Research Articles/Case Summaries (November): Advances in Reproductive Health

This November compilation brings together a selection of research articles and case summaries that shed light on cutting-edge developments in reproductive health. From optimizing sperm cryopreservation techniques to understanding the genetic and environmental factors influencing fertility, these studies offer crucial insights for both clinical practice and future research.

1. The Beneficial Role of Low PVP Concentration on Sperm Apoptotic Gene Expression, Embryo Morphokinetics Status, and Clinical ICSI Outcomes

Synopsis: Research indicates that using a lower concentration of Polyvinylpyrrolidone (PVP), specifically 5%, significantly reduces apoptosis rates in sperm cells. This concentration not only enhances embryo quality and sperm DNA integrity but also improves clinical outcomes in Intracytoplasmic Sperm Injection (ICSI) settings. Additionally, timing analysis and cleavage abnormality assessments show that 5% PVP correlates with better embryo kinetics compared to 10% PVP. Therefore, 5% PVP is recommended as a suitable alternative for routine use in cases of male infertility, as it demonstrates less detrimental effects on sperm viability and function compared to higher concentrations.

2. Fish Consumption Once a Week Improves Sperm Quality and Testosterone Levels

Synopsis: Moderate fish consumption positively influences sperm quality and testosterone levels, increasing sperm volume and reducing non-progressive spermatozoa without affecting overall sperm count. In contrast, high fish intake may lead to decreased sperm quality. These findings suggest that optimizing fish and seafood recommendations could benefit specific groups, such as overweight and obese men with poor sperm parameters. Further research is needed to explore the effects of controlled fish intake on semen quality and male fertility.

3. A novel solution for freezing individual spermatozoa using a right angular cryopiece embedded in a grooved petri dish

Synopsis: The SpermCD is an innovative sperm freezing device that allows for simultaneous sperm transfer and ICSI. In a study of 35 patients, it achieved a 97.1% sperm recovery rate after thawing. Out of 65 injected MII oocytes, fertilization and high-quality embryo rates were 68% and 24.4%, respectively, resulting in four successful deliveries from eight implanted embryos. SpermCD proves to be a practical tool for sperm cryopreservation in assisted reproduction.

4. Chromosome 17 translocation affects sperm morphology: Two case studies and literature review

Synopsis: This study reports two cases of infertile males with teratozoospermia due to chromosome 17 translocation, revealing novel karyotypes. Gene analysis indicates that interactions among ALKBH5, TOP3A, and LLGL1 may cause abnormal sperm morphology, while associated genes contribute to oligozoospermia and asthenozoospermia. The findings highlight chromosome translocation as a risk factor for sperm abnormalities and recommend preimplantation genetic diagnosis for couples to reduce the likelihood of unbalanced karyotypes in future pregnancies.

5. Targeting soluble guanylate cyclase with Riociguat has potency to alleviate testicular ischaemia reperfusion injury via regulating various cellular pathways

Synopsis: This study examines the effects of Riociguat, a soluble guanylate cyclase (sGC) stimulator, on testicular ischemia-reperfusion (I/R) injury in rats. Twenty-one male rats were divided into Control, I/R, and Riociguat-treated (IRR) groups. After inducing 3 hours of ischemia through testicular rotation, Riociguat was administered before reperfusion. The results indicated that Riociguat significantly reduced tissue malondialdehyde levels and pro-apoptotic proteins while increasing anti-apoptotic Bcl-2 expression. Additionally, it modulated pro-inflammatory cytokine IL-1β levels and decreased NF-κB activity. These findings suggest that targeting sGC may help alleviate oxidative stress, inflammation, and apoptosis in testicular I/R injury, warranting further investigation into its protective mechanisms.

6. A new diagnostic definition for patients with lower urinary tract symptoms evaluated by corpus cavernosum electromyography: ‘Pelvic autonomic dysfunction’

Synopsis: This study evaluates corpus cavernosum electromyography (CC-EMG) as a diagnostic tool for pelvic autonomic dysfunction (PAD) in patients with lower urinary tract symptoms (LUTS) and erectile dysfunction (ED). Among 50 patients, those with PAD (Group 1) showed significantly lower urodynamic parameters and International Index of Erectile Function (IIEF) scores compared to those without PAD (Group 2). The mean relaxation degree was notably lower in Group 1, indicating impaired autonomic function. The findings suggest that CC-EMG effectively identifies PAD and associated cavernous autonomic dysfunction.

7. Association between international index of erectile function-5 scores and circadian patterns of newly diagnosed hypertension in erectile dysfunction patients

Synopsis: This study explores the relationship between erectile dysfunction (ED) and circadian patterns of newly diagnosed hypertension in 371 patients aged 30-70 years. Among these, 125 patients were identified with newly diagnosed hypertension, categorized into dippers and non-dippers based on ambulatory blood pressure monitoring. Results indicated that non-dippers had significantly lower erectile function scores (IIEF-5: 11.5 vs. 14.4) and higher serum creatinine levels compared to dippers. The findings suggest that non-dipping hypertension is associated with poorer erectile function and that IIEF-5 scores may serve as independent risk factors for this condition.

8. Elastography and contrast-enhanced ultrasound to assess the effect of varicocelectomy: A case-controlled study

Synopsis: This case-controlled study evaluated changes in testicular stiffness and microcirculation following spermatic vein ligation in 27 patients with grade III left varicocele. Using shear wave elastography and contrast-enhanced ultrasound, it was found that the shear wave velocity of the left internal parenchyma decreased from 1.10 ± 0.06 m/s to 1.09 ± 0.06 m/s post-ligation, indicating softer testicular parenchyma. The left epididymis exhibited higher peak intensity and washout area compared to the right, suggesting improved perfusion of the internal testicular parenchyma but temporary stasis in the epididymis. Overall, spermatic vein ligation enhanced blood flow to the testis while affecting epididymal function.

9. Assessment of the potential toxic effect of magnetite nanoparticles on the male reproductive system based on immunological and molecular studies

Synopsis: This research investigates the immunotoxic and reproductive toxic effects of magnetite nanoparticles (MNPs) in male rats, involving 36 adult albino rats divided into three groups. The experimental groups received intraperitoneal injections of MNPs at doses of 5 and 10 mg/kg body weight three times a week for 60 days, while a control group received saline. Results showed significant reductions in body weight, lymphocyte proliferation, testosterone levels, and sperm parameters, along with increased malondialdehyde levels and testicular DNA damage. The study concludes that MNPs adversely affect the immune system and reproductive health in male rats by inducing oxidative stress and damaging testicular function.

10. Trabectedin (ET-743) in prostate cancer: Endoplasmic reticulum stress-induced apoptotic effect

Synopsis: This study investigates the DNA-independent mechanisms of trabectedin, a chemotherapy agent, in prostate cancer (PCa) cells. Trabectedin was found to induce cytotoxicity and cell cycle arrest at the G2/M phase, while decreasing mitochondrial membrane potential through reactive oxygen species (ROS) generation. Additionally, the treatment elevated levels of endoplasmic reticulum (ER) stress-related proteins, indicating the induction of ER stress and apoptosis. The findings suggest that trabectedin may be an effective chemotherapeutic option for prostate cancer by triggering oxidative stress and promoting cell death through ER stress pathways.

11. Relaxation mechanisms of chloroform root extracts of Prangos heyniae and Prangos uechtritzii on mouse corpus cavernosum

Synopsis: This study investigates the relaxant effects of chloroform root extracts from Turkish endemic plants Prangos heyniae and Prangos uechtritzii on mouse corpus cavernosum, focusing on their potential as treatments for erectile dysfunction (ED). Using isolated organ bath experiments, the researchers found that the extract from P. heyniae (Ph-CE) induced significant relaxations that were inhibited by nitric oxide (NO) and hydrogen sulfide (H2S) synthesis inhibitors, indicating these pathways are involved in its mechanism. In contrast, the extract from P. uechtritzii (Pu-CE) did not show similar dependency on NO and H2S but effectively reduced contractions induced by calcium and potassium. The findings suggest that these extracts may offer therapeutic benefits for ED by directly relaxing smooth muscle and enhancing vasodilatory pathways.

12. The effect of green coffee and/or endurance exercise on sperm function in pre-diabetic mice

Synopsis: This study investigates the effects of green coffee (GC), chlorogenic acid (CA), and exercise on spermatogenesis and sperm function in pre-diabetic mice. Results indicated that pre-diabetic conditions adversely affected sperm parameters, including concentration and motility, while exercise improved sperm motility. GC alone enhanced motility in pre-diabetic mice, but CA did not show beneficial effects on its own; however, CA combined with exercise significantly improved motility to levels comparable to the control group. The findings suggest that GC supplementation may help reduce DNA damage in high-DNA-damage scenarios, while CA combined with exercise could be a viable alternative for addressing asthenozoospermia.

13. A mixture of pyrethroids induces reduced fecundity and increased testicular genotoxicity in rats

Synopsis: This study investigates the long-term effects of pyrethroid exposure on male reproductive health by administering a mixture of pyrethroids found in Indian agricultural products to male rats over 15 months. The results indicated significant reductions in fecundity, sperm count, and the activity of the enzyme 13β-hydroxysteroid dehydrogenase, alongside alterations in serum hormone concentrations related to male reproductive function. Additionally, testicular genotoxicity was observed, evidenced by changes in gene expression involved in gametogenesis. These findings suggest that chronic exposure to pyrethroids through contaminated food may negatively impact reproductive health in humans, similar to the effects seen in the animal model.

14. Determining the expression levels of CSF-1 and OCT4, CREM-1, and protamine in testicular biopsies of adult Klinefelter patients: Their possible correlation with spermatogenesis

Synopsis: This study investigates the expression of premeiotic, meiotic, and post-meiotic markers in testicular biopsies from Klinefelter syndrome (KS) patients who lack mature sperm. It was found that even in biopsies classified as Sertoli cell-only (SCO), markers such as OCT4 and CSF-1 correlated positively with the presence of meiotic and post-meiotic cells, suggesting that these markers could serve as predictors for sperm retrieval. The research highlights that conventional hormonal assessments are not reliable indicators of mature sperm presence, and emphasizes the potential of using RNA expression analysis to improve predictions for sperm retrieval outcomes in KS patients. The authors advocate for larger studies to validate these findings and enhance diagnostic precision for non-obstructive azoospermia patients considering sperm retrieval options.

15. Kisspeptin-10 in cryodiluent improves the post-thaw quality of Nili-Ravi buffalo (Bubalus bubalis) bull spermatozoa

Synopsis: The study evaluates the effects of kisspeptin-10 as an antioxidant in cryodiluent on the post-thaw quality of buffalo spermatozoa. Semen samples from five bulls were pooled and treated with varying doses of kisspeptin-10 (5, 10, 15, and 20 μmol L−1) before cryopreservation. Results showed that the highest levels of catalase, peroxidase, and reduced glutathione were observed with 20 μmol L−1 kisspeptin-10, which also significantly reduced lipid peroxidation. Additionally, sperm motility, viability, and DNA integrity improved with kisspeptin-10 treatment, particularly at doses of 15 and 20 μmol L−1, indicating that kisspeptin-10 enhances the overall quality of frozen-thawed buffalo spermatozoa.

16. Influence on the adult male Leydig cell biomarker insulin-like peptide 3 of maternal exposure to estrogenic and anti-androgenic endocrine disrupting compound mixtures: A retrospective study

Synopsis: Maternal exposure to endocrine-disrupting chemicals (EDCs) has been linked to various adverse effects on male reproductive health, including altered puberty timing, reduced sperm counts, and increased incidence of conditions like cryptorchidism. While many studies have documented these associations, there is currently no clear link between early EDC exposure and adult testosterone levels, likely due to compensatory mechanisms in the hypothalamic-pituitary-gonadal (HPG) axis. The study highlights the use of INSL3 as a reliable biomarker for Leydig cell function, revealing that maternal exposure to certain EDCs did not significantly affect adult INSL3 levels, except for a mixture of bisphenol A and butylparaben, suggesting potential interactions between these compounds. Overall, while individual EDCs may have limited effects, mixtures could influence Leydig cell development and function, warranting further investigation into their long-term impacts on male reproductive health.

17. Shear wave elastography for the evaluation of testicular salvage after testicular torsion

Synopsis: This study assesses the utility of shear wave elastography (SWE) in monitoring testicular detorsion and its long-term outcomes, focusing on tissue stiffness values, pain duration, and torsion type. Conducted on 24 patients with a mean age of 21.1 years, the study found excellent inter-observer reliability for measuring testicular elasticity (ICC: 0.939). Results indicated that while there were no significant differences in testicular volume or speed mode values between the salvage group and controls, tissue stiffness was higher in cases of complete torsion compared to incomplete torsion. The findings suggest that SWE is a valuable complementary imaging technique for evaluating testicular health post-torsion, aiding in the differentiation of focal lesions from malignant conditions.

18. The effect of aromatase inhibitors against possible testis toxicity in pembrolizumab treated rats

Synopsis: This study investigates the protective effects of anastrozole and resveratrol against reproductive damage induced by pembrolizumab in Sprague-Dawley rats. Forty-two rats were divided into six groups: control, pembrolizumab (PEMB), PEMB with anastrozole (ANAST), PEMB with resveratrol (RES), RES alone, and ANAST alone. Results showed that pembrolizumab treatment significantly increased oxidative stress markers while decreasing antioxidant levels, sperm motility, and testosterone levels. However, both anastrozole and resveratrol mitigated these adverse effects, indicating their potential as protective agents against pembrolizumab-induced reproductive toxicity.

19. ANXA2, SP17, SERPINA5, PRDX2 genes, and sperm DNA fragmentation differentially represented in male partners of infertile couples with normal and abnormal sperm parameters

Synopsis: This study evaluates the expression of genes related to fertilization potential, embryo development, sperm DNA fragmentation (SDF), and acrosome reaction in male partners of infertile couples with varying sperm parameters compared to fertile men. It involved 25 men with abnormal sperm parameters, 25 with normal sperm parameters, and 10 fertile controls. Results indicated significantly lower expression of the SP17 gene in both experimental groups, while SERPINA5 was down-regulated in men with abnormal sperm, correlating with a low acrosome reaction rate. Additionally, both experimental groups exhibited higher SDF rates compared to controls, suggesting that SP17 could serve as a diagnostic biomarker for male infertility regardless of sperm quality, and highlighting SDF as an independent factor contributing to male infertility.

20. Evaluation of cell-free seminal mRNA for the diagnosis of obstruction as the cause of azoospermia in infertile men: A prospective cohort study

Synopsis: This study evaluates the efficacy of cell-free seminal markers DDX4, PRM1, and PRM2 in differentiating between obstructive azoospermia (OA) and non-obstructive azoospermia (NOA) in infertile men. The results indicate that DDX4 is more sensitive for diagnosing NOA, particularly in cases of maturation arrest and hypospermatogenesis, while PRM1 and PRM2 showed low positivity rates. The findings suggest that these seminal markers could serve as non-invasive diagnostic tools for identifying the causes of azoospermia, although further validation through long-term studies is necessary.