Despite that the SARS-CoV-2 pandemic has been controlled, it has affected a large proportion of the population, raising some concerns about potential sequelae in men at reproductive age. To contribute to the clarification of this issue, we performed a retrospective study comparing semen parameters values before and after confirmed SARS-CoV-2 infection in a large cohort of infertile men, compared to a control group that did not undergo SARS-CoV-2 infection. Wilcoxon test on paired samples and general linear regression model showed that SARS-CoV-2 infection has a detrimental effect on semen volume values (p < 0.005). However, semen volume seems to be significantly lower only during the first spermatogenic cycle after SARS-COV-2 infection (p < 0.005) and mainly in unvaccinated patients (p < 0.05). In addition, we detected alterations in progressive motility in patients infected with the alpha SARS-COV-2 strain (p < 0.05). In conclusion, our results show that although SARS-CoV-2 has a small effect on semen volume and sperm motility in infertile men, depending on the infectious strain or vaccination status, pre-infection values of semen parameters appear to be restored over one spermatogenic cycle after infection.

UNASSIGNED: Epididymal cyst lesions (ECLs) include both spermatoceles and epididymal cysts and are often incidentally found on physical exam or scrotal US (SUS). We aimed to determine the association of ECLs and semen parameters among men presenting for fertility evaluation.
UNASSIGNED: We reviewed men at our institution who had at least 1 semen analysis and SUS available for review between 2002 and 2022. SUS data included testicular measurements, presence or absence of subclinical varicocele, and size and laterality of ECL, if present. Demographic and clinical information including serum testosterone and follicle-stimulating hormone and semen parameters were compared between men with and without ECLs.
UNASSIGNED: Among 861 men, 164 (19%) had unilateral right ECL (median 4 mm, interquartile range 3-8 mm), 189 (22%) had unilateral left ECL (median 4 mm, interquartile range 3-9 mm), and 113 (13%) had bilateral ECL. Patients with ECLs were significantly older than men without ECLs at the time of evaluation but had no statistically significant difference in semen volume, sperm concentration, sperm motility, sperm morphology, total motile sperm count, or serum hormonal values. Analysis of men with unilateral and bilateral ECLs showed that ECL size and laterality did not significantly correlate with any semen parameter evaluated.
UNASSIGNED: We found no association between ECLs and semen parameters. Patients should be counseled toward conservative management with observation for asymptomatic ECLs in the setting of fertility evaluation.

OBJECTIVE: The aim of this study is to evaluate the relationship between semen parameters, complete blood count, and hormone levels on the day of spermiogram.
METHODS: Semen parameters of 230 patients who were examined for full blood count test and hormone levels on the day of spermiogram were included in the study. Patients were grouped according to the total motile sperm count (TMSC), semen parameters, hemogram, and hormone levels were compared between groups.
RESULTS: No statistically significant difference was found between groups in neutrophil ratios, neutrophil, lymphocyte, platelet counts, neutrophile-to-lymphocyte ratio (N/L), and platelet-to-lymphocyte ratio (P/L). However, white blood cell (WBC) and lymphocyte counts were weakly positively correlated with sperm concentration (p=0.021, p=0.026), and a weakly significant positive correlation was found with WBC and neutrophil count for motility (p=0.038, p=0.004). FSH level was found to be lower in cases with TMSC >20 m than those with TMSC <5 m and 5-10 m (p=0.004, p=0.022). LH was found to be lower in cases with TMSC >20 m than those with TMSC <5 m (p=0.048). A negative correlation was found for both FSH and LH levels with sperm concentration, motility, and TMSC (p<0.001, p=0.014).
CONCLUSIONS: In this study, a significant negative correlation was demonstrated between FSH, LH levels and sperm concentration, motility, TMSC. N/L and P/L cannot be used as predictive markers of sperm quality. The results of a significant positive correlation between WBC, neutrophil counts, and sperm parameters encourage researchers to conduct prospective randomized controlled trials with larger sample sizes and different inflammatory and hormonal markers.

OBJECTIVE: Chromosomal abnormalities play an important role in male infertility, which is becoming a significant issue in human fertility. Aim of this study was to evaluate the incidence of spermatic aneuploidies and diploidies in human sperm, according to semen parameters.
METHODS: We performed semen analysis according to the 6th edition of WHO criteria in 50 male subjects; samples were divided into normozoospermic (n = 23) or those with altered seminal parameters (n = 27). To assess chromosomal numerical alterations of sperm, fluorescence in situ hybridization (FISH) was used.
RESULTS: A significant increase in aneuploidies and diploidies was observed in samples with altered seminal parameters. Furthermore, stratifying this group, we observed a significant increase in aneuploidies and total abnormalities in oligozoospermic, asthenoteratozoospermic (AT), and oligoteratoasthenozoospermic (OAT) samples compared to normozoospermic.
CONCLUSIONS: Our results showed the correlation between altered seminal parameters and numerical chromosomal abnormalities, confirming that sperm FISH analysis could be an additional clinical tool to assess reproductive potential in infertile males. Moreover, our results point to the importance of updating the normality ranges for detecting chromosomal aneuploidies using FISH.

BACKGROUND: The research regarding the effect of hookah smoking on health is still deficient, even though it has been proven to jeopardize human health by raising the hazard of different types of cancers, infections, and cardiovascular disease. We aimed to study the effect of dual tobacco smoking (hookah and cigarettes) on semen parameters of infertile men.
METHODS: In this cross-sectional study, we studied the effect of different types of smoking patterns on human semen parameters among men who visited IVF laboratories to do a seminal fluid analysis (SFA). A total number of 761 participants were included, divided into the following: 108 dual smokers, 219 hookah smokers, 222 cigarette smokers, and 212 non-smokers. To analyze the effect of dual smoking on normal morphology, an interaction term between the cigarette index and hookah index was used.
RESULTS: Multivariable regression analysis after adjustment for age, BMI, education level, children, chronic diseases, varicocele, testicular surgery history, infertility duration, and cause revealed no significant difference in the sperm concentration and the percentage of progressive motility between non-smokers, cigarette smokers, or hookah smokers. However, there was a significant difference in the log of normal morphology percentage between the three groups. Cigarette and hookah smoking were significantly associated with having lower percentages of normal morphology. There was a significant difference in the log-normal morphology %, where light and heavy dual smokers had the least exponential beta of log-normal morphology %, 0.43 (95% CI: 0.33-0.55) and 0.36 (95% CI: 0.24-0.53), respectively.
CONCLUSIONS: Dual tobacco smoking can adversely affect sperm morphology.

Semen analysis is essentially used to check the fertility of a man, especially when couples are having difficulties conceiving. Studies concerning male fertility, testicular factors, and seminal characteristics have been under investigation for the last few decades. In 1980, the World Health Organization (WHO) started reaching out to scientists in order to set standards for high-quality semen and develop a semen manual. From this point to the present, six editions of this manual have been produced, delineating the characteristics of semen and reporting protocols for semen analysis. Sperm morphology is analyzed as per WHO norms to measure the biological capacity of a male for reproduction. Both national and international manuals have been developed, with the latest, the sixth edition, produced in July 2021. This review paper conveys the current WHO publication\'s updates and identifies the clinical recommendations for proper evaluations. The publication considers the characteristics of semen in order to discuss the content of the previous editions of the WHO. It is also utilized to assess the method applied to determine the DNA presence of sperm fragmentation.

OBJECTIVE: This study focuses on the association between seminal concentration of prosaposin and ambient air pollutants and whether the association affects the normal fertilization rate in vitro fertilization (IVF) treatment.
METHODS: The cohort of 323 couple participants aged 22-46 was recruited from Jan. 2013 to Jun. 2018. At enrollment, resident address information was obtained and semen parameters of male counterparts were evaluated according to WHO criteria. We used inverse distance weighting interpolation to estimate the levels of ambient pollutants (SO2, O3, CO, NO2, PM2.5, and PM10) in the surrounding area. The exposure of each participant was estimated based on the data gathered from air quality monitoring stations and their home address over various periods (0-9, 10-14, and 0-90 days) before semen sampling. The generalized linear regression model (GLM) and the Bayesian kernel machine regression (BKMR) were used to analyze the associations between pollutants, semen parameters, prosaposin, and normal fertilization. Additionally, the mediating effect of prosaposin and semen parameters on the link between pollutants and normal fertilization was investigated.
RESULTS: GLM and BKMR showed exposure to ambient air pollutants was all associated with the concentration of seminal prosaposin, among them, O3 and CO were also associated with normal fertilization (-0.10, 95 %CI: -0.13, -0.06; -26.43, 95 %CI: -33.79, -19.07). Among the semen parameters, only the concentration of prosaposin and total motile sperm count (TMC) was associated with normal fertilization (0.059, 95 %CI: 0.047, 0.071; 0.016, 95 %CI: 0.012, 0.020). Mediation analysis showed that prosaposin played a stronger mediating role than TMC in the relationship between short-term exposure to O3 and fertilization (66.83 %, P<0.001 versus 3.05 %, P>0.05).
CONCLUSIONS: Seminal plasma prosaposin showed a stronger meditating effect reflect the correlation between ambient air pollutants and normal fertilization rate than conventional semen parameters, which may be used as one of the indicators between pollution and fertilization in IVF.

Exposure to mycotoxins is unavoidable in daily life through ingestion, dermal, and inhalation routes. Toxicological studies found that exposure to mycotoxins might affect male reproductive function. However, there is still a lack of population evidence. We aimed to assess the association of individual and joint exposure to spectrum of mycotoxins with semen quality. The present study included 192 participants in Beijing, China. We measured conventional semen parameters and assessed semen quality. Sixty-seven traditional or emerging mycotoxins were determined to describe the spectrum of mycotoxins. The participants were widely exposed to multiple mycotoxins, and nearly half were simultaneously exposed to more than six mycotoxins. After adjusting potential confounders, logistic regression indicated that the number and concentration of plasma mycotoxin were correlated to the risk of low semen quality. Plasma beauvericin and citrinin concentrations were associated with lower semen quality. The least absolute shrinkage and selection operator regression showed similar results to logistic regression. Quantile-based g-computation and Bayesian kernel machine regression models found that the mixture of mycotoxins was harmful to semen quality, especially in sperm motility. In conclusion, both individual and mixture of mycotoxin exposure were correlated with lower semen quality. More regulations and measures should be taken to reduce mycotoxin contamination.

UNASSIGNED: This study aimed to investigate the effects of ejaculatory abstinence on sperm parameters.
UNASSIGNED: This analysis was registered in PROSPERO (CRD42023472124). We performed a search on PubMed using the following text terms: ((\"sperm parameters\" OR \"sperm analysis\" [Mesh]) AND (\"sperm DNA fragmentation\" OR \"DNA fragmentation\" [Mesh]) AND (\"sexual abstinence\" [Mesh] OR \"abstinence\")) and an advanced search in Scopus using the terms (\"sperm parameters\" OR \"sperm parameters\" OR \"DNA fragmentation\") AND (\"abstinence\"). The sperm parameters that were investigated were sperm volume, total sperm motility, progressive sperm motility, sperm concentration, sperm morphology, and sperm DNA fragmentation (SDF). A two-day cut-off as a \"short\" or \"long\" abstinence period has been defined.
UNASSIGNED: Thirteen studies published between 2013 and 2022 were included in this meta-analysis. A total of 2,315 patients, ranging from 6 to 836 from each cohort, were enrolled in the study. We showed that longer abstinence time was associated with greater sperm concentration (mean difference [MD]: 8.19; p <0.01), sperm volume (MD: 0.96; p <0.01), and higher SDF (MD: 3.46; p <0.01), but lower progressive sperm motility (MD: -1.83; p <0.01). Otherwise, no statistically significant difference was observed in patients with longer vs. shorter abstinence times regarding total sperm motility (MD: -1.83; p = 0.06). Meta-regression analysis showed that days of abstinence were positively and linearly related to sperm concentration (slope: 3.74; p <0.01) and SDF (slope: 0.65; p = 0.044).
UNASSIGNED: According to our data, short ejaculatory abstinence is associated with better sperm quality. Indeed, a higher percentage of progressive sperm motility and lower levels of SDF have been reported in a short abstinence cohort. In contrast, the long abstinence group reported a higher sperm concentration.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023472124.

Reliable molecular biomarkers to predict fertility remain scarce. The current study explored the potential of testis-specific circBOULE RNAs as biomarkers for male infertility and sperm quality. Using RT-PCR and RT-qPCR assays, we identified seven circular RNAs from the human BOULE gene in human sperm. We found that sperm circEx3-6 RNA exhibited a significantly decreased expression in asthenozoospermia while circEx2-6 and circEx2-7 expression decreased in teratozoospermia, compared with the controls. Furthermore, circEx2-6 expression exhibited a negative correlation with sperm DNA Fragmentation Index (DFI), and circEx2-7 levels were correlated with both fertilization and cleavage rates involving assisted reproductive technologies. Further functional analyses in a transgenic fly model lent support for the roles of circBOULE RNAs in sperm development and human fertility. Collectively, our findings support that sperm circBOULE RNAs may serve as diagnostic biomarkers for assessing sperm motility and DNA quality. Hence clinical application and significance of sperm circular RNAs in assisted reproductive technologies warrant further investigation.