Objectives This study investigated the relationship between body mass index (BMI) and metabolic syndrome on sperm DNA fragmentation (SDF) in males from infertile couples. Methods This cross-sectional study was performed from September 2018 to September 2019 at the Hue Center for Reproductive Endocrinology and Infertility (HUECREI), Vietnam. The study included men from couples with at least one year of infertility, who were subjected to semen analysis and SDF assay (Halosperm). We also performed a 2-h oral glucose tolerance test and measured lipidemia. Metabolic syndrome (MetS) was defined based on the NHLBI/AHA-ATP III guidelines. Results The mean age of the patients was 35.26 ± 5.87 years and 53.8% of them had a BMI ≥23.0 kg/m 2 . The DNA fragmentation index was significantly associated with overweight (p = 0.024). Men without MetS had a higher rate of big halos and a lower rate of small halos, no halos, and degraded semen compared to that in men with MetS, but the differences were not significant (p > 0.05). By performing multivariable analysis, we found that the SDF value was significantly different among the two groups with either overweight or normal weight. Conclusion In males from infertile couples with a relatively young mean age, BMI can be an independent indicator for SDF. MetS thus has a significant role in the development of sperm DNA fragmentation, at least in overweight individuals; it should thus be assessed under the scope of BMI, for better/earlier detection of increased SDF.

This study is aimed at comparing clinical pregnancy rates (CPRs) in patients who are administered either gonadotropin-releasing hormone agonist (GnRHa) or human chorionic gonadotropin (hCG) for ovulation trigger in intrauterine insemination (IUI) cycles. A prospective randomized comparative study was conducted at Hue University Hospital in Vietnam. A total of 197 infertile women were randomly assigned to receive either GnRHa trigger (n=98 cycles) or hCG trigger (n=99 cycles) for ovulation trigger. Patients returned for ultrasound monitoring 24 hours after IUI to confirm ovulation. A clinical pregnancy was defined as the presence of gestational sac with fetal cardiac activity. There was no difference in ovulation rates in either group receiving GnRHa or hCG trigger for ovulation. Biochemical and CPR were higher in patients who received hCG (28.3% and 23.2%) versus GnRHa (14.3% and 13.3%) (p=0.023, OR 0.42, 95%CI=0.21−0.86 and p=0.096, OR 0.51, 95%CI=0.24−1.07, respectively). After adjusting for body mass index (BMI) and infertility duration, there was no difference in CPR between the two groups (OR 0.58, 95% CI 0.27-1.25, p=0.163). In conclusion, the use of the GnRHa to trigger ovulation in patients undergoing ovulation induction may be considered in patients treated with IUI.

<b><i>Objective: </i></b>Scrotal ultrasound is not a routine investigation in the clinical approach to male infertility analysis. This study aims to identify the role of testicular Doppler ultrasound in male infertility assessment and its relation to semen parameters in non-azoospermic men. <b><i>Methods: </i></b>Cross-sectional descriptive analysis of 558 men from infertile couples were examined at the Hue Center for Reproductive Endocrinology and Infertility, Hue University Hospital from June 2016 to May 2018. Some cohort characteristics, semen analysis and testicular Doppler ultrasound were analyzed. Men with acute systemic diseases, acute urinary tract infection, hepatic dysfunction, malignant diseases, retrograde ejaculation, cryptorchidism or azoospermia were excluded. <b><i>Results: </i></b>The mean volumes of the right and left testicles were 8.87 and 8.77 ml, respectively. The total volume of the 2 sides was 17.63 ± 4.34 ml (95% confidence interval 17.27-18.00 ml). The mean right resistive index (RI) was 0.61 ± 0.23, and the mean left RI was 0.59 ± 0.01. The rate of normal semen quality was 23.2% in group with varicocele and 30.6% in group with non-varicocele. The ultrasound results from the normal semen group were much different from those of the abnormal semen group regarding testicular volume: mean right testis volume: 9.67 ± 1.88 vs. 8.75 ± 2.34 ml, p = 0.0096; mean left testis volume: 9.54 ± 1.78 vs. 8.51 ± 2.44 ml, p = 0.0047; mean total volume of 2 sides: 19.21 ± 3.60 vs. 17.26 ± 4.59 ml, p = 0.005 (varicocele group); mean right testis volume: 9.21 ± 2.21 vs. 8.63 ± 2.21 ml, p = 0.029 (non-varicocele group). The other indexes of color Doppler ultrasound (peak systolic velocity, end diastolic velocity, RI) were not found to correlate with semen quality. <b><i>Conclusions: </i></b>Testicular volume which has a close relation to the semen parameters could be used as a clinical prediction factor for the quality of semen.

Background: Ureaplasma urealyticum (U. urealyticum) and Mycoplasma genitalium (M. genitalium) may colonize the male genital tract. However, the negative effects of these bacteria on overall sperm quality, including semen pH, sperm concentration, motility, morphology, and total sperm count remain unclear. Objective: This study aimed to determine the presence of genital U. urealyticum and M. genitalium in semen and evaluate the effect of these organisms on sperm quality. Materials and Methods: A cross-sectional study was conducted on 380 men from infertile couples at a tertiary university hospital from July 2017 to June 2018. Semen quality was analyzed according to the World Health Organization 2010 standard, and U. urealyticum and M. genitalium were detected in the semen samples using polymerase chain reaction. Results: 338 men (88.9%) presented with at least one abnormal semen parameter. The detection rates of U. urealyticum and M. genitalium were 16.05% and 0.79%, respectively. There was no significant difference between the Ureaplasma-positive group and the Ureaplasma-negative group in terms of sperm characteristics. Sperm motility and sperm vitality in the Mycoplasma-positive group were much lower than those in the Mycoplasma-negative group (p = 0.02 and p < 0.001, respectively). Conclusion: The presence of U. urealyticum in the semen of infertile men did not affect the sperm characteristics. Although the positive rate of M. genitalium was low, colonization by these bacteria was more likely to negatively affect sperm quality. Key words: Ureaplasma urealyticum, Mycoplasma genitalium, Infertility, Spermatozoa.

Objectives: This study aimed to determine the role of pre-surgical markers in the prediction of sperm retrieval in infertile Vietnamese men with azoospermia. Patients and Methods:Retrospective descriptive analysis of 136 infertile men with azoospermia, examined from August 2014 to July 2018. Patients underwent stepwise surgical sperm retrieval via percutaneous epididymal sperm aspiration, testicular sperm aspiration then multiple testicular sperm extraction in up to 3 locations until sperm were detected. Factorswere analyzed to determine the prediction of sperm retrieval.Results: The overall success rate of sperm retrieval was 49.3% including 88.3% and 18.4% in the OA and NOA group, respectively. The results of sperm retrieval were significantly associated only with the OA and NOA group, not with endocrine test or testicular volume. We found no significant difference in the endocrine test and testicular volume’s result between successful and unsuccessful sperm retrieval in either group.Conclusions: Neither an endocrine test nor testicular volume should be used for predicting the results of surgical sperm retrieval in infertile Vietnamese males with azoospermia.