Obesity has been shown to adversely affect male fertility, by reducing spermatogenesis. There are several aetiological theories including endocrine abnormalities, genetic, sexual dysfunction and testicular hyperthermia. Of these, endocrine abnormalities are likely to be the most important, involving increased oestrogen and increased insulin resistance, reduced androgens and reduced inhibin B levels. Possible management options include weight reduction by dieting or surgery and medical treatment to correct specific endocrine abnormalities, but as yet none has been proven to be effective.
STUDY QUESTIONWhat is the prevalence of defects in the Ca2+-signalling pathways mediating hyperactivation (calcium influx and store mobilization) among donors and sub-fertile patients and are they functionally significant, i.e. related to fertilization success at IVF?
The objectives of this study were two-fold: firstly to determine whether female age exerts an influence on the fertility outcome of couples attending an infertility clinic, independent of demographic and clinical details; and secondly to examine the relationship between the length of involuntary infertility prior to investigation and the subsequent chance of conception. Seven-hundred-and-thirty-one subjects whose partner did not have azoospermia were recruited to the study. Female age ranged from 20 to 46 (mean = 31.1). The range of involuntary infertility prior to investigation was 12-216 (mean = 62) months. One-hundred-and-twenty-four women conceived. The following variables achieved the 5% level of significance when a stepwise analysis was performed on all cases; the concentration of spermatozoa exhibiting slow or sluggish linear or non-linear motility (chi 2(1) = 17.57, P less than 0.0001, RR = 1.67 per 50 x 10(6)), female age (chi 2(1) = 12.44, P = 0.0004, RR = 0.92 per annum), tubal status (chi 2(1) = 12.22, P = 0.0005, RR = 2.15), length of infertility before investigation (chi 2(1) = 11.22, P = 0.0008, RR = 0.87 per annum) and past paternity (chi 2(1) = 8.43, P = 0.0037, RR = 1.81). Female age was found to be positively correlated with the incidence and severity of ovulatory dysfunction, tubal occlusive disease, pelvic adhesions and endometriosis. Where the female partner was 'normal' on investigation, all conceptions were independent of treatment to either partner.(ABSTRACT TRUNCATED AT 250 WORDS)A study was conducted on 731 women to determine whether female age has an effect on couple infertility and to discover the relationship that may exist between the length of involuntary infertility prior to investigation and the chance of fertility after attending an infertility clinic. The female age range was 20-46 years with a mean age of 31.1; the male age range was 21-69 with a mean age of 33.7. The involuntary infertility range before attending an infertility clinic was 12-216 months. Follow-up period range at the infertility clinic was 0-34 months. The results of the study are as follows: 124 women conceived (16.8%); 2 females had hysterectomy; 4 couples started using contraception; and 14 couples separated. An analysis was performed on all of the couples entering demographic and clinical information. Variables receiving 5% significance were: the concentration of spermatozoa exhibiting slow or sluggish linear or non-linear motility, female age, tubal status, length of infertility before investigation, and past paternity. A Spearman correlation was performed and a significant association was found with the following: female age, incidence and severity of ovulatory dysfunction, tubal occlusive disease, pelvic adhesions, endometriosis, and female age. However, when the female was deemed "normal", 5% significance was attributed to spermatozoa that exhibited slow or sluggish linear or non-linear motility.
Abstract Title Research Funding for Male Reproductive Health and Infertility in the UK and USA [2016 – 2019] Study question What is the research funding for male reproductive health and infertility in the UK and US between 2016 to 2019? Summary answer The average funding for a research project in male reproductive health and infertility was not significantly different to that for female-based projects (£653,733 in the UK and $779,707 in the US). However, only 0.07% and 0.83% of government funds from NIHR (UK) and NICHD (USA) was granted for male reproductive health, respectively. What is known already There is a marked paucity of data on research funding for male reproductive health. Study design, size, duration Examined government databases over a total 4-year period from January 2016 to December 2019. Participants/materials, setting, methods Information on the funding provided to male-based and female-based research was collected using public accessed web-databases from the UKRI-GTR, the NIHR’s Open Data Summary, and the US’ NIH RePORT. Funded projects that began research activity between January 2016 to December 2019 were recorded, along with their grant and project details. Strict inclusion-exclusion criteria were followed for both UK and US data with a primary research focus of male infertility, reproductive health and disorders, and contraception development. Funding support was divided into three research groups: male-based, female-based, and not-specified research. Between the 4-year period, the UK is divided into 5 funding periods, starting from 2015/16 to 2019/20, and the US is divided into 5 fiscal years, from 2016 to 2020. Main results and the role of chance Between January 2016 to December 2019, UK agencies awarded a total of £11,767,190 to 18 projects for male-based research and £29,850,945 to 40 projects for female-based research. There was no statistically significant difference in funding average between the two research groups (P=0.56, W=392). The US NIH funded 76 projects totaling $59,257,746 for male-based research and 99 projects totaling $83,272,898 for female-based research. There was no statistically significant difference in funding average between the two groups (P=0.83, W=3834). Limitations, reasons for caution The findings of this study cannot be used to generalize and reflect global funding trends towards infertility and reproductive health as the data collected followed a narrow funding timeframe from government agencies and only two countries. Other funding sources such as charities, industry and major philanthropic organizations were not evaluated. Wider implications of the findings This is the first study examining funding granted by main government research agencies from the UK and US for male reproductive health. This study should stimulate further discussion of the challenges of tackling male infertility and reproductive health disorders and formulate appropriate investment strategies. Study funding/competing interest(s) CLRB is Editor for RBMO and has received lecturing fees from Merck, Pharmasure, and Ferring. His laboratory is funded by Bill and Melinda Gates Foundation, CSO, Genus. No other authors declare a conflict of interest.
Abstract STUDY QUESTION Do publications that involve the interpretation of the results of a basic semen analysis, published in Human Reproduction and Fertility & Sterility between 2011 and 2020, give sufficient evidence in their methodology to demonstrate that they followed the technical methods recommended in the fifth edition of the World Health Organization (WHO) laboratory manual, entitled WHO Laboratory Manual for the Examination and Processing of Human Semen (WHO5)? SUMMARY ANSWER Evidence of methodological agreement of studies with the WHO5 recommendations was low, despite 70% of papers stating that they followed WHO5 recommendations. WHAT IS KNOWN ALREADY A basic semen analysis is currently an integral part of infertility investigations of the male, but method standardization in laboratories remains an issue. The different editions of the WHO manual for the basic semen analysis (WHO1–6) have attempted to address this by providing increasingly rigorous methodological protocols to reduce experimental error. However, to what extent these methods are followed by studies that involve the interpretation of the results of basic semen analysis remains unknown. STUDY DESIGN, SIZE, DURATION A survey of the technical methods used to perform a basic semen analysis was conducted on studies published in two leading reproduction journals (Human Reproduction and Fertility & Sterility) between 2011 and 2020. PARTICIPANTS/MATERIALS, SETTING, METHODS The literature search was performed on the electronic databases PUBMED and MEDLINE Ovid between January 2021 and March 2021. The MeSH terms included in the search were ‘sperm concentration’ OR ‘sperm motility’ OR ‘sperm morphology’ OR ‘sperm vitality’ OR ‘male fertility’ AND ‘human spermatozoa’ NOT ‘animals’. A total of 122 studies were available for analysis. MAIN RESULTS AND THE ROLE OF CHANCE In total, 70% of the studies cited WHO5 in their methods section. Of the remaining studies, 10% cited the fourth edition of the WHO laboratory manual (WHO4), 7% cited both WHO4 and WHO5, 1% cited the third edition of the WHO laboratory manual (WHO3), and 12% did not cite the WHO at all. Overall methodological agreement with WHO5 recommendations was poor, with the main reason for this lack of agreement being that the research studies did not disclose specific details of the technical methods and equipment used. LIMITATIONS, REASONS FOR CAUTION In the case of studies that did not disclose any specific technical methods that they used, we did not attempt to contact these authors and so were unable to confirm the agreement between their technical methods and WHO5 recommendations. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest there is an urgent need to develop strategies to address standardization in reporting the results of a semen analysis for publication. This is particularly timely given the recent publication of WHO6 and ISO standard 23162 for the basic examination of human semen. STUDY FUNDING/COMPETING INTEREST(S) There was no funding for this project. C.L.R.B., as an employee of the University of Dundee, serves on the Scientific Advisory board of ExSeed Health (from October 2021, financial compensation to the University of Dundee) and is a scientific consultant for Exscientia (from September 2021, financial compensation to the University of Dundee). C.L.R.B. has previously received a fee from Cooper Surgical for lectures on scientific research methods outside the submitted work (2020) and Ferring for a lecture on male reproductive health (2021). C.L.R.B. is Editor for RBMO. TRIAL REGISTRATION NUMBER N/A.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
