• Clinical and Experimental Reproductive Medicine
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• 제51권2호
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• pp.125-134
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• 2024

Objective: Vitamin D deficiency is a major problem for human health worldwide. The mechanisms of vitamin D in the male reproductive system are unknown. After coronavirus disease 2019 (COVID-19) vaccines were developed, doubts were raised about their possible effects on male fertility. Based on vitamin D's function in the immune system, its potential role as an adjuvant for COVID-19 vaccines is intriguing. The aims of this study were to assess the effects of vitamin D first on sperm parameters and sex hormones, and then as an immune adjuvant on sperm parameters and sex hormones after study participants had received their second doses of COVID-19 vaccines. Methods: Phase 1 (before the COVID-19 pandemic) included 72 men with idiopathic infertility, and phase 2 had 64 participants who received two doses of COVID-19 vaccines. Both groups were instructed to take 50,000 IU of vitamin D twice monthly for 3 months. Sperm parameters and sex hormones were assessed pre-and post-supplementation. Results: Regular vitamin D intake for 3 months significantly increased the participants' vitamin D levels (p=0.0001). Both phases showed a positive correlation between vitamin D intake and sperm parameters. Vaccination had no negative effects on sperm parameters and sex hormones. Vitamin D was associated with follicle-stimulating hormone (p=0.02) and testosterone (p=0.0001) in phase 2 after treatment. Conclusion: Our results support vitamin D supplementation as an immune adjunct to COVID-19 vaccination for improving sperm parameters and hormone levels. COVID-19 vaccination is not harmful for male fertility potential, and vitamin D is an effective factor for male fertility.

• Clinical and Experimental Reproductive Medicine
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• 제23권3호
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• pp.367-377
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• 1996

Genes on the long arm of Y chromosome, particularly interval 6, are believed to playa critical role in human spermatogenesis. The objective of this study was to validate a sequenced-tagged site(STS)-mapping strategy for the detection of Yq microdeletion and to use this method to determine the proportion of men with Yq microdeletions in idiopathic, obstructive, nonobstructive azoospermia, severe OATS and in normal males. We analyzed three STS markers mapped to interval 6 within long arm of the Y chromosome from 106 nonobstructive, 30 obstructive azoospermia, 15 severe OATS patients, and normal 42 males in Korean men. By PCR, we tested leukocyte DNA, for the presences of STS markers(DAZ, sY129 and sY134) and SRY gene as internal control. And PCR results were confirmed by Southern hybridization, and were investigated by SSCP analysis for DAZ gene mutation. None of 42 normal males and 30 obstructive azoospermia had microdeletions, Of the 15 severe OATS typed with DAZ, sY129 and sY134, 3(20.0%) patients failed to amplify 1 or more STS markers, and of the 106 nonobstructive azoospermia typed with DAZ, sY129 and sY134, 12(11.3%) patients failed to amplify 1 or more STS markers. From these results, high prevalence(12.4%) of Yq deletion(DAZ, sY129, sY134) in men with nonobstructive idopathic azoospermia and severe OATS were observed in Korean infertility patients. To avoid the infertile offspring by assisted reproductive technique using ICSI or ROSI, genetic diagnosis will be needed in IVF-ET program.

• Clinical and Experimental Reproductive Medicine
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• 제49권1호
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• pp.49-56
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• 2022

Objective: Oxidative stress and sperm DNA fragmentation (SDF) have been linked to idiopathic male infertility (IMI). Various antioxidants have been tried to improve semen parameters and fertility potential in IMI patients, but with inconsistent results. The study aimed to compare the effects of coenzyme Q10 (CoQ10) and Centrum multivitamins on semen parameters, seminal antioxidant capacity, and SDF in infertile men with idiopathic oligoasthenospermia (OA). Methods: This prospective controlled clinical study involved 130 patients with idiopathic OA and 58 fertile controls. The patients were divided randomly into two groups: the first group received CoQ10 (200 mg/day orally) and the second group received Centrum multivitamins (1 tablet/day) for 3 months. Semen parameters, CoQ10 levels, reactive oxygen species (ROS), total antioxidant capacity (TAC), catalase, SDF, and serum hormone levels (follicle-stimulating hormone, luteinizing hormone, testosterone, and prolactin) were compared at baseline and after 3 months. Results: Both CoQ10 and Centrum improved sperm concentration and motility, but the improvement was greater with Centrum therapy (p<0.05). Similarly, both therapies improved antioxidant capacity, but TAC and catalase improvement was greater (p<0.01 and p<0.001 respectively) with CoQ10, whereas ROS (p<0.01) and SDF (p<0.001) improvements were greater with Centrum administration. Centrum therapy was associated with reduced serum testosterone (p<0.05). Conclusion: In conclusion, both CoQ10 and Centrum were effective in improving semen parameters, antioxidant capacity, and SDF, but the improvement was greater with Centrum than with CoQ10. Therefore, Centrum-as a source of combined antioxidants-may provide more effective results than individual antioxidants such as CoQ10 in the treatment of infertile men with idiopathic OA.

• Clinical and Experimental Reproductive Medicine
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• 제21권3호
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• pp.253-259
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• 1994

A clinical investigation was undertaken on primary male infertility patients of recent 5 years. The results obtained were as follow: 1. Suspective etiologic factors were: 1) testicular failure, 36.1 %; 2) varicocele, 18.7%; 3) endocrine abnormality, 13.5%; 4) obstruction, 13.5%; 5) idiopathic, 10.9%; 6) cryptorchidism, 2.6%; 7) necrospermia, 0.9%. 2. On semen analyses, azoospermia was found in 55.8%, single abnormal parameter in 21.5 %, and multiple/all abnormal parameter in 22.7% of the 163 cases. 3. For the evaluation of the sensitivity and specificity of noninvasive variables in predict in obstruction as the cause of azoospermia in patient who had undergone testicular biopsy, the testicular size and serum follicle-stimulating hormone(FSH) level revealed 100% of sensitivity. 4. Among the 43 patients with a testicular biopsy confirmed diagnosis there was a significant difference in testicular size, ejaculate volume(p<0.0001) and serum FSH(p<0.0001) between patients with testicular failure and those with ductal obstruction. 5. Of 93 treated patients with primary male infertility, 42 were managed by medical treatment including endocrine treament, retrograde ejaculation treatment, infection treatment and observation; 29 were managed by surgical treatment including varicocelectomy, vasovasostomy, vasoepididymostomy and TUR of ejaculatory duct; 20 were managed by sperm preparation treatment including artificial insemination(AI), electroejaculation plus AI and vibration ejaculation plus AI ; 2 were managed by microscopic epididymal sperm aspiration plus IVF, repectively. 6. 42 patients who could be followed-up, 21 patients(50%) impregnated their wives.

• Clinical and Experimental Reproductive Medicine
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• 제46권3호
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• pp.112-118
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• 2019

Objective: Oxidative stress contributes to male infertility, and antioxidants have been recommended for treating idiopathic oligoasthenoteratozoospermia (OAT). There is, however, a lack of agreement on the type, dosing, and use of individual antioxidants or combinations thereof. The purpose of this study was to compare the effects of two doses of coenzyme Q10 (CoQ10) on semen parameters and antioxidant status in men with idiopathic OAT. Methods: In this prospective study, patients with idiopathic OAT received 200 mg/day (n = 35) or 400 mg/day (n = 30) of CoQ10 orally for 3 months. All patients underwent semen analysis according to the fifth editions of the World Health Organization criteria. Total antioxidant capacity (TAC), catalase (CAT) activity, and superoxide dismutase (SOD) activity were measured both before and after treatment. Results: Treatment with CoQ10 (200 mg/day or 400 mg/day) resulted in a significant increase in sperm concentration from baseline ($8.22{\pm}6.88$ to $12.53{\pm}8.11million/mL$, p= 0.019; $7.58{\pm}5.41$ to $12.33{\pm}6.1million/mL$, p= 0.002, respectively), progressive motility ($16.54%{\pm}9.26%$ to $22.58%{\pm}10.15%$, p=0.011; $14.22%{\pm}12.85%$ to $26.1%{\pm}14.52%$, p= 0.001, respectively), and total motility ($25.68%{\pm}6.41%$ to $29.96%{\pm}8.09%$, p= 0.016; $23.46%{\pm}12.59%$ to $34.82%{\pm}14.17%$, p= 0.001, respectively). CoQ10 therapy also increased TAC (p= 0.009, p= 0.001, respectively), SOD activity (p= 0.004, p= 0.001, respectively), and CAT activity (p= 0.039, p= 0.024, respectively). Furthermore, antioxidant measures correlated significantly with seminal fluid parameters (r = 0.36-0.76). Conclusion: CoQ10 supplementation improved semen parameters and antioxidant status in men with idiopathic OAT, with a greater improvement shown in men who took 400 mg/day than in those who took 200 mg/day.

• Clinical and Experimental Reproductive Medicine
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• 제34권4호
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• pp.305-312
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• 2007

목 적: 본 연구에서는 일반적인 체외수정과 세포질내 정자주입술을 병행하여 시행하는 분할 수정법의 효용성을 정상적인 정자 소견을 나타내는 비남성요인 불임 환자의 체외수정 및 배아이식술에서 살펴보고자 하였다. 연구방법: 제일병원 아이소망센터에서 정자 소견상 결함이 없는 비남성요인 불임 환자에게 분할 수정법을 이용한 505주기의 임상 결과를 후향적으로 분석하였다. 획득된 난자는 무작위로 나누어 일반적인 체외수정이나 세포질내 정자주입술을 이용하여 수정을 시켰다. 수정란은 이식할 때까지 2$\sim$5일간 배양하였고, 잉여의 수정란과 배아는 동결보관하여 동결-융해 이식에 사용하였다. 수정 방법에 따른 임상 결과를 통계학적인 방법으로 비교하였다. 결 과: 획득된 난자의 수정율은 분할 수정법을 시행하였을 때 일반적인 체외수정보다 세포질내 정자주입술에서 통계적으로 유의하게 높게 나타났다 (52.9$\pm$28.0% vs 62.5$\pm$22.3%, p<0.01). 전체적인 수정의 실패는 분할 수정법을 시행한 505주기 중에서 단지 2주기에서만 (0.4%) 나타났으며, 수정 실패와 0$\sim$30% 이하의 수정률을 나타내는 빈도는 세포질내 정자주입술에서 일반적인 체외수정보다 통계적으로 유의하게 낮았다 (1.1% and 7.5% vs 8.5% and 22.0%, p<0.01). 분할 수정주기에서의 신선 배아와 동결-융해 배아이식 후 분만율은 각각 40.0% (185/462)와 35.0% (55/157)였으며, 일반적인 체외수정이나 세포질내 정 자주입술로 얻어진 배아의 착상률과 분만율은 유의적인 차이가 나타나지 않았다. 결 론: 결론적으로 비남성요인 불임 환자의 보조생식술에서 분할 수정법이 수정 실패와 낮은 수정율을 방지하고 성공적인 임상 결과를 제공할 수 있는 효과적인 방법으로 사료된다.

• Clinical and Experimental Reproductive Medicine
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• 제18권1호
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• pp.101-105
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• 1991

Although many therapies have been advocated in the treatment of idiopathic male infertility, the results of treatment are poor. This probably seems to be due to a lack of one or more proteins constituting the key structures of the spermatozoa. We evaluated the functional structures of the spermatozoa in 11 infertile patients whose semen showed severe oligoasthenozoospermia with immunochemical method and found a case with spermatozoa lacking acrosin. Evaluation of the spermatozoal defect with immunochemical method is desirable in patients with severe oligoasthenozoospermia, especially in cases unresponsive to medical therapy.

• Clinical and Experimental Reproductive Medicine
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• 제31권3호
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• pp.177-182
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• 2004

Purpose: To determine the efficacy of $Carnitil^{(R)}$ (acetylcarnitine, Hanmi, Korea) therapy in idiopathic oligoasthenospermic men. Materials and Methods: Forty-four subfertile men with abnormal semen parameters were treated between March, 2003 and March, 2004 with 3 g of $Carnitil^{(R)}$ daily for 3 months. Changes in semen parameters were evaluated 3 months after this therapy. Results: The mean age was 34.2 years and the mean follow-up duration was 3.7 months. In asthenospemic patients (n=28), semen analysis before and after $Carnitil^{(R)}$ treatment showed an increase in volume ($2.64{\pm}1.65\;ml$ vs. $3.10{\pm}1.60\;ml$), motility ($35.1{\pm}17.7%$ vs. $45.9{\pm}20.4%$) and viability ($51.4{\pm}20.3%$ vs. $59.3{\pm}13.6%$) respectively. In oligoasthenospermic patients (n=16), semen analysis before and after $Carnitil^{(R)}$ treatment showed an increase in sperm count ($10.7{\pm}54.4\;million/ml$ vs. $38.4{\pm}32.5\;million/ml$) respectively. Conclusions: These results suggested that in idiopathic oligoasthenospermic men the empirical medical therapy with acetylcarnitine may be considered as primary treatment.

• Clinical and Experimental Reproductive Medicine
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• 제8권2호
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• pp.45-55
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• 1981

Clomiphene citrate. antiestrogen, was given to 39 infertile males whose spermatogenesis were disturbed and the efficacy of the drug was evaluated at the Department of Urology in 1980. (Table 1). Patients were divided into 3 clinical observation groups such as group I composed of 19 cases of idiopathic azoospermia, group II consisted of 15 cases of oligospermia following the vasovasostomy, and group III comprised 5 cases of testicular azoospermia. (Table 2). Clinical characteristics of these patients were as follows: Age of the patients ranged from 26 to 43 years old with mean of 34, and that of their wives ranged from 24 to 41 years old with mean of 31. Duration of marital life ranged from 1 to 21 years with mean of 5 years. Sizes of testis ranged from 6 to 25 ml with mean of 16 ml. Coital frequency ranged from 0.5 to 6 per week with mean of 2.4 per week. Levels of plasma FSH ranged from 3.15 to 23.06 lU/1 with mean of 8.15 lU/1, those of LH ranged from 2.98 to 19.89 lU/1 with mean of 8.18 lU/1 and those of testosterone ranged from 3.09 to 9.97 ng/ml with mean of 6.48 ng/ml. (Table 3). Clomiphene citrate was given in dosage of 50 mg per day (in d.) orally to 31 patients for 3 to 9 months and in dosage of 100 mg per day (b.i.d.) orally to 8 patients for 3 to 9 months. (Table 8). Semen samples were analysed monthly on each patient by routine analysis techniques. For the assessment of the efficacy of Clomiphene citrate on faulty spermatogenesis following empirical criteria were used: For semen quality: Improvement (I) represents that semen parameter increased more than 25% from basal level after the treatment, Unchange (U) expresses that semen parameter increased less than 25% of basal level or not changed after the treatment and Deterioration (D) means that semen parameter decreased from basal level after the treatment. For fertility unit (total counts ${\times}$ motility ${\times}$ morphology ${\div}10^6$): Improvement (I) represents that fertility unit increased more than 10 units after the treatment, Unchange (U) expresses that fertility unit increased less than 10 units or not changed after the treatment, and Deterioration (D) means that fertility unit decreased after the treatment. (Table 4). Results obtained from the Clomiphene therapy were as follows: Changes of spermiograme before and after the Oomiphene therapy shown in the Table 5. Sperm counts increased from 23 to 31 ${\times}10^6$/ml in group I, from 17 to 29 ${\times}10^6$/ml in group II. Other parameters of spermiogramme were not changed significantly after the treatment. Fertility units increased from 14 to 18 units after the treatment in group I, and from 16 to 18 units after the treatment in group II. Effectiveness of Clomiphene citrate on spermatogenesis was summarised in the Tables 6 and 7. After the treatment, sperm count increased in 11 patients, motility increased in 6 patients, morphology increased in 4 patients and fertility units increased in 9 patients. No sperm could be produced by Clomiphene citrate in group III of testicular azoospermia. Dosage of 50 mg of Clomiphene citrate per day for 3 to 6 months was proved to be the most effective in the present series. (Table 8). Pregnancy occurred in 2 patients after the treatment. No particular side effects were noted by the treatment. Pharmacologic compounds used for male infertility were shown in the Table 9. Reported results of Clomiphene citrate were shown in the Table 10.