Jorge Ten

Food intake and its relationship with semen quality: a case-control study

OBJECTIVE To compare dietary habits in normospermic and oligoasthenoteratospermic patients attending a reproductive assisted clinic. DESIGN An observational, analytical case-control study. SETTING Private fertility clinics. PATIENT(S) Thirty men with poor semen quality (cases) and 31 normospermic control couples attending our fertility clinics. INTERVENTION(S) We recorded dietary habits and food consumption using a food frequency questionnaire adapted to meet specific study objectives. Analysis of semen parameters, hormone levels, Y microdeletions, and karyotypes were also carried out. MAIN OUTCOME MEASURE(S) Frequency of intake food items were registered in a scale with nine categories ranging from no consumption to repeated daily consumption. RESULT(S) Controls had a higher intake of skimmed milk, shellfish, tomatoes, and lettuce, and cases consumed more yogurt, meat products, and potatoes. In the logistic regression model cases had lower intake of lettuce and tomatoes, fruits (apricots and peaches), and significantly higher intake of dairy and meat processed products. CONCLUSION(S) Frequent intake of lipophilic foods like meat products or milk may negatively affect semen quality in humans, whereas some fruits or vegetables may maintain or improve semen quality.

A low intake of antioxidant nutrients is associated with poor semen quality in patients attending fertility clinics

OBJECTIVE To compare specific nutrient intake between normospermic and oligoasthenoteratospermic patients attending infertility clinics in two Mediterranean provinces of Spain. DESIGN Case-control study. SETTING Private fertility clinics in southeastern Spain. PATIENT(S) Thirty men with poor semen quality (case subjects) and 31 normospermic control subjects of couples attending our fertility clinics. INTERVENTION(S) We recorded dietary habits and nutrient consumption using a food frequency questionnaire adapted to meet specific study objectives. MAIN OUTCOME MEASURE(S) We calculated nutrient intakes by multiplying the frequency of use for each food by the nutrient composition of the portion size specified on the food frequency questionnaire and by addition across all foods to obtain a total nutrient intake for each individual. Semen quality was assessed by measuring volume, concentration, motility, and morphology. Hormones levels were also analyzed in case and control subjects. RESULT(S) In the logistic regression, control subjects had a significantly higher intake of carbohydrates, fiber, folate, vitamin C, and lycopene and lower intakes of proteins and total fat. CONCLUSION(S) A low intake of antioxidant nutrients was associated with a poor semen quality in this case-control study of Spanish men attending infertility clinics.

Relationships between heavy metal concentrations in three different body fluids and male reproductive parameters: a pilot study

BackgroundAnimal studies have shown the reproductive toxicity of a number of heavy metals. Very few human observational studies have analyzed the relationship between male reproductive function and heavy metal concentrations in diverse biological fluids.MethodsThe current study assessed the associations between seminal and hormonal parameters and the concentration of the 3 most frequent heavy metal toxicants (lead, cadmium and mercury) in three different body fluids. Sixty one men attending infertility clinics that participated in a case-control study to explore the role of environmental toxins and lifestyles on male infertility were analyzed. Concentration of lead, cadmium and mercury were measured in blood and seminal plasma and whole blood using anodic stripping voltammetry and atomic absorption spectrophotometry. Serum samples were analyzed for follicle-stimulating hormone, luteinizing hormone and testosterone. Semen analyses were performed according to World Health Organization criteria. Mann-Whitney test and Spearmans rank correlations were used for unadjusted analyses. Multiple linear regression models were performed controlling for age, body mass index and number of cigarettes per day.ResultsThere were no significant differences between cases and controls in the concentrations of heavy metals in any of the three body fluids. In multivariate analyses using all subjects no significant associations were found between serum hormone levels and metal concentrations. However there was a significant positive association between the percentage of immotile sperms and seminal plasma levels of lead and cadmium.ConclusionsOur results suggest that the presence of lead and cadmium in the reproductive tract of men may be related to a moderate alteration of their seminal parameters.

Donor oocyte dysmorphisms and their influence on fertilization and embryo quality

The aim of this study was to identify predictors of fertilization rate (FR) and embryo quality (EQ) in 126 donor women who underwent 160 intracytoplasmic sperm injection (ICSI) cycles. Main outcome measures were oocyte dysmorphisms (OD) [perivitelline space (normal/large), perivitelline debris (no/yes), oocyte shape (spherical/non-spherical), zona pellucida (normal/abnormal), first polar body morphology (normal/fragmented or irregular), cytoplasmic granularity (normal/excessive), cytoplasmic vacuoles (no/yes) and colour of cytoplasm (normal/dark)], semen source (ejaculated or testicular), donor age, number of days of stimulation, plasma oestradiol concentration (pg/ml) on the day of human chorionic gonadotrophin administration, FR and day 2 EQ. No significant predictors of fertilization were identified. However, the presence of a dark cytoplasm decreased by 83% the likelihood of obtaining good quality embryos (OR=0.17; 95% CI: 0.04-0.74). Oocytes with a larger than normal perivitelline space were associated with 1.8 times higher chance of having good quality embryos (OR=1.80; 95% CI: 1.15-2.80). Patients and ovarian stimulation characteristics evaluated here did not affect FR and EQ. ICSI technique may guarantee good FR in spite of OD; however, certain cytoplasmic anomalies at the oocyte level, such as a dark cytoplasm, could compromise subsequent embryo development.

Exposure to environmental toxins in males seeking infertility treatment: a case-controlled study

This case-control study explored the role of environmental toxins in male infertility in patients attending an assisted reproduction clinic in southeastern Spain. Exposures were compared by questionnaire for 30 infertile oligoasthenoteratozoospermic males (cases) and 31 normozoospermic controls residing in the area. Odds ratios and 95% confidence intervals (CI) were used to estimate differences in lifestyle and chemical occupational exposures. More than two-thirds of the cases (23/30), compared with less than one-third of controls (10/31), had been exposed occupationally to at least one toxin or pollutant (OR = 6.9; 95% CI: 2.2-21.4) and were also more exposed to them currently (OR = 5.2; 95% CI: 1.6-17.2). Exposure to glues, solvents or silicones (OR = 22.9; 95% CI: 2.8-190.9), metals (OR = 8.8; 95% CI: 1.4-54.2) and physical agents (OR = 7.3; 95% CI: 1.4-36.7) in the past, as well as current exposure to glues, solvents or silicones (OR = 10.4; 95% CI: 2.6-42.5) and physical agents (OR = 4.7; 95% CI: 1.1-19.2), were significantly higher in cases than in controls. Average duration of exposure was also significantly higher in cases (P < 0.001). This study suggests that male infertility in patients attending infertility clinics may often be the result of occupational exposure.

The paternal effect of chromosome translocation carriers observed from meiotic segregation in embryos

BACKGROUND Human translocation carriers may present alterations in meiosis. Understanding the mechanism of meiotic segregation of reciprocal translocations is important for estimation of the risk of either pregnancy loss or birth defects. The objective of this work was to estimate meiotic segregation rates in preimplantation embryos from preimplantation genetic diagnosis (PGD) cycles of female and male reciprocal translocation carriers. METHODS In 20 cycles for 14 couples, PGD was performed on 118 day three embryos using fluorescence in situ hybridization (FISH) with specific probes for each translocation. The meiotic segregation modes and the effect of the paternal origin of translocated carrier were estimated. RESULTS Overall, the proportions of alternate segregation for normal or balanced chromosome contents in preimplantation embryos from PGD cycles in reciprocal male and female carriers were not significantly different (35.5 versus 23.8%). However, the frequencies of adjacent-1 and adjacent-2 segregation were lower in embryos from female reciprocal translocation carriers than from male carriers. For male translocations, alternate segregation was the most frequent mode. The proportion of 3:1 segregation was the most frequent in female translocations carriers. CONCLUSIONS We report differences in segregation modes in embryos obtained from PGD cycles according to the gender of reciprocal translocation carrier. However, these differences did not affect the proportion of balanced embryos and the take home baby rate. The analysis of the meiotic behaviour of chromosomes and the differences between the meiotic products of female and male for a chromosomal rearrangement could help predict the outcome of PGD for translocation carriers.

A crucial step in assisted reproduction technology: human embryo selection using metabolomic evaluation.

We present a new methodology to predict embryo viability in assisted reproductive technology (ART) treatments by determining the relative amino acid concentrations in human embryo culture medium on day 3, using high-performance liquid chromatography with mass spectroscopy analysis without derivatization. The model was performed with soft independent modeling of class analogy for the samples from nonpregnancy and pregnancy cases.

Effect of follicle-stimulating hormone receptor N680S polymorphism on the efficacy of follicle-stimulating hormone stimulation on donor ovarian response.

Objective The aim of this study was to investigate whether N680S FSHR polymorphism has a predictive value for the ovarian response to stimulation with gonadotropins and cycle outcome in our egg donor program. Methods The oocyte donor candidates were selected according to the Instituto Bernabeu egg donation program requirements and ASRM and ESHRE guidelines for oocyte donation. The FSHR polymorphism N680S was studied in 145 oocyte donors. All donors underwent controlled ovarian hyperstimulation (COH) (n=355) using urinary follicle-stimulating hormone in a GnRH antagonist protocol and receiving a GnRH agonist triggering. The main outcome measures were oocyte yield, days of stimulation, gonadotropin doses, biochemical pregnancy, ongoing pregnancy, and miscarriage rates. Results Significant differences were reported in the antral follicle count (16.5±5.0 for NN, 14.5±4.7 for NS, and 14.1±3.8 for SS), number of eggs retrieved (21.5±9.2 for NN, 18.5±8.2 for NS, and 19.8±8.9 for SS), and gonadotropin doses (2098.5±639.4 IU for NN, 2023 ±490.1 IU for NS, and 2149.5±552.3 IU for SS) between the genotypes. The clinical outcome was not affected by the N680S polymorphism of the FSHR gene in the egg donors. Conclusion In a population of fertile egg donors, the FSHR gene polymorphism at position 680 is associated with different ovarian responses to COH. The genotype of the FSHR gene is an important factor for determining the prognosis of the COH cycles in normo-ovulatory fertile women.

Occupational and Lifestyle Exposures on Male Infertility: A Mini Review

Human semen quality may be declining due to environmental pollutants, occupational exposures or changes in lifestyle. Nonetheless, we still know little about the impact of those factors on male fertility. Some heavy metals, volatile organic compounds or xenoestrogens may compromise reproductive male function. This process could take place along the human life cycle and not only in certain stages of development. We review the main factors that affect human male fertility and their possible influence in current human reproduction.

Intermediate and normal sized CGG repeat on the FMR1 gene does not negatively affect donor ovarian response

BACKGROUND Fragile X syndrome is associated with low ovarian reserve and poor ovarian response. The aim of this study was to investigate whether CGG repeats on the fragile X mental retardation 1 (FMR1) gene have predictive value for ovarian response to stimulation with gonadotrophins and for clinical outcome in our oocyte donation program. METHODS Oocyte donor candidates were selected according to Instituto Bernabeu oocyte donation program requirements. Fragile X genetic screening was performed in 204 oocyte donors, defining 141 controls and 63 cases: 35-39 repeats (n = 34), 40-45 (n = 12) and >45 (n = 17). All the patients underwent ovarian stimulation using a GnRH antagonist protocol and received a GnRH agonist trigger. The main factors used to measure outcome were oocyte yields, days of stimulation, gonadotrophin dosages, biochemical pregnancy, ongoing pregnancy and miscarriage rates. RESULTS No differences between the study group and controls were reported in oocyte yields (17.5 versus 18.9) or days of stimulation (11.40 versus 9.82). The control group used significantly more gonadotrophin (2212 versus 1850 IU) than the study group. Clinical outcome was not affected by the CGG repeats on the FMR1 gene in oocyte donors. CONCLUSIONS No negative effect was observed for intermediate-sized CGG repeats on ovarian stimulation and clinical outcome using a non-confounding model of oocyte donation. These results disagree with previous studies performed on infertility patients. Owing to the present study, fragile X genetic screening should not be considered for prediction of response to ovarian stimulation.