 3.08 to 7.09, p < 0.0001).

Conclusions: Poor male sleep quality is associated with impaired semen quality and reduced chances of pregnancy in couples with infertility. These findings highlight the potential value of improving sleep as a modifiable factor to enhance male reproductive health and fertility outcomes.

Background: To compare surgical and long-term patient-reported outcomes (PRO) between excisional (Nesbit) and incisional (Yachia) corporoplasty for correction of uncomplicated Peyronie's-related penile curvature in a large, single-surgeon cohort. A retrospective audit identified men who underwent Nesbit or Yachia corporoplasty (2015-2021). Operative data was extracted from records. A structured telephone survey captured long-term PRO.

Results: The cohort comprised 101 men (Nesbit = 31, Yachia = 70). Nesbit patients were younger (55 vs 59.7 yr; p = 0.02) and had greater baseline curvature (55° vs 45°; p = 0.01). Every case was surgically successful (residual curvature < 20° in 100%, < 10° in 58% overall, p = 0.66). Yachia procedures were shorter (45 vs 71 min; p < 0.05) but required > 2 plications more often (41% vs 7%; p = 0.01). The PRO survey had a 74.3% response rate, with a median follow-up of 5 years. 'Patient Global Impression of Improvement' scores reflected strong improvement with median scores of 1 ("very much better") and 2 ("much better") in the Nesbit and Yachia groups respectively (p = 0.35). However, this perceived improvement did not translate uniformly into long-term satisfaction. Only 66.7% of respondents reported being "completely" or "mostly" satisfied with the overall outcome (p = 0.60). The most frequent cause of dissatisfaction was perceived penile shortening, reported by 85% of men. Erectile function declined postoperatively in 30% of Yachia and 15% of Nesbit patients (p = 0.03), though this is possibly confounded by the older age of the Yachia cohort. Bothersome curvature recurrence and post-operative cosmesis did not significantly impact satisfaction in either group.

Conclusions: Both Nesbit and Yachia corporoplasties provide effective and durable results with comparable long-term patient satisfaction. Regardless of technique, subjective reporting of penile shortening was particularly pervasive and was highly bothersome. This underscores the need for meticulous pre-operative counselling.

Background: Infections of the urogenital tract are recognized as potential contributors to male subfertility or infertility. Ureaplasma parvum is frequently detected in semen samples, yet its specific impact on semen quality and the potential benefit of antibiotic treatment remain uncertain.

Results: In a retrospective cohort of 3,464 semen samples collected for fertility evaluation, Ureaplasma parvum was identified in 12.4% of cases using a multiplex PCR assay. Semen volume was significantly lower in infected individuals compared to uninfected controls. However, no significant differences were observed in sperm concentration, motility, morphology, or inflammatory markers. Among 124 men with documented pathogen eradication and follow-up semen analysis, doxycycline treatment led to a significant increase in sperm concentration (4.01 ± 4.69 to 9.20 ± 15.63 million/ml, p = 0.01) and motility (18.97 ± 16.04% to 29.66 ± 22.18%, p = 0.002). Peroxidase-positive leukocytes declined (1.84 ± 0.74 to 0.68 ± 0.79 million/ml, p = 0.005). In contrast, no significant changes were observed in men with normal baseline semen parameters.

Conclusion: The mere detection of Ureaplasma parvum does not appear to compromise semen quality and may not warrant routine antibiotic treatment. Nevertheless, in Ureaplasma parvum-positive patients with abnormal semen parameters and elevated inflammatory markers, targeted antibiotic therapy may improve sperm quality. These findings support a selective treatment strategy, emphasizing clinical context and inflammatory status rather than routine screening or treatment of all infected individuals.

Background: High paraplegia, primarily affecting young men during their reproductive years, often results in ejaculatory dysfunction and infertility. Testicular sperm aspiration (TESA) combined with intracytoplasmic sperm injection (ICSI) offers a viable path to biological parenthood for this population. However, evidence on nursing strategies supporting such procedures is limited. This study aimed to evaluate the clinical and psychosocial outcomes of patients with high paraplegia due to spinal cord injury who underwent TESA-ICSI and explore the effectiveness of specialized nursing interventions.

Case presentation: A retrospective case series was conducted on nine male patients with high paraplegia treated at Sir Run Run Shaw Hospital (Zhejiang, China) between January 2021 and October 2023. The mean age of the patients was 31.89 ± 4.83 years, with injury durations ranging from 1 to 13 years. Psychological evaluations using the SAS, SDS, SSRS, and WHOQOL-BREF scales revealed that three patients had anxiety, four had depression, and most had moderate to high social support. The WHOQOL-BREF scores indicated generally good perceived quality of life (score range, 82-91). TESA was performed under local anesthesia, with perioperative nursing measures including bladder management, wound care, and infection prevention. Viable sperm were successfully retrieved in all cases without complications. Eight couples proceeded to ICSI, with viable embryos obtained in all. Six couples achieved pregnancy (66.7%)and live births. One case ended in miscarriage due to trauma, and one couple had no embryos suitable for transfer.

Conclusion: Comprehensive nursing interventions, including psychological support, ethical evaluation and procedural adaptations, may facilitate the successful application of TESA-ICSI in men with high paraplegia, highlighting the need for standardized interdisciplinary nursing protocols to optimize fertility outcomes in this underserved population.

Background: Epigenetic mechanisms influencing sperm production and function are closely linked to male infertility. Among these, tRNA-derived fragments have recently been identified as important modulators of cellular stress responses and gene expression. The purpose of this study was evaluate the potential role of 5'tRF-Glu-CTC in the context of assisted reproductive technologies (ART) outcomes by comparing its differential expression in the seminal plasma of oligozoospermic and normozoospermic infertile men.

Results: Total RNA was extracted from seminal plasma, and 5'tRF-Glu-CTC expression was measured by qRT-PCR. Sperm DNA fragmentation index (DFI) was assessed via the TUNEL assay. The results revealed significantly elevated 5'tRF-Glu-CTC expression in the oligozoospermic group compared to the normozoospermic group (15.58 ± 4.34 vs. 12.53 ± 4.99; fold change: 1.692; P = 0.024). Sperm DFI showed a significant negative correlation with both the progressive motile sperm (ρ = -0.537, P = 0.015) and the total progressive motile sperm count (ρ = -0.509, P = 0.026). However no significant differences in DFI was observed between the oligozoospermic and control groups (P > 0.05). Analysis of ART outcomes revealed that male partners of couples who achieved pregnancy had lower mean 5'tRF-Glu-CTC expression and DFI, although these differences did not reach statistical significance (P > 0.05).

Conclusions: These results suggest that 5'tRF-Glu-CTC might be serve as a potential biomarker and could play a role in the pathophysiology of oligozoospermia.

Background: Varicocele (VC) is a significant contributor to both primary and secondary male infertility. VC can lead to progressive, time-dependent damage to testicular function, as demonstrated in both animal and human studies. To assess testicular tissue alterations, we conducted the first systematic review and meta-analysis on the effects of VC on testicular stiffness and volume. A literature search was conducted in June 2024 without language or geographic restrictions. The search included the databases PubMed, Embase, and Medline. We reviewed the literature to identify all published clinical trials using shear wave elastography (SWE) to evaluate the stiffness and volume of varicocele-affected and normal testes. The reference lists of the retrieved studies were examined. We conducted a systematic review and meta-analysis.

Results: Seven articles, encompassing 1118 testes, were selected from a pool of eighty-seven. The analysis revealed that the stiffness of varicocele-affected ipsilateral testes was higher than that of normal testes (p < 0.05), and the stiffness of normal testes was higher than that of contralateral testes (p < 0.05). Regarding volume, the varicocele-affected ipsilateral testes were smaller than the contralateral testes (p < 0.05), with no significant difference between the contralateral and normal testes (p > 0.05).

Conclusions: This meta-analysis indicates that VC impacts the stiffness and volume of both testes. SWE is an effective technique for assessing testes affected by VC, but a large-scale, multicenter randomized controlled study is needed for further confirmation.