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Inhibin B:are modified ranges needed for orchiectomised testicular cancer patients?

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Asian Journal of Andrology 2019年第4期21卷 332-336页

作者： Alessandra Petrozzi Francesco Pallotti Marianna Pelloni Antonella Anzuini Antonio Francesco Radicioni Andrea Lenzi Donatella Paoli Francesco Lombardo Laboratory of Seminology Sperm Bank "Loredana Gandini" Department of Experimental Medicine Medical Pathophysiology Section"Sapienza" University of Rome Rome 00161 Italy Hormone Laboratory Department of Experimental Medicine Medical Pathophysiology Section"Sapienza" University of Rome Rome 00161 Italy

Inhibin B is a gon adal horm one that down regulates the pituitary production of follicle-stimulati ng horm one (FSH). In recent years, inhibin B has proved to be an excellent marker of spermatogenesis and even a predictive factor for the recovery of fertility in patients undergoing orchiectomy and antineoplastic treatments. We propose to study inhibin B levels in orchiectomised testicular cancer patients, in order to identify a minimum value representative of normal semen quality. This retrospective study evaluates horm onal and semen parameters of 290 no rmozoospermic patie nts atte nding the Laboratory of Semi no logy - Sperm Bank "Loredana Gandini"(Rome, Italy) for cryopreservation of seminal fluid following a diagnosis of testicular cancer (TC group) and 117 healthy, normozoospermic men as a control group (CTR group). The percentile distribution of gonadotropin and inhibin B values in the TC and CTR groups was analyzed. There was a statistically significant differenee between the two groups in the levels of all hormones (P ≤ 0.001) and in all semen parameters (P 95^th percentile of CTR group. Orchiectomised patients for testicular cancer presented inhibin B levels lower than healthy patients, despite normozoospermia. Our study revealed the poor sensitivity of the current inhibin B reference range when applied to monorchidic patients, suggesting the need to establish more representative ranges to enable more appropriate counseling in relation to the patienfs new endocrine condition.

关键词： inhibin B orchiectomy referenee range testicular cancer

A comparison of the relative efficiency of ICSI and extended culture with epididymal sperm versus testicular sperm in patients with obstructive azoospermia

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Asian Journal of Andrology 2020年第2期22卷 222-226页

作者： Scott J Morin Brent M Hanson Caroline R Juneau Shelby A Neal Jessica N Landis Richard T Scott Jr James M Hotaling Reproductive Medicine Associates of New Jersey 140 Allen RoadBasking RidgeNJ 07920USA Division of Reproductive Endocrinology and Infertility Department of Obstetrics and GynecologySidney Kimmel Medical College at Thomas Jefferson University833 Chestnut StreetPhiladelphiaPA 19107USA Foundation for Embryonic Competence 140 Allen RoadBasking RidgeNJ 07920USA Division of Urology Department of SurgeryUniversity of Utah School of Medicine30 N 1900 ESalt Lake CityUT 84132USA Department of Obstetrics and Gynecology University of Utah School of Medicine30 N 1900 ESalt Lake CityUT 84132USA.An abbreviated version of this manuscript was published and presented as an abstract at the American Society for Reproductive Medicine(ASRM)2017 Scientific Congress.

This is a retrospective cohort study comparing blastocyst transfer outcomes following intracytoplasmic sperm injection utilizing epididymal versus testicular sperm for men with obstructive azoospermia.All cases at a single center between 2012 and 2016 were included.Operative approach was selected at the surgeon’s discretion and included microepididymal sperm aspiration or testicular sperm extraction.Blastocyst culture was exclusively utilized prior to transfer.The primary outcome was live birth rate.Secondary outcomes included fertilization rate,blastulation rate,euploidy rate,and implantation rate.A mixed effects model was performed.Seventy-six microepididymal sperm aspiration cases and 93 testicular sperm extraction cases were analyzed.The live birth rate was equivalent(48.6%vs 50.5%,P=0.77).However,on mixed effects model,epididymal sperm resulted in a greater likelihood of fertilization(adjusted OR:1.37,95%CI:1.05–1.81,P=0.02)and produced a higher blastulation rate(adjusted OR:1.41,95%CI:1.1–1.85,P=0.01).As a result,the epididymal sperm group had more supernumerary blastocysts available(4.3 vs 3,P<0.05).The euploidy rate was no different.Pregnancy rates were no different through the first transfer cycle.However,intracytoplasmic sperm injection following microepididymal sperm aspiration resulted in a greater number of usable blastocysts per patient.Thus,the true benefit of epididymal sperm may only be demonstrated via a comparison of cumulative pregnancy rates after multiple transfers from one cohort.

关键词： azoospermia intracytoplasmic sperm injection male infertility testicular sperm extraction

Predictive significance of serum inhibin B on testicular haploid gamete retrieval outcomes in nonobstructive azoospermic men

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Asian Journal of Andrology 2019年第2期21卷 137-142页

作者： Zhi-Guo Zhu Zhi-Gang Zhao Qing-Yang Pang Tong Chen Jian-Min Zhang Tai-Jian Zhang Chao Xu Hao-Bo Zhang Wen Liu Xu-Jun Xuan Department of Urology and Andrology Minimally Invasive Surgery CenterThe First Affiliated Hospital of Guangzhou Medical UniversityGuangzhou 510230China Guangzhou Institute of Urology Guangzhou 510230China Guangdong Key Laboratory of Urology Guangzhou 510230China Center for Reproductive Medicine Shandong UniversityJinan 250001China National Research Center for Assisted Reproductive Technology and Reproductive Genetics Jinan 250001China The Key Laboratory for Reproductive Endocrinology of Ministry of Education Jinan 250001China Shandong Xiehe University Jinan 250109China

The purpose of this study was to determine the diagnostic accuracy of serum inhibin B(INHB)as a predictor of the retrieval outcome of testicular haploid gametes(spermatids and testicular spermatozoa)in nonobstructive azoospermic men.Serum hormone levels,testicular volume,and histological evaluation were performed in 403 Chin ese non obstructive azoospermic men.testicular haploid gamete was successfully retrieved in 213 of 403 patients(52.85%).The haploid gamete group always had higher INHB levels than the non-haploid gamete group.According to the receiver operating characteristic(ROC)curve analysis,INHB was a good predictor of testicular haploid gamete retrieval outcome in all patients(sensitivity:77.93%and specificity:91.58%)and patients with normal follicle-stimulating hormone(FSH;sensitivity:88.52%and specificity:70.83%).The area under the ROC curve(AUC)of INHB was similar to that of FSH in all patients or patients with normal FSH.In patients with elevated FSH,INHB was superior to FSH in predicting the presence of haploid gamete(AUC:0.73 vs 0.55,Ptesticular haploid gamete retrieval outcomes in nonobstructive azoospermic men.Especially,INHB is superior to FSH in predicting the presenee of haploid gamete in the patients with elevated FSH.

关键词： azoospermia biomarker follicle-stimulating hormone inhibin B testicular sperm extraction

Bilateral versus unilateral cryptorchidism in nonobstructive azoospermia:testicular sperm extraction outcomes

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Asian Journal of Andrology 2019年第5期21卷 445-451页

作者： Anne-Laure Barbotin Anais Dauvergne Agathe Dumont Nassima Ramdane Valerie Mitchell Jean-Marc Rigot Florence Boitrelle Geoffroy Robin CHU Lille Reproductive Biology-Spermiology-CECOS InstituteJeanne de Fla nd re HospitalF-59000 LilleFrance EA4308:Gametogenesis and Gamete Quality Lille UniversityF-59000 LilleFrance CHU Lille Department of AndrologyCalmette HospitalF-59000 LilleFrance CHU Lille Department of Endocrine Gynaecology and Reproductive MedicineJeanne de Flandre HospitalF-59000 LilleFrance CHU Lille Department of BiostatisticsEA2694Lille UniversityF-59000 LilleFrance Fertility Unit Poissy-Saint-Germain-en-Laye General Hospital78303 PoissyFrance.

Cryptorchidism is one of the most frequent causes of nonobstructive azoospermia(NOA)in adulthood.Although it is well known that spermatogenesis is more impaired in bilateral than in unilateral cryptorchidism,previous studies have only described small cohorts or inhomogeneous population.Consequently,we analyzed a cohort of 225 men with only a history of cryptorchidism as sole etiopathogenetic factor for NOA,and compared testicular sperm extraction(TESE)outcomes between men with bilateral versus unilateral cryptorchidism.Our results show no difference in follicle-stimulating hormone(FSH)levels and testicular volumes between men with a history of bilateral cryptorchidism compared to unilateral cryptorchidism(median:21.3 IU I^-1 vs 19.3 IU I^-1,P=0.306;and 7.2 ml vs 7.9 ml,P=0.543,respectively).In addition,sperm retrieval rates were similar(66.2%vs 60.0%,P=0.353).Using multivariate analysis,we have found that only a low inhibin B level(above the assay's detection limit)was positively associated with successful sperm retrieval(Ptesticular impairment.Interestingly,inhibin B level might be a predictor of successful TESE.

关键词： cryptorchidism in tracytoplasmic sperm in jection non obstructive azoospermia testicular sperm extraction

The modern testicular prosthesis:patient selection and counseling,surgical technique,and outcomes

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Asian Journal of Andrology 2020年第1期22卷 64-69页

作者： Solomon Hayon Jamie Michael R Matthew Coward Department of Urology University of North Carolina School of MedicineChapel HillNC 27500-7235USA University of North Carolina School of Medicine Chapel HillNC 27500-7235USA

The testicular prosthesis can be an afterthought for providers when performing an orchiectomy for testicular cancer,torsion,atrophic testis,or trauma.However,data suggest that patients find the offer of a testicular prosthesis and counseling regarding placement to be extremely important from both a pragmatic and a psychosocial perspective.Only two-thirds of men undergoing orchiectomy are offered an implant at the time of orchiectomy and of those offered about one-third move forward with prosthesis placement.The relatively low acceptance rate is in stark contrast with high patient satisfaction and low complication rates for those who undergo the procedure.The most common postoperative patient concerns are minor and involve implant positioning,size,and weight.Herein,we provide an up-to-date review of modern preoperative evaluation,patient selection,expectation management,surgical technique,and expected outcomes for testicular prostheses.

关键词： anorchia orchiectomy patient satisfaction prostheses and implants testicular neoplasms testis

The role of tumor size,ultrasonographic findings,and serum tumor markers in predicting the likelihood of malignant testicular histology

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Asian Journal of Andrology 2019年第2期21卷 196-200页

作者： Gang Song Geng-Yan Xiong Yu Fan Cong Huang Yong-Ming Kang Guang-Jie Ji Jin-Chao Chen Zhong-Cheng Xin Li-Qun Zhou Department of Urology Peking University First HospitalBeijing 100034China Institute of Urology Peking UniversityNational Urological Cancer CenterBeijing 100034China Department of Urology Suining Central HospitalSuining 629000China Department of Andrology Peking University First HospitalBeijing 1CX3034China

The clin ical predictive factors for maligna nt testicular histology remain unclear because of the low prevale nee.Therefore,the aim of this study was to investigate predictors of malignant histology for testicular masses and decide more testis-sparing surgeries before surgery.This retrospective study enrolled 325 consecutive testicular mass patients who underwent radical orchiectomy(310/325)or testicular preserving surgery(15/325)from January 2001 to June 2016.The clinicopathological factors,including tumor diameter,cryptorchidism history,ultraso und fin dings,serum alpha-fetoprotein,and human chorio nic gonadotropin(HCG)levels,were collected retrospectively for statistical an alysis.A predictive no mogram was also gen erated to evaluate the qua ntitative probability.Among all patients,247(76.0%)were diagnosed with a malignant testicular tumor and 78(24.0%)with benign histology.Larger tumor diameter(percm increased,hazard ratio[HR]=1.284,P=0.036),lower ultrasound echo(HR=3.191,P=0.001),higher ultrasound blood flow(HR=3.320,Ptesticular mass patients?The nomogram generated was well calibrated for all predicti ons of malig nant probability,and the accuracy of the model no mogram measured by HarrelTs C statistic(C-in dex)was 0.92.According to our data,the proportion of patients who underwent radical orchiectomy for benign tumors(24.0%)was much larger tha n gen erally believed(10.0%).Our results in dicated that the diameter,ultras onic echo,ultras onic blood flow,and serum HCG levels could predict the malignancy in testicular mass patients.

关键词： malignant likelihood predictive model testicular tumor urological oncology

Reduced semen quality in patients with testicular cancer seminoma is associated with alterations in the expression of sperm proteins

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Asian Journal of Andrology 2020年第1期22卷 88-93页

作者： Tania R Dias Ashok Agarwal Peter N Pushparaj Gulfam Ahmad Rakesh Sharma American Center for Reproductive Medicine Cleveland ClinicClevelandOH 44195USA Department of Health Sciences Faculty of Health SciencesUniversity of Beira InteriorCovilha 6201-001Portugal Department of Microscopy and Unit for Multidisciplinary Research in Biomedicine Institute of Biomedical Sciences Abel SalazarUniversity of PortoPorto 4050-313Portugal Center of Excellence in Genomic Medicine Research Faculty of Applied Medical SciencesJeddah 21589Saudi Arabia Division of Pathology School of Medical SciencesSydney UniversityLidcombe NSW 2141Australia

testicular cancer seminoma is one of the most common types of cancer among men of reproductive age.Patients with this condition usually present reduced semen quality,even before initiating cancer therapy.However,the underlying mechanisms by which testicular cancer seminoma affects male fertility are largely unknown.The aim of this study was to investigate alterations in the sperm proteome of men with seminoma undergoing sperm banking before starting cancer therapy,in comparison to healthy proven fertile men(control group).A routine semen analysis was conducted before cryopreservation of the samples(n=15 per group).Men with seminoma showed a decrease in sperm motility(P=0.019),total motile count(P=0.001),concentration(P=0.003),and total sperm count(P=0.001).Quantitative proteomic analysis identified 393 differentially expressed proteins between the study groups.Ten proteins involved in spermatogenesis,sperm function,binding of sperm to the oocyte,and fertilization were selected for validation by western blot.We confirmed the underexpression of heat shock-related 70 kDa protein 2(P=0.041),ubiquinol-cytochrome C reductase core protein 2(P=0.026),and testis-specific sodium/potassium-transporting ATPase subunit alpha-4(P=0.016),as well as the overexpression of angiotensin I converting enzyme(P=0.005)in the seminoma group.The altered expression levels of these proteins are associated with spermatogenesis dysfunction,reduced sperm kinematics and motility,failure in capacitation and fertilization.The findings of this study may explain the decrease in the fertilizing ability of men with seminoma before starting cancer therapy.

关键词： male fertility proteomics seminoma sperm proteins sperm quality testicular cancer

Effects of percutaneous varicocele repair on testicular volume:results from a 12-month follow-up

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Asian Journal of Andrology 2019年第4期21卷 408-412页

作者： Andrea Sansone Danilo Alunni Fegatelli Carlotta Pozza Giorgio Fattorini Rosa Lauretta Marianna Minnetti Francesco Romanelli Pierleone Lucatelli Mario Corona Mario Bezzi Francesco Lombardo Andrea Lenzi Daniele Gianfrilli Departme nt of Experime ntal Medici ne Sa pie nza Un iversity of Rome Rome 00161 Italy Department of Public Health and In fectious Diseases Sapienza University of Rome Rome 00161 Italy Unit of Endocrinology Regina Elena National Cancer Institute Rome 00144 Italy Vascular and Interventional Radiology Unit Department of Radiological Oncological and Anatomo-Pathological Sciences Sapienza-University of Rome Rome 00161 Italy

Varicocele is a comm on fin ding in men. Varicocele correcti on has bee n advocated for young patients with testicular hypotrophy, but there is a lack of morphofunctional follow-up data. We assessed whether percutaneous treatment of left varicocele is associated with testicular "catch-up growth" in the following 12 months by retrospectively reviewing data from an electronic database of 10 656 patients followed up in our clinic between 2006 and 2016. We selected all young adults (testicular volume. One hundred and fourteen men (mean±standard deviation [s.d.] of age: 22.8 ± 5.4 years) met the inclusion and exclusion criteria. Left testicular hypotrophy (LTH), defined as a >20% difference between left and right testicular volume at baseline, was observed in 26 (22.8%) men. Participants with LTH (mean±s.d.: 14.5 ± 2.7 ml) had lower baseline testicular volume compared to those without LTH (mean±s.d.: 15.7 ± 3.8 ml;P= 0.032). Repeated measures mixed models showed a sign ifica nt in teraction betwee n LTH and time posttreatme nt when correcting for baseli ne left testicular volume (β= 0.114, 95% confidence interval [Cl]: 0.018-0.210, P=0.020), resulting in a catch-up growth of up to 1.37 ml per year (95% Cl: 0.221- 2.516). Age at intervention was also associated with reduced testicular volume (-0.072 ml per year, 95% Cl:-0.135--0.009;P = 0.024). Percutaneous treatment of left varicocele in young adults with LTH can result in catch-up growth over 1 year of follow-up. The reproductive and psychological implicati ons of these findings n eed to be confirmed in Ion ger and larger prospective studies.

关键词： catch-up growth percutaneous treatment testicular hypotrophy testicular ultrasound testicular volume varicocele young adults

Association between KITLG Gene Polymorphisms and testicular Germ Cell Tumors:A Systematic Review and Meta-analysis

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Current Medical Science 2019年第5期39卷 702-706页

作者： Jia-xuan QIN Zong-long CAI Yu-feng YANG Jin-chun XING Xuan ZHUANG Department of Urology Surgery Center of Diagnosis and Treatment of Urinary System Diseasesthe Key Laboratory of Urinary Tract Tumors and Calculi of Xiamen Citythe First Affiliated Hospital of Xiamen UniversityXiamen 361003China The First Clinical Medical School of Fujian Medical University Xiamen 361003China

It has been reported that c-KIT ligand(KITLG)gene polymorphisms may be associated with testicular germ cell tumors(TGCT).Owing to mixed and inconclusive results,we con ducted a systematic review and meta-analysis to summarize and clarify this association.A systematic search of studies on the association between KITLG gene polymorphisms and TGCT susceptibility was conducted in databases.Odds ratios and 95%confidence intervals were used to pool the effect size.Six articles were included in our systematic review and meta-analysis.Compared with adenine(A),KITLG rs995030 guanine(G)might be associated with increased risk of TGCT.There are insufficient data to fully confirm the association between KITLG rs4474514 and TGCT susceptibility.Well-designed studies with larger sample size and more subgroups are required to validate the risk identified in the current meta-analysis.

关键词： c-KIT ligand single nucleotide polymorphisms testicular germ cell tumors metaanalysis