Article
Multidisciplinary Sciences
Xinzong Zhang, Cuncan Deng, Wujiang Liu, Huang Liu, Yu Zhou, Qianyi Li, Houbin Zheng, Qiling Wang, Min Jiang, Tao Pang, Chunjie Ma, Cheng Huang, Qingguo Zhao, Yunge Tang
Summary: The influence of varicocele and microsurgical varicocelectomy on semen quality remains unclear. This study investigated the changes in semen metabolism after microsurgical varicocelectomy and found that varicocele significantly affects semen metabolism and microsurgical varicocelectomy can reverse this metabolic abnormality. Additionally, three dipeptides were identified in the seminal plasma of varicocele patients, which decreased after varicocelectomy coincident with an improvement in semen quality. Furthermore, eight metabolites may be helpful to distinguish varicocele patients from normal subjects.
SCIENTIFIC REPORTS
(2022)
Review
Obstetrics & Gynecology
Filipe Tenorio Lira Neto, Matheus Roque, Sandro C. Esteves
Summary: This study found that varicocelectomy can reduce sperm deoxyribonucleic acid fragmentation rates in infertile men with clinical varicocele. Men with elevated preoperative SDF levels showed a more significant treatment effect after the surgery.
FERTILITY AND STERILITY
(2021)
Review
Endocrinology & Metabolism
Jiaxing Feng, Hui He, Yu Wang, Xu Zhang, Xiuying Zhang, Tiantian Zhang, Mengyi Zhu, Xiaoke Wu, Yuehui Zhang
Summary: Male infertility, a social, cultural, and medical issue, has become a topic of public concern due to its impact on future health. Traditional therapeutic approaches for male infertility have shown unsatisfactory efficacy, leading many men to choose acupuncture as an alternative treatment.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Andrology
Mesut Berkan Duran, Yalcin Kizilkan, Samet Senel, Taha Numan Yikilmaz, Serdar Toksoz
Summary: This study evaluated the effect of inflammation on the success of varicocelectomy by analyzing data from adult male patients with infertility. The results showed that patients with low NLR and MLR values before the surgery had a higher success rate.
Article
Andrology
Mohamed Mahdi, Ahmad Majzoub, Kareim Khalafalla, Jason To, Maria Aviles-Sandoval, Haitham Elbardisi, Sami AlSaid, Ashok Agarwal, Ralf Henkel, Mohamed Arafa
Summary: This study evaluated the efficacy of redo varicocelectomy on male fertility potential and pregnancy outcome through a systematic review and meta-analysis. The results showed significant improvements in semen parameters following the surgery, with overall pregnancy outcome reported in seven studies. No significant changes were noted in hormone levels.
Review
Biochemistry & Molecular Biology
Chien-Zhi Lai, Szu-Ju Chen, Chi-Ping Huang, Huey-Yi Chen, Ming-Yen Tsai, Po-Len Liu, Yung-Hsiang Chen, Wen-Chi Chen
Summary: Varicocele is a common urological disorder with a prevalence rate of 8% to 15% in healthy men. However, the incidence is higher in male patients with infertility, with up to 35% to 80% of cases occurring in this population. Clinical manifestations of varicocele include an asymptomatic mass, chronic scrotal pain, and infertility. Postoperative scrotal pain may persist due to varicocele recurrence, hydrocele, neuralgia, referred pain, ureteral lesions, or nutcracker syndrome. Clinicians should consider these conditions as potential causes and take measures to address them in order to optimize surgical outcomes.
Article
Medicine, General & Internal
Marek Szymanski, Piotr Domaracki, Angelika Szymanska, Tomasz Wandtke, Robert Szyca, Lukasz Brycht, Karolina Wasilow, Wojciech Jan Skorupski
Summary: The article discusses the global impact of infertility and the pathological causes of male infertility, as well as the method and effectiveness of treating male infertility patients with antioxidant supplements, especially showing more significant benefits in patients with varicocele.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Andrology
Jih Hoon Park, Kyoungjune Pak, Nam Cheol Park, Hyun Jun Park
Summary: This study found that patients complaining of dull pain preoperatively had a higher likelihood of postoperative pain resolution. Subinguinal ligation was more effective for pain resolution than high ligation, and microsurgical varicocelectomy showed better surgical outcomes than laparoscopic varicocelectomy.
WORLD JOURNAL OF MENS HEALTH
(2021)
Review
Immunology
Yiwei Fang, Yufang Su, Jia Xu, Zhiyong Hu, Kai Zhao, Chunyan Liu, Huiping Zhang
Summary: Studies have shown that varicocele can disrupt the testicular immune system, leading to the production of anti-sperm antibodies and inflammatory factors, activation of inflammatory pathways, and disruption of the blood-testis barrier, potentially impacting the occurrence of infertility. Therefore, further research on how immunotherapy can improve patient outcomes is crucial.
FRONTIERS IN IMMUNOLOGY
(2021)
Review
Urology & Nephrology
S. Kale, T. Rashid
Summary: Loupe-assisted subinguinal varicocelectomy has a positive impact on semen quality, serum testosterone level, and spontaneous pregnancy rate.
ACTAS UROLOGICAS ESPANOLAS
(2022)
Review
Andrology
Azizbek B. Shomarufov, Vladimir A. Bozhedomov, Nikolay Sorokin, Igor P. Matyukhov, Abdukodir A. Fozilov, Shukhrat A. Abbosov, Armais A. Kamalov
Summary: This review aimed to systematize the evidence on the predictors of microsurgical varicocelectomy efficacy in male infertility treatment from 1993 to 2021, collected from various databases. The outcomes of varicocele repair, including semen improvement and pregnancy, were analyzed separately. Preoperative total motile sperm count (TMSC) coupled with sperm concentration was found to be a significant predictor of semen improvement and pregnancy after varicocelectomy. Scrotal Doppler ultrasound (DUS) parameters, sperm DNA fragmentation index (DFI), and bilateral varicocelectomy were reliable predictors of microsurgical varicocelectomy efficacy for semen improvement alone.
ASIAN JOURNAL OF ANDROLOGY
(2023)
Review
Urology & Nephrology
Suks Minhas, Carlo Bettocchi, Luca Boeri, Paolo Capogrosso, Joana Carvalho, Nusret Can Cilesiz, Andrea Cocci, Giovanni Corona, Konstantinos Dimitropoulos, Murat Gul, Georgios Hatzichristodoulou, Thomas Hugh Jones, Ates Kadioglu, Juan Ignatio Martinez Salamanca, Uros Milenkovic, Vaibhav Modgil, Giorgio Ivan Russo, Ege Can Serefoglu, Tharu Tharakan, Paolo Verze, Andrea Salonia
Summary: The latest guidelines from the European Association of Urology recommend comprehensive urological evaluation for infertile men to identify and treat modifiable causes of infertility, as well as to monitor their risk for cardiovascular disease and cancer. However, there is still insufficient evidence to support the routine use of some treatments and surgical interventions in clinical practice.
Article
Andrology
Sherif Salah Azab, Taymour Mostafa, Khadiga M. Abougabal, Asmaa A. Tohamy, Nashaat Nabil
Summary: This study found that seminal Ca and Mg levels in infertile men associated with Vx significantly decreased, but increased significantly after surgical repair. Additionally, seminal Ca, Mg levels, and Ca/Mg ratio showed significant positive correlations with sperm concentration, motility percentage, and normal forms percentage.
Review
Urology & Nephrology
Giuseppe Fallara, Stanley Tang, Karl H. Pang, Edoardo Pozzi, Federico Belladelli, Nicolo Schifano, Paolo Capogrosso, Hussain M. Alnajjar, Francesco Montorsi, Andrea Salonia, Fabio Castiglione, Asif Muneer, ESSM Sci Collaborat Partnership ESCAP
Summary: This systematic review explores the outcomes and morbidity of treating persistent or recurrent varicoceles. The results indicate that treatment for varicocele persistence/recurrence has a good rate of success, with improvements in pregnancy rate and pain control. However, there is still a risk of complications.
EUROPEAN UROLOGY FOCUS
(2023)
Article
Urology & Nephrology
Gal Wald, Nahid Punjani, Christopher Gaffney, Marc Goldstein, James A. Kashanian
Summary: Two different microsurgical varicocelectomy techniques showed no significant difference in improving semen parameters, but were associated with improvement in testosterone levels.
INTERNATIONAL UROLOGY AND NEPHROLOGY
(2021)
Article
Urology & Nephrology
Peter Humaidan, Thor Haahr, Betina Boel Povlsen, Louise Kofod, Rita Jakubcionyte Laursen, Birgit Alsbjerg, Helle Olesen Elbaek, Sandro C. Esteves
Summary: This study evaluated the impact of lifestyle changes and oral antioxidant intake on sperm DNA fragmentation index (DFI) and static oxidation-reduction potential (sORP) in male factor infertility. The intervention program, combined with antioxidant therapy, significantly reduced DFI but did not affect sperm parameters and sORP. There was no correlation between DFI and sORP.
INTERNATIONAL BRAZ J UROL
(2022)
Article
Obstetrics & Gynecology
Sandro C. Esteves, Hakan Yarali, Lan N. Vuong, Alessandro Conforti, Peter Humaidan, Carlo Alviggi
Summary: The POSEIDON criteria can identify and classify low-prognosis patients in assisted reproductive technology, and recent studies using real-world data have validated the effectiveness of this system and provided corresponding reproductive outcomes.
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
(2022)
Review
Genetics & Heredity
Romualdo Sciorio, Luca Tramontano, Erika Rapalini, Serena Bellaminutti, Francesco M. Bulletti, Antonio D'Amato, Claudio Manna, Antonio Palagiano, Carlo Bulletti, Sandro C. Esteves
Summary: Assisted reproductive technology may have an impact on the epigenome of embryos, but the extent of this influence is not yet clear. Concerns have been raised about the increased occurrence of epigenetic anomalies and imprinting following assisted reproductive technology. The periconceptional period is particularly vulnerable to environmental conditions, and various factors in assisted reproductive technology have the potential to disrupt epigenetic regulation.
Article
Obstetrics & Gynecology
Sandro C. Esteves, Arnold P. P. Achermann, Manuela Simoni, Daniele Santi, Livio Casarini
Summary: Evidence-based gonadotropin therapy effectively restores spermatogenesis and fertility in male infertility disorders associated with hypogonadotropic hypogonadism. However, its use to improve fertility in men with idiopathic oligozoospermia or nonobstructive azoospermia remains controversial. Real-world data research suggests that gonadotropin therapy may be more effective in managing selected male infertility patients, with potential gains for all parties involved.
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
(2023)
Article
Obstetrics & Gynecology
Panagiotis Drakopoulos, Yakoub Khalaf, Sandro C. Esteves, Nikolaos P. Polyzos, Sesh K. Sunkara, Daniel Shapiro, Botros Rizk, Hong Ye, Michael Costello, Yulia Koloda, Bruno Salle, Monica Lispi, Thomas D'Hooghe, Antonio La Marca
Summary: A high ovarian response refers to a greater number of follicles and/or oocytes compared to a normal response. It can be diagnosed before oocyte pick-up when there are >18-20 follicles ≥11-12 mm, or after oocyte pick-up when >18-20 oocytes have been retrieved. Women with a high response are at high risk of ovarian hyperstimulation syndrome (OHSS). Appropriate management strategies, such as individualized gonadotropin dosing, monitoring, and choice of protocols, can greatly reduce the risk of high response.
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
(2023)
Letter
Obstetrics & Gynecology
Sandro C. Esteves, Jose F. Carvalho
FERTILITY AND STERILITY
(2023)
Article
Obstetrics & Gynecology
Esra Uyanik, Sezcan Mumusoglu, Mehtap Polat, Irem Yarali Ozbek, Sandro C. Esteves, Peter Humaidan, Hakan Yarali
Summary: A drop in serum P-4 level from oocyte pick-up (OPU) + 3 days to OPU + 5 days may result in a decrease in ongoing pregnancy rates. This decrease may be associated with lower initial pregnancy rates rather than increased overall pregnancy loss rates.
HUMAN REPRODUCTION
(2023)
Review
Andrology
Sandro C. Esteves, Igor Coimbra, Jorge Hallak
Summary: Intracytoplasmic sperm injection (ICSI) using surgically retrieved spermatozoa outside the classic context of azoospermia has shown improvement in pregnancy and miscarriage rates, possibly due to lower levels of DNA damage in testicular spermatozoa compared to ejaculated spermatozoa. However, data is limited and mainly focuses on males with confirmed sperm DNA damage. Further research is needed to assess the health of ICSI offspring resulting from surgically retrieved spermatozoa of non-azoospermic males. A comprehensive evaluation and treatment of underlying male infertility factors contributing to sperm DNA damage is crucial for safer and more effective ICSI utilization.
Article
Obstetrics & Gynecology
Vera Baukloh, Rita C. S. Figueira, Fabiola C. Bento, Fabiana Y. Nakano, Silval F. C. Zabaglia, Sandro C. Esteves, Robert Fischer
Summary: This report presents real-life data from two clinics using the Fischer protocol for cycle programming in patients undergoing assisted reproductive technology (ART) treatment. The study found that ovarian stimulation using the Fischer protocol provides consistent and optimal ART outcomes. However, high rates of multiple implantation were observed, especially when transferring two embryos to patients aged over 39 years. Live birth rates were higher after comprehensive chromosome screening (CCS) compared to untested embryos. Therefore, the recommendation is to implement a single embryo transfer policy, particularly for women under 34 years of age with favorable ART treatment conditions.
BEST PRACTICE & RESEARCH CLINICAL OBSTETRICS & GYNAECOLOGY
(2023)
Article
Obstetrics & Gynecology
Gerard Campos, Romualdo Sciorio, Sandro C. Esteves
Summary: Total fertilization failure is the failure of all metaphase II oocytes to fertilize in assisted reproduction cycles. Oocyte activation deficiency is the main cause of fertilization failure, attributed to sperm or oocyte issues. Diagnostic testing and artificial oocyte activation treatments are crucial for overcoming fertilization failure.
HUMAN REPRODUCTION UPDATE
(2023)
Article
Reproductive Biology
Luca Tramontano, Romualdo Sciorio, Serena Bellaminutti, Sandro C. Esteves, Patrick Petignat
Summary: Human papillomavirus (HPV) is a common sexually transmitted disease associated with cancer and reproductive health issues. The influence of HPV on assisted reproductive technology (ART) outcomes is not well understood, leading to a need for HPV testing in couples undergoing infertility treatments. Infertile men with seminal HPV infection may experience compromised sperm quality and reproductive function, highlighting the importance of investigating the correlation between HPV and ART outcomes. Understanding the potential detrimental effects of HPV on ART outcomes may have significant implications for infertility management.
REPRODUCTIVE BIOLOGY
(2023)
Editorial Material
Urology & Nephrology
Sandro C. Esteves
INTERNATIONAL BRAZ J UROL
(2023)
Article
Medicine, General & Internal
Michael L. Eisenberg, Sandro C. Esteves, Dolores J. Lamb, James M. Hotaling, Aleksander Giwercman, Kathleen Hwang, Yu-Sheng Cheng
Summary: Clinical infertility refers to the inability of a couple to conceive after 12 months of trying. Male factors contribute to 30-50% of infertility cases. Infertility can be caused by testicular dysfunction, endocrinopathies, lifestyle factors, congenital anatomical factors, gonadotoxic exposures, and aging among others. The evaluation of male infertility includes history taking, physical examination, and laboratory testing. Treatments include lifestyle optimization, medical therapy, and surgical interventions.
NATURE REVIEWS DISEASE PRIMERS
(2023)
Article
Obstetrics & Gynecology
Jeanett L. M. Nielsen, Ahmad Majzoub, Sandro Esteves, Peter Humaidan
Summary: In recent years, there has been an increasing interest in identifying subcellular causes of male infertility, with a focus on sperm DNA fragmentation (SDF) research. SDF can occur during spermatogenesis or as sperm transit through the genital tract, negatively impacting male reproductive potential. Studies have found that DNA damage is associated with sperm morphological and functional abnormalities, ultimately affecting natural conception and assisted reproductive technology outcomes.
SEMINARS IN REPRODUCTIVE MEDICINE
(2023)
Review
Endocrinology & Metabolism
Francesco Pallotti, Sandro C. Esteves, Fabiana Faja, Alessandra Buonacquisto, Anna Chiara Conflitti, Maria Neve Hirsch, Andrea Lenzi, Donatella Paoli, Francesco Lombardo
Summary: COVID-19 may have indirect effects on male reproductive system, but there is limited evidence to support this. Despite the low quality of available evidence, careful andrological evaluation and follow-up for men recovering from COVID-19 are still necessary.