Semenogelins (SEMGs) are major components of human seminal vesicle secretions. Due to SEMG’s sperm-motility inhibitor, a significant negative correlation between sperm motility and the proportion of SEMG-bound spermatozoa (SEMG+) was found in asthenozoospermic patients. SEMGs also show intrinsic inhibitory capability for sperm capacitation; however, studies on actual clinical specimens have not been conducted. To reveal the relationship between SEMGs and the fertilizing capacity of sperm from male infertile patients who are not restricted to asthenozoospermia, we measured the proportion of SEMG+ in the spermatozoa of 142 male infertile patients. The pregnancy outcomes in partners of these patients were retrospectively analyzed using questionnaires. Among examined semen parameters, only the total SEMG-unbound sperm count showed a tendency to be different between the spontaneous pregnancy or intra-uterine-insemination-pregnancy groups and in-vitro-fertilization- or intracytoplasmic-sperm-injection-pregnancy groups. It was elevated in the former group, which includes patients who used in vivo fertilization. The total SEMG-unbound sperm count would be a relevant parameter for in vivo fertilization. This result suggests that SEMGs inhibit ectopic capacitation before sperm reach the fertilization site and that the number of total SEMG-unbound sperm is a parameter directly linked to the possibility of in vivo fertilization.

Purpose: In this pilot study, the authors compared the effects of antioxidant co‐supplementation therapy and methylcobalamin therapy in patients with impaired semen quality.Methods: Eighty‐four subjects who visited male infertility clinics and showed abnormal semen test results were randomly subjected to one of the two therapies: antioxidant co‐supplementation therapy with vitamin C, vitamin E, coenzyme Q10, and flaxseed oil or methylcobalamin therapy. The oxidation–reduction potential (ORP) and 8‐hydroxy‐2′‐deoxyguanosine levels were used as indicators of oxidative stress levels in semen. Semen analysis was also performed.Results: The authors obtained results from 67 patients who had completed 3 months of treatment. Neither antioxidant co‐supplementation therapy nor methylcobalamin therapy changed the semen parameters significantly (except for the sperm concentration, which was increased by the latter therapy). When the pre‐treatment ORP value in semen was higher than the cutoff value, both therapies significantly increased the sperm concentration. The 8‐hydroxy‐2′‐deoxyguanosine level did not yield any meaningful predictive value with regard to increased sperm concentrations.Conclusions: Both antioxidant co‐supplementation therapy and methylcobalamin therapy increased the sperm concentration in patients with impaired semen quality when the basal ORP levels in their semen were elevated.

Purpose: To investigate the relationship between the ratio of index to ring finger lengths (2D:4D ratio), reflecting androgen exposure in utero, and reproductive function among men.Methods: Male patients (N = 180) who consulted for fertility issues participated in the study. The palms of both hands were scanned, and the 2D:4D ratio was calculated. Data on semen volume, sperm concentration and total motility, total and motile sperm counts, and serum hormone concentrations were obtained. Spearman correlation coefficients between the 2D:4D ratio and hormone and semen quality parameters were calculated.Results: The total sperm count was significantly negatively correlated with the 2D:4D ratio of the left hand (r = −0.154, p = 0.039) but not with that of the right hand (r = −0.045, p = 0.548). Testosterone showed weak negative correlations with the 2D:4D ratio in the left (r = −0.142, p = 0.058) and right (r = − 0.149, p = 0.046) hands. Follicle‐stimulating hormone levels were negatively correlated with the 2D:4D ratios of the left (r = −0.173, p = 0.020) and right (r = −0.164, p = 0.027) hands. Other semen quality parameters or luteinizing hormone levels showed no significant correlation with the 2D:4D ratios.Conclusions: No clear associations were observed between the 2D:4D ratios and reproductive function.

Elevated sperm mitochondrial DNA copy number (mtDNAcn) is associated with damage to sperm and poorer measures of semen quality. Exposure to cadmium (Cd) can increase oxidative stress and damage sperm mitochondria. The adverse effects of Cd can potentially be reduced by sufficient selenium (Se). The objective of this study was to examine the associations between sperm mtDNAcn and urinary concentrations of Cd and Se, as well as the Cd/Se molar ratio. Participants were recruited from patients who sought infertility treatment at two hospitals in Japan. Urine and semen specimens and self-administered questionnaires were collected on the day of recruitment. Sperm mtDNAcn was measured in extracted sperm DNA by multiplex real-time qPCR. Urinary Cd and Se concentrations were measured using inductively coupled plasma mass spectrometry, and their molar weights were calculated to obtain the Cd/Se molar ratio. Linear regression was used to estimate associations after adjusting for age, body mass index, smoking, drinking, exercise, varicocele, and hospital of recruitment. Sperm mtDNAcn showed statistically insignificant associations with creatinine-adjusted concentrations of urinary Cd (β = 0.13, 95% CI −0.18, 0.44) and Se (β = −0.09, 95% CI −0.54, 0.35), and Cd/Se molar ratio (β = 0.12, 95% CI −0.13, 0.37). The current study found no evidence of an association between mtDNAcn and urinary concentrations of Cd or Se, or the Cd/Se molar ratio.

Sexual dysfunction, which is increasingly recognized as a cause of male infertility, may be influenced by environmental factors such as phthalic acid diesters (phthalates) and prenatal androgen exposure. This study aimed to investigate the association between male sexual function and recent exposure to phthalates and prenatal testosterone. The cross-sectional study included 177 males seeking fertility treatment. The index-to-ring-finger length ratio (2D:4D) was calculated as a measure of prenatal androgen exposure. To evaluate recent phthalate exposure, urinary concentrations of seven phthalate metabolites were measured. Their associations with International Index of Erectile Function (IIEF) scores were analyzed using generalized linear models. One standard deviation increase of mono-methyl phthalate was negatively associated with IIEF domains A (erectile function; exponentiated coefficient, 0.95; exponentiated 95% confidence interval, CI, [0.91, 0.98]) and D (intercourse satisfaction; exponentiated coefficient, 0.91; exponentiated [0.85, 0.97]). While mono-butyl phthalate was positively associated with domain A, mono-ethyl phthalate, monobenzyl phthalate, and the molar sum of di (2-ethylhexyl) phthalate metabolites showed no significant association with IIEF domain scores. When the serum testosterone concentration was included as an exposure variable, the overall association between urinary phthalates and IIEF domain scores remained similar. The left- and right-hand 2D:4D ratios did not show significant associations with any IIEF domain scores. Recent phthalate exposure may affect male sexual function by decreasing testosterone levels and other potential mechanisms.

Introduction: Repair of obstructive azoospermia caused by childhood herniorrhaphy may be difficult. Therefore, intracytoplasmic sperm injection using testicular sperm is performed. However, vasovasostomy combined with laparoscopic surgery is challenging.Case presentation: A 42‐year‐old man underwent inguinal hernia repair at age 3. He had normal testicular size, azoospermia, normal hormone levels (follicle‐stimulating hormone, luteinizing hormone, and testosterone), absence of Y chromosome micro deletion, and karyotype:46XY, t(1:21)(p34.1:q22.3). He was diagnosed with obstructive azoospermia. Repeated intracytoplasmic sperm injections using testicular sperm resulted in miscarriages. Vasovasostomy combined with laparoscopic surgery was subsequently performed. Postoperative semen analysis result was almost normal. After intracytoplasmic sperm injection of ejaculated sperm, his wife got pregnant.Conclusion: Even if patients have chromosomal abnormalities, performing microsurgical re‐anastomosis first is recommended. To our knowledge, this is the first case of a laparoscopy‐assisted vasovasostomy for post‐herniorrhaphy vas deferens obstruction in Japan.