The factors affecting male infertility: A systematic review

Background: In recent years, the incidence of male infertility has increased worldwide. It is necessary to study the factors that influence male infertility in each area/region for better management. Objective: To determine the factors affecting male infertility in the Iranian male population. Materials and Methods: An online search was conducted in electronic databases including PubMed, Google Scholar, SID, and Scopus to identify articles on the factors associated with male infertility, published in English and Persian. The keywords used to perform the search included “factor”, “epidemiology”, “causes of infertility”, and “male infertility”. The search was conducted without a time restriction, up to April 2020. Results: The search resulted in a total number of 691 studies. After an assessment of the articles, finally 14 studies were included in this study with a total number of 26,324 infertile males. The factors associated with male infertility included semen abnormalities, varicocele and testis disorder, smoking, exposure to heat, obesity, anabolic steroids, vascular abnormalities, anti-spermatogenesis factors, antidepressants, taking ranitidine and cimetidine, penile discharge and genital ulcers, painful micturition, occupational factors, alcohol, chronic disease, sexual disorder, Surgical and urological diseases, genetic factors and herpes infection. Among these, the semen and varicocele disorders were common in most studies. Conclusion: The present review suggests that the factors affecting male infertility in Iran are similar to those reported from other countries. The results of this study can be used in adopting appropriate strategies for infertility management in Iran. Key words: Male, Infertility, Sterility, Urogenital diseases.

Spontaneous pregnancies and determinant factors in infertility: A cross-sectional study

Background: The phenomenon of infertility may be derived from different factors - either in males or females or both genders, including few unexplained factors. It is generally managed by medical and surgical treatments. Objective: To find a relation of occurrence of spontaneous pregnancy (SP) with effective factors in infertility. Materials and Methods: This cross-sectional study was conducted at two referral infertility centers (university and privacy center) in the southwest of Iran from March 2015 and March 2016 on 655 infertile couples, who were divided in two groups of with (n = 31) and without (n = 624) SP. The variables included female and male age, male smoking, male job, the place of living, the causes of infertility, the type and duration of infertility, and the subgroups of infertility causes. Results: Infertility may be caused due to both male- and female- related factors (47.5%). While female-related infertility was found in 31.5%, male-related infertility in 14.5%, and infertility due to unexplained factors in 6.6% of our patients. The rate of SP was 4.7%, which had a significant relation with the duration of infertility (p = 0.01), with women’s age (p = 0.048), unexplained infertility (p = 0.001), and husband’s job (p = 0.004). Conclusion: The occurrence of SP in infertile couples was related to age of the female partner, the duration of unexplained infertility, and the male partner’s job. Key words: Male infertility, Female infertility, Spontaneous pregnancy, Epidemiology, Etiology.

Strategies for whole-exome sequencing analysis in a case series study of familial male infertility

Background: Infertility is one of the common health issues around the world. The prevalence of male factor infertility among infertile couples is approximately 30%- 35%, of which genetic factors account for 15%. The family-based whole-exome sequencing (WES) approach can accurately detect novel variants. However, selecting an appropriate sample for data generation using WES has proven to be challenging in familial male infertility studies. The aim of this study was to identify types of pathogenic male infertility in cases of familial asthenozoospermia. Case: Two families with multiple cases were recruited for the purpose of WES. The study population included two affected cases in pedigree I and three affected cases in pedigree II. Two different variant callers (SAMtools and GATK) with a single-sample calling strategy (SSCS) and a multiple-sample calling strategy (MSCS), were applied to identify variant sites. Conclusion: In this study, we represented the results for variant prioritization of WES data without sequencing fertile siblings in the same pedigree by applying two different pipelines (homozygosity and linkage-based strategy). Using the aforementioned strategies, we prioritized annotated variants and generated a logical shortlist of private variants for each pedigree. Key words: Male infertility, Whole-exome sequencing, GATK, SAMtools.

The value of risk factors in infertile men in the aspect of choice of assisted reproductive technologies to renew fertility in married couples

The objective: the rationalization of a personalized approach to the selection of the program art on the basis of the allocation of risk. Patients and methods. Were analyzed 180 couples with male factor infertility, which in 2012-2015, in the Institute of reproductive medicine (IRM) (Kiev) was held the program of intracytoplasmic sperm injection (ICSI) with the aim of restoring fertility. Examination and ICSI procedure is carried out in accordance with clinical protocols. Results. According to the results of analytical and synthetic analysis of primary documents (enhanced, adapted to the purpose of the work of the medical record) were identified risk factors (and their signs) for the development of male infertility and grouped by direction of impact. As a result, 25 of the 51 factors and their basis formed three groups: social (behavioral), biological/clinical and special medical. With the help of mathematical analysis it was determined the boundary values of the minimum and maximum of reliability of the negative result of the application of ART. Conclusion. It was proposed the predictive map for the determination of the probability of pregnancy in couples with male infertility problems with the application of ART. Was justified the separation of three risk groups to restore fertility in couples with male factor infertility using ART. Was based the principle of personalized approach to choosing the best program of art-based stratification of men at risk groups. Key words: male infertility, assisted reproductive technologies, risk factors, prognostic chart.

Insemination by husband’s sperm: fertility renewal in married couples with male infertility

The objective: analysis of the results in the resumption of fertility of infertile couples with male factor with a program of insemination with husband's sperm. Patients and methods. There are analyzed the results of achievement of genital function in 140 married couples with man’s infertility who in 2013–2015 underwent the program of insemination by man’s sperm at the Institute of Reproductive Medicine (Kyiv). Results. It has been stated that the pregnancy number and births after 3 attempts (420 cycles) with 3–5 month interval was reached in 17.0±1.8% and 15.0±1.8% of cases, respectively. There was confirmed the linear dependence between the fact of renewal of fertility and such factor as an age of a woman, duration of absence of native pregnancy, response of ovular function on stimulation. There was objectivized the influence on the result of readings of a spectrogram: the kind of pathospermia, the concentration of spermatozoons which is in the inverse dependence on the presence of predictors and determinants aggravating the total state of a man, and also the percent of actively movable fractions of sperms. Conclusions. Confirmed a causal relationship the result with such factors as age of women, duration of occurrence of natural pregnancy, ovulatory response to the stimulation. However, it is crucial to objectively brought the semen: patospermia, concentration of sperm and percentage of actively motile fractions thereof, as well as overall health of men. Key words: male infertility factor, insemination by man’s sperm, result.

The analysis of the efficiency of the program ІМSI at fertilization in vitro

The aim of the study: to analyze the results of the program ІМSI as one of the methods of VRT to ensure in vitro fertilization. Materials and methods. The basis of the study consisted of 100 couples with male factor infertility. Pair was examined and treated at the Institute of reproductive medicine (Kiev) in 2013-2015. The Diagnosis verified, assistance was provided in the framework of standard clinical protocols. The 51 men were diagnosed oligoasthenozoospermia, obstructive and non-obstructive azoospermia - in 28 and 21 men, respectively. Results. There were identified features according to the results of cycles. When native - biochemical pregnancy achieved almost equally often oligoasthenozoospermia and obstructive azoospermia (53.0±6.9% and 53.4±9.4%), whereas non-obstructive in two times less (28.6±9.8%). When critical the difference in results is not traced with obstructive and non-obstructive azoospermia and was 16% lower in cases of oligoasthenozoospermia. Biochemical pregnancies occurred in 63 of the 100 pairs (63.0±4.8%), with oligoasthenozoospermia and 37 of 51 (72.5 per cent), obstructive azoospermia – in 19 of 28 (67.8 per cent), non-obstructive – 7 of 21 (33.3 percent). After reproductive losses (5 of 63, 7.9% as) the end result was lower – 58.0±4.9 per cent. The number of births in total in the group with oligoasthenozoospermia was 35 of 51 (68.6%), obstructive and non-obstructive azoospermia - 17 of 28 (60.7 per cent) and 6 of 21 (28.6 per cent), respectively. Conclusion. The data motivate the need of finding opportunities to improve program performance ІМSI. Promising in this regard is the preparation of the pair to her conduct, which goes beyond the limits of the medical, carried out according to the protocols. An important point should be the identification and leveling of risk factors for general medicine and a social plan. Key words: male infertility, the program ІМSI, results.

THE VELOCITY CHARACTERISTICS OF SPERM MOVEMENT BY CASA MACHINE

Objective: To study the velocity characteristics of sperm movement by CASA machine. Materials and Method: Using description method, we analyse speed of 136 semen samples in male infertilities. Results: (i) In the primary infertile males group: the rate of patients with mobile speed of sperm <30µm/s is 3.64%, > 30-40µm/s is 25.45%, > 40-50µm/s is 50.91% and > 50 µm/s is 20%. These indicators in the secondary infertile males group as follow: 6.17%, 18.52%, 51.85 %, and 23.46%; (ii) The rate of samples with sperm progressive motility ≥ 25% in primary and secondary infertilities was no statistically significant difference. Discussion: using the rate of sperm progressive motility, we can’t identify the different between primary and secondary infertility, however speed of sperms were different. Conclusion: Measuring the speed of sperm provide the characteristics of male infertility. Key words: Male infertility, sperm, sperm motility, primary infertility, secondary infertility.