RESUMO
Varicocele is found in approximately 20% of adults and adolescents and in 19-41% of men seeking treatment for infertility. It is associated with a decrease in sperm count as well as sperm motility and morphology. The currently accepted description of the pathophysiology of varicocele does not explain all its clinical manifestations; therefore, other factors such as genetic and epigenetic changes, associated with the environment, might be involved in causing infertility and decrease in sperm quality. It has been reported that the varicocele-induced deterioration of testicular function is progressive and interferes with fertility; hence, early and efficient assessment of the genetic manifestations in patients would be important for developing future medical interventions. Chromosomal disorders, mutations, polymorphisms, changes in gene expression, and epigenetic changes have all been reported to be associated with varicocele. Several studies are underway to unravel the genetic basis of this disease, as it is important to understand the origin and the aggravating factors to ensure appropriate guidance and intervention. Here, we review the available literature regarding the genetic and epigenetic changes associated with varicocele, and how these alterations are related to the different clinical manifestations of the disease.
Assuntos
Epigênese Genética , Infertilidade Masculina/complicações , Varicocele/genética , Fragmentação do DNA , DNA Mitocondrial/química , Humanos , Infertilidade Masculina/genética , Masculino , Estresse Oxidativo , Análise do Sêmen , Varicocele/patologia , Varicocele/fisiopatologiaRESUMO
INTRODUCTION: Obesity has become a major problem in most developed countries. Infertility ranks high among the issues brought by excessive weight gain, particularly as it may affect male sexual function. This study investigated a population of Brazilian infertile men in an attempt to establish a relationship between obesity and infertility. METHODS: A total of 153 infertile men had their anthropometric data collected and were divided into groups according to their body mass index and waist circumference measurements. Sperm parameters including sperm count, concentration, morphology, and motility were compared. RESULTS: Multivariate analysis failed to show a positive correlation between excessive weight gain or increased waist circumference, and sperm alterations in a population of infertile men. CONCLUSIONS: The findings described in this study support the idea that there is no association between obesity and semen alterations in a population of infertile men.
Assuntos
Infertilidade Masculina/complicações , Infertilidade Masculina/epidemiologia , Obesidade/complicações , Obesidade/epidemiologia , Brasil/epidemiologia , Estudos de Coortes , Humanos , Masculino , Contagem de Espermatozoides , Motilidade dos Espermatozoides , Circunferência da CinturaRESUMO
OBJECTIVE: To assess the sociodemographic profile and gynecologic and obstetric characteristics of women referred to a public reference center in Campinas, Brazil, for in vitro fertilization (IVF). METHODS: Women referred between April 1, 2008, and October 31, 2009, were eligible for inclusion in a cross-sectional study. Participants were interviewed about sociodemographic characteristics, obstetric and gynecologic history, and etiologic factors resulting in the referral. Preliminary clinical examinations performed elsewhere were evaluated. RESULTS: A total of 176 women were included, of whom 129 (73.3%) presented with tubal factor infertility. Tubal ligation had been performed in 66 (37.5%) women. Overall, 121 (68.8%) women were aged 30 years old or less, 110 (62.5%) had received more than 8 years of schooling, 123 (69.6%) had had infertility for up to 5 years, and 99 (56.3%) did not have any children. Moreover, 25 (14.2%) women had endometriosis and 25 (14.2%) had a male factor issue. A previous ectopic pregnancy was reported for 20 (11.4%) women and pelvic inflammatory disease for 49 (27.8%). CONCLUSION: Tubal factor infertility was the most common indication for IVF. Preventive measures are required, in addition to policies that ensure access to high-complexity treatments in the public sector.
Assuntos
Doenças das Tubas Uterinas/complicações , Fertilização in vitro , Infertilidade Feminina/etiologia , Setor Público , Serviços de Saúde Reprodutiva , Aborto Espontâneo/cirurgia , Adulto , Brasil , Estudos Transversais , Dilatação e Curetagem , Escolaridade , Endometriose/complicações , Feminino , Número de Gestações , Humanos , Infertilidade Masculina/complicações , Masculino , Paridade , Doença Inflamatória Pélvica/complicações , Gravidez , Esterilização Tubária/efeitos adversos , Adulto JovemAssuntos
Modelos Animais de Doenças , Hipóxia/complicações , Hipóxia/fisiopatologia , Infertilidade Masculina/complicações , Infertilidade Masculina/fisiopatologia , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/fisiopatologia , Animais , Feminino , Humanos , Masculino , GravidezRESUMO
The presence of classical components of the renin-angiotensin system has been demonstrated in the male reproductive tract, mainly in the testes and epididymis. The objective of this study was to verify the localization of angiotensin (Ang)-(1-7) and its receptor Mas in human testis. The study included 12 men with previously proven fertility submitted to orchiectomy for prostate cancer and 20 infertile men submitted to testicular biopsy for infertility work-up, comprising a subgroup with obstructive azoospermia/normal spermatogenesis (n = 8) and another with non-obstructive azoospermia and severely impaired spermatogenesis (n = 12). Testicular tissue samples were processed by immunohistochemistry and real time polymerase chain reaction. Ang-(1-7) was strongly expressed in the interstitial compartment, mainly in Leydig cells, with similar intensity in all groups evaluated. The peptide was also detected in the seminiferous tubules, but with much less intensity compared to interstitial cells. The receptor Mas was equally distributed between interstitial and tubular compartments and was found in all layers of the normal seminiferous epithelium. However, neither Ang-(1-7) nor Mas were detected in the seminiferous tubules of samples with impaired spermatogenesis. The testicular samples of infertile men with impaired spermatogenesis (non-obstructive azoospermia) expressed Mas and ACE2 mRNA at lower concentrations (fold change = 0.06 and 0.04, respectively, P < 0.05) than samples with full spermatogenesis (obstructive azoospermia). This shows, for the first time, the immunolocalization of Ang-(1-7) and its receptor Mas in testes of fertile and infertile men, and suggests that this system may be altered when spermatogenesis is severely impaired.
Assuntos
Angiotensina I/metabolismo , Infertilidade Masculina/genética , Infertilidade Masculina/patologia , Fragmentos de Peptídeos/metabolismo , Proteínas Proto-Oncogênicas/metabolismo , Receptores Acoplados a Proteínas G/metabolismo , Testículo/metabolismo , Testículo/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiotensina I/genética , Enzima de Conversão de Angiotensina 2 , Azoospermia/complicações , Azoospermia/enzimologia , Azoospermia/genética , Azoospermia/patologia , Biópsia , Regulação da Expressão Gênica , Humanos , Infertilidade Masculina/complicações , Infertilidade Masculina/enzimologia , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/genética , Peptidil Dipeptidase A/genética , Peptidil Dipeptidase A/metabolismo , Transporte Proteico , Proto-Oncogene Mas , Proteínas Proto-Oncogênicas/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptores Acoplados a Proteínas G/genética , Testículo/enzimologia , Adulto JovemRESUMO
Male infertility is a common barrier that prevents successful conception. There have been reports of azoospermia in men with familial Mediterranean fever, some of whom had not been treated with colchicine. Variation in this disorder could be a risk factor for amyloidosis associated with azoospermia. We determined the frequency of 6 of the most common Mediterranean fever gene mutations, M680I, M694V, M694I, V726A, P369S, and A744S, in 74 infertile men, 155 men diagnosed with familial Mediterranean fever and 55 healthy fertile men in eastern Turkey. All three groups were screened for the 6 mutations using an amplification refractory mutation system and restriction fragment length polymorphism methods. Allelic frequencies were 2.7% for M694V and 1.35% for V726A in the infertile patient group and 1.8% for M694V and 1.8% for V726A in healthy subjects. Other mutations were not detected in patients or controls. The mutation frequency was not found to be significantly higher in infertile patients when compared with healthy fertile male controls. To our knowledge, this is the first study to determine the frequency of Mediterranean fever gene mutations in infertile male and the infertility rate of male patients with familial Mediterranean fever.
Assuntos
Proteínas do Citoesqueleto/genética , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/genética , Infertilidade Masculina/complicações , Infertilidade Masculina/genética , Mutação/genética , Adolescente , Adulto , Alelos , Estudos de Casos e Controles , Análise Mutacional de DNA , Humanos , Masculino , Pessoa de Meia-Idade , Pirina , Turquia , Adulto JovemRESUMO
BACKGROUND: It has been consistently demonstrated that infertility is associated with quality of life (QOL) impairments. Research to date has mostly focused on individual's reactions to infertility (mainly women), without an examination of how the partner is reacting to the same condition. The few studies that assessed QOL among couples did not use couple-based analyses, consequently not considering the intra-couple effects. The objectives of this study were to explore the congruence of QOL perception within infertile couples and to estimate the effect of depression levels on the congruence. METHODS: In total, 162 couples were interviewed in an assisted reproduction clinic cross-sectionally. Subjects completed a socio-demographic form, World Health Organization Quality of Life-BREF and the Beck Depression Inventory independently. The statistical strategy was guided to ensure that subjects would be explored within pairs at all times and not as independent groups. Paired t-tests were run, and Cohen's effect was estimated. Depression levels were controlled by linear multiple regressions and repeated-measures ANCOVAs. RESULTS: Out of the five QOL domain scores, only two showed a significant discrepancy between partners (psychological and social relationship domains). Male depression was a significant predictor for all five QOL difference scores, whereas female depression was associated with three (overall, psychological and physical). Moreover, it was demonstrated that, except for the psychological domain and for the female depression on the physical domain, the load of depression as a predictor of the QOL difference scores was markedly low, accounting for not more than 7.5% of the variance of congruence between men's and women's QOL. CONCLUSION: Our findings suggest that QOL scores do not differ markedly between spouses. Since QOL seemed similarly affected in both men and women, consideration might be given to offering interventions to them as a dyad. These results are not in line with the previous non-paired studies, and further investigations are required to address this dissimilarity.
Assuntos
Características da Família , Infertilidade/psicologia , Qualidade de Vida/psicologia , Adulto , Estudos Transversais , Transtorno Depressivo/etiologia , Transtorno Depressivo/psicologia , Feminino , Humanos , Infertilidade/complicações , Infertilidade Feminina/complicações , Infertilidade Feminina/psicologia , Infertilidade Masculina/complicações , Infertilidade Masculina/psicologia , Masculino , Estudos ProspectivosRESUMO
The aim of this study was to describe the ultrastructural features observed in semen samples of men with infertility and subfertility of unknown cause infected with Chlamydia trachomatis and mycoplasmas. The findings observed by ultrastructure included destruction or persistence of bacteria in leukocytes, phagocytosis of spermatozoa by leukocytes, and structural damage of spermatozoa.
Assuntos
Infecções por Chlamydia/patologia , Chlamydia trachomatis/ultraestrutura , Infertilidade Masculina/patologia , Infecções por Mycoplasma/patologia , Espermatozoides/ultraestrutura , Adulto , Infecções por Chlamydia/complicações , Infecções por Chlamydia/microbiologia , Chlamydia trachomatis/patogenicidade , Humanos , Infertilidade Masculina/complicações , Leucócitos/microbiologia , Leucócitos/ultraestrutura , Masculino , Pessoa de Meia-Idade , Infecções por Mycoplasma/complicações , Infecções por Mycoplasma/microbiologia , Fagocitose , Espermatozoides/microbiologia , Adulto JovemRESUMO
OBJECTIVE: To evaluate whether increasing antioxidant intake in men with high levels of DNA damage or lipid peroxidation improves gestational results in couples with history of recurrent embryo loss. DESIGN: Descriptive study (case series). SETTING: Early recurrent embryo loss program at the University of Antioquia, Medellín, Colombia. PATIENT(S): Seventeen men whose spouses had a history of two or more embryo losses before 12 weeks of gestation. INTERVENTION(S): Male partners with increased DNA fragmentation index (%DFI) or high thiobarbituric acid reactive substances (TBARS) were instructed to consume a diet rich in antioxidants or commercial multivitamins containing beta-carotene, vitamin C, vitamin E, and zinc for at least 3 months. MAIN OUTCOME MEASURE(S): Pregnancy outcome was recorded in the spouses of men with increased %DFI or TBARS who received antioxidant supplementation. RESULTS: Of the 17 men, 9 (53%) presented with an increased %DFI or TBARS. They were started on an antioxidant supplementation regimen. Of these nine men, six of their spouses became pregnant. All couples whose male partners accepted antioxidant supplementation achieved a successful pregnancy. CONCLUSIONS: Our study demonstrates the benefits of an increased intake of antioxidant-rich food or antioxidant supplements by men who show high levels of sperm DNA fragmentation or lipid peroxidation, which could result in an improvement in gestational outcomes in couples with history of recurrent embryo losses.
Assuntos
Antioxidantes/administração & dosagem , Dano ao DNA/efeitos dos fármacos , Perda do Embrião/prevenção & controle , Infertilidade Masculina/prevenção & controle , Resultado da Gravidez , Motilidade dos Espermatozoides/efeitos dos fármacos , Espermatozoides/efeitos dos fármacos , Administração Oral , Perda do Embrião/etiologia , Feminino , Humanos , Infertilidade Masculina/complicações , Infertilidade Masculina/diagnóstico , Masculino , Gravidez , Fatores Sexuais , Resultado do TratamentoRESUMO
Seminal vesiculitis is generally not investigated in infertile men, since it is uncommon and often nonspecific in signs and symptoms. In this article, the author reports an unusual presentation of seminal vesiculitis, incidentally diagnosed in a man referred for semen analysis to investigate infertility. Analyses of physical properties of the ejaculate (coagulation, liquefaction, volume, viscosity and pH) and of biochemical markers of the prostate (total calcium and zinc) and seminal vesicle (fructose and inorganic phosphorus) detected a dysfunction of the seminal vesicles that was subsequently diagnosed as vesiculitis using transrectal ultrasound. After treatment with a single 500-mg dose of oral ciprofloxacin, the patient was referred again for semen analysis. The analysis showed considerable improvement of the seminal vesicle function. The clinical significance of these findings is discussed.