Luca Boeri, Edoardo Pozzi, Federico Belladelli, Christian Corsini, Simone Cilio, Alessandro Bertini, Francesco Lanzaro, Luigi Candela, Massimiliano Raffo, Fausto Negri, Ludovica Cella, Margherita Fantin, Giuseppe Fallara, Paolo Capogrosso, Alessia d'Arma, Francesco Montorsi, Andrea Salonia
{"title":"每两名特发性不育男性中，就有一人的精子DNA碎片值达到病理水平：对临床实践的潜在影响","authors":"Luca Boeri, Edoardo Pozzi, Federico Belladelli, Christian Corsini, Simone Cilio, Alessandro Bertini, Francesco Lanzaro, Luigi Candela, Massimiliano Raffo, Fausto Negri, Ludovica Cella, Margherita Fantin, Giuseppe Fallara, Paolo Capogrosso, Alessia d'Arma, Francesco Montorsi, Andrea Salonia","doi":"10.1111/cen.15093","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>To investigate the distribution of sperm DNA fragmentation (SDF) values and their association with clinical and seminal parameters in idiopathic infertile men.</p>\n </section>\n \n <section>\n \n <h3> Design, Patients, Measurements</h3>\n \n <p>Data from 3224 primary infertile men (belonging to couples having failed to conceive a pregnancy within 12 months) who underwent a thorough diagnostic work-up were analysed. A SDF value ≥ 30% (according to Sperm Chromatin Structure Assay) was considered pathologic. We excluded: (1) men with genetic abnormalities; (2) men with history of cryptorchidism; (3) men with biochemical hypogonadism; (4) men with clinical varicocele; and (5) men with other possible known aetiological factors. Descriptive statistics and logistic regression analyses were used to describe the whole cohort.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Of all, 792 (23%) men with at least one abnormal WHO semen parameter but without any identified aetiologic factor for infertility, were considered as idiopathic infertile men. Of 792, 418 (52.7%) men had SDF ≥30%. Men with pathologic SDF were older (<i>p</i> = .02), had higher Follicle-stimulating hormone (FSH) (<i>p</i> = .04) but lower total testosterone (<i>p</i> = .03) values than those with SDF <30%. The homoeostatic model assessment index for insulin resistance (HOMA-IR) was higher in men with SDF ≥30% (<i>p</i> = .01). Idiopathic infertile men with SDF ≥30% presented with lower sperm concentration (<i>p</i> < .001) and lower progressive sperm motility (<i>p</i> < .01) than those with SDF < 30%. Logistic regression analysis revealed that older age (OR: 1.1, <i>p</i> = .02) and higher HOMA-IR score (OR: 1.8, <i>p</i> = .03) were associated with SDF ≥ 30%, after accounting for FSH and sperm concentration values.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Approximately half of infertile men categorized as idiopathic had pathologic SDF values. Idiopathic infertile men with pathologic SDF showed worse clinical, hormonal and semen parameters than those with normal SDF values. These results suggest that including SDF testing could be clinically relevant over the real-life management work-up of infertile men.</p>\n </section>\n </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"One out of two idiopathic infertile men has pathologic sperm DNA fragmentation values: Potential implications for clinical practice\",\"authors\":\"Luca Boeri, Edoardo Pozzi, Federico Belladelli, Christian Corsini, Simone Cilio, Alessandro Bertini, Francesco Lanzaro, Luigi Candela, Massimiliano Raffo, Fausto Negri, Ludovica Cella, Margherita Fantin, Giuseppe Fallara, Paolo Capogrosso, Alessia d'Arma, Francesco Montorsi, Andrea Salonia\",\"doi\":\"10.1111/cen.15093\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>To investigate the distribution of sperm DNA fragmentation (SDF) values and their association with clinical and seminal parameters in idiopathic infertile men.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design, Patients, Measurements</h3>\\n \\n <p>Data from 3224 primary infertile men (belonging to couples having failed to conceive a pregnancy within 12 months) who underwent a thorough diagnostic work-up were analysed. A SDF value ≥ 30% (according to Sperm Chromatin Structure Assay) was considered pathologic. We excluded: (1) men with genetic abnormalities; (2) men with history of cryptorchidism; (3) men with biochemical hypogonadism; (4) men with clinical varicocele; and (5) men with other possible known aetiological factors. Descriptive statistics and logistic regression analyses were used to describe the whole cohort.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>Of all, 792 (23%) men with at least one abnormal WHO semen parameter but without any identified aetiologic factor for infertility, were considered as idiopathic infertile men. Of 792, 418 (52.7%) men had SDF ≥30%. Men with pathologic SDF were older (<i>p</i> = .02), had higher Follicle-stimulating hormone (FSH) (<i>p</i> = .04) but lower total testosterone (<i>p</i> = .03) values than those with SDF <30%. The homoeostatic model assessment index for insulin resistance (HOMA-IR) was higher in men with SDF ≥30% (<i>p</i> = .01). Idiopathic infertile men with SDF ≥30% presented with lower sperm concentration (<i>p</i> < .001) and lower progressive sperm motility (<i>p</i> < .01) than those with SDF < 30%. Logistic regression analysis revealed that older age (OR: 1.1, <i>p</i> = .02) and higher HOMA-IR score (OR: 1.8, <i>p</i> = .03) were associated with SDF ≥ 30%, after accounting for FSH and sperm concentration values.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Approximately half of infertile men categorized as idiopathic had pathologic SDF values. Idiopathic infertile men with pathologic SDF showed worse clinical, hormonal and semen parameters than those with normal SDF values. These results suggest that including SDF testing could be clinically relevant over the real-life management work-up of infertile men.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10346,\"journal\":{\"name\":\"Clinical Endocrinology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-06-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Endocrinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cen.15093\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cen.15093","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
One out of two idiopathic infertile men has pathologic sperm DNA fragmentation values: Potential implications for clinical practice
Objectives
To investigate the distribution of sperm DNA fragmentation (SDF) values and their association with clinical and seminal parameters in idiopathic infertile men.
Design, Patients, Measurements
Data from 3224 primary infertile men (belonging to couples having failed to conceive a pregnancy within 12 months) who underwent a thorough diagnostic work-up were analysed. A SDF value ≥ 30% (according to Sperm Chromatin Structure Assay) was considered pathologic. We excluded: (1) men with genetic abnormalities; (2) men with history of cryptorchidism; (3) men with biochemical hypogonadism; (4) men with clinical varicocele; and (5) men with other possible known aetiological factors. Descriptive statistics and logistic regression analyses were used to describe the whole cohort.
Results
Of all, 792 (23%) men with at least one abnormal WHO semen parameter but without any identified aetiologic factor for infertility, were considered as idiopathic infertile men. Of 792, 418 (52.7%) men had SDF ≥30%. Men with pathologic SDF were older (p = .02), had higher Follicle-stimulating hormone (FSH) (p = .04) but lower total testosterone (p = .03) values than those with SDF <30%. The homoeostatic model assessment index for insulin resistance (HOMA-IR) was higher in men with SDF ≥30% (p = .01). Idiopathic infertile men with SDF ≥30% presented with lower sperm concentration (p < .001) and lower progressive sperm motility (p < .01) than those with SDF < 30%. Logistic regression analysis revealed that older age (OR: 1.1, p = .02) and higher HOMA-IR score (OR: 1.8, p = .03) were associated with SDF ≥ 30%, after accounting for FSH and sperm concentration values.
Conclusions
Approximately half of infertile men categorized as idiopathic had pathologic SDF values. Idiopathic infertile men with pathologic SDF showed worse clinical, hormonal and semen parameters than those with normal SDF values. These results suggest that including SDF testing could be clinically relevant over the real-life management work-up of infertile men.
期刊介绍：
Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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