Iraqi Journal of Embryos and Infertility Researches
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Search Results for male-infertility

Article
Relationship between potency of hypo osmotic swelling test and antisperm antibody assay for fertile and infertile men in Thi-Qar governorate

Basim K. Gootee

Pages: 44-48

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Abstract

Background: The sperm plasma membrane activity and absence of antisperm antibodies in infertile patients ejaculate significantly associated with fertilization potential of human spermatozoa. The sperm viability detected by hypoosmotic swelling test (HOST) and autoimmune infertility detected by antisperm antibody assay presented diagnostic and prognostic tools for male infertility factors. Objective: This study was devised to compare the results of hypoosmotic swelling test and antisperm antibody assay for normozoospermic men and infertile patients affected by autoimmune infertility. Methods: Thirty semen samples were collected by masturbation and prepared by direct layering technique. Hypo-osmotic swelling test was performed by mixing 0.1 ml of semen with 0.9 ml of a 150 mOsm/L NaCl as a hypo-osmotic solution and direct immunobead assay were used to determine the presence of Antisperm Antibodies (ASA) bound on sperm surface. However, sperm concentration, sperm motility, and normal sperm morphology were evaluated according to World Health Organization (WHO) criteria and subjected to HOS test and ASA assay. The sperm prepared and incubated for 30 minute in 5% CO2 at 37°C after in vitro sperm preparation. Results: The results of the present study reported that the percentage of HOS test score in antisperm antibodies positive sperm samples (52.30 ±5.2) was significantly lower than that noticed in antisperm antibodies negative (70.30 ± 3.4) sperm samples. Conclusion: It was concluded that the use of HOS test as a simple and diagnostic and prognostic tools for identify male infertility. Further studies are suggested to assess the effect of ASA on sperm plasma functional integrity after ICSI and in vitro fertilization and embryo transfers (IVF-ET).

Article
Effect of Tannery Work Exposure on Seminal Fluid Parameters in Iraqi Men

Alaa N. Mohammed Ali, Samal H. Kareem, Noor AL-Huda A. Abdul Hussein, Ali I. Mohammed

Pages: 72-86

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Background: Tannery work share exposure to solvents and chemicals , which has been linked with inverse pregnancy and fertility outcomes in human being as reported in some studies . Objective: The current study aimed to through some light on the harmful pollutant chemicals effect on tannery workers reproductive health. Literature in this portion are rare in Iraq, so it had been tested the hypotheses that leather workers suffered from male infertility parameters due to the continuous exposure to chemicals that used in this industry. Subjects, Materials and Methods: This study included 60 subjects can divided into 2 groups: 30 males as study group and 30 males as control group, the period of study was between October 2014 to April 2016, the samples were taken from tanneries workers from various governorates of Iraq. Results: The data clearly showed a significant infertility parameters among these workers represented by low total sperm number, low sperm activity the significance levels were within the value of P ≤0.05 accompanied with a significant high seminal fructose. Conclusion: The main conclusion was that chronic exposure to these chemicals in tannery workers especially Cr VI and N,N-dimethyle form amide may cause male infertility parameters.

Article
Evaluation of seminal plasma IL-17 and IL-25 and its relation with serum anti-sperm antibody among infertile men

Fahad Oleiwi, Chateen Pambuk, Mousa Al-Humesh

Pages: 30-40

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The structural elements like the “blood-testis barrier” (BTB) and systemic and local tolerance mechanisms help to maintain testicular homeostasis, which shields germ cells and mature sperms from immune attack. Any damage to this barrier could result in an immune attack and may lead to infertility. This study aims to look at the correlation between male infertility and immunological factors (IL-17, IL-25, and anti-sperm antibody). During the months of October 2021 and July 2022, a total of 144 samples were taken from patients who sought to have infertility tested. The subjects' semen specimens were taken in order to perform the ELISA tests for IL-17, IL-25, and ASA. The levels of ASA, IL-17, and IL-25 differed significantly (P≤ 0.05) across study groups, according to the results of immunological parameters. The results of the correlation analysis revealed a strong positive association between IL-17 and IL-25, but not between those two interleukins and ASA. Although there was theoretically a positive link in this study, it was very weak and not significant. The findings suggest that IL-17, IL-25, and ASA influence seminal fluid parameters, which in turn affect male fertility.

Article
Relationship of Inhibin-B with Gonadal Hormones Levels in Seminal Plasma of Infertile Patients in Diyala Governorate

Ehssan N. Jasim Al-Obaidy, Abdul-Monaim H. Al-Samarrai

Pages: 37-43

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Background: Over 70 million couples suffer from infertility worldwide and the majority of those couples can be found in developing countries. Aims of study: This study aims to determine if there is any significant difference in levels of inhibin B and gonadal hormones in fertile and infertile men. Subjects, Materials & Methods: Clinical and hormonal characteristics related to male infertility factor of the infertile patients(n=75)and representative proven fathers as a control(normozoospermic ones)(n=25)were studied. All males attending infertility clinic at Baquba General Hospital, Diyala in Iraq. The study included the measurement of gonadal hormones levels by using (ELISA)method and it was also used in analyzing the inhibin B hormone. The VIDAS instruments were used for enzyme immunoassay measurements Luteininzing Hormone(LH),Testosterone(T) ;and Follicle Stimulating Hormone(FSH). The samples were analyzed and classified according to WHO criteria. Results: The results of this study showed that inhibin B hormone and other gonadal hormones in control (representative proven fathers-normozoospermic ones)as inhibin B (240.2±17.4)Pg/ml, LH (1.639±0.103)mIU/ml, Testosterone (0.6253±0.035)ng/ml and FSH (0.469±0.0103)mIU/ml. In asthenozoospermic ones as an example of infertile patients the results showed that inhibin B (76.9±8.99)Pg/ml, LH(1.4311±0.033)mIU/ml, T (0.5483±0.030)ng/ml and FSH (0.495±0.0124)mIU/ml. Except the inhibin B comparisons all of other non significant evaluated parameters & correlations within this study could be ascribed to the role of cascaded role of inhibin B with the gonadal hormones in spermatogenesis. Conclusions: It concluded from this study that decreased levels of inhibin B, LH,Testosterone, but increased levels of FSH hormones were shown in asthenozoospermia group as an example of infertile patients,and increased levels of inhibin B,LH and Testosterone but decreased levels of FSH were shown in normozoospermia as control.

Article
Relevance of seminal plasma fructose concentrations to male infertility

Alaa Jaleel Hamada, Dina T. Ali, Usama S. AL-Nasiri

Pages: 31-37

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Abstract

Background: Seminal fructose is derived from the seminal vesicle and is therefore a suitable marker for its function. Fructose is the energy source for sperm and may have an importance in pathological conditions of semen, e.g. in asthenozoospermia. Objective: To find out if there is a correlation between seminal plasma fructose level and sperm concentration and motility in infertile Iraqi men. In addition, the study assessed the reliability of using seminal fructose concentration as indicator of seminal vesicles function. Patients and Methods: Forty six infertile men, free from infectious disease or endocrine disorders, were selected for the study. Control group, selected from couples with proven male fertility, were 10 fertile men. Semen samples, collected from theses fertile and infertile men, were analyzed for general seminal fluid examination and fructose concentration determination. Results: Seminal fructose has been noticed to have significant negative correlations with sperm count, with percentage of motile sperm and with absolute number of motile sperms. These negative correlations may be due to increased rate of fructolysis with higher sperm count and motility or due to an endocrine cause related to relatively high FSH in infertile men. To use seminal plasma fructose as a marker for seminal vesicles function, a correction for the opposing factors that affect fructose level such as sperm count and motility is carried out. Corrected seminal fructose is positively correlated with the total number of motile sperm. Furthermore, a positive correlation between true corrected fructose and the percentage as well as the total number of motile sperm has been found. Conclusion: Seminal fructose level has an inverse correlation with sperm count and percentage and number of motile sperm in the study group. Seminal fructose is a good marker of seminal vesicle function after using the correction formulae.

Article
Effect of non-ionizing radiation from mobile phones in different time periods exposure on DNA integrity of infertile men.

Enaam J. Husain, Hayder M. Al-Dabbach, Saad S. AL-Dujaily

Pages: 73-85

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Exposure to radiation of various forms is one of the many environmental, health, and lifestyle variables that have been linked in recent years to an increase in the rate of male infertility. According to data from several recently published studies, mobile phone use may negatively affect sperm parameters, which may lower male fertility. Ninety-seven samples of semen from fertile and infertile individuals were sent to the "High Institute for Infertility Diagnosis and Assisted Reproductive Technologies. Al-Nahrain University in Baghdad, between November 2022 and May 2023. The samples were split into four groups: normozoospermia (n = 40), asthenozoospermia (n = 25), oligozoospermia (n = 16), and teratozoospermia (n = 16). Each group was further divided into two groups based on the amount of time spent using a mobile phone each day: less than 4 hours per day and equal to or more than 4 hours per day. A routine seminal fluid analysis was carried out to measure the sperm parameters and test the deoxyribonucleic acid fragmentation rate using an acridine orange stain. Samples exposed to electromagnetic waves of cell phones showed a significant decrease in DNA normality. deoxyribonucleic acid fragmentation index (p < 0.001) in normozoospermia patients exposed to more than 4 hours/day of non-ionizing electromagnetic waves. The results of deoxyribonucleic acid fragmentation index after treatment were shown a significant improvement compared to before the treatment in all fertile and infertile groups. Electromagnetic waves emitted from cell phones are associated with a decrease of deoxyribonucleic acid normality when exposure for <4hours/day. The study recommend that men of reproductive age avoid keeping their cell phones in the hip pocket and front pants pocket which may negatively affect spermatozoa deoxyribonucleic acid integrity and impair male fertility.

Article
The role of sperm DNA integrity in seminal plasma of infertile men

Hamdya A. Ali, Ula Al-Kawaz, Wasan A. Abdulhamed

Pages: 34-44

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One-half of the genome is delivered by the sperm, and a healthy sperm is needed for fertilization, fetal development, and child wellbeing. Abnormal sperm DNA can impact any of these processes. The measurement of sperm DNA fragmentation has been added to some medical andrology laboratories as a crucial addition to the standard analysis of the semen. Sperm DNA fragmentation has also been linked to male infertility including idiopathic male infertility. Some degree of controlled DNA nicking is essential for adequate DNA compaction, but excessive sperm DNA fragmentation is usually associated with reduced male fertility potential, reduced fertilization, poor embryo quality, recurrent pregnancy loss and poor assisted reproductive techniques outcomes. Semen samples from 50 infertile males (as 19 asthenozoospermia, 7 oligozoospermia, 13 normospermia and 11 combined defects) were analyzed for sperm DNA fragmentation. This study followed the World Health Organization 2010 guidelines to assess the sperm parameters. Sample were collected by masturbation and put in a 37 °C incubator to be liquefied, then they were placed in a centrifuge (3000 rpm for 10 min) to extract the pellet, which was used for assessment of DFI% by anillin blue staining. Negative significant correlation (p = 0.023) between morphologically normal sperms and DFI % was found in normozoospermia group. The objective of this study is to examine the correlation of DFI among different seminal fluid categories (normozoospermia, oligozoospermia, asthenozoospermia and, combined).

Article
Effect of L-carnitine administered to pregnant mice on some reproductive properties of their male offspring

Muhammad-Baqir M-R. Fakhrildin

Pages: 35-39

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Background: Carnitines are widely distributed in nature and their potential health benefits have been popularized. The carnitines exert a substantial antioxidant action. It is often sold as a nutritional supplement. The use of carnitine showed some promise in treatment of male infertility. Objectives: This study was designed to investigate the effects of L-carnitine (LC) administered to pregnant mice on some reproductive parameters of male offspring. Methods: Ninety mature male offspring mice (age: 6 weeks) were divided originally into two groups depending on the pregnant mothers were administered either 0.5 mg/Kg L-carnitine (Treated group) or distilled water (Control group) throughout pregnancy period. Whole body and testicular weight, diameter of seminiferous tubules, thickness of spermatogenic cell layers, levels of serum gonadotropins and sperm parameters were assessed. Results: In the present study, weight of whole body and testes of the male mice offspring group where mothers treated with 0.5 mg/Kg L-carnitine throughout gestation period was significantly increased (P<0.05) as compared to the control group. Further, significant increment (P<0.05) was observed in the thickness of spermatogenic cell layers and diameter of seminiferous tubules for the treated group as compared to the control group. Also, levels of serum follicle stimulating hormone (FSH) and Luteinizing hormone (LH) in the treated group showed significant elevation (P<0.05) as compared to the control group. Sperm parameters for the treated group were enhanced significantly (P<0.05) as compared to the control group. Conclusion: Administration of low dose of L-carnitine to pregnant mice improved reproductive performance of male offspring. Further molecular studies are recommended to investigate the effects of L-carnitine administered to pregnant mice on quality and quantity of acrosomal enzymes for male offspring.

Article
The Correlation Between Sperm DNA Integrity and Conventional Semen Parameters

Narges Mohsen Khalaf, Amal Abdulwahid Mohammed, Ali Ibrahim Rahim

Pages: 1-11

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The integrity of sperm deoxyribonucleic acid (DNA) and chromatin is very important for genetic material transmission into offspring. Therefore, the aim of the present study was to investigate the correlation between sperm deoxyribonucleic acid integrity and sperm parameters. The current study was conducted on 96 semen samples. This study was done at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, for the period between November 2020 and May 2021. The samples were collected, and seminal fluid analysis was performed according to World Health Organization guidelines. Sperm Chromatin Dispersion test was performed. The results showed that the deoxyribonucleic acid fragmentation of sperms in infertile men in this study was higher than reported in fertile men in previous studies, indicating deoxyribonucleic acid fragmentation (DNA) is actively contributing at least partially to male infertility. In terms of enrolled men, sperm deoxyribonucleic acid fragmentation (SDF) showed a significant positive correlation with round cell count.

Article
Estimation of Aromatase Enzyme in Obese Infertile Men

Ula M. AL-Kawaz, Nawal K. AL-Ani, Hikmat F. Wassef

Pages: 22-31

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Abstract

Background: Male obesity is associated with physiological changes that can negatively affect male fertility. Obese men have demonstrated a 3-fold increase in the prevalence of oligozoospermia when compared with men with normal Body Mass Index (BMI). Objective: To estimate the role of aromatase enzyme in decreasing sperm parameters in obese infertile men. Subjects, Materials and Methods: Seventy obese infertile male (patients) and twenty obese fertile male (control) are enrolled in this study. Seminal fluid analysis done according to criteria of WHO (2010). Results: A significant negative correlation was found between human cytochrome enzyme and sperm concentration, progressively motile sperm, non-progressively motile sperm, immotile sperm and normal morphology. Conclusion: The present study showed clearly that male obesity negatively impacts fertility through direct association between increased (BMI) and semen parameters. The results suggest that increased estrogen as a result of aromatization in the fatty tissue, reflected through the increase in human cytochrome enzyme (aromatase), may be an important mechanism for the hypoandrogenemia and altered sperm parameters.

Article
Male Fertility Supplements (MFS Plus) Treatment Improve Se­ men Quality in a Sample of Iraqi Infertile Males

Haider M. M.Dabbach, Majid H. Ahmed

Pages: 14-20

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Abstract

Background : At least in 25% of infertile men, no identifiable cause can be at­ tributed to the problem,so it is termed idiopathic infertility. Those men are candi­ dates for empiric medical therapy which include antioxidant therapy. Men upple­ ment Plus (MFS Plus) uses a powerful all-natural formula of many antioxidants in addition to Relora to improve semen quality. Objectives: To evaluate the effect of MFS Plus on sperms concentration, motility and morphology in men with oligo and/or asthenozoopermia in sample of Iraqi infertile males. Methods: Acomparative clinical trial study was conducted at High Institute of Infertility Diagnosis and Assisted Reproductive Technologies during the period from July 2015 till February 2017. Male partner of infertile couples who had one or more of the following criteria oligo, astheno, and/or teratozospermia accord­ ing to criteria of WHO 2010 were involved in this study. Eighty-one males were divided randomly into two groups, the first group (group A) were given MFS Plus capsule AMS® (America Medic & Science) two cap­ sules twice daily for three months and the second group (group B) were given vitamin E capsule (one capsule three times daily) for the same period.A second semen analysis were done after three months for each subject in both groups to show the effect of both types of treatment on semen quality. Results: There was a highly significant increase in sperms progressive motility % (14.0±11.41 vs 29.35±15.61, p value < 0.001) and a highly significant decrease in immotile sperms % (60.15±19.3 vs 41.52±18.18, p value < 0.001) in the group of patients who received MFS Plus treatment. Moreover, there was significant increase in sperm concentration and percentage of normal sperm morphology (p value = 0.027, 0.019 respectively). However, no significant change was observed regarding semen volume and percentage of non-progressive motility.Whereas there were no significant changes in any of semen analysis parameters in the group of patients (group B) who received placebo. Conclusion: MFS Plus usage for three months is very beneficial for sperm motil­ ity in addition to its valuable effect on sperm concentration and morphology and it is more efficient than vitamin E alone.

Article
Effect of L-carnitine on in vitro sperm activation of infertile men

Saad S. AL-Dujaily, Nahla J. AL-Shahery, Areeg A. Zabbon

Pages: 22-25

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Abstract

Background: The effect of L-carnitine (LC) on the male infertility have been previously reviewed. However there are few studies about the effect of LC on sperm function parameters in vitro. Objectives: The objective of this study was to improve certain sperm function parameters in vitro of asthenozoospermic infertile men using LC as a motility stimulant substance which may enhance the medium used for assisted reproductive technologies (such as artificial insemination) in future. Methods: Semen was collected from 50 infertile men involved in the current study. Each semen sample was divided into two portions. One part was considered as a control and in vitro activated by using culture medium only. The other portion was considered as treated group and in vitro activated by adding LC (0.5mg) to the culture media. Certain sperm function parameters were examined before and following in vitro activation using simple layer technique. Results: The results revealed highly significant increment (P<0.01) in the percentage of total sperm motility grades (A+B+C) and progressive sperm motility grade (A) with a significant improvement (P<0.05) in the percentage of progressive sperm motility grade (B) and morphologically normal sperm when using LC medium in comparison with control medium after 30 minutes incubation. Conclusion: It is concluded from the results of the present study that adding 20% LC to the culture medium ofthe in vitro sperm activation leads to an improvement in certain spermfunction parameters.

Article
In Vitro Studying the Effect of Adding Autologous Platelet Rich Plasma (PRP) to the Human Semen on the Sperm DNA Integrity

Dhafer Abbas Hamdan, Ali Ibrahim Rahim, Ula M. R. Al-Kawaz

Pages: 90-100

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Abstract

For conception and the development of healthy embryos, sperm DNA integrity is crucial. According to a growing body of studies, there is a strong correlation between sperm DNA damage and male infertility. Among the new medicines being developed in the medical field, the application of Platelet Rich Plasma (PRP) in human reproduction has yet to be examined. A total of 100 semen samples were used in the current experimental investigation. From November 2020 to June 2021, the research was conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies. Masturbation was used to get an ejaculated semen sample. After semen analysis, the samples were separated into two equal parts, one without autologous PRP and the other with 2% autologous PRP, with the DNA fragmentation assessed using the Sperm Chromatin Dispersion Test. There was highly significant reduction in DNA fragmentation index (p < 0.001). The mean sperm DNA integrity was reduced after adding PRP (33.85±16.73 vs 38.55±16.64), Mean (± SE). PRP has been shown to improve human sperm DNA integrity.

Article
Study of Interleukin-6 (IL-6) Profile in the Seminal Fluid of Oligozoospermia Men

Osama A Hachim, Anam R. AL-Salihi, Sabah N. AL-Alwachi

Pages: 30-35

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Background: Oligozoospermia is one of male infertility type which related with sperm lowering count in seminal fluid under limited reference. There are many factors leads to oligozoospermia like, congenital defects, endocrinal disorders, genetic abnormalities, immunological factors , life style , or in some cases unknown reasons. Immune and some non-immune cells produce immuno-chemical messengers proteins called (Interleukins) work as alerts proteins and contribute in immune body defend. These mediators found in all body fluids, also found in seminal fluid,and it’s presence of certain concentrations reflects the state of health of the body. Objective:Measure the level of interleukin-6 in fertile (normospermia) and infertile (Oligozoospermia). Materials and Methods: Microscopically and macroscopically ejaculates analysis according to WHO (2010) criteria for eighty -seven ejaculate from normospermia and oligozoospermia patients with age rang (21-47)yrs. , in duration of ( Nov-2013 to Mar-2014), study divide in to three groups according to the concentration ranges in to (normospermia > 15X 106 cells/ml), (Mild to Moderate Oligozoospermia 15-5 X106cells/ml) , (Severe Oligozoospermia< 5X106). Then store all samples in(-20 ) , IL-6 was detected through the (ELISA) specific way and kit . Results: Interleukin-6level is less in normospermia group than Oligozoospermia groups at (P<0.05), IL-6 level not correlated with sperm count, except weak correlation in severe group at (P≤ 0.05) and (t α=0.05). Conclusions: There are no correlation between IL-6 level and sperm cells concentration but the variation of interleukin-6 level among the groups indicate that some sperms parameters influence on interleukin-6 levels among the groups like sperm motility or morphology and also that the causative factors which lead to oligozoospermia also effect on IL-6 level and effect on spermatogenesis .

Article
The Influence of Density Gradient Technique and Autologous Platelet Rich Plasma Mixed with Glycyrrhiza Glabra Root Extraction Medium on DNA Fragmentation Index of Teratozoospermic Men

Noor Kadhim, Saad S. Al-Dujaily, Laith A. Al-Anbari

Pages: 1-16

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Male infertility is a global health issue affecting over 20 million males. A spermatogenesis-related cell differentiation abnormality causes teratozoospermia (TZS). Extensive research has linked TZS to poor fertilization outcomes at assisted reproductive technology (ART) centers as well as to spontaneous pregnancies. This study used Glycyrrhiza glabra (Gg) and Platelet Rich Plasma (PRP) media to establish a culture medium that aimed to improve certain sperm functions of teratozoospermic men in vitro. A total of fifty semen samples were examined. The World Health Organization 2021 and 1999 standards were used to evaluate certain sperm parameters and the DNA fragmentation index. Platelet-rich plasma and Gg extract were utilized as a medium for in vitro preparation and activation of semen samples complaining of teratozoospermia factor. Following activation by the utilization of the density gradient approach and the combination of Gg and PRP medium, there was a statistically significant ( p <0.001) improvement in certain sperm function metrics. These improvements included a higher percentage of morphologically normal sperm, a rise in active motility, and a drop in the DNA fragmentation index. The density gradient technique, regardless of the medium used in this investigation, resulted in a significant enhancement of morphologically normal sperms with other certain sperm parameters and a decrease in the DNA fragmentation index.

Article
Estimation of Aromatase Enzyme in Obese Infertile Men in Correlation with Sex Hormones and BMI

Hikmat F. Wassef, Nawal K. AL-Ani, Ula M. AL-Kawaz

Pages: 62-70

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Background: Male obesity is associated with physiological changes that can negatively affect male fertility. Obese men have demonstrated a 3-fold increase in the prevalence of oligozoospermia when compared with men with normal Body Mass Index (BMI). Objective: To find the correlation between Aromatase enzyme with the following hormones (follicle stimulating hormone(FSH), Luteinizing hormone(LH), Estradiol(E2), and testosterone) in the obese infertile male. Subjects, Materials and Methods: Seventy obese infertile male (patients) and twenty obese fertile male (control) are enrolled in this study. Aromatase enzyme, FSH, LH, E2 and testosterone hormones were measured in their serum. All serum samples were measured by ELISA method. Results: Median human cytochrome enzyme level was significantly higher in patients than in control group, 87.55+ 12.48 pg./ml versus 56.95+9.88 pg./ml, P= 0.014. In patients group, a significant positive correlation was found between human cytochrome enzyme, FSH, and LH. Conclusions: The present study showed clearly that male obesity negatively affects fertility through changes in hormone levels. The results suggest that increased estrogen because of aromatization in the fatty tissue, reflected through the increase in human cytochrome enzyme (aromatase), may be an important mechanism for the hypoandrogenemia and altered sperm parameters.

Article
Effect of smoking on sex hormones, inflammatory markers and semen parameters in infertile men

Majid H. Ahmed, Anam R. Al-Salihi, Isra'a F. Al-Samarae

Pages: 9-15

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Background: Infertility is a common social and health problem. Male factor is a major cause in 30% of infertile couples. Smoking is common at reproductive age and its effect on fertilitiy is still in controversy. Studying its effect on fertility helps in the management of infertility. Objectives: To assess the effect of smoking on serum sex steroidal hormones as well as on seminal plasma (SP) IL-2, IL-6 and conventional semen parameters in infertile men and their correlations between each other. Methods: Seventy male partners of infertile couples (30 smokers and 40 non-smokers) were involved in this study. The man was considered smoker if he had history of smoking of more than 10 cigarettes per day for at least one year. Semen analysis was done according to world health organization (WHO) 2010. Specific kits were used for measurement of serum testosterone, serum estradiol II, SP IL-2, and SP IL-6. Results: The median of SP IL-2 was significantly (p<0.05) higher in smokers than in non-smokers group and positively correlated with SP IL-6 in them. In addition, IL-2 was negatively correlated with semen volume, sperm motility and morphology, while IL-6 was negatively correlated only with sperm motility. However, there was no significant difference of serum sex hormones level or on semen parameters between smokers and non-smokers. Conclusion: Cigarette smoking affect cytokine levels in the seminal plasma but has no effect on serum sex hormones level or semen parameters.

Article
Correlation between Post-Tamoxifen Hormonal Changes and Seminal Fluid Analysis Parameters Improvement .

Ali Abdulkhaleq, Ula Al-kawaz

Pages: 1-13

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Oligoasthenoteratozoospermia is a prevalent cause of male infertility. (iOAT). It is generally acknowledged that, due to the fact that spermatogenesis is a sex-hormone-dependent process, specific endocrine treatments might enhance or recover male fertility. The typical negative feedback of sex steroids is disrupted by anti-estrogen medication, leading to a rise in endogenous gonadotropin-releasing hormone secretion (FSH and LH) straight from the pituitary. The stimulation of Leydig cells in the testes by FSH and LH is thought to promote local testosterone synthesis, which in turn may improve spermatogenesis. The study sample consisted of 42 iOAT patients. Baseline seminal fluid analysis (SFA) and hormonal assessment (FSH, LH, prolactin, and testosterone) were taken. Each patient was given medical treatment with tamoxifen (20 mg/day) for three months. SFA, FSH, and testosterone were taken after three months. There was a significant increase in FSH, testosterone, sperm concentration, and progressive motility after treatment (p value <0.001), furthermore, there was no significant correlation between hormonal changes and changes in SFA study markers (p value > 0,05). Improvements in hormone levels following tamoxifen treatment for patients with idiopathic oligoasthenoteratospermia do not correlate with alterations in SFA markers.

Article
The Profile of Apoptotic Marker sFas Ligand in seminal plasma of Oligozoospermic men

Ahmed Hussein Zwamel, Anam Rasheed AL-Salihi, Sabah N. Alwachi

Pages: 19-24

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Background: The Fibroblast associated (Fas) system in the testes has been identified as a key regulator of apoptosis, a process that greatly influences the germ cell population of the testes. Objective: This study measures the level of soluble Fas Ligand (sFasL) in the semen of oligozoospermic men evaluating the association between seminal plasma sFasL and spermatogenesis. Methods: A total 58 oligozoospermic men and 29 normal volunteers were included in this study. semen was evaluated according to World Health Organization 2010 standard parameters. sFasL was measured using ELISA enzyme immunoassay for quantitative determination of sFasL. Results: s FasL level was found significantly higher (P< 0.01) in seminal plasma of oligozoospermic men, with weak correlation of the level of this marker with the degree of severity of oligozoospermia. Conclusions: The apoptotic marker, sFasL is a novel marker found in the seminal plasma of oligozoospermic men. It's level is higher in cases of oligozoospermia regardless of its severity.

Article
Effects of sperm mitochondrial activity on motility, parameter of human fertility

Alaa Ahmed, Thaer M. Farhan

Pages: 69-77

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Abstract

Mitochondria play a significant key in sperm metabolism as well as power generation. The mitochondria nucleolus is essential for several sperm activities. such as sperm capping, hyperactivation, and acrosome reactions, and oocyte fusion, mitochondrial membrane potential can be used to study sperm mitochondrial activity, the mitochondrial integrity of sperm is evaluated by examination of mitochondrial membrane potential MMP, which may be achieved by using fluorescent dyes like JC-1 probe is composed of 5,5,6,6-tetrachloro-1,1,3,3-tcarbocyanine iodide. To study the correlation between mitochondrial membrane potential Red MMP and sperm motility . This study included 42 male samples who were separated into two groups. (21 normozoospermic, 21 asthenozoospermia) through the period of attendance at the infertility clinic at High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, and Um Al-Banin Center for Management and in vitro fertilization the collected semen was obtained and seminal fluid analysis was assisted according to (WHO,2021). fluorescent staining of the sample prepared is done by using an MMP Assay Kit (with JC-1) was performed. A positive significant correlation between sperm motility percentage and red MMP intensity (p < 0.001). Mitochondrial activity plays an essential function in sperm motility and male fertility Male infertility, Sperm Motility, Mitochondrial Membrane Potential, MMP Assay Kit (with JC-1).

Article
The Impact of Obesity on Some Reproductive Hormones in Infertile Men

Mahdi Abdulwahed Mahdi, Ruwaidah Fawziy Khaleel, Mutaz Sabah Ahmeid

Pages: 44-51

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Background: Obesity, defined by the World Health Organization (WHO) as “abnormal or excessive fat accumulation that may impair health .The effects of obesity on male reproduction have been less well studied than those on female reproduction, but there is a growing body of evidence suggesting that obesity has an adverse effect on male reproduction However, a little is known about the effect of obesity on male reproductive system and infertility. Infertility is defined as inability to achieve conception within one year. It has not yet been clearly established how excess adiposity relates to the biological changes that underlie male infertility, although there are several theories worth exploring. The endocrine abnormalities associated with obesity in women are well known with an increase in androgen metabolism and changing in reproductive hormones in over weight and obese men. Objective: The study aim at assessing the role of obesity in infertile males through measurement of BMI, some of sex hormones. Methods: This study was carried out in Tikrit Teaching Hospital, on the adult male population aged 17-45 years, from September 2013 to April 2014. The recruited cases divided into 90 infertile obese male and 30 normal weights infertile as pathological control group and 30 normal weight fertile men as normal control group.The serum samples willed collect of the patients and measure the concentrations of the sex hormones (FSH, LH, INHB) by using ELISA technique. Body Mass Index Calculation Height (m) and weight (kg). Results: There was no significant correlation between BMI (30.1±93.45, 21.40±5.24,23.24±1.42)kg/m2 in patients group, pathological control group and control group and serum LH level (22.35±12.79, 19.31±9.94, 13.90±8.33) ml U/ml in all three group respectively. There was a significant negative correlation (P< 0.03) between BMI (23.24±1.42)kg/m2 and serum FSH level (7.10±3.77) ml U/ml, in control group. While there was no significant correlation between BMI (30.19±3.45,21.40 ±5.24) kg/m2 and serum FSH level (13.59±15.72, 11.58±14.06) ml U/ml in both patients' group and pathological control group respectively.There was no significant correlation between BMI (30.19±3.45, 21.40±5.24,23.2±1.42) kg/m2and serum INHB level in the patients group, pathological control group and control group (88.8±57.96, 108.51±78.39, 141.65±63.95) pg/ml respectively. Conclusions: The BMI did not correlated with some reproductive hormones (LH, FSH,INHB) in obese infertile males, but there was a significant correlation between the FSH and BMI in control group. In infertile obese group found the highest level of LH, FSH, and the lowest level of INHB comparing with other group in this study.

Article
Correlation of serum and seminal plasma human growth hormone concentration with semen parameters of normozoospermic and infertile men

Muhammad-Baqir M-R. Fakhrildin

Pages: 18-24

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Background: Human growth hormone (HGH) is undisputedly a potent hormone with a wide variety of biological effects. The anabolic actions of human growth hormone have made it attractive as a potential agent for catabolic problems in a wide range of clinical conditions. Objectives: In the present study, we investigated the possible relationship between levels of HGH in serum (S. HGH) and seminal plasma (Sp. HGH) and semen parameters in normozoospermic (NZS) men and infertile patients. Materials and Methods: In total, 66 infertile patients with azoospermia (AZS; no. 52), asthenozoospermia (AsZS; no. 6) and oligoasthenoteratozoospermia (OATZS; no. 8), and normozoospermic men (NZS; no. 12) were included in this study. From each subject, semen and blood samples were taken to assess seminal plasma and sperm parameters and levels of S. HGH and Sp. HGH; respectively. Results: The highest S. HGH was evaluated in AZS patients when compared to NZS and other infertile groups. Significant elevation (P<0.05) in the level of S. HGH was assessed for AZS patients as compared to NZS men. In contrast, the level of Sp. HGH in NZS men was significantly elevated (P<0.05) when compared to AZS patients only. Positive and significant correlations were noticed between levels of Sp. HGH and semen liquefaction time in NZS, AZS and OATZS groups. In NZS men, positive and significant correlation were observed between Sp. HGH and semen volume and negative and significant correlations were detected between Sp. HGH and percentages of sperm motility, progressive motility, immobility and agglutination. Conclusion: Our study represents the first study in Iraq showing that the level of HGH in serum and seminal plasma affect male fertility and sperm parameters in normozoospermic males and infertile patients. Further biochemical and molecular studies are recommended to investigate the mode of action of HGH and its receptors in relation to fertility.

Article
The Effect of Oxidative Stress on Oocyte Characteristics and Pregnancy Outcome in a Sample of Iraqi Infertile Women Undergoing ICSI

Fatima Abdulrazzaq Al-Muttalibi, Hayder A. L. Mossa, Liqaa R. Altamimi, Wasan A. Abdulhamed

Pages: 109-123

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Oxidative stress in the field of reproduction has been extensively considered in association with sperm properties and male infertility; in any case, the effect of oxidative stress in association with oocyte trademark got less thought than that of sperms. The goal of the study is to understand the possible association among serum and follicular oxidative markers in infertile women and oocyte characteristics and pregnancy result in ICSI cycles. The present case-control study included 57 infertile women undergoing ICSI that was done in the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies at Al-Nahrain University. The assessment started in April 2018 and connected with March 2019. Mean metaphase II oocyte count of all women was 5.70±3.87, that of pregnant women was 6.90±3.68 and that of non-pregnant women was 4.46±3.73; there was a basic qualification in mean metaphase II oocyte check among pregnant and non-pregnant women (P = 0.016); being higher in pregnant women. The mean abnormal oocyte count of all women was 0.63±1.26, that of pregnant women was 0.28±0.45 and that of non-pregnant women was 1.00±1.68. Oxidative stress markers inside and out affected clinical pregnancy result (P < 0.05) and appear to impact clinical pregnancy bring about women undergoing ICSI due to its effect of oocyte characteristics.

Article
Role of Clomiphene Citrate and Tamoxiphene Citrate in Mice Sperm Motility and Activity

Rae ʼd Abdalelah Abbas, Muhammad-Baqir M-R. Fakhrildin, Mohammad Oda Salman

Pages: 1-5

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Abstract

Background: Both clomiphene citrate and tamoxiphene citrate, as an anti estrogen, is the most common prescribed medication for male infertility.In humans, ant estrogens interfere with the normal negative feedback of sex steroids at the hypothalamus and pituitary, thereby increasing endogenous gonadotropin releasing hormone (GnRH) secretion from the hypothalamus and follicle stimulating hormone (FSH) and luteinizing hormone (LH) secretion directly from the pituitary. Objective: The objective of this study was to investigate the effect of clomiphene citrate (CC) and tamoxiphene citrate (TC) administered to male mice on quality of sperm motility and activity. Materials and Methods: Ninety six male mice were divided into two major groups, and every one of these groups was subdivided into three minor groups involving control and two treated groups. In the CC study, 48 mice were administrated orally 0, 0.0125 mg and 0.025 mg as control (G 1), low dose (G 2) and high dose (G 3) for 42 days. While, in the TC study, 48 mice were administrated orally 0, 0.01 mg and 0.02 mg as control (G 1), low dose (G 2) and high dose (G 3) for 42 days. Then, the male mice were sacrificed, both vas deferens were collected and assessment sperm motility and activity. Results: The results of present study appeared that the use high dose of CC or TC significantly increment (P<0.05) sperm motility and activity as compared to control groups. Conclusions: Based on the results of this study, it can be concluded that the administration of high dose of either CC or TC increases sperm motility and activity.

Article
Comparing the Activation Role of Centrifugation Swim-up and the Density Gradient Combined with ALLGrad Sperm Preparation Techniques

Sahar Muhssin Muhammad, Muhammad-Baqir Muhammad-Rashad Fakhrildin

Pages: 111-134

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Abstract

In about 40% of infertile couples, the husband was found to be either the single or a contributing cause of infertility and the systemic management ready for those couples with male infertility are restricted. 135 couples with infertility shared herein; the husbands required in vitro activation for their sperm samples, their wives however; had no fertility problem and were submitted ovarian induction protocol. However; Sperm preparation was done using both, the centrifugation indirect swim-up technique with Global medium and density gradient with ALLGrad solution. While ALLGrad 45% is a ready-to-be-used upper layer. There was an acceleration in seminal parameters after preparation using both various techniques. So, a highly significant increment (P≤0.001) in the percentages of progressive forward motility was in grades (A and B) and grade (A) progressive sperm motility, also a significant enhancement (P≤0.05) in percentage of morphologically normal sperms when applying density gradient mechanism in relation to centrifugation swim-up technique. This study concludes that the use of density gradient mechanism with ALLGrad solution and Global culture medium are more efficient in achieving better percentages of progressive forward motility grades (A and B), grade (A) progressive motility and morphologically normal values of spermatozoa than centrifugation indirect swim-up technique by using Global culture medium. However, it was found there was a non-significant difference when we use both techniques concerning other sperm parameters.

Article
The New Approach of Hyaluronic Binding Assay in Relevance to Sperm Activation by Direct Swim-up Technique in Iraqi Infertile Men

Ezdehar N. Ali, Hayder A. L. Mossa, Ula M. R. Al-Kawaz

Pages: 15-31

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Abstract

Hyaluronic acid (HA) is a polysaccharide, that composed in the extracellular matrix of the cumulus cells, and considered to take function in choosing mature spermatozoa. The Sperm-hyaluronic binding assay (HBA) is significant diagnostic instrument for suspected male infertility when examining the semen. The HBA slide supplies the ratio of mature binding sperm in the specimen. To evaluate sperm parameters, and to evaluate the (HBA Score percentage (%) before and after activation. Twenty-five infertile couples a sharer in this current study through their attendance to the Al Nahrain University. Males undergoing seminal fluid analysis were done according to (WHO 2010, and WHO 1999). Sperm parameters assessed and calculate the HBA Score% pre-and-post-direct swim-up technique, the results were statistically tested. In Post-activation there was considerable increment noticed in the progressive motility and morphology of spermatozoa, likewise significant improvement in the (HBA score %). Furthermore, considerable reduction in the concentration, agglutination of spermatozoa and round cells count, when compared to pre-activation. The mean of binding of spermatozoa to hyaluronan pre-activation (direct swim-up technique) was less than normal limit for normozoospermic males. However, it significantly improves post-activation.

Article
Role of leptin in infertile men before and after treatment with clomiphene citrate and vitamin E

Ahlam H. Essai, Waleed H. Yousif

Pages: 29-33

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Abstract

Background: Leptin is an adipocyte —secreted protein that participates in the regulation of energy homeostasis. It prevents the body from storing fat, controls hunger and cravings, regulates food intake and energy expenditure, provides the body with an index of nutritional status and controls the whole body fat metabolism. Leptin is a product of ob gene created by adipocytes. It seems to signal metabolic information to the reproductive system. Objective: The aim of this study to evaluate the relationship between serum leptin and infertility in oligozoospermic men. Materials and Methods: Seventy men were investigated; fertile normozoospermic as a control (n=35) and infertile oligozoospermic (n=35). The patients underwent estimation of body weight (kg), height body mass index (BMI), semen analysis, serum FSH, LH, testosterone and leptin, lipid profile and serum malondialdehyde (MDA). The infertile group was given a treatment course of clomiphene citrate (50 mg) and vitamin E (400mg) and then all the previous parameters were reevaluated after 3 months. Results: Mean body weight was significantly higher in infertile oligozoospermia compared to controls. The height showed no significant difference between the groups. Hormonal profile revealed significant (P=0.0001) difference in FSH between control group and oligozoospermic group (7.04±4.20 versus 3.35±1.47 mIU/ml), but after treatment with clomiphene citrate and vitamin E there is a slight non-significant (P=0.231) decrease in the level of FSH in oligozoospermic group. The level of testosterone showed a statistically significant (P=0.0001) difference between fertile normozoospermic (5.52 ±1.29 ng/ml) and infertile oligozoospermic. This hormone showed a significant (P<0.0001) increase in its level after treatment with clomiphene citrate and vitamin E (3.48±1.56 ng/ml). Other hormone showed non significant difference between the two groups pre and post treatment. Lipid profile showed no significant difference between the two groups. There was no significant (P=0.477) difference in serum MDA between the control and the infertile groups (4.69±1.32 vs. 5.18±1.19 µmol/L) respectively, but after treatment the results showed a mild significant (P=0.026) decrease in comparison to the level in the control group and also a significant (P=0.0001) decrease in comparison to the level before treatment. Infertile oligozoospermic had significantly higher serum leptin level (8.03±1.22 ng/ml) than control (3.62 ± 1.00 ng/ml). Conclusion: Serum leptin demonstrated a significant positive correlation with age, body weight, BMI and a significant inverse correlation with serum testosterone. It had nonsignificant correlation with the height and sperm concentration. These results are suggestive of a link between the adipocyte derived hormone leptin and male reproduction.

Article
Molecular Identification of Azoospermia in Iraqi Patients Based on (NR5A1) Gene Sequencing

Shaimaa Y. Abdulfattah, Najwa S. Ahmed, Farah T. Abdullah, Bushra J. Majeed

Pages: 32-44

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Abstract

Background: Infertility is considered one of the main public health issues, as it affects about 15% of the couples of reproductive age. The male factor is involved in 40% - 50% of infertility cases. It is difficult to assess accurately the overall magnitude of the contribution of genetics to infertility as most, if not all, conditions are likely to have a genetic component. The genetic causes of infertility are varied and include chromosomal abnormalities, single gene disorders and phenotypes with multifactorial inheritance. Some genetic factors influence males specifically, whereas others affect both males and females. Frequently, however, in the clinic no clear cause for the observed infertility could be diagnosed which at least in part, it reflects our still poor understanding of the basic mechanisms that regulating and controlling the genetic networks of male infertility. Objective: To study the molecular identification of Azoospermic infertile patients by the gene sequencing of NR5A1. Subjects, Materials and Methods: A study carried out during the period from November 2014 to June 2015. Fifty specimens were collected from thirty azoospermic patients and twenty normal healthy subjects (normozoospermic subjects) as control their age ranged between 23 and 48 years old, the seminal fluid of cases indicated that liquefaction time, color and viscosity equal in normozoospermic subjects (control group) and patient group while there is significant difference P≥0.05 in sperm count reach to more than 20 million and motility reach to more than > 25% in control subjects while there is no sperm count found in azoospermic patients. Then blood was collected for hormonal assay, in azoospermic patients the results revealed a gradual decrease in serum testosterone levels with a concomitant increase in serum follicular stimulating hormone (FSH) level when compared with control subjects . NR5A1 gene were investigated in 30 samples of extracted DNA from azoospermic patients by using polymerase chain reaction (PCR) method it can directly detect the NR5A1 gene content after it had been molecularly identified then were sent successfully for sequencing analysis ,this study examined the presence of two transversion and one transition mutation of NR5A1 gene in azoospermic patients compared with control subjects, there’s no mutation in the same gene when compared with gene bank.

Article
Assessment Quality of Selected Sperm During Glass Wool and Sephadex Filtration Techniques in Infertile Men

Reem Q. M. Wafeeq, Hayder A. L. Mossa

Pages: 1-14

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Abstract

Infertility has been defined as the disability to fulfill pregnancy after twelve months of regular sex coition, with no contraceptive taken. Male factor infertility was explained in terms of low spermatozoa concentration (oligozoospermia), or morphology (teratozoospermia), impaired motility (asthenozoospermia), or in some cases, total lack of spermatozoa in the ejaculate (azoospermia). In several cases, a collection of one, or more of these sperm variables defects may be noticed, evaluation these factors by the initial and most important step is seminal analysis. Our study aims to study some sperm characteristics in asthenozoospermia men in comparison with normozoospermia men before and after glass wool and Sephadex activation. This study involved 60 semen samples collected from male patients that came to male infertility clinic at Al-Nahrain University; the recruited semen samples were divided into 2 groups, (40 asthenozoospermic and 20 normozoospermic subjects). After collected semen samples, and assessed analysis of seminal fluid. Each semen samples were divided into 3 aliquots. The first aliquot prepared was In-Vitro to assessed sperm characterization before activation, the second part using glass wool filtration (GWF) technique, while the last part was prepared using Sephadex. Both techniques resulted equally in reducing sperm concentration, were equally effective in upgrading sperm motility and in minimizing round cell count; however, Sephadex was superior to glass wool method in upgrading the percentage of morphologically normal sperm. Both Sephadex and glass wool techniques has been proved effective to improve semen quality.

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Iraqi Journal of Embryos and Infertility Researches (IJEIR)

High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University

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