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Commentary on "Delayed covering causes the accumulation of motile sperm, leading to overestimation of sperm concentration and motility with a Makler counting chamber". 评论“延迟覆盖导致活跃精子的积累,导致马克勒计数室对精子浓度和活力的高估”。
Pub Date : 2025-01-01 Epub Date: 2024-11-26 DOI: 10.4103/aja202482
Elisabetta Tosti
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引用次数: 0
Single-incision laparoscopic totally extraperitoneal retrieval of retroperitoneal vas deferens in vasovasostomy for obstructive azoospermia patients postchildhood bilateral herniorrhaphy. 在输精管造口术治疗儿童双侧疝气术后梗阻性无精子症患者中,采用单切口腹腔镜完全腹膜外取回腹膜后输精管。
Pub Date : 2025-01-01 Epub Date: 2024-08-09 DOI: 10.4103/aja202456
Chen-Wang Zhang, Wei-Dong Wu, Jun-Wei Xu, Jing-Peng Zhao, Er-Lei Zhi, Yu-Hua Huang, Chen-Cheng Yao, Fu-Jun Zhao, Zheng Li, Peng Li
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引用次数: 0
Impact of human papillomavirus and coinfection with other sexually transmitted pathogens on male infertility. 人类乳头瘤病毒和其他性传播病原体合并感染对男性不育症的影响。
Pub Date : 2025-01-01 Epub Date: 2024-09-13 DOI: 10.4103/aja202473
Xin Fan, Ya Xu, Li-Feng Xiang, Lu-Ping Liu, Jin-Xiu Wan, Qiu-Ting Duan, Zi-Qin Dian, Yi Sun, Ze Wu, Yun-Hua Dong

Abstract: This study primarily aimed to investigate the prevalence of human papillomavirus (HPV) and other common pathogens of sexually transmitted infections (STIs) in spermatozoa of infertile men and their effects on semen parameters. These pathogens included Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae, Pseudomonas aeruginosa , and Staphylococcus aureus . A total of 1951 men of infertile couples were recruited between 23 March 2023, and 17 May 2023, at the Department of Reproductive Medicine of The First People's Hospital of Yunnan Province (Kunming, China). Multiplex polymerase chain reaction and capillary electrophoresis were used for HPV genotyping. Polymerase chain reaction and electrophoresis were also used to detect the presence of other STIs. The overall prevalence of HPV infection was 12.4%. The top five prevalent HPV subtypes were types 56, 52, 43, 16, and 53 among those tested positive for HPV. Other common infections with high prevalence rates were Ureaplasma urealyticum (28.3%), Ureaplasma parvum (20.4%), and Enterococcus faecalis (9.5%). The prevalence rates of HPV coinfection with Ureaplasma urealyticum, Ureaplasma parvum, Chlamydia trachomatis, Mycoplasma genitalium , herpes simplex virus 2, Neisseria gonorrhoeae, Enterococcus faecalis, Streptococcus agalactiae , and Staphylococcus aureus were 24.8%, 25.4%, 10.6%, 6.4%, 2.4%, 7.9%, 5.9%, 0.9%, and 1.3%, respectively. The semen volume and total sperm count were greatly decreased by HPV infection alone. Coinfection with HPV and Ureaplasma urealyticum significantly reduced sperm motility and viability. Our study shows that coinfection with STIs is highly prevalent in the semen of infertile men and that coinfection with pathogens can seriously affect semen parameters, emphasizing the necessity of semen screening for STIs.

本研究的主要目的是调查不育男性精子中人类乳头瘤病毒(HPV)和其他常见性传播感染病原体的流行情况及其对精液参数的影响。这些病原体包括尿解支原体、副脲原体、沙眼衣原体、生殖器支原体、单纯疱疹病毒 2、淋病奈瑟菌、粪肠球菌、无乳链球菌、铜绿假单胞菌和金黄色葡萄球菌。2023 年 3 月 23 日至 2023 年 5 月 17 日期间,云南省第一人民医院(中国昆明)生殖医学科共招募了 1951 名不育夫妇中的男性。HPV基因分型采用多重聚合酶链反应和毛细管电泳技术。聚合酶链反应和电泳也用于检测是否存在其他性传播感染。HPV 感染的总体流行率为 12.4%。在人乳头瘤病毒检测呈阳性的人群中,前五位流行的人乳头瘤病毒亚型分别是 56、52、43、16 和 53 型。其他流行率较高的常见感染包括尿解支原体(28.3%)、副脲原体(20.4%)和粪肠球菌(9.5%)。人乳头瘤病毒与解脲支原体、副溶性解脲支原体、沙眼衣原体、生殖器支原体、单纯疱疹病毒 2、淋病奈瑟菌、粪肠球菌、无乳链球菌和金黄色葡萄球菌合并感染的流行率分别为 24.8%、25.4%、10.5%和 10.5%。分别为 24.8%、25.4%、10.6%、6.4%、2.4%、7.9%、5.9%、0.9% 和 1.3%。单独感染 HPV 会使精液量和精子总数大大减少。同时感染人乳头瘤病毒和尿解支原体会显著降低精子的活力和存活率。我们的研究表明,在不育男性的精液中,合并感染性传播疾病的情况非常普遍,而且合并感染病原体会严重影响精液参数,这强调了对精液进行性传播疾病筛查的必要性。
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引用次数: 0
Pharmacological actions of the bioactive compounds of Epimedium on the male reproductive system: current status and future perspective. 淫羊藿生物活性化合物对男性生殖系统的药理作用:现状与未来展望。
Pub Date : 2025-01-01 Epub Date: 2024-07-09 DOI: 10.4103/aja20248
Song-Po Liu, Yun-Fei Li, Dan Zhang, Chun-Yang Li, Xiao-Fang Dai, Dong-Feng Lan, Ji Cai, He Zhou, Tao Song, Yan-Yu Zhao, Zhi-Xu He, Jun Tan, Ji-Dong Zhang

Abstract: Compounds isolated from Epimedium include the total flavonoids of Epimedium , icariin, and its metabolites (icaritin, icariside I, and icariside II), which have similar molecular structures. Modern pharmacological research and clinical practice have proved that Epimedium and its active components have a wide range of pharmacological effects, especially in improving sexual function, hormone regulation, anti-osteoporosis, immune function regulation, anti-oxidation, and anti-tumor activity. To date, we still need a comprehensive source of knowledge about the pharmacological effects of Epimedium and its bioactive compounds on the male reproductive system. However, their actions in other tissues have been reviewed in recent years. This review critically focuses on the Epimedium , its bioactive compounds, and the biochemical and molecular mechanisms that modulate vital pathways associated with the male reproductive system. Such intrinsic knowledge will significantly further studies on the Epimedium and its bioactive compounds that protect the male reproductive system and provide some guidances for clinical treatment of related male reproductive disorders.

摘要:从淫羊藿中分离出的化合物包括淫羊藿总黄酮、淫羊藿甙及其代谢物(淫羊藿甙、淫羊藿甙Ⅰ和淫羊藿甙Ⅱ),它们具有相似的分子结构。现代药理研究和临床实践证明,淫羊藿及其有效成分具有广泛的药理作用,特别是在改善性功能、调节激素、抗骨质疏松、调节免疫功能、抗氧化、抗肿瘤等方面。迄今为止,我们仍需要全面了解淫羊藿及其生物活性化合物对男性生殖系统的药理作用。不过,近年来已经对其在其他组织中的作用进行了综述。这篇综述批判性地关注淫羊藿、其生物活性化合物以及调节与男性生殖系统相关的重要通路的生化和分子机制。这些内在知识将有助于进一步研究淫羊藿及其生物活性化合物对男性生殖系统的保护作用,并为相关男性生殖系统疾病的临床治疗提供一些指导。
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引用次数: 0
Injectable agents for the induction of Peyronie's disease in model rats: a comparative study. 用于诱导模型大鼠患佩罗尼氏病的注射剂:一项比较研究。
Pub Date : 2025-01-01 Epub Date: 2024-08-13 DOI: 10.4103/aja202430
Guang-Jun Du, Si-Yan Xing, Ning Wu, Tong Wang, Yue-Hui Jiang, Tao Song, Bai-Bing Yang, Yu-Tian Dai

Abstract: Peyronie's disease (PD) is a disorder characterized by fibrous plaque formation in the penile tissue that leads to curvature and complications in advanced stages. In this study, we aimed to compare four injectable induction agents for the establishment of a robust rat model of PD: transforming growth factor-β1 (TGF-β1), fibrin, sodium tetradecyl sulfate (STS) combined with TGF-β1, and polidocanol (POL) combined with TGF-β1. The results showed that injection of TGF-β1 or fibrin into the tunica albuginea induced pathological endpoints without causing penile curvature. The STS + TGF-β1 combination resulted in both histological and morphological alterations, but with a high incidence of localized necrosis that led to animal death. The POL + TGF-β1 combination produced pathological changes and curvature comparable to STS + TGF-β1 and led to fewer complications. In conclusion, fibrin, STS + TGF-β1, and POL + TGF-β1 all induced PD with a certain degree of penile curvature and histological fibrosis in rats. The POL + TGF-β1 combination offered comparatively greater safety and clinical relevance and may have the greatest potential for PD research using model rats.

佩罗尼氏病(PD)是一种以阴茎组织纤维斑块形成为特征的疾病,晚期会导致阴茎弯曲和并发症。在这项研究中,我们旨在比较四种注射诱导剂,以建立稳健的佩鲁尼氏病大鼠模型:转化生长因子-β1(TGF-β1)、纤维蛋白、十四烷基硫酸钠(STS)与 TGF-β1 结合使用,以及多聚十六烷醇(POL)与 TGF-β1 结合使用。结果表明,向白膜注射 TGF-β1 或纤维蛋白会诱发病理终点,但不会导致阴茎弯曲。STS + TGF-β1 组合可导致组织学和形态学改变,但局部坏死发生率高,导致动物死亡。POL + TGF-β1 组合产生的病理变化和弯曲度与 STS + TGF-β1 相当,且并发症较少。总之,纤维蛋白、STS + TGF-β1和POL + TGF-β1都能诱导大鼠出现一定程度的阴茎弯曲和组织学纤维化的PD。POL + TGF-β1 组合具有相对更高的安全性和临床相关性,在利用模型大鼠进行脊髓灰质炎研究方面可能具有最大的潜力。
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引用次数: 0
Role of pericytes in regulating penile angiogenesis and nerve regeneration. 周细胞在调节阴茎血管生成和神经再生中的作用
Pub Date : 2025-01-01 Epub Date: 2024-08-20 DOI: 10.4103/aja202455
Guo Nan Yin, Ji-Kan Ryu

Abstract: Pericytes are multifunctional mural cells that surround the abluminal wall of endothelial cells and are associated with vascular development, vascular permeability, and angiogenesis. Additionally, pericytes demonstrate stem cell-like properties and contribute to neuroinflammatory processes. Pericytes have been extensively studied in the central nervous system. However, specific mechanisms underlying its involvement in various physiological and pathological conditions, especially in erectile dysfunction (ED), remain poorly understood. Advancements in in vitro and in vitro techniques, such as single-cell RNA sequencing, are expanding our understanding of pericytes. Recent studies have shown that pericyte dysfunction is considered an important factor in the pathogenesis of vascular and neurological ED. Therefore, this study aims to analyze the specific role of pericytes in ED, focusing on diabetic and neurogenic ED. This article provides a comprehensive review of research findings on PubMed from 2000 to 2023, concerning pericyte dysfunction in the process of ED, offering valuable insights, and suggesting directions for further research.

周细胞是围绕内皮细胞腔壁的多功能壁细胞,与血管发育、血管通透性和血管生成有关。此外,周细胞还具有类似干细胞的特性,有助于神经炎症过程。对中枢神经系统中的周细胞进行了广泛的研究。然而,人们对其参与各种生理和病理状况(尤其是勃起功能障碍(ED))的具体机制仍然知之甚少。体外和体外技术(如单细胞 RNA 测序)的进步正在扩大我们对周细胞的了解。最近的研究表明,周细胞功能障碍被认为是血管性和神经性 ED 发病机制中的一个重要因素。因此,本研究旨在分析周细胞在 ED 中的特殊作用,重点关注糖尿病和神经源性 ED。本文全面综述了2000年至2023年PubMed上有关ED过程中包膜细胞功能障碍的研究成果,提出了有价值的见解,并为进一步的研究指明了方向。
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引用次数: 0
Chronic prostatitis/chronic pelvic pain syndrome induces metabolomic changes in expressed prostatic secretions and plasma. 慢性前列腺炎/慢性盆腔疼痛综合征会诱导前列腺分泌物和血浆中的代谢组发生变化。
Pub Date : 2025-01-01 Epub Date: 2024-08-09 DOI: 10.4103/aja202434
Fang-Xing Zhang, Xi Chen, De-Cao Niu, Lang Cheng, Cai-Sheng Huang, Ming Liao, Yu Xue, Xiao-Lei Shi, Zeng-Nan Mo

Abstract: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex disease that is often accompanied by mental health disorders. However, the potential mechanisms underlying the heterogeneous clinical presentation of CP/CPPS remain uncertain. This study analyzed widely targeted metabolomic data of expressed prostatic secretions (EPS) and plasma to reveal the underlying pathological mechanisms of CP/CPPS. A total of 24 CP/CPPS patients from The Second Nanning People's Hospital (Nanning, China), and 35 asymptomatic control individuals from First Affiliated Hospital of Guangxi Medical University (Nanning, China) were enrolled. The indicators related to CP/CPPS and psychiatric symptoms were recorded. Differential analysis, coexpression network analysis, and correlation analysis were performed to identify metabolites that were specifically altered in patients and associated with various phenotypes of CP/CPPS. The crucial links between EPS and plasma were further investigated. The metabolomic data of EPS from CP/CPPS patients were significantly different from those from control individuals. Pathway analysis revealed dysregulation of amino acid metabolism, lipid metabolism, and the citrate cycle in EPS. The tryptophan metabolic pathway was found to be the most significantly altered pathway associated with distinct CP/CPPS phenotypes. Moreover, the dysregulation of tryptophan and tyrosine metabolism and elevation of oxidative stress-related metabolites in plasma were found to effectively elucidate the development of depression in CP/CPPS. Overall, metabolomic alterations in the EPS and plasma of patients were primarily associated with oxidative damage, energy metabolism abnormalities, neurological impairment, and immune dysregulation. These alterations may be associated with chronic pain, voiding symptoms, reduced fertility, and depression in CP/CPPS. This study provides a local-global perspective for understanding the pathological mechanisms of CP/CPPS and offers potential diagnostic and therapeutic targets.

慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)是一种复杂的疾病,通常伴有心理健康障碍。然而,CP/CPPS 异质性临床表现的潜在机制仍不确定。本研究分析了表达性前列腺分泌物(EPS)和血浆的广泛靶向代谢组学数据,以揭示 CP/CPPS 的潜在病理机制。本研究共纳入了南宁市第二人民医院(中国南宁)的 24 名 CP/CPPS 患者和广西医科大学第一附属医院(中国南宁)的 35 名无症状对照者。研究人员记录了与 CP/CPPS 和精神症状相关的指标。通过差异分析、共表达网络分析和相关分析,确定了患者体内发生特异性改变并与 CP/CPPS 不同表型相关的代谢物。研究还进一步探讨了 EPS 与血浆之间的重要联系。CP/CPPS 患者 EPS 的代谢组学数据与对照组有显著差异。通路分析显示,EPS 中氨基酸代谢、脂质代谢和柠檬酸循环失调。研究发现,色氨酸代谢途径是与 CP/CPPS 不同表型相关的改变最明显的途径。此外,研究还发现色氨酸和酪氨酸代谢失调以及血浆中氧化应激相关代谢物的升高有效地阐明了 CP/CPPS 抑郁症的发展过程。总体而言,患者 EPS 和血浆中的代谢组学改变主要与氧化损伤、能量代谢异常、神经损伤和免疫失调有关。这些改变可能与 CP/CPPS 患者的慢性疼痛、排尿症状、生育能力下降和抑郁有关。这项研究为了解 CP/CPPS 的病理机制提供了一个局部-全球视角,并提供了潜在的诊断和治疗目标。
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引用次数: 0
Perioperative therapies and techniques to enhance penile dimensional and functional outcomes following inflatable penile prosthesis implantation: a contemporary 10-year systematic review. 可充气阴茎假体植入术后围手术期提高阴茎尺寸和功能结果的治疗和技术:当代10年系统回顾。
Pub Date : 2024-12-27 DOI: 10.4103/aja2024105
Jan Łaszkiewicz, Ettore De Berardinis, Wojciech Krajewski, Łukasz Nowak, Tomasz Szydełko, Dalila Carino, Vincenzo Asero, Roberta Corvino, Carlo Maria Scornajenghi, Gabriele Savarese, Gabriele Bignante, Felice Crocetto, Matteo Ferro, Bernardo Rocco, Maria Chiara Sighinolfi, Shufeng Li, Chiyuan Amy Zhang, Satvir Basran, Anthony Mulloy, Frank Glover, Michael Scott, Albert Sangji Ha, Michael L Eisenberg, Francesco Del Giudice

Abstract: Implantation of inflatable penile prosthesis should be considered as a definitive treatment of erectile dysfunction. However, the sole procedure might not allow for optimal dimensional and functional outcomes. The aim of this study was to systematically review the literature and present the findings on the optimal choice of perioperative methods, surgical techniques, and pharmacotherapy to improve penile length, curvature, and erectile function. Fifteen studies and 697 men were included. Nine studies focused on intraoperative techniques only, while 6 described intra- and postoperative methods. Regarding the outcomes, curvature of the penis was reported in 12 studies, penile length in 5 studies, penile girth in 2 studies, and the International Index of Erectile Function-5 (IIEF-5) score in 7 studies. According to this systematic review, extreme angulation can be reduced using plaque/corporal incisions and grafting with collagen fleece, as well as "scratch" technique with postoperative vacuum therapy. Also, among patients with preoperative curvature of approximately 30°-40°, penile plication, corporoplasty, tunica expansion procedure, manual, and at-home modeling can provide good results. In addition, corporal incisions plus grafting, as well as postoperative vacuum therapy might be the most beneficial in terms of length improvement. Importantly, penile implant in combination with the sealing, daily, and early prosthesis activation proved to improve length. Moreover, postoperative vacuum therapy has also been shown to greatly increase penile circumference. Finally, penile implant in combination with the sealing, corporal incisions plus grafting, "scratch" technique, vacuum therapy, and phosphodiesterase-5 inhibitor are all associated with major improvements in sexual function.

摘要:充气式阴茎假体的植入应被视为勃起功能障碍的最终治疗方法。然而,单一的手术可能无法获得最佳的尺寸和功能结果。本研究的目的是系统地回顾文献,并介绍围手术期方法、手术技术和药物治疗的最佳选择,以改善阴茎长度、弯曲度和勃起功能。包括15项研究和697名男性。9项研究仅关注术中技术,6项研究描述了术中和术后方法。关于结果,12项研究报告了阴茎的曲率,5项研究报告了阴茎长度,2项研究报告了阴茎周长,7项研究报告了国际勃起功能指数-5 (IIEF-5)评分。根据这篇系统综述,可以使用斑块/体表切口和胶原蛋白羊毛移植,以及术后真空治疗的“划痕”技术来减少极端角度。此外,在术前曲率约为30°-40°的患者中,阴茎扩张、体成形术、膜扩张术、手工和家庭建模均可提供良好的效果。此外,下体切口加移植以及术后真空治疗在长度改善方面可能是最有益的。重要的是,阴茎植入与密封、日常和早期假体激活相结合被证明可以改善阴茎长度。此外,术后真空治疗也显示大大增加阴茎周长。最后,阴茎植入联合封闭、下体切口加移植、“划痕”技术、真空治疗和磷酸二酯酶-5抑制剂都与性功能的重大改善有关。
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引用次数: 0
Medical treatment prior to micro-TESE. 显微tese前的医疗治疗。
Pub Date : 2024-12-24 DOI: 10.4103/aja202492
Sujoy Dasgupta, Thanh Sang Le, Amarnath Rambhatla, Rupin Shah, Ashok Agarwal

Abstract: Except in cases of hypogonadotropic hypogonadism, the use of medical therapy before microsurgical testicular sperm extraction (micro-TESE) is controversial. In some studies, hormone therapy has been shown to improve the possibility of sperm retrieval during micro-TESE and even lead to the presence of sperm in the ejaculate in some cases, thereby obviating the need for micro-TESE. However, their routine use before micro-TESE in cases of nonobstructive azoospermia (NOA) being associated with hypergonadotropic hypogonadism and eugonadism (normogonadotropic condition) has not been supported with robust evidence. In this review, we discuss different types of medical therapy used before micro-TESE for NOA, their risks and benefits, and the available evidence surrounding their use in this setting.

摘要:除促性腺功能减退症外,显微手术睾丸精子提取(micro-TESE)前的药物治疗存在争议。在一些研究中,激素治疗已被证明可以提高微tese过程中精子回收的可能性,甚至在某些情况下导致射精中存在精子,从而消除了对微tese的需要。然而,在非阻塞性无精子症(NOA)伴有促性腺功能亢进症和促性腺功能亢进症(促性腺功能正常症)的病例中,常规使用微tese之前,还没有强有力的证据支持。在这篇综述中,我们讨论了在微tese治疗NOA之前使用的不同类型的药物治疗,它们的风险和益处,以及在这种情况下使用它们的现有证据。
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引用次数: 0
Association of higher serum follicle-stimulating hormone levels with successful microdissection testicular sperm extraction outcomes in nonobstructive azoospermic men with reduced testicular volumes. 高血清促卵泡激素水平与睾丸体积减小的非阻塞性无精子症男性成功显微解剖睾丸精子提取结果的关系
Pub Date : 2024-12-24 DOI: 10.4103/aja202493
Ming-Zhe Song, Li-Jun Ye, Wei-Qiang Xiao, Wen-Si Huang, Wu-Biao Wen, Shun Dai, Li-Yun Lai, Yue-Qin Peng, Tong-Hua Wu, Qing Sun, Yong Zeng, Jing Cai

Abstract: To investigate the impact of preoperative serum follicle-stimulating hormone (FSH) levels on the probability of testicular sperm retrieval, we conducted a study of nonobstructive azoospermic (NOA) men with different testicular volumes (TVs) who underwent microdissection testicular sperm extraction (micro-TESE). A total of 177 NOA patients undergoing micro-TESE for the first time from April 2019 to November 2022 in Shenzhen Zhongshan Obstetrics and Gynecology Hospital (formerly Shenzhen Zhongshan Urology Hospital, Shenzhen, China) were retrospectively reviewed. The subjects were divided into four groups based on average TV quartiles. Serum hormone levels in each TV group were compared between positive and negative sperm retrieval subgroups. Overall sperm retrieval rate was 57.6%. FSH levels (median [interquartile range]) were higher in the positive sperm retrieval subgroup compared with the negative outcome subgroup when average TV was <5 ml (first quartile [Q1: TV <3 ml]: 43.32 [17.92] IU l-1 vs 32.95 [18.56] IU l-1, P = 0.048; second quartile [Q2: 3 ml ≤ TV <5 ml]: 31.31 [15.37] IU l-1 vs 25.59 [18.40] IU l-1, P = 0.042). Elevated serum FSH levels were associated with successful micro-TESE sperm retrieval in NOA men whose average TVs were <5 ml (adjusted odds ratio [OR]: 1.06 per unit increase; 95% confidence interval [CI]: 1.01-1.11; P = 0.011). In men with TVs ≥5 ml, larger TVs were associated with lower odds of sperm retrieval (adjusted OR: 0.84 per 1 ml increase; 95% CI: 0.71-0.98; P = 0.029). In conclusion, elevated serum FSH levels were associated with positive sperm retrieval in micro-TESE in NOA men with TVs <5 ml. In men with TV ≥5 ml, increases in average TVs were associated with lower odds of sperm retrieval.

摘要:为了探讨术前血清促卵泡激素(FSH)水平对睾丸精子提取概率的影响,我们对不同睾丸体积(TVs)的非阻塞性无精子症(NOA)男性进行了显微解剖睾丸精子提取(micro-TESE)。回顾性分析2019年4月至2022年11月深圳中山妇产医院(原深圳中山泌尿外科医院)首次行微创tese的NOA患者177例。研究对象根据电视平均四分位数分为四组。比较各电视组取精阳性亚组和取精阴性亚组血清激素水平。总体取精率为57.6%。当平均电视为时,精子恢复阳性亚组的FSH水平(中位数[四分位数范围])高于阴性亚组
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引用次数: 0
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Asian journal of andrology
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