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Review Special Issue Series: Old and New Challenges in the...
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Review Special Issue Series: Old and New Challenges in the Management of Male Factor Infertility

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Reproductive Medicine & Andrology".

Deadline for manuscript submissions: 20 July 2024 | Viewed by 1459

Special Issue Editors

Prof. Dr. Giovanni M. Colpi

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Guest Editor
Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
Interests: azoospermia (non-obstructive and obstructive); surgical sperm retrieval for ICSI; epididymis pathology in male infertility; seminal tract surgery; severe male infertility (all kinds); sperm DNA fragmentation in clinical practice; varicocele
Special Issues, Collections and Topics in MDPI journals
Dr. Ettore Caroppo

E-Mail
Guest Editor
Department of Maternal and Child Health, Reproductive and IVF Unit, Asl Bari, Conversano, Italy
Interests: male infertility; non-obstructive azoospermia; hormonal treatment of male infertility; epigenetic factors; infertility
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Review Special Issue Series, entitled “Old and New Challenges in the Management of Male Factor Infertility”, is committed to presenting an exclusive collection of comprehensive reviews.

Although the infertility of couples is caused by a male factor in 30-50% of cases, an adequate (or even any) andrological assessment of the male partner is seldom obtained, the assumption being that only the male gamete, and not the human subject, matters in the achievement of oocyte fertilization and pregnancy, regardless of the man’s health condition. This represents a clear case of gender discrimination. The reproductive ability of couples with severe male factor infertility may be significantly impaired without the appropriate medical or surgical management of the severe spermatogenic dysfunction; on the other hand, couples are referred to donor sperm IUI or IVF when the male partner is azoospermic, without attempting to individuate the cause and the possible medical or surgical treatment applicable to such a condition. Managing infertile couples in such a way may expose couples to an increased risk of treatment failure; in addition, since male infertility has been proposed as an independent risk factor for poor health status and early mortality, if infertile men are evaluated early in life, there is an opportunity for health assessment, counseling, and disease prevention. Clinical training in male infertility is most commonly an aspect of andrology training; however, some urologists or endocrinologists may have little experience in the counseling and management of infertile men. The purpose of the present Special Issue is, therefore, thanks to the contribution of internationally renowned experts in the field, to provide the readers with a comprehensive and evidence-based update on the challenges faced in the management of male factor infertility.

Prof. Dr. Giovanni M. Colpi
Dr. Ettore Caroppo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • male infertility
  • male gamete
  • reproductive ability
  • surgical management
  • spermatogenic dysfunction

Published Papers (2 papers)

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Review

29 pages, 1697 KiB  
Review
Leukocytospermia and/or Bacteriospermia: Impact on Male Infertility
by Ralf Henkel
J. Clin. Med. 2024, 13(10), 2841; https://doi.org/10.3390/jcm13102841 - 11 May 2024
Viewed by 394
Abstract
Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the prevalence of male factor infertility is about 7%. Among numerous other causes, the prevalence of male genital tract infections reportedly [...] Read more.
Infertility is a globally underestimated public health concern affecting almost 190 million people, i.e., about 17.5% of people during their lifetime, while the prevalence of male factor infertility is about 7%. Among numerous other causes, the prevalence of male genital tract infections reportedly ranges between 10% and 35%. Leukocytospermia is found in 30% of infertile men and up to 20% in fertile men. Bacterial infections cause an inflammatory response attracting leukocytes, which produce reactive oxygen species (ROS) and release cytokines, both of which can cause damage to sperm, rendering them dysfunctional. Although leukocytospermia and bacteriospermia are both clinical conditions that can negatively affect male fertility, there is still debate about their impact on assisted reproduction outcomes and management. According to World Health Organization (WHO) guidelines, leukocytes should be determined by means of the Endtz test or with monoclonal antibodies against CD15, CD68 or CD22. The cut-off value proposed by the WHO is 1 × 106 peroxidase-positive cells/mL. For bacteria, Gram staining and semen culture are regarded as the “gold standard”, while modern techniques such as PCR and next-generation sequencing (NGS) are allowing clinicians to detect a wider range of pathogens. Whereas the WHO manual does not specify a specific value as a cut-off for bacterial contamination, several studies consider semen samples with more than 103 colony-forming units (cfu)/mL as bacteriospermic. The pathogenic mechanisms leading to sperm dysfunction include direct interaction of bacteria with the male germ cells, bacterial release of spermatotoxic substances, induction of pro-inflammatory cytokines and ROS, all of which lead to oxidative stress. Clinically, bacterial infections, including “silent” infections, are treatable, with antibiotics being the treatment of choice. Yet, non-steroidal antiphlogistics or antioxidants should also be considered to alleviate inflammatory lesions and improve semen quality. In an assisted reproduction set up, sperm separation techniques significantly reduce the bacterial load in the semen. Nonetheless, contamination of the semen sample with skin commensals should be prevented by applying relevant hygiene techniques. In patients where leukocytospermia is detected, the causes (e.g. infection, inflammation, varicocele, smoking, etc.) of the leukocyte infiltration have to be identified and addressed with antibiotics, anti-inflammatories or antioxidants in cases where high oxidative stress levels are detected. However, no specific strategy is available for the management of leukocytospermia. Therefore, the relationship between bacteriospermia and leukocytospermia as well as their specific impact on functional sperm parameters and reproductive outcome variables such as fertilization or clinical pregnancy must be further investigated. The aim of this narrative review is to provide an update on the current knowledge on leukocytospermia and bacteriospermia and their impact on male fertility. Full article
(This article belongs to the Special Issue Review Special Issue Series: Old and New Challenges in the Management of Male Factor Infertility)
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10 pages, 552 KiB  
Review
Partial Epididymal Obstruction as a Cause of Idiopathic Oligozoospermia: A Reproductive Urologist’s Perspective Following 35 Years of Surgical and Clinical Experience
by Giovanni M. Colpi and Ettore Caroppo
J. Clin. Med. 2024, 13(2), 382; https://doi.org/10.3390/jcm13020382 - 10 Jan 2024
Viewed by 819
Abstract
The role of partial epididymal obstruction as contributing to the development of oligozoospermia has been neglected for decades. In the early 1970s, however, Robert Schoysman, a gynecological surgeon devoted to the surgical and medical management of male factor infertility, dedicated many efforts to [...] Read more.
The role of partial epididymal obstruction as contributing to the development of oligozoospermia has been neglected for decades. In the early 1970s, however, Robert Schoysman, a gynecological surgeon devoted to the surgical and medical management of male factor infertility, dedicated many efforts to study such a pathology and its possible effects on male fertility. Following the studies of this pioneer in the field, we concentrated our attention to the patterns of partial and complete epididymal obstruction during surgical scrotal exploration, once made possible even in oligozoospermic men by diagnostic and therapeutic interventions, such as vasovesciculography or seminal tract washout test, at present considered obsolete and no longer feasible in light of the current guidelines. Interestingly, we found signs of partial epididymal obstruction in about 30% of oligozoospermic men with normal testicular volume and serum FSH level as well as normal spermatogenesis at testis biopsy. We, then, compared the findings of scrotal ultrasound with those of scrotal exploration and found that the ultrasound abnormalities of the epididymis were highly predictive of anatomic alteration of the gland. In the present study, we report our experience, together with a historical review of the literature, on this topic. Full article
(This article belongs to the Special Issue Review Special Issue Series: Old and New Challenges in the Management of Male Factor Infertility)
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