Background Infertile men have higher levels of semen reactive oxygen species (ROS) than fertile men. High levels of semen ROS can cause sperm dysfunction, sperm DNA damage and reduced male reproductive potential. This study investigated the effects of supplementation with N-acetyl-cysteine (NAC) on the sperm quality, chromatin integrity and levels of oxidative stress in infertile men. Methods The study was carried out in the unit of ACECR Infertility Research Center, Qom, Iran. The patients consisted of 50 infertile men with asthenoteratozoospermia who received NAC (600 mg/d) orally for 3 months, after which they were compared with pre-treatment status. Semen was analyzed according to WHO (2010), followed by the assessment of protamine content [chromomycin A3 (CMA3)] and DNA integrity [terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL)]. Oxidative stress markers, i.e. total antioxidant capacity (TAC) and malondialdehyde (MDA), as well as hormonal profile (LH, FSH, Testosterone and Prolactin) were determined by ELISA kit. Results After NAC treatment, patients’ sperm count and motility increased significantly whereas abnormal morphology, DNA fragmentation and protamine deficiency showed significant decreases compared to pre-treatment levels ( P < 0.05). Hormonal profile improvement was associated with lowered FSH and LH levels and increased amount of testosterone ( P < 0.05). TAC significantly increased and MDA decreased with an inverse significant correlation between TAC and MDA ( P < 0.05). Conclusion NAC oral supplementation may improve sperm parameters and oxidative/antioxidant status in infertile males.

Background:Most studies on anabolic-androgenic steroids abuse have been done in adult rats, but few data are available to immature.Objective: This study was conducted to assay the effect of Nandrolone Decanoate (ND) on the testis and testosterone concentration in male immature rats compare with mature ones in short and long time.Materials and Methods:40 mature rats were divided into 4 groups: group A (short term) and group B (long-term) received 10 mg/kg/day ND interaperitoneally for 35 and 70 days, respectively. Group C (control) without any treatment, and group D (vehicle) received dimethyl sulfoxide (DMSO) solution in two periods 35 and 70 days. 40 immature rats were divided into 4 groups same as mature ones. After surgery body weight, testis size, histomorphometry of testis, and serum testosterone level were evaluated. Results:Our results showed that ND decreased the number of Leydig cells in group B (39.9 ±. 919), group A (43.4 ±. 120), and long term (40.6 ±. 299) immature rats, which could result in a reduction of testosterone concentration significantly in all experimental groups except short term mature group. Number of sertoli cells, testis size, and diameter of seminiferous tubules decreased in the long-term immature group. Eventually, the number of sperm was decreased in mature and immature groups, but a severe depletion of sperm was occurred in both mature and immature in long time in comparison to the control group (p< 0.05). Conclusion:This time course study showed that supraphysiological dose of ND may negatively affect the number of Leydig cells, sperm cell, and testosterone concentration of immature rats in the same matter of mature rats. However, the number of sertoli cell, testis size, and seminferous diameter were decreased only in the long immature rats.

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Background: Coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may lead to the infertility of men. Objectives: This study aimed to investigate the impact of COVID-19 infection on sperm parameters and reproductive hormones in fertile men. Methods: A total of 100 males were selected and divided into two groups: (1) patients in convalescence (patients suffering from COVID-19 infection in pharyngeal swab in accordance with reverse-transcription polymerase chain reaction [RT-PCR] or antibodies); (2) negative control group (without antibodies). Semen and blood samples were gathered from all subjects. In the native semen, immunoglobulin (Ig) M and IgG antibodies in the blood were confirmed, and COVID-19 was detected via RT-PCR. To this end, based on the World Health Organization (WHO) guidelines, semen analysis, total antioxidant capacity (TAC), and sperm DNA integrity were assessed. Results: Results demonstrated that sperm concentration, motility, sperm viability, and TAC significantly reduced in fertile males with virus infection. In comparison with the control group, sperm DNA integrity was significantly increased (P < 0.05). Data indicated that the semen volume was not significantly correlated with COVID-19, and there was a significantly negative correlation between sperm concentration, sperm total motility, sperm vitality, sperm normal forms, and TAC with COVID-19. Sperm DNA fragmentation index had a significant and positive correlation with COVID-19 (P < 0.05). In addition, reproductive hormones significantly reduced in fertile males with COVID-19 infection (P < 0.05). Conclusions: COVID-19 infection has a negative influence on sperm parameters and reproductive hormones in fertile males.

We aimed to investigating the effects of metformin (MET) in combination with alpha lipoic acid (ALA) on hormonal and biochemical parameters, in polycystic ovary syndrome (PCOS) women undergoing intracytoplasmic sperm injection (ICSI). This experimental pilot study with a randomized design was carried out on 40 PCOS women in two groups: (1) MET group, administered 1,500 mg/day MET, and (2) MET (1,500 mg/day)+ALA (1,800 mg/day) group. Drugs were administered from the third day of the previous cycle until the day of oocyte aspiration (six weeks of treatment in total). MET+ALA significantly increased the number of maturated oocytes and the rate of fertilization when compared to the MET group. Combination MET+ALA could increase significantly the number of oocytes retrieval and the number of good-quality embryos. Also, the malondialdehyde (MDA) level decreased significantly in the MET+ALA group and the total antioxidant capacity (TAC) level increased significantly in the MET+ALA group compared to the MET group. Also, fasting blood sugar (FBS), insulin, luteinizing hormone (LH), and LH/follicle stimulating hormone (FSH) levels were significantly lower in the MET+ALA group. The pregnancy outcomes showed no significant difference in the rates of biochemical pregnancy, clinical pregnancy, miscarriage, and live births between the control and study groups. The combination of MET+ALA treatment could moderate the complications of PCOS and subsequently improve oocyte and embryo quality.

Background and Objectives:The semen cryopreservation is not only required for improving the success chance of assisted reproductive technologies fertility but also is performed for men undergoing chemotherapy, radiotherapy, and surgery, and facing ejaculation problems. This study aimed to investigate the effects of N-acetylcysteine on human sperm parameters and DNA damage in frozenthawed sperm samples of patients with asthenozoospermia. Methods:In this study, 20 patients with asthenozoospermia referring to Jihad University Infertility Treatment Center, Qom, Iran, were evaluated in three groups, namely control, freezing, and freezing + Nacetyl-cysteine (1mg/ml). Sperm parameters, viability, and DNA damage were respectively assessed using the World Health Organization guideline (2010), eosin-nigrosin staining, and sperm chromatin dispersion kit, respectively in all three groups. The statistical analysis was performed using one-way ANOVA and Tukey post hoc test. The significance level was considered at the p-value of < 0.05. Results:The freezing process resulted in a decrease in sperm motility parameters, and the addition of the antioxidant N-acetyl-cysteine improved sperm motility, morphology, and sperm viability. The addition of N-acetyl-cysteine could reduce DNA damage (P<0.05). Conclusion:Our results showed that N-acetyl-cysteine could reduce the disruptive effects of the freezing-thawing process.

In infertile men, reduced expression of heat shock protein A2 (HSPA2) is related to reduced sperm quality and function. The present study has aimed to investigate the effects of N‐acetyl‐cysteine (NAC) supplementation on expression of heat shock protein A2 (HSPA2). In this study in continuation of previous study, semen samples from 50 astheno‐terato‐zoospermic men who have received NAC (600 mg/day) orally for three months were evaluated for expression HSPA2 using RT‐PCR, and Western blot analysis. In addition, semen samples of these individuals were assessed for sperm parameters, DNA fragmentation (TUNEL), protamine deficiency (CMA3), lipid peroxidation index (MDA) and total antioxidant capacity (TCA). All assessment was carried out before and after NAC treatment. In addition to improved sperm parameters and aforementioned functional parameters, the presented results revealed the significant increase in relative expression levels of HSPA2 was obtained after using NAC treatment (p < .05). Correlation analysis also demonstrated that HSPA2 expression is significantly related to most of the assessed parameters. NAC may directly or indecently impose its beneficial effect through increased expression of HSPA2, which plays a potential role in proper folding of element needed to counteract stress condition in infertile individuals.

Background and Aim: Applying Assisted Reproductive Technologies (ARTs) is increasing. A critical step in ART is the frozen embryo transfer, in which the endometrium thickness has great significance in the outcome. In this case, the frozen embryo will be transferred during the next cycle. There are several ways to prepare an endometrium for transmitting embryos; however, choosing the best method remains debated. The present study aimed to evaluate the pregnancy rate of frozen embryo transfer in the presence or absence of GnRH agonists. Methods & Materials: A retrospective analysis was conducted on 146 consecutive patients attending Qom’s infertility treatment center from 2015 to 2017; these subjects were candidates for the transfer cycle of the frozen-thawed embryo and randomly assigned to receive either protocol with or without GnRH agonist. Clinical features, implantation rate, pregnancy rate (chemical & clinical), and abortion rate were assessed. Ethical Considerations: This study was approved by the Research Ethics Committee of the Academic Center for Education, Culture, and Research of Mashhad University (Code: IR.ACECR.JDM.REC.1398.001). Results: There was no significant difference in baseline and clinical characteristics, implantation rate, pregnancy rate (chemical & clinical), and abortion rate between the study groups of endometrial preparations with or without GnRH agonist (P<0.05). Conclusion: In this study, pregnancy outcome was similar in both study groups; thus, this method is recommended as an endometrial preparation without GnRH agonist.