Purpose: To evaluate the impact of the COVID-19 pandemic lifestyle change on couples of reproductive age and on their desire for parenthood. Materials and methods: A quantitative correlational research study, based on a web survey, was conducted among Italian men and women in heterosexual stable relationships, aged between 18 and 46 years. The self-administered Italian version questionnaire was created using Google Forms and posted on chats and social networks.The mood of participants before and during the quarantine was assessed using a scale from 1 to 10 (1 ¼ no wellbeing; 10 ¼ total wellbeing). Couples' quality of life and their reproductive desire were evaluated. Results: 1482 respondents were included: 944 women (63.7%) and 538 men (36.3%). A significant trend toward reduced mean wellbeing scores during the quarantine, compared to before, was found (p < .01). From 18.1% participants who were planning to have a child before the pandemic, 37.3% abandoned the intention, related to worries of future economic difficulties (58%) and consequences on pregnancy (58%). Of 81.9% who did not intend to conceive, 11.5% revealed a desire for parenthood during quarantine than before (p < .01), related to will for change (50%) and need for positivity (40%). 4.3% of these actually tried to get pregnant. Stratifying by age, a trend toward older ages was found in the desire for parenthood before and during the COVID-19 pandemic (p < .05). Conclusions: COVID-19 pandemic is impacting on the desire for parenthood. It is unknown whether these findings will result in a substantial modification of birth rate in the near future. ARTICLE HISTORY

Objective The aim of the study is to evaluate how individual and couple's sexuality had changed during the COVID-19 pandemic related quarantine. Methods A quantitative correlational research study was conducted, using a web-based survey. Results 1576 participants were involved: 1018 women (64.6%) and 558 men (35.4%). A significant decline in the mean wellbeing scores during the quarantine, compared to before, was reported. A positive correlation between the wellbeing scores and the number of sexual intercourse (SI) before and during the quarantine was found. The mean number of SI decreased significantly during the quarantine. The main reasons were: poor privacy (43.2%) and lack of psychological stimuli (40.9%). 1124 respondents (71.3%) did not report sexual desire (SD) reduction. A positive association between SD and SI during the quarantine was found. 61.2% did not report autoerotism reduction. In those who reported decreased masturbation activity, the main causes were poor privacy (46.4%) and lack of desire (34.7%). We found that men presented lower SD during the quarantine, than women ( p <0.01). Conclusion Potentially, the more time available might lead couples to reconnect at an intimate level and to improve their sexuality. However, the majority of quarantined participants experienced reduced number of SI per week, with poor household privacy and lack of psychological stimuli as cited causes, even as a majority did not report reduced autoeroticism.

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To date, the key role of vitamin D in male reproductive system has been suggested, since the expression of vitamin D receptors and metabolizing enzymes was demonstrated in the testis and spermatozoa. Nevertheless, a general consensus about the role of vitamin D in male fertility is still debated. The aim of this review is to provide an updated systematic revision of the current available literature, discussing the experimental and clinical evidence on the role of vitamin D in the regulation of testis hormone production, seminal parameters and male fertility. The consequences of vitamin D deficiency on serum levels of testicular hormones have been analysed by several observational and interventional studies, with controversial results. Equally, the experimental researches not were able to state a certain relationship between vitamin D status and testis hormone production. Possible bias, including age, body mass index, and baseline vitamin D status justified the differences among studies. As well as concerning the effect of vitamin D on semen parameters, most of the studies agreed in the possibility that vitamin D might have a positive effect on human male fertility potential, particularly through better sperm motility. Regarding pregnancy outcomes, normal level of vitamin D seems to be related to better pregnancies. However, all the previous studies displayed a wide heterogeneity in study design, population, methodology, and cut off values used for the evaluation of vitamin D status. Future studies are needed to better clarify the exact role of vitamin D on hormonal and seminal panel in both fertile and infertile men.

Purpose: To compare the efficacy and safety of intralesional hyaluronic acid (HA) as compared with verapamil injection in patients with Peyronie's disease (PD). Materials and Methods: Between January 2015 and December 2018, men in PD acute phase were prospectively recruited. This open-label, prospective study included 2 different protocols. Group A: 8-week cycle of weekly intraplaque injections with HA; Group B: 8-week cycle of weekly intraplaque injections with verapamil. Penile curvature, plaque size, International Index of Erectile Function (IIEF)-15 score and visual analogue scale (VAS) were assessed at baseline and after 3 months. Results: Two-hundred forty-four patients were enrolled. Of these, 125 received intralesional HA (Group A), 119 received intralesional verapamil (Group B). At enrollment, median age was 56.0 years (interquartile range [IQR]=47.0-63.0 years), median curvature 35.0° (IQR=25.0°-45.0°), median IIEF-15 score 19.0 (IQR=16.0-23.0), median VAS 4.0 (IQR=4.0-5.0). Median difference for IIEF-15 was 1.0 (95% confidence interval [CI]=1.12-1.94) in Group A and 0.0 (95% CI=-0.04-0.14) in Group B (p<0.05) and median difference for VAS score was-4.0 (95% CI=-4.11-3.65) in Group A and-1.0 (95% CI=-0.50-2.01) in Group B (p<0.05). Plaque size decreased by-1.50 mm (IQR=1.60-2.10 mm) in Group A and-1.20 in Group B (p=0.10), while penile curvature decreased by-9.50° (IQR=4.50°-13.00°) in group A and-4.50 (IQR=2.50-7.50) in Group B (p<0.01). Conclusions: Intralesional HA injections could represent a reliable treatment option for the conservative management of patients with acute phase of PD.

Zinner syndrome (ZS) could represent an uncommon cause of male infertility, as result of the ejaculatory duct block, which typically leads to low seminal volume and azoospermia. A 27‐year‐old Caucasian man reported persistent events of scrotal‐perineal pain and dysuria during the past 6 months. The andrological examination showed testicular volume of 10 ml bilaterally. Follicle‐stimulating hormone was 32.0 IU/L, luteinising hormone was 16.3 IU/L, total testosterone was 9.0 nmol/L, and 17‐beta‐oestradiol was 0.12 nmol/L. The semen analysis revealed absolute azoospermia, semen volume of 0.6 ml and semen pH of 7.6. The abdominal contrast‐enhanced computed tomography showed (a) left kidney agenesis; (b) an ovaliform hypodense mass of 65 × 46 millimetres with fluid content, which was shaping the bladder and the left paramedian prostatic region, compatible with a left seminal vesicle pseudocyst; and (c) an enlargement of the right seminal vesicle. The patient was diagnosed with ZS, and he was scheduled for robot‐assisted laparoscopic left vesiculectomy. Subsequently, testis biopsy was characterised by complete germ cell aplasia. The onset symptomatology is often blurred and difficult to detect. It is important to diagnose and manage early this condition, because a long‐lasting seminal tract obstruction could determine an irreversible secretory testicular injury.

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Background Oxidative stress (OS) is one of the most prevalent causes of sperm damage, through the toxic effects of endogenously generated hydrogen peroxide, superoxide anion, and hydroxyl radicals. Peripheral leukocytes represent a feasible model for studying the pathophysiology of OS‐mediated homeostasis, which can be responsible for cell dysfunction and cell injury. Objective To evaluate the redox status in patients with non‐obstructive azoospermia (NOA), establishing the potential role exerted by reactive oxygen species (ROS) in the genesis of testicular secretory injury. Material and methods From May 2018 to March 2019, 39 patients were enrolled in this prospective single‐center cohort study and divided into two groups. Group 1 included 19 patients with NOA, and Group 2 included 20 normozoospermic men, partners of women with infertility tubal factor. All patients underwent serum blood tests. NOA underwent testicular sperm extraction (TeSE). ROS production (in lymphocytes, monocytes, and granulocytes) was assessed by fluorescence‐activated cell sorting (FACS) analysis. Plasma oxidative stress was evaluated by lipid peroxidation markers (MDA) and total antioxidant capacity (TAC) both assessed by fluorometric techniques. Results Mean lymphocyte ROS production resulted 967.0 ± 224.5 vs 728.0 ± 98.0 (NOA vs Controls, P < .001), monocyte ROS resulted 2102.5 ± 517.5 vs 1253 ± 171 (P < .001), and granulocyte ROS were 2366.5 ± 595.4 vs 1751.0 ± 213.0 (P < .001). Significant increases plasma lipid peroxidation markers were found in NOA patients compared with controls (2.7 ± 0.8 vs 0.37 ± 0.2 nmol/mL, P < .001). Significant decreased TAC was evident in NOA compared with controls (13.4 ± 3.9 vs 3.0 ± 0.2 µmol/mL Trolox equivalents, P < .001). No significant differences were found in blood leukocyte subpopulations ROS production, plasma lipid peroxidation, and TAC comparing groups (positive vs negative sperm retrieval, P > .05). Conclusion ROS production can be directly related to disorders of spermatogenesis, leading to severe conditions of male infertility, including azoospermia.