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   Table of Contents     
REVIEW ARTICLE  
Year : 2015  |  Volume : 8  |  Issue : 4  |  Page : 191-196
 

Trends of male factor infertility, an important cause of infertility: A review of literature


1 Department of Obstetrics and Gynecology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India
2 Department of Physiology, Rural Institute of Medical Sciences, Safai, Uttar Pradesh, India

Date of Submission09-May-2015
Date of Decision10-Jul-2015
Date of Acceptance13-Aug-2015
Date of Web Publication25-Nov-2015

Correspondence Address:
Naina Kumar
Department of Obstetrics and Gynecology, Mahatma Gandhi Institute of Medical Sciences, Sewagram, Wardha - 442 102, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0974-1208.170370

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   Abstract 

Infertility and problems of impaired fecundity have been a concern through ages and is also a significant clinical problem today, which affects 8-12% of couples worldwide. Of all infertility cases, approximately 40-50% is due to "male factor" infertility and as many as 2% of all men will exhibit suboptimal sperm parameters. It may be one or a combination of low sperm concentration, poor sperm motility, or abnormal morphology. The rates of infertility in less industrialized nations are markedly higher and infectious diseases are responsible for a greater proportion of infertility. The present literature will help in knowing the trends of male factor infertility in developing nations like India and to find out in future, various factors that may be responsible for male infertility.


Keywords: Infertility, semen, sperm


How to cite this article:
Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci 2015;8:191-6

How to cite this URL:
Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci [serial online] 2015 [cited 2022 May 17];8:191-6. Available from: https://www.jhrsonline.org/text.asp?2015/8/4/191/170370



   Introduction Top


Infertility is a condition with psychological, economic, medical implications resulting in trauma, stress, particularly in a social set-up like ours, with a strong emphasis on child-bearing. According to the International Committee for Monitoring Assisted Reproductive Technology, World Health Organization (WHO), infertility is a disease of reproductive system defined by failure to achieve the clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. [1] It can also be defined as failure of couple to conceive after 12 months of regular intercourse without the use of contraception in women <35 years; and after 6 months of regular intercourse without the use of contraception in women ≥35 years. [2]


   Global incidence of infertility Top


There are no reliable figures for global prevalence of infertility, [3] but estimates suggest that nearly 72.4 million couples globally experience fertility problems. [4] As per the WHO estimates 60-80 million couples worldwide currently suffer from infertility. [5] It varies across regions of the world and is estimated to affect 8-12% of couples worldwide. [6],[7] It tends to be the highest in countries with high fertility rates; an occurrence termed "barrenness amid plenty." [8] In recent decades, infertility has impacted an increasing number of couples. Approximately, 10% of couples in the United States are defined as infertile based on the inability to conceive after 12 months of unprotected intercourse. [9],[10] According to National Center for Health Statistics, the absolute numbers of impaired fecundity increased by about 2.7 million women, from 4.56 million in 1982 to 7.26 million in 2002, then fell slightly to 6.71 million in 2006-2010. [11] Moreover, the fertility rate in men younger than age 30 years has also decreased worldwide by 15%. [12]


   Infertility in india Top


As per the WHO, the overall prevalence of primary infertility ranges between 3.9% and 16.8%. [5] Also, the estimates of infertility vary widely among Indian states from 3.7% in Uttar Pradesh, Himachal Pradesh, and Maharashtra, [13] to 5% in Andhra Pradesh, [14] and 15% in Kashmir. [15] Moreover, the prevalence of primary infertility has also been shown to vary across the tribes and castes within the same region in India. [13],[16]

It was reported that 40% of infertility cases were related to men, 40% of women and 20% of both sexes. [17] According to a multicentric study conducted by WHO from 1982 to 1985, 20% of cases were attributed to male factors, 38% to female factors, 27% had causal factors identified in both partners, and 15% could not be satisfactorily attributed to either partner. [18] In Indian couples seeking treatment, the male factor is the cause in approximately 23%. [15] A recent report on the status of infertility in India, states that nearly 50% of infertility is related to the reproductive anomalies or disorders in the male. [19] In addition, over 25% of infertility cases, no detectable cause can be traced after routine tests, which leaves the case as unexplained infertility. [19]


   Male Infertility: An Important Factor Top


Male infertility refers to a male's inability to result pregnancy in a fertile female. "Male factor" infertility is seen as an alteration in sperm concentration and/or motility and/or morphology in at least one sample of two sperm analyzes, collected 1 and 4 weeks apart. [20] In humans, it accounts for 40-50% of infertility [21],[22],[23] and affects approximately 7% of all men. [24] Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity. [25]

Males with sperm parameters below the WHO normal values are considered to have male factor infertility. [26] The most significant of these are low sperm concentration (oligospermia), poor sperm motility (asthenospermia), and abnormal sperm morphology (teratospermia). Other factors less well associated with infertility include semen volume and other seminal markers of epididymal, prostatic, and seminal vesicle function. [27] As high as 90% of male infertility problems are related to count and there is a positive association between the abnormal semen parameters and sperm count. [28] The problem with sperm count, motility, and morphology stems from disarray in control mechanism, including pre-testicular, testicular, and post-testicular factors. [29]

Hence, semen analysis remains the single most useful and fundamental investigation with a sensitivity of 89.6%, that it is able to detect 9 out of 10 men with a genuine problem of male infertility. [30] It is a simple test that assesses the formation and maturity of sperm as well as how the sperm interacts in the seminal fluid. It also provides insight not only on sperm production (count), but the sperm quality (motility, morphology) as well. [31]


   Normal seminal parameters Top


Semen analysis is an imperfect tool but remains the cornerstone to investigate male infertility. [32] It must be performed to a consistently high standard in order to evaluate the descriptive parameters of the ejaculate. [20],[33] Although this assay reveals a useful information for the initial evaluation of the infertile male, it is not a test of fertility. [34] It provides no insights into the functional potential of the spermatozoon to undergo subsequent maturation processes required to achieve fertilization. It is important that while the results may correlate with "fertility," the assay is not a direct measure of fertility. [35],[36],[37]

The WHO has revised lower reference limits for semen analyses: The following parameters represent the accepted 5 th percentile (lower reference limits and 95% confidence intervals [CIs] in parentheses), derived from a study of over 1900 men whose partners had a time-to-pregnancy of ≤12 months. [25]

  • Volume: 1.5 mL (95% CI: 1.4-1.7)
  • Sperm concentration: 15 million spermatozoa/mL (95% CI: 12-16)
  • Total sperm number: 39 million spermatozoa per ejaculate (95% CI: 33-46)
  • Morphology: 4% normal forms (95% CI: 3-4), using "strict" Tygerberg method [33]
  • Vitality: 58% live (95% CI: 55-63)
  • Progressive motility: 32% (95% CI: 31-34)
  • Total (progressive + nonprogressive motility): 40% (95% CI: 38-42).



   Abnormalities of sperm count and morphology Top


Sperm abnormalities are a critical factor in male infertility. These abnormalities include:

Abnormalities related to sperm count

  • Azoospermia: Absence of sperm in seminal plasma
  • Low sperm count (oligozoospermia: <15 million sperms/mL). [25]


Abnormalities related to sperm motility

The efficient passage of spermatozoa through the cervical mucus depends on rapid progressive motility, [38],[39] that is, spermatozoa with a forward progression of at least 25 μm/s. A normal semen analysis must contain at least 50% grade A and B, progressively motile spermatozoa. Persistent poor motility is a predictor of failure in fertilization. [40]

Abnormal sperm structure and shape (teratozoospermia)

For morphology of sperms, smears can be scored using the WHO classification, or by Kruger's strict criteria classification. [41] Morphology should be used along with other parameters, and not as an isolated parameter when determining clinical implications. [42],[43]


   Male infertility on the rise? Top


Time and again, various studies have been published supporting a decline in sperm quality or dismissing the same. [44],[45],[46],[47],[48] Analysis of retrospective data indicates that sperm counts may have declined in some parts of the world, but there seems to be geographical variations in the semen quality. [49],[50],[51] The reason for geographic variations in semen characteristics is not clear, but it may be due to environmental, nutritional, socioeconomic, or other unknown causes. [52] The decline in the semen quality coincides with an increasing incidence of abnormalities of the male genital tract including testicular cancer and cryptorchidism in various countries. [53],[54]


   Global trends of male infertility Top


As early as in the 1980s, many scientists/clinicians reported an emerging concern about deteriorating semen quality. [55],[56],[57] To better elucidate this problem, a study was done in 1992, which included the meta-analysis of, which had 61 articles 14,947 men with no previous history of infertility. This study concluded that the mean sperm count of healthy men declined by 1% per year between 1938 and 1990. [44] Furthermore, they reported a statistically significant 50% reduction in the mean sperm count from 113 Χ 10 6 mL−1 in 1940 to 66 Χ 10 6 mL−1 in 1990 and in the seminal volume from 3.40 to 2.75 mL, using linear regression data weighted by the number of men in each study. [44] In 2000, an updated comprehensive meta-analysis was done, which also confirmed the falling trend in sperm count. [58] Also, an another meta-analysis reported that sperm density has decreased globally by about 50% over the past 50-60 years. [31],[44] A study in Finland found a temporal decrease in semen quality in the general population over a period of 1998 to 2006. [59] Another study between 1996 and 2007 in the Sfax area of Southern Tunisia in a sample of 2940 men in infertile relationships concluded the decline in semen quality over a period of 12 years. [60] A retrospective study of 9168 cases (men ages 20 to 77) obtained from Andrology and Reproduction Laboratory in Cordoba, Argentina for 10 years (1995-2004) showed a significant decrease in seminal volume, sperm count, motility, viability and normal morphology, and a reduction in alpha-glucosidase and fructose levels in relation to age. [61] Furthermore, a study at the Reproduction Biology Laboratory of the University Hospital of Marseille (France) between 1988 and 2007, which included semen analysis of 10,932 male partners of infertile couples concluded that the whole population demonstrated the declining trends in sperm concentration (1.5%/year), total sperm count (1.6%/year), total motility (0.4%/year), rapid motility (5.5%/year), and normal morphology (2.2%/year). Also, in the group of selected samples with total normal sperm count, the same trends of sperm quality deterioration with time were observed. [62]

On contrary to this many studies have demonstrated no change in seminal parameters over the time. For example, a cross-sectional study of 4867 men from the general Danish population between 1996 and 2010 concluded that over 15 years, median sperm concentration increased from 43 to 48 million/ml and the total sperm count from 132 to 151 million. The median percentage of motile spermatozoa and abnormal spermatozoa were 68% and 93% and did not change during the study period. [63] Another similar study conducted between 2000 and 2010 among young Swedish men from the general population concluded that there is no evidence of time-related deterioration of semen parameters. [64]


   Trends of male infertility in india Top


Although, the baseline semen quality and sperm functional parameters in fertile Indian men have been documented, [65] the data on declining sperm count in Indian males is limited. According to a study conducted in South India over a period of 13 years, it was found that the decline in sperm count was 30.31% whereas, sperm motility and morphology was reduced by 22.92% and 51.25%, respectively. [66] More importantly, the increase in the incidence of sperm morphological abnormalities in addition to the low sperm count observed in this study indicates the qualitative impairment of spermatogenesis and perhaps of the  Sertoli cells More Details. [67]

Also, the Doctors from the All India Institute of Medical Sciences reported that over 12-18 million couples in India are diagnosed with infertility every year. [68] They have reported that while the sperm count of a normal Indian adult male used to be 60 million/ml three decades ago, it now stands at around 20 million/ml. [69] It was found that majority of men who were exposed to high temperature at their workplace - welders, dyers, blast furnace workers and those employed in cement and steel factories - were more prone to infertility. This is due to excess environmental heat which increases the temperature of the scrotum, causing a negative effect on sperm production. A 1΀ elevation in testicular temperature leads to 14% depression of spermatogenesis. [68] Not only has quantity of sperm production declined in males across the world, but there has also been a decrease in motility and morphology of the sperms. There has been a 2% decrease in quality of male sperm annually. [69] About 40% men in the reproductive age group are presently recording a quantitative and qualitative decline in sperm quality. [70] According to a 10-year comparison study on sperm quality and quantity (2000-2001 to 2010-2011), the percentage of semen ejaculation, which is considered less than normal (below 4 ml), increased from 34% to 65% and the most suitable ejaculation volume (more than 4 ml) went down from 15% to 3%. [69] As far as the morphology of sperm was concerned, in 2000-2001, 26% of the sperms showed above 60% normality, whereas in 2000-2011 this was reduced to 7%. [69] However, a similar study in Calcutta, which included semen analysis of 3729 men presenting with infertility problems in two distinct decades, that is, between 1981-1985 and 2000-2006 concluded a significant decline in the sperm motility parameters and seminal volume in the present decade, but no change in overall sperm concentration. A decline was seen in sperm motility with increasing age in both decades. [71]

The exact reason for the decline in semen quality is not clear, but it may be due to environmental, nutritional, socioeconomic or other unknown causes. [43],[44],[50],[72] Aging is an important factor responsible for the decline in semen quality, as first described in 1969 by Sasano and Ichijo, that the sperm concentration decreases as men age. They reported that 90% of seminiferous tubules in men in their 20s and 30s contained spermatids, whereas men in their 40s and 50s had spermatids in 50% of their seminiferous tubules. Only 10% of seminiferous tubules from men aged >80 years contained spermatids. [73] In contrast to concentration, evidence consistently indicates that sperm motility decreases with advancing age. [27] Various studies revealed statistically significant decreases in motility of 0.17-0.6% per year of age [44],[48] resulting in a 3-12% decline in motility over 20 years. Similar to motility, morphology appears to decrease with advancing male age. [27] Studies indicate a decline in normal sperm morphology of 0.2-0.9% per year of age, [27] resulting in a 4-18% decrease in normal morphology over a 20-year period. [45],[74]

Also, in utero exposures to exogenous estrogenic compounds are capable of altering neonatal testicular development and reducing sperm production in adult men. [67],[75] Diethylstilbestrol is thought to be responsible for an increase in abnormalities of the reproductive tract and for a reduction in the output and fertilizing potential of sperm of male offspring. [76]


   Conclusion Top


Hence, male infertility is an important cause of infertility with a strong impact on the psychology and physiology of couple. It can be due to several reasons. Also, the present literature reveals that its trend is increasing in India. Therefore, it's the need of the hour to look into the factors which are causing such a rise in male infertility and attempts should be made to control such factors in near future.


   Way forward Top


Male infertility is an alarming global health issue that has not been researched or studied to truly understand its magnitude and prevalence. There is still a great need for further research into underlying etiology and treatment of male infertility. In future, we can work together in this field to achieve certain goals like:

  • Attempts should be made to reduce the barriers from stigmas associated with infertility due to religious and cultural beliefs so that patients open up and share their problems
  • Create a globally accepted population-based calculation in order to understand the prevalence and magnitude of male infertility
  • To create awareness about male infertility in society.


The present study is only a review of various studies conducted all over the world. The exact rates of male infertility from developing countries like ours are difficult to find because of the problem with the definition of male infertility and lack of accurate reporting rather than a true reflection of male infertility. But still in future, we can conduct various research studies to find out the major causes of male infertility and can work in that direction to reduce such factors which can affect the future fertility of males.

Acknowledgement

I acknowledge and thank Dr. Namit Kant Singh for his advice and expertise.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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Semyon Kolmykov, Gennady Vasiliev, Ludmila Osadchuk, Maxim Kleschev, Alexander Osadchuk
Frontiers in Genetics. 2021; 12
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69 Effectiveness of Pharmacological Intervention Among Men with Infertility: A Systematic Review and Network Meta-Analysis
Muhammad Nabeel Shahid, Tahir Mehmood Khan, Chin Fen Neoh, Qi Ying Lean, Allah Bukhsh, Mahmathi Karuppannan
Frontiers in Pharmacology. 2021; 12
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70 Role of Lactobacillus in Female Infertility Via Modulating Sperm Agglutination and Immobilization
Fenghao Zhang, Jie Dai, Tingtao Chen
Frontiers in Cellular and Infection Microbiology. 2021; 10
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71 Copy Number Variation Analysis in Turkish Patients with Congenital Bilateral Absence of Vas Deferens
Durkadin DEMIR EKSI, Elanur YILMAZ, Yigit AKIN, Mustafa Faruk USTA, Mehmet Murad BASAR, Semra KAHRAMAN, Munire ERMAN, Özgül M. ALPER
Acta Medica Alanya. 2021;
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72 Y-Chromosome Microdeletions: A Review of Prevalence, Screening, and Clinical Considerations
Matthew J Rabinowitz, Phillip J Huffman, Nora M Haney, Taylor P Kohn
The Application of Clinical Genetics. 2021; Volume 14: 51
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73 RELATIONSHIP OF SEMINAL FRUCTOSE AND SERUM PROLACTIN LEVELS IN INFERTILE MEN
JUHI KATARIA, GURPREET KAUR GILL, LOUIS COJANDARAJ
Asian Journal of Pharmaceutical and Clinical Research. 2021; : 85
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74 Herbal foodstuffs in Avicenna’s recommended diet to improve sperm quality and increase male fertility; an evidence-based approach
Azita Sadogh, Narjes Gorji, Reihaneh Moeini
Journal of Complementary and Integrative Medicine. 2021; 0(0)
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75 MiR-181a Promotes Spermatogenesis by Targeting the S6K1 Pathway
Lei Wang, Juan Sun, Jin Han, Zhaowen Ma, Meiling Pan, Zhaojin Du
International Journal of Stem Cells. 2021; 14(3): 341
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76 Ginger (Zingiber officinale Roscoe) Improves Ethanol-Induced Reproductive Dysfunction by Enhancing Steroidogenesis and Inhibiting Oxidative Stress and Inflammation
Ni Li, Yan Xing, Afrah Hameed Sultan, Mahdieh Raeeszadeh, Abolfazl Akbari, Haining Liu
Brazilian Archives of Biology and Technology. 2021; 64
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77 THE COMPARISON OF CIGARETTE CONSUMPTION TOWARDS SEMEN ANALYSIS IN ANDROLOGY POLYCLINIC OF DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA IN 2017
Yohanes Widyakusuma Eka Saputra, Kristanti Wanito Wigati, Rina Yudiwati, Ni Wajan Tirthaningsih
Majalah Biomorfologi. 2021; 31(2): 31
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78 Cytomegalovirus infection and male infertility: case report
V. ?. Kovalyk, V. V. Malinovskaya, A. N. Shuvalov, L. F. Kurilo, ?. I. Yurlov, ? A. Gomberg, A. A. Kushch
Andrology and Genital Surgery. 2021; 22(1): 85
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79 Downregulation of KIF2C and TEKT2 is associated with male infertility and testicular carcinoma
Haiming Cao, Zi Wan, Fei Wang, Ziyin Liu, Xiaofeng Li, Jianquan Hou
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80 The effects of Vitamin D3 supplementation on Spermatogram and endocrine factors in asthenozoospermia infertile men: a randomized, triple blind, placebo-controlled clinical trial
Leila Maghsoumi-Norouzabad, Ahmad Zare Javid, Anahita Mansoori, Mohammadreza Dadfar, Amirarsalan Serajian
Reproductive Biology and Endocrinology. 2021; 19(1)
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81 Baseline levels of seminal reactive oxygen species predict improvements in sperm function following antioxidant therapy in men with infertility
Wayne Vessey, Shaghayegh Saifi, Aditi Sharma, Cassandra McDonald, Paula Almeida, Monica Figueiredo, Suks Minhas, Ashraf Virmani, Waljit S. Dhillo, Jonathan W. Ramsay, Channa N. Jayasena
Clinical Endocrinology. 2021; 94(1): 102
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82 The Effect of Oral Vitamin E on Semen Parameters and IVF Outcome: A Double-Blinded Randomized Placebo-Controlled Clinical Trial
Soudabeh Sabetian, Bahia Namavar Jahromi, Sina Vakili, Sedighe Forouhari, Shohreh Alipour, Seyithan Taysi
BioMed Research International. 2021; 2021: 1
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83 Protective Effect of Nano-Vitamin C on Infertility due to Oxidative Stress Induced by Lead and Arsenic in Male Rats
Mahdieh Raeeszadeh, Behzad Karimfar, Ali Akbar Amiri, Abolfazl Akbari, Hangbiao Jin
Journal of Chemistry. 2021; 2021: 1
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84 A low protein maternal diet during gestation has negative effects on male fertility markers in rats – A Systematic Review and Meta-analysis
Peter K. Ajuogu, Mohammed A. K. Al-Aqbi, Robert A. Hart, James R. McFarlane, Neil A. Smart
Journal of Animal Physiology and Animal Nutrition. 2021; 105(1): 157
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85 The effectiveness of weight-loss lifestyle interventions for improving fertility in women and men with overweight or obesity and infertility: A systematic review update of evidence from randomized controlled trials
Emma Hunter, Alison Avenell, Abha Maheshwari, Gertraud Stadler, Damian Best
Obesity Reviews. 2021; 22(12)
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86 Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility)
Luis Fernando Perez-Garcia, Esther Röder, Robbert J Goekoop, Johanna M W Hazes, Marc R Kok, Hieronymus T W Smeele, Ilja Tchetverikov, Annette H M van der Helm-van Mil, Jos H van der Kaap, Petra Kok, Bouwe P Krijthe, Radboud J E M Dolhain
Annals of the Rheumatic Diseases. 2021; 80(12): 1545
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87 Sperm selection strategies and their impact on assisted reproductive technology outcomes
Soraia Pinto, David F. Carrageta, Marco G. Alves, António Rocha, Ashok Agarwal, Alberto Barros, Pedro F. Oliveira
Andrologia. 2021; 53(2)
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88 The role of infections and leukocytes in male infertility
Ralf Henkel, Ugochukwu Offor, David Fisher
Andrologia. 2021; 53(1)
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89 The impact of the origin of surgical sperm retrieval on placental and embryonic development: The Rotterdam Periconception cohort
Jeffrey Hoek, Willem P. A. Boellaard, Eva S. Marion, Sten P. Willemsen, Esther.B. Baart, Régine P. M. Steegers-Theunissen, Sam Schoenmakers
Andrology. 2021; 9(2): 599
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90 Evaluation of the potential role of shear wave elastography as a promising predictor of sperm retrieval in non-obstructive azoospermic patients: A prospective study
Alaaeldien Mohamed Abdelmoniem Abdelaal, Hatem Mohamed El-Azizi, Sameh Fayek GamalEl Din, Omar Abdulsalam Mohammad Azzazi, Mohamed Shokr Mohamed
Andrology. 2021; 9(5): 1481
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91 Regional and ethnic differences in semen quality and reproductive hormones in Russia: A Siberian population-based cohort study of young men
Ludmila Osadchuk, Larisa Shantanova, Ivan Troev, Maxim Kleshchev, Alexander Osadchuk
Andrology. 2021; 9(5): 1512
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92 Aqueous leaf extract of Moringa oleifera reduced intracellular ROS production, DNA fragmentation and acrosome reaction in Human spermatozoa in vitro
Faith T. Moichela, Gbenga A. Adefolaju, Ralf R. Henkel, Chinyerum S. Opuwari
Andrologia. 2021; 53(1)
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93 SERPIN A5 may have a potential as a biomarker in reflecting the improvement of semen quality in infertile men who underwent varicocele repair
Kerem Teke, Murat Kasap, Emrah Simsek, Ayimgul Uzunyol, Ali Kemal Uslubas, Gurler Akpinar, Mustafa Melih Culha
Andrologia. 2021; 53(7)
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94 Assessment of serum vitamin D level and seminal vitamin D receptor gene methylation in a sample of Egyptian men with idiopathic infertility
Tarek M. Hussein, Nermeen Eldabah, Hadil A. Zayed, Rasha M. Genedy
Andrologia. 2021; 53(9)
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95 Abnormal Y chromosome detection in infertile males using multiplex ligation-dependent probe amplification
Xiaoying Dai, Fu Shi, Cindy Ka Yee Cheung, Jue Li, Shengmou Lin
Andrologia. 2021;
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96 Mutations in DNAH8 contribute to multiple morphological abnormalities of sperm flagella and male infertility
Mingxiang Weng, Yanwei Sha, Y u Zeng, Ningyu Huang, Wensheng Liu, Xinzong Zhang, Huiliang Zhou
Acta Biochimica et Biophysica Sinica. 2021; 53(4): 472
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97 Current updates and future perspectives in the evaluation of azoospermia: A systematic review
Nahid Punjani, Caroline Kang, Dolores J. Lamb, Peter N. Schlegel
Arab Journal of Urology. 2021; 19(3): 206
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98 Redox Regulation to Modulate Phosphorylation Events in Human Spermatozoa
Steven Serafini, Cristian O'Flaherty
Antioxidants & Redox Signaling. 2021;
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99 L-amino acid oxidase 1 in sperm is associated with reproductive performance in male mice and bulls
Haolin Zhang, Hong Liu, Sachi Kataoka, Masashi Kinukawa, Kyoko Uchiyama, Jun Kambe, Gen Watanabe, Wanzhu Jin, Kentaro Nagaoka
Biology of Reproduction. 2021; 104(5): 1154
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100 When idiopathic male infertility is rooted in maternal malnutrition during the perinatal period in mice
Yuki Muranishi, Laurent Parry, Mélanie Vachette-Dit-Martin, Fabrice Saez, Cécile Coudy-Gandilhon, Pierre Sauvanet, David H Volle, Jérémy Tournayre, Serge Bottari, Francesca Carpentiero, Guillaume Martinez, Jana Muronová, Jessica Escoffier, Alain Bruhat, Anne-Catherine Maurin, Julien Averous, Christophe Arnoult, Pierre Fafournoux, Céline Jousse
Biology of Reproduction. 2021;
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101 Sperm performance in oligoasthenoteratozoospermic patients is induced by a nutraceuticals mix, containing mainly myo-inositol
Marta Santoro, Saveria Aquila, Giampiero Russo
Systems Biology in Reproductive Medicine. 2021; 67(1): 50
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102 DNA variants are an unlikely explanation for the changing quality of spermatozoa within the same individual
Jacob Netherton, Rachel Ogle, Louise Hetherington, Tony Velkov, Ryan Rose, Mark Baker
Human Fertility. 2021; 24(5): 376
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103 The effects of tobacco and cannabis use on semen and endocrine parameters in infertile males
Nawabzada Khan, Mohsin Shah, Muhammad Omar Malik, Haroon Badshah, Syed Hamid Habib, Inayat Shah, Fawad Ali Shah
Human Fertility. 2021; : 1
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104 Aphrodisiac and spermatogenic potential of alkaloidal fraction of Argyreia nervosa (Burm. f.) Bojer roots in male rats
Niraj Vyas, Manan Raval
Natural Product Research. 2021; : 1
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105 A review of methods for preserving male fertility
Fereshteh Aliakbari, Neda Taghizabet, Faezeh Azizi, Fatemeh Rezaei-Tazangi, Keshvar Samadee Gelehkolaee, Ebrahim Kharazinejad
Zygote. 2021; : 1
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106 Postnatal cadmium administration affects the presence and distribution of carbohydrates in the sperm membrane during maturation in the epididymis in adult Wistar rats
Joel Hernández-Rodríguez, Edith Arenas-Ríos, Irma Jiménez-Morales, Edith Cortés-Barberena, Sergio Montes, Rosa María Vigueras-Villaseñor, Marcela Arteaga-Silva
Reproduction, Fertility and Development. 2021; 33(5): 349
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107 An innovative approach to polycystic ovary syndrome
Mariano Bizzarri, Patrizia Logoteta, Giovanni Monastra, Antonio Simone Laganà
Journal of Obstetrics and Gynaecology. 2021; : 1
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108 Association between the presence of Mycoplasma spp. and male infertility
Sajad Babakhani, Marziyeh Eslami, Mohammad Javad Kazemi, Mohammad Sadegh Shirsalimian, Sajad Rajabi
Journal of Obstetrics and Gynaecology. 2021; : 1
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109 Effects of quetiapine administration on sperm quality and testicular histology
Busra Korkut Celikates, Volkan Kilic, Ozlem Atli-Eklioglu, Merve Baysal, Gozde Aydogan-Kilic, Seyda Ucarcan, Sinem Ilgin
Drug and Chemical Toxicology. 2021; : 1
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110 Sildenafil aggravates adriamycin-induced testicular toxicity in rats; a preliminary investigation
Anne A. Adeyanju, Omolola R. Oyenihi, Oluwafemi O. Oguntibeju, Oreoluwa Ojomu
Drug and Chemical Toxicology. 2021; : 1
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111 Assessing the clinical value of the Kruger strict morphology criteria over the World Health Organization fourth edition criteria
Gal Wald, Nahid Punjani, Russell Hayden, Miriam Feliciano, Vanessa Dudley, Marc Goldstein
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112 Optimal timing for repeat semen analysis during male infertility evaluation
Nahid Punjani, Gal Wald, Omar Al-Hussein Alwamlh, Miriam Feliciano, Vanessa Dudley, Marc Goldstein
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113 Stem cell therapy as a recent advanced approach in male infertility
Ayshe Hajiesmailpoor, Payam Emami, Bahman Jalali Kondori, Masoud Ghorbani
Tissue and Cell. 2021; 73: 101634
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114 Are Infertile Men Less Healthy Than Fertile Men? An Analysis of the National Survey for Family Growth
Jesse B. Persily, Sameer Thakker, William Beaty, Bobby B. Najari
Urology. 2021; 156: 134
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115 Metal(loid)s and human semen quality: The LIFE Study
Francesca M. Branch, Melissa J. Perry, Zhen Chen, Germaine M. Buck Louis
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116 Determining the need for fertility care and the acceptability and feasibility of administering a fertility awareness tool from the user’s perspective in a sample of Sudanese infertility patients
R.R. Bayoumi, E. Koert, S. Van der Poel, J. Boivin
Reproductive Biomedicine & Society Online. 2021; 13: 85
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117 Neuropeptides as regulators of the hypothalamus-pituitary-gonadal (HPG) axis activity and their putative roles in stress-induced fertility disorders
Milosz Golyszny, Ewa Obuchowicz, Michal Zielinski
Neuropeptides. 2021; : 102216
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118 Increased pro-inflammatory cytokines in ovary and effect of ?-linolenic acid on adipose tissue inflammation in a polycystic ovary syndrome model
Yogamaya D. Prabhu, Atreyee Borthakur, Subeka A.G, Balachandar Vellingiri, Abilash Valsala Gopalakrishnan
Journal of Reproductive Immunology. 2021; 146: 103345
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119 Barriers and factors associated with significant delays to initial consultation and treatment for infertile patients and partners of infertile patients
Alice Domar, Rita Vassena, Marjorie Dixon, Mauro Costa, Elena Vegni, Barbara Collura, Marie Markert, Carl Samuelsen, Jillian Guiglotto, Eva Roitmann, Jacky Boivin
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120 Ameliorating potential and fertility enhancing activities of nutritional dietary supplementation of D-Ribose –l-Cysteine in cisplatin induced oligoasthenoteratozoospermia and seminiferous epithelium degeneration in adult male Sprague-Dawley rats
Sunday Aderemi Adelakun, Babatunde Ogunlade, Kingley Afoke Iteire, Oluwafemi Abidemi Adedotun
Metabolism Open. 2021; 12: 100128
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121 Novel association of PhosphoSerine PHosphatase (PSPH) gene mutations with male infertility identified through whole exome sequencing of South Indians
Golnaz Shemshaki, Mohsen Najafi, Ashitha S. Niranjana Murthy, Suttur S. Malini
Meta Gene. 2021; 29: 100897
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122 l-carnitine modulates autophagy, oxidative stress and inflammation in trazodone induced testicular toxicity
Naglaa F. Khedr, Rehab Werida
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123 Diverse role of endocannabinoid system in mammalian male reproduction
Tahseen S. Sayed, Nafisa H. Balasinor, Kumari Nishi
Life Sciences. 2021; 286: 120035
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124 A comprehensive Ayurvedic treatment along with counseling in oligoasthenozoospermia with previous intrauterine insemination failure-A case report
Vandana K. Vasudevan, Parvathy Unnikrishnan, Anjaly Muraleedharan, Hemavathi Shivapura Krishnarajabhatt
Journal of Ayurveda and Integrative Medicine. 2021; 12(1): 148
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125 Development and validation of a novel mail-in semen analysis system and the correlation between one hour and delayed semen analysis testing
Mary K. Samplaski, Owen Falk, Stanton Honig, David Shin, William Matthews, James F. Smith
Fertility and Sterility. 2021; 115(4): 922
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126 TG12-T5-V470 haplotype in the CFTR gene is associated with non-obstructive azoospermia in Iranian infertile men
Azam Khedri, Amir Yousef Farahmandi, Mohammad Moghaveleh, Kourosh Akbari Baghbani, Saman Naddaf Khoob, Sahar Moghbelinejad, Fatemeh Asadi
Gene Reports. 2021; 23: 101095
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127 Onset of azoospermia in man treated with ipilimumab/nivolumab for BRAF negative metastatic melanoma
Matthew J. Rabinowitz, Taylor P. Kohn, Vanessa N. Peña, Iryna V. Samarska, Andres Matoso, Amin S. Herati
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128 Comparison of spermatozoal RNA extraction methods in goats
Bijayalaxmi Sahoo, Praveen Kumar Guttula, Mukesh Kumar Gupta
Analytical Biochemistry. 2021; 614: 114059
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129 Effect of deep transfer and multi-task learning on sperm abnormality detection
Amir Abbasi, Erfan Miahi, Seyed Abolghasem Mirroshandel
Computers in Biology and Medicine. 2021; 128: 104121
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130 The effects of broccoli and caraway extracts on serum oxidative markers, testicular structure and function, and sperm quality before and after sperm cryopreservation
Mahdieh Raeeszadeh, Nadia khademi, Abolfazl Akbari
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131 Decabromodiphenyl ether (BDE-209) exposure to lactating mice perturbs steroidogenesis and spermatogenesis in adult male offspring
Debarshi Sarkar, Shio Kumar Singh
Ecotoxicology and Environmental Safety. 2021; 209: 111783
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132 Effects of Medicines and Supplements on Spontaneous Pregnancy and Semen Parameters in Male Infertility: A Systematic Review Update and Network Meta-Analysis
Jian Li, Qi Wu, Ernest Hung Yu Ng, Ben Willem J. Mol, Xiao Ke Wu, Chi Chiu Wang
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133 Effect of Titanium Dioxide and Silver Nanoparticles on Mitochondrial Dynamics in Mouse Testis Tissue
Nazli Pinar Arslan, Osman Nuri Keles, Nurdan Gonul-Baltaci
Biological Trace Element Research. 2021;
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134 Microdissection testicular sperm extraction (micro-TESE) in men with infertility due to nonobstructive azoospermia: summary of current literature
Arnold P. P. Achermann, Thairo A. Pereira, Sandro C. Esteves
International Urology and Nephrology. 2021; 53(11): 2193
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135 Comparison of the Effect of Ceratonia siliqua L. (Carob) Syrup and Vitamin E on Sperm Parameters, Oxidative Stress Index, and Sex Hormones in Infertile Men: a Randomized Controlled Trial
Mir Mohammad Reza Aghajani, Soleiman Mahjoub, Faraz Mojab, Mahshid Namdari, Neda Mahdinezhad Gorji, Afsaneh Dashtaki, Parvaneh Mirabi
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136 Male Factors: the Role of Sperm in Preimplantation Embryo Quality
Zahra Bashiri, Fardin Amidi, Iraj Amiri, Zahra Zandieh, Chad B. Maki, Fatemeh Mohammadi, Sadegh Amiri, Morteza Koruji
Reproductive Sciences. 2021; 28(7): 1788
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137 Photobiomodulation Therapy Improves Spermatogenesis in Busulfan-Induced Infertile Mouse
Fatereh Rezaei, Mohammad Bayat, Hamid Nazarian, Abbas Aliaghaei, Hojjat-Allah Abaszadeh, Parvaneh Naserzadeh, Abdollah Amini, Vahid Ebrahimi, Shabnam Abdi, Mohammad-Amin Abdollahifar
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138 Diet Supplemented with Chrysophyllum albidum G. Don (Sapotaceae) Fruit Pulp Improves Reproductive Function in Hypertensive Male Rats
Seun F. Akomolafe, Tosin A. Olasehinde, Iyabo F. Oladapo, Sunday I. Oyeleye
Reproductive Sciences. 2021;
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139 Vitamin D3 Supplementation Effects on Spermatogram and Oxidative Stress Biomarkers in Asthenozoospermia Infertile Men: a Randomized, Triple-Blind, Placebo-Controlled Clinical Trial
Leila Maghsoumi-Norouzabad, Ahmad Zare Javid, Anahita Mansoori, Mohammadreza Dadfar, Amirarsalan Serajian
Reproductive Sciences. 2021;
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140 Point-of-care semen analysis of patients with infertility via smartphone and colorimetric paper-based diagnostic device
Yu-Ting Tsao, Chung-Yao Yang, Yun-Chiao Wen, Ting-Chang Chang, Koji Matsuura, Yu Chen, Chao-Min Cheng
Bioengineering & Translational Medicine. 2021; 6(1)
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141 High cholesterol diet activates ER stress mediated apoptosis in testes tissue: Role of a-tocopherol
Erdi Sozen, Tugce Demirel-Yalciner, M. Kutay Koroglu, Merve Acikel Elmas, Feriha Ercan, Nesrin Kartal Ozer
IUBMB Life. 2021;
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142 Parabens enhance the calcium-dependent testicular mitochondrial permeability transition: Their relevance on the reproductive capacity in male animals
Fátima C. Martins, Romeu A. Videira, Maria Manuel Oliveira, Daniela Silva-Maia, Fernanda M. Ferreira, Francisco P. Peixoto
Journal of Biochemical and Molecular Toxicology. 2021; 35(3)
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143 Effect of Acoustic Cavitation on Mouse Spermatogonial Stem Cells
Zeinab Hormozi Moghaddam, Manijhe Mokhtari-Dizaji, Mansoureh Movahedin
Journal of Ultrasound in Medicine. 2021; 40(5): 999
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144 Counteracting effects of heavy metals and antioxidants on male fertility
Soudeh Ghafouri-Fard, Hamed Shoorei, Mahdi Mohaqiq, Moloud Tahmasebi, Mohammad Seify, Mohammad Taheri
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145 Genetic basis of acephalic spermatozoa syndrome, and intracytoplasmic sperm injection outcomes in infertile men: a systematic scoping review
Marziyeh Mazaheri Moghaddam, Madiheh Mazaheri Moghaddam, Hamid Hamzeiy, Amir Baghbanzadeh, Fariba Pashazadeh, Ebrahim Sakhinia
Journal of Assisted Reproduction and Genetics. 2021; 38(3): 573
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146 Fertility and pregnancy outcome among women undergoing assisted reproductive technology treatment in Windhoek, Namibia
Adão Francisco Lucas, Dibaba B. Gemechu, Stefan S. Du Plessis, Yapo G. Aboua
Journal of Assisted Reproduction and Genetics. 2021; 38(3): 635
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147 Role of Aquaporins in Spermatogenesis and Testicular Steroidogenesis
Arun Kannan, Antojenifer Panneerselvam, Lezy Flora Mariajoseph-Antony, Chithra Loganathan, Chidambaram Prahalathan
The Journal of Membrane Biology. 2020; 253(2): 109
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148 Mini review: The FDA-approved prescription drugs that induce ovulation in women with ovulatory problems
Chunlei Sun, Xi Rong, Yongqin Cai, Song Qiu, Maryam Farzaneh
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149 Head-attached live sperm cell for label-free micro-Raman evaluation of sperm DNA integrity: A preliminary study
Zufang Huang, ShengRong Du, Xiaozhou Liang, Yan Sun, Xiwen Chen, Juqiang Lin, Yongzeng Li, Guannan Chen, Shangyuan Feng
Journal of Raman Spectroscopy. 2020; 51(4): 591
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150 Quantification of human sperm concentration using machine learning-based spectrophotometry
Ali Lesani, Somaieh Kazemnejad, Mahdi Moghimi Zand, Mojtaba Azadi, Hassan Jafari, Mohammad R.K. Mofrad, Reza Nosrati
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151 Clinical implications of Y chromosome microdeletions among infertile men
Nahid Punjani, Caroline Kang, Peter N. Schlegel
Best Practice & Research Clinical Endocrinology & Metabolism. 2020; 34(6): 101471
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152 Genetic mutations contributing to non-obstructive azoospermia
Vanessa N. Peña, Taylor P. Kohn, Amin S. Herati
Best Practice & Research Clinical Endocrinology & Metabolism. 2020; 34(6): 101479
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153 Oral supplementation of fucoxanthin-rich brown algae extract ameliorates cisplatin-induced testicular damage in hamsters
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Biomedicine & Pharmacotherapy. 2020; 125: 109992
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154 Integration of transcriptomic and metabolomic data reveals metabolic pathway alteration in mouse spermatogonia with the effect of copper exposure
Shuai Lin, Na Qiao, Hanming Chen, Zhaoxin Tang, Qingyue Han, Khalid Mehmood, Sarfaraz Ali Fazlani, Sajid Hameed, Ying Li, Hui Zhang
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155 CRISPR/Cas9 in Male Factor Infertility
Davide Pietro Cinà, Drew Phillips, Ryan Flannigan
Current Tissue Microenvironment Reports. 2020; 1(3): 89
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156 When the Path to Parenthood Does Not Go as Planned: Genetic Counseling for Infertility and Miscarriage
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Fertility and Sterility. 2020; 114(1): 83
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158 Male infertility and genitourinary birth defects: there is more than meets the eye
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159 Role of IL-6 signalling in Polycystic Ovarian Syndrome associated inflammation
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160 Gamete preservation: knowledge, concerns and intentions of Israeli and Danish students regarding egg and sperm freezing
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161 In Vitro Meiosis of Male Germline Stem Cells
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162 Low dose lead exposure at the onset of puberty disrupts spermatogenesis-related gene expression and causes abnormal spermatogenesis in mouse
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163 The occurrence and pathology of chlamydiosis in the male reproductive tract of non-human mammals: A review
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164 Care Delivery for Male Infertility
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165 Microfluidic System for Rapid Isolation of Sperm From Microdissection TESE Specimens
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Urology. 2020; 140: 70
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166 Sperm DNA fragmentation index and high DNA stainability do not influence pregnancy success after intracytoplasmic sperm injection
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F&S Reports. 2020; 1(3): 233
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167 Online access to male factor infertility care: the challenge of finding a specialist
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168 Publication or pregnancy? Employment contracts and childbearing of women academics in China
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169 SPANX-A/D protein subfamily plays a key role in nuclear organisation, metabolism and flagellar motility of human spermatozoa
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170 Germline-dependent transmission of male reproductive traits induced by an endocrine disruptor, di-2-ethylhexyl phthalate, in future generations
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171 Age negatively impacts reproduction in high-ranking male rhesus macaques on Cayo Santiago, Puerto Rico
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172 Clomiphene citrate improved testosterone and sperm concentration in hypogonadal males
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173 Producing Parenthood: Islamic Bioethical Perspectives & Normative Implications
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174 Optimization of a microfluidic spiral channel used to separate sperm from blood cells
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175 Chronic testicular Chlamydia muridarum infection impairs mouse fertility and offspring development†
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176 Photobiomodulation with 810?nm Wavelengths Improves Human Sperms' Motility and Viability In Vitro
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177 A Prospective Cohort Study to Evaluate the Impact of Diet, Exercise, and Lifestyle on Fertility: Design and Baseline Characteristics
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178 A Randomized Trial to Evaluate the Effects of Folic Acid and Zinc Supplementation on Male Fertility and Livebirth: Design and Baseline Characteristics
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179 Knockout of mouse receptor accessory protein 6 leads to sperm function and morphology defects†
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180 Melatonin protects the mouse testis against heat-induced damage
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181 Effect of lycopene on testicular androgenic and anti-oxidative enzymes in cyproterone acetate-induced male infertile Wistar strain albino rats: An in vitro study
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182 Failure modes and effects analysis for testicular sperm extraction management process
Pierandrea Canepa, Caterina De Leo, Ida Casciano, Camilla Rizzo, Fausta Sozzi, Francesca Ambrosini, Carlo Terrone, Aldo F. De Rose, Paola Anserini, Paola Scaruffi
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183 Coenzyme Q10 effect on semen parameters: Profound or meagre?
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184 Aquaporin3 expression and the potential role of aquaporins in motility and mitochondrial membrane potential in human spermatozoa
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185 Oxidative stress markers in seminal plasma of idiopathic infertile men may be associated with glutathione S-transferase M1 and T1 null genotypes
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186 Rutin protects boar sperm from cryodamage via enhancing the antioxidative defense
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187 Impact of silymarin on cadmium-induced apoptosis in human spermatozoa
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188 Sperm morphology: What implications on the assisted reproductive outcomes?
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189 The Effect of Genetically Modified Food on Infertility Indices: A Systematic Review Study
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190 Association of polymorphism c.-124G>A and c.-16 C>T in the promoter region of human INHA gene with altered sperm parameters; A pilot study
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192 Association of depression and resilience with fertility quality of life among patients presenting to the infertility centre for treatment in Karachi, Pakistan
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194 Measuring Fertility Health Knowledge in University Students: Development and Testing of a Survey Tool
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195 Genetic and reproductive toxicity of lamivudine, tenofovir disoproxil fumarate, efavirenz and their combination in the bone marrow and testicular cells of male mice
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196 Secretory and Excretory Function of Testicles in Conditions of Serotonin Disorder of Spermatogenesis and Experimental Correction of Chondroitin Sulphate
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197 Exploring Iranian Women’s Perceptions and Experiences of Their Spouses’ Behavior towards Male Factor Infertility: A Qualitative Study
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199 Metformin Ameliorates Testicular Function and Spermatogenesis in Male Mice with High-Fat and High-Cholesterol Diet-Induced Obesity
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201 The Role of Zinc in Male Fertility
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202 Time-Lapse Flow Cytometry: A Robust Tool to Assess Physiological Parameters Related to the Fertilizing Capability of Human Sperm
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211 ANTIOXIDANT EFFECT OF AQUEOUS EXTRACT OF MUCUNA PRURIENS (LINN) BY DPPH ASSAY- AN IN-VITRO STUDY
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    Abstract
   Introduction
    Global incidence...
   Infertility in india
    Normal seminal p...
    Abnormalities of...
    Global trends of...
    Trends of male i...
   Conclusion
   Way forward
    Male Infertility...
    Male infertility...
    References

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