Objective:To investigate whether differences exist in DNA fragmentation levels and protamine deficiency in the sperm of obese men compared to those of overweight and proven fertile,normal weight men and evaluate the a...Objective:To investigate whether differences exist in DNA fragmentation levels and protamine deficiency in the sperm of obese men compared to those of overweight and proven fertile,normal weight men and evaluate the alterations related to reproductive hormones,semen parameters and their association with body mass index(BMI).Methods:Participants in this observational study were divided into three groups based on their BMI:proven fertile,normal weight men(n=200);overweight men(n=200);and obese men(n=200).After 3 days of abstinence,seminal fluid was collected from all participants and analyzed.Blood samples were also collected on the same day for hormonal analysis.Sperm DNA fragmentation and protamine deficiency were also assessed.Results:A total of 600 men with a mean age of(34.3±7.9)2 years were included in the study.Obese males(BMI 30 kg/m or higher)exhibited significant reductions in semen volume,sperm concentration,total sperm motility percentage,progressive motility,non-progressive motility,and levels of total testosterone,follicle-stimulating hormone(FSH)and luteinizing hormone(LH)compared to overweight(BMI 25 to 29.9 kg/m2)and normal weight males(BMI 18.5 to 24.9 kg/m2)(P<0.001).Conversely,obese males showed a significant increase in prolactin level,sperm DNA fragmentation,and protamine deficiency compared to overweight and normal weight males(P<0.001).Significant negative correlations were demonstrated between BMI and sperm concentration,motility,total testosterone,FSH and LH(P<0.001),whereas prolactin,sperm DNA fragmentation and protamine deficiency were positively correlated with BMI(P<0.001).Conclusions:This study provides clear evidence that obesity contributes potentially to male infertility by inducing sperm DNA fragmentation and protamine deficiency,as well as negatively impacting reproductive hormones and semen quality.展开更多
Objective:To speculate which of the following parameters:antral follicle count(AFC),anti-Müllerian hormone(AMH),follicle-stimulating hormone(FSH)and age can be used as a predictor of ovarian response to gonadotro...Objective:To speculate which of the following parameters:antral follicle count(AFC),anti-Müllerian hormone(AMH),follicle-stimulating hormone(FSH)and age can be used as a predictor of ovarian response to gonadotropin-releasing hormone(GnRH)antagonist stimulation multiple-dose protocol in women under 45 years,and to determine the cutoff value of these parameters and their correlations for predicting low and high ovarian response.Methods:This prospective study included 462 women with the mean age of(29.3±6.5)years.All women were subjected to the GnRH antagonist stimulation multiple-dose protocol.On the second day of the menstrual cycle,ultrasonography was conducted to determine AFC in both ovaries.Peripheral blood samples were collected to evaluate the level of estradiol,FSH,luteinizing hormone,prolactin,thyroid-stimulating hormone,and AMH.The women were divided into three groups:low response(AHH<1 ng/mL,n=173),normal response(AMH=1.0-3.5 ng/mL,n=175),and high response(AMH>3.5 ng/mL,n=114).Results:A significant decrease was found in the age and FSH level in the high response group compared to other groups(P<0.001).Conversely,a significant increase was shown in AMH,estradiol on human chorionic gonadotropin(hCG)day,AFC,mature oocytes,fertilized oocytes,and embryos transferred in the high response group compared to the other two groups(P<0.001).The receiver operating characteristic(ROC)curves demonstrated that AFC and AMH had the highest accuracy,followed by basal FSH level and age in the prediction of low ovarian reserves(P<0.001)with cutoff values of≤4.50 and≤0.95 for AFC and AMH,respectively.Moreover,the ROC analysis showed that AFC had the highest accuracy,followed by AMH level and age in the prediction of high ovarian reserves with a cutoff value of≥14.50,≥3.63,and≤27.50 years,respectively(P<0.01).A significant decrease was observed in women's age,estradiol level,and oocyte fertilization rate in pregnant women compared to non-pregnant women(P<0.001).Additionally,significant negative correlations were found between the AFC,the number of mature oocytes,fertilized oocytes,embryos transferred,and the age of pregnant women(P<0.001).Conclusions:AFC and AMH predict low and high ovarian response to GnRH antagonist stimulation multiple-dose protocol in women under 45 years.展开更多
文摘Objective:To investigate whether differences exist in DNA fragmentation levels and protamine deficiency in the sperm of obese men compared to those of overweight and proven fertile,normal weight men and evaluate the alterations related to reproductive hormones,semen parameters and their association with body mass index(BMI).Methods:Participants in this observational study were divided into three groups based on their BMI:proven fertile,normal weight men(n=200);overweight men(n=200);and obese men(n=200).After 3 days of abstinence,seminal fluid was collected from all participants and analyzed.Blood samples were also collected on the same day for hormonal analysis.Sperm DNA fragmentation and protamine deficiency were also assessed.Results:A total of 600 men with a mean age of(34.3±7.9)2 years were included in the study.Obese males(BMI 30 kg/m or higher)exhibited significant reductions in semen volume,sperm concentration,total sperm motility percentage,progressive motility,non-progressive motility,and levels of total testosterone,follicle-stimulating hormone(FSH)and luteinizing hormone(LH)compared to overweight(BMI 25 to 29.9 kg/m2)and normal weight males(BMI 18.5 to 24.9 kg/m2)(P<0.001).Conversely,obese males showed a significant increase in prolactin level,sperm DNA fragmentation,and protamine deficiency compared to overweight and normal weight males(P<0.001).Significant negative correlations were demonstrated between BMI and sperm concentration,motility,total testosterone,FSH and LH(P<0.001),whereas prolactin,sperm DNA fragmentation and protamine deficiency were positively correlated with BMI(P<0.001).Conclusions:This study provides clear evidence that obesity contributes potentially to male infertility by inducing sperm DNA fragmentation and protamine deficiency,as well as negatively impacting reproductive hormones and semen quality.
文摘Objective:To speculate which of the following parameters:antral follicle count(AFC),anti-Müllerian hormone(AMH),follicle-stimulating hormone(FSH)and age can be used as a predictor of ovarian response to gonadotropin-releasing hormone(GnRH)antagonist stimulation multiple-dose protocol in women under 45 years,and to determine the cutoff value of these parameters and their correlations for predicting low and high ovarian response.Methods:This prospective study included 462 women with the mean age of(29.3±6.5)years.All women were subjected to the GnRH antagonist stimulation multiple-dose protocol.On the second day of the menstrual cycle,ultrasonography was conducted to determine AFC in both ovaries.Peripheral blood samples were collected to evaluate the level of estradiol,FSH,luteinizing hormone,prolactin,thyroid-stimulating hormone,and AMH.The women were divided into three groups:low response(AHH<1 ng/mL,n=173),normal response(AMH=1.0-3.5 ng/mL,n=175),and high response(AMH>3.5 ng/mL,n=114).Results:A significant decrease was found in the age and FSH level in the high response group compared to other groups(P<0.001).Conversely,a significant increase was shown in AMH,estradiol on human chorionic gonadotropin(hCG)day,AFC,mature oocytes,fertilized oocytes,and embryos transferred in the high response group compared to the other two groups(P<0.001).The receiver operating characteristic(ROC)curves demonstrated that AFC and AMH had the highest accuracy,followed by basal FSH level and age in the prediction of low ovarian reserves(P<0.001)with cutoff values of≤4.50 and≤0.95 for AFC and AMH,respectively.Moreover,the ROC analysis showed that AFC had the highest accuracy,followed by AMH level and age in the prediction of high ovarian reserves with a cutoff value of≥14.50,≥3.63,and≤27.50 years,respectively(P<0.01).A significant decrease was observed in women's age,estradiol level,and oocyte fertilization rate in pregnant women compared to non-pregnant women(P<0.001).Additionally,significant negative correlations were found between the AFC,the number of mature oocytes,fertilized oocytes,embryos transferred,and the age of pregnant women(P<0.001).Conclusions:AFC and AMH predict low and high ovarian response to GnRH antagonist stimulation multiple-dose protocol in women under 45 years.
