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Dioxins in the semen of men with infertility

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Abstract

The purpose of the present study was to assess ejaculate contamination by polychlorinated dibenzo-p-dioxins/furans in male infertility. The database of 168 infertile and 49 fertile men was included in the study. Dioxin content was determined using gas chromatography/high-resolution mass spectrometry (GC/HRMS). In the ejaculate of infertile men, the content of dioxins and furans was 2.2-2.3 times higher than in fertile donors. The maximum level of the most toxic dioxin congener was detected in pathospermia. Contamination of semen of infertile men by polychlorinated dibenzo-p-dioxins/furans supports the hypothesis about the relationship between environmental factors and reproductive health.
12TH IHPA FORUM AND SELECTED STUDIES ON POPS
Dioxins in the semen of men with infertility
E. F. Galimova &Z. K. Amirova &Sh. N. Galimov
Received: 21 March 2014 /Accepted: 26 May 2014 / Published online: 5 June 2014
#Springer-Verlag Berlin Heidelberg 2014
Abstract The purpose of the present study was to assess
ejaculate contamination by polychlorinated dibenzo-p-
dioxins/furans in male infertility. The database of 168 infertile
and 49 fertile men was included in the study. Dioxin content
was determined using gas chromatography/high-resolution
mass spectrometry (GC/HRMS). In the ejaculate of infertile
men, the content of dioxins and furans was 2.22.3 times
higher than in fertile donors. The maximum level of the most
toxic dioxin congener was detected in pathospermia. Contam-
ination of semen of infertile men by polychlorinated dibenzo-
p-dioxins/furans supports the hypothesis about the relation-
ship between environmental factors and reproductive health.
Keywords POP .Dioxins .Furans .Male infertility .
Ejaculate
Introduction
At present, the degradation of male reproductive health is
being observed in industrialized countries, and environmental
pollution is supposed as the main reason for it (Sharpe 2010).
Markers of anthropogenic influence are pathology of sper-
matogenesis, delay of puberty period, bias of sex ratio of
newborns, growth of incidence of cancer of testis and prostate
gland, and an increase of frequency of cryptorchidism and
hypospadias (Ryan et al. 2002;Hauseretal.2005;Delbèsetal.
2010;Zandenetal.2012). Dioxins and dioxin-like compounds
(polychlorinated dibenzo-para-dioxins and furansPCDD/Fs)
refer to reprotoxic pollutants (Mocarelli et al. 2011;Schecter
2012); these substances exert their cellular and metabolic
effects via the interaction with arylhydrocarbon receptor
(AhR) associated with xenobiotic- (XRE) and antioxidant
responsive (ARE) DNA elements (Nguyen et al. 2009). How-
ever, some researchers have doubts about both the crisis of
spermatozoidand its relations to environmental health risks
(Fisch 2008; Te Velde and Bonde 2013). The purpose of the
present study was to compare the concentration of dioxin-like
compounds in ejaculate with fertility pathology.
The city of Ufa was selected due to a dioxin pollution hot
pointsituated close to the residential areathis is the terri-
tory of the Khimprom plant (Maystrenko et al. 1998). The
plant produced 2,4,5-trichlorophenoxyacetic acid (2,4,5-T)
during the 60s until the late 80s, chlorine, and some herbi-
cidesup to its shutdown in 2004. For 55 years of plant
operation, several chlororganic products have been
manufactured at large scale2,4-dichlorophenoxyacetic acid
(2,4-D), 2,4,5-trichlorphenol and trichlorphenolate of copper,
orthochlorphenol. In 19641967, the production of butyl ether
of 2,4,5-trichlorphenoxyacetic acid was organized. 2,4,5-
Trichlorphenol and 2,4,5-trichlorphenolate of copper were
produced in 19621987 (Amirova et al. 2006). The polluted
territory still remains a source of PCDD/Fs emission spread-
ing over residential areas. The area of the city with the popu-
lation of 1.1 million is 753.7 km
2
.Thelargelandsizeofthe
city and the prevailing winds allow for a high gradient of soil
pollutionfrom background levels (24 ppt) to scores of ppb
(Amirova et al. 2012). In the higher-risk zone (3 km away
Responsible editor: Leif Kronberg
E. F. Galimova (*)
Central Research Laboratory, Bashkir State Medical University,
450000 Ufa, Russia
e-mail: efgalimova@mail.ru
Z. K. Amirova
State-financed Institution of the Republic of Bashkortostan
Environmental Research and Protection Center, 450075 Ufa, Russia
e-mail: ecocnt@ufanet.ru
S. N. Galimov
Department of Biochemistry, Bashkir State Medical University,
450000 Ufa, Russia
e-mail: sngalim@mail.ru
Environ Sci Pollut Res (2015) 22:1456614569
DOI 10.1007/s11356-014-3109-z
from the plant), about 2,500 people are living in the area
within 7 kmover 300,000 people. Concentration of dioxins
in breast milk, blood, and adipose tissue donors from this area
ranges from 28 to 62 pg/g lipid (WHO-TEQ). Increased
PCDD/Fs level for inhabitants of the industrial zone confirm
the high background level for the city in the whole. PCDD/Fs
concentrations in blood and breast milk exceed the back-
ground level in the region by 3040 % (Amirova and
Kruglov 2001,2005, Amirova et al. 2007).
Materials and methods
One hundred and sixty eight married men aged 2241 years
patients of subsidiary reproductive clinicswere examined.
All of them experienced infertility for 110 marriage years.
Exclusion criteria were severe somatic pathology, diseases of
the testes, and their adnexa. The control group comprised 49
fertile males having 1 to 3 healthy children and matched the
infertile group by age, growth, and other parameters. Exami-
nation included spermogram analysis and identification
of PCDD/Fs congeners in the ejaculate. The sperm
assessment was performed according to the WHO re-
quirements (WHO, 2010). Standard ejaculation analysis
includes sperm counts, amounts of progressive motility,
and abnormal forms. The study procedures were ap-
proved by the institutional review board; the written
informed consent was obtained from all subjects. The
data were processed with Statistica software package
(StatSoft, Tulsa, OK, USA). Medians, means (M), and
standard deviations (SD) were calculated; the signifi-
cance of differences was assessed according to Students
ttest.
Infertile men were divided into two groups. Group I com-
prised patients without changes in their spermogram
(normospermia)63 men. Group II consisted of 105 males
with symptoms of pathospermia. Before dioxin determination,
the samples of ejaculate from each group were pooled, 100 ml
of the summary pool were used for analysis.
All samples had been frozen at 18 °C and kept in this state
up to the time of analysis. Lipids from semen were extracted
by the mixture of hexane/diethylether/ethanol. The amount of
lipids was determined gravimetrically. The cleanup procedure
was performed by classical methods, namely multi-layer
SiO
2
,Al
2
O
3
, and Carbopac-C/Celite columns. For the sepa-
ration of high-molecular compounds in the sample prepara-
tion, the method of gel-chromatography (Envirogel TM GPC
Cleanup, Waters) was used.
For measuring PCDD/Fs and DL-PCBs, HRGC/HRMS
(RTX-Dioxin, 60 m, Autospec-Ultima, Waters, UK) and a
series of isotope-labeled standards (CIL Corp.) were used in
compliance with the US EPA 1613B methods. For calculating
TEQ, the scales TEF-2005 were used.
Results and discussion
We present parameters of spermogram of infertile patients in
Tab le 1. Spermogram parameters of 63 infertile men (group I,
38 % of all infertile men) were within WHO norms. Terato-
zoospermia of different degrees combined with oligo- and/or
asthenospermia was diagnosed in 105 patients (group II, 62 %
of all infertile men).
PCDD/Fs analysis revealed a number of specificities
concerning their content and distribution in the ejaculate
(Table 2).
Dioxin/furan level in seminal fluid of fertile controls was
lower than that of infertile men. At the same time, there was no
significant difference in total concentrations of these pollut-
ants in infertile patients with normo- and pathospermia.
It was found that the highest concentration of 2,3,7,8-
TCDD, the most toxic congener, was found in the ejaculate
of men with pathospermia. Paradoxically, 2,3,7,8-TCDD
made no considerable contribution to the total level of dioxin
load; its share was 12 % of the equivalent dose, whereas the
major part of toxicity was determined by the presence of
chlorinated dibenzofurans. This aspect is not easily explained.
There may be unidentified sources of PCDD/Fs emission to
the environment. As a whole, the profile of PCDD/Fs conge-
ners in the ejaculate was close to the range of PCDD/Fs in the
process of incineration and does not contradict the
technogenic nature of reproductive pathology.
Interpretation of our results when comparing dioxin con-
centration with other biological liquids is not easy. The lipid-
adjusted concentration of dioxins in the sperm is higher than
in breast milk and close to occupationally exposed subjects.
However, the wet weight dioxin concentration in semen,
taking into account low lipid levels in this liquid (1.04 g/l in
pathospermia and 1.46 g/l in normospermia), appears to be
considerably lower.
To understand the exposure mechanism of dioxin-like
compounds on sperm, we calculated dioxin content per one
gamete. We found that in patients with normospermia, there
were about 16 molecules per one spermatozoon. In patients
with pathospermia, however, there were 72 molecules that
documents health hazard for future generation.
Tabl e 1 Spermogram parameters of infertile males studied
Parameter Infertile men
Normospermia
Group I (n=63)
Pathospermia
Group II (n=105)
Concentration (10
6
per mL) 47.3±2.4 12.6±2.0*
Abnormal forms (%) 41.5±5.3 90.1±5.8*
Progressive motility (%) 45.8±6.1 21.3±1.9*
*The differences between the table groups are significant according to
Students test with p<0.05
Environ Sci Pollut Res (2015) 22:1456614569 14567
Our data show that PCDD/Fs can pass across the
hematotesticular barrier. This is confirmed by the fact that
their concentrations in the ejaculate are comparable with those
in blood serum (Schecter et al. 1996). Taking into account the
high biological activity of PCDD/Fs and the involvement of
the AhR system responsible for their bioreception in provid-
ing the reproduction function (Brokken and Giwercman
2014), it is possible to suggest that dioxins as endocrine
disruptorsare directly or indirectly involved in the chain of
events in reproductive organs resulting in the abnormality of
the fecundating ability of spermatozoon. Our previous exper-
iments showed the accumulation of other chlororganic pollut-
antspolychlorinated biphenylsin the male reproductive
system (Gromenko et al. 2008).
The toxic action of dioxins is mediated by the AhR/ARNT
receptor complex. In this connection, it is important that AhR
and ARNT are expressed in all seminiferous tubule stages of
the human testes (Karman et al. 2012). AhR are localized in
acrosome and the principal piece of the sperm flagella in
normal sperm which are key regulators of reproductive pro-
cesses and play an important role in normal sperm develop-
ment (Hansen et al. 2014). AhR activation may result in
inflammation, apoptosis, and oxidative stress in sperm leading
to DNA damage (Matsumura 2009). Given that numerous
metals, solvents, drugs, pesticides, and other chemical com-
pounds and metabolites have been found in human seminal
fluid (Figà-Talamanca et al. 2001), AhR may contribute to
xenobiotic metabolism in sperm and may be important for
fertilization. For example, 2,3,7,8-tetrachlorodibenzo-p--
dioxin (TCDD) can increase intracellular calcium concentra-
tion (National Research Council 2013), which could impair
sperm capacitation.
AhR/ARNTcomplex is associated with the redox-sensitive
Keap1/Nrf2/ARE defense pathway (Qiang Ma and Xiaoqing
He 2012). The Keap1/Nrf2/ARE redox-sensitive signal sys-
tem plays the function of a molecular sensor for homeostasis
shifts and is responsible for cellular protection against stress
(Lushchak 2011). Disarrangement of this complicated hierar-
chic system in stress situations may result in its switching off,
deficit of mechanisms for xenobiotics neutralization, activa-
tion of free radical processes, disturbances of homeostasis in
male genital organs, and the development of reproduction
pathology (Bozhedomov et al. 2009; Aitken et al. 2012).
The hypothesis that the male reproductive function deteri-
orated during the past 50 years is the subject of lively scientific
debate. Despite the fact that there have been new studies
documenting the reduction in ejaculate quality in diverse
countries (Mukhopadhyay et al. 2010; Iwamoto et al. 2013;
Rolland et al. 2013), on the whole, this hypothesis is not
considered to be cogent enough. Meanwhile, as compared
with advances in the treatment of female infertility, therapy
for male infertility remains ineffective, empirical with unex-
pected results (Galimov et al. 2012;Koetal.2012) since the
underlying cause of male infertility is often not clear (the so-
called idiopathic infertility). Understanding mechanisms of
the development of spermatogenesis pathology is necessary
for the prevention of male infertility and efficiency of its
treatment. The results of our research as well as data of other
authors (Foster et al. 2010;Manikkametal.2012; Vandenberg
et al. 2012)suggest effect of low concentrations of POPs on
male reproductive status and call for rational preventive
measures.
Conclusions
An increased level of polychlorinated dibenzo-para-dioxins
and furans in the ejaculate of infertile males compared with
fertile donors suggests a relationship between environmental
pollution and reproduction function. The detection of a typical
profile of dioxin/furan congeners corresponding to contempo-
rary industrial manufacture confirms technogenic nature of
sperm contamination.
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Tabl e 2 PCDD/PCDF content in semen of the males studied (TEQ, рg/g lipids)
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Environ Sci Pollut Res (2015) 22:1456614569 14569
... Motor vehicle exhaust smoke, a significant cause of air pollution, has been shown to reduce sperm quality [23]. Dioxins, by-products of forest fires, commercial waste incineration, pesticides, and paper production have negative effects on sperm motility, morphology, and count [24]. Environmental exposure to metals and metalloids such as arsenic (As), cadmium (Cd), copper (Cu), selenium (Se), and tin (Sn) has been reported to impair male reproductive health [25]. ...
... Once inside the body, furan can readily cross the biological membranes due to its low polarity and it interferes with the endogenous anti-oxidants in cells or tissues and initiates free radical formation (Yilmaz et al., 2017). According to Galimova et al. (2015), high levels of furans were present in the ejaculate of infertile males, as compared to control, suggests a link between furan exposure and reproductive function. Some investigations reported the application of anti-oxidants and antioxidant-rich foods to restraint oxidative damage (Chinoy and Memon, 2001). ...
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Sommario Evidenze sperimentali in modelli animali e in vitro dimostrano un ruolo deleterio degli interferenti endocrini (IE) sulla gonade maschile; tuttavia, nonostante vi siano alcune evidenze osservazionali di associazione tra alterazioni seminali e/o endocrine ed esposizione ad alcuni IE, in particolare quelli ad azione anti-androgenica, pro-estrogenica o capaci di indurre stress ossidativo, non è tuttora dimostrabile l’inferenza di casualità nell’uomo, e permane una vasta area di incertezza. La rassegna fornisce una panoramica sinottica delle evidenze cliniche relative alle alterazioni di spermatogenesi e steroidogenesi testicolare in relazione all’esposizione a selezionati IE, con particolare riferimento all’esposizione in età adulta.
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Understanding the potential impact of organic contaminants on male fertility is crucial, yet limited studies have examined these chemicals in semen, with most focusing on urine and blood. To address this gap, we developed and validated a robust LC-HRMS methodology for semen analysis, with a focus on polar and semipolar chemicals. Our methodology enables the quantitative (or semiquantitative) analysis of >2000 chemicals being compatible with suspect and nontarget strategies and providing unprecedented insights into the occurrence and potential bioaccumulation of diverse contaminants in this matrix. We comprehensively analyzed exogenous organic chemicals and associated metabolites in ten semen samples from Spanish participants collected in an area with a large presence of the chemical industry included in the LED-FERTYL Spanish study cohort. This investigation revealed the presence of various contaminants in semen, including plastic additives, PFAS, flame retardants, surfactants, and insecticides. Notably, prevalent plastic additives such as phthalic acid esters and bisphenols were identified, indicating potential health risks. Additionally, we uncovered previously understudied chemicals like the tire additive 2-mercaptobenzothiazole and specific organophosphate flame retardants. This study showcases the potential of our methodology as a valuable tool for large-scale cohort studies, providing insights into the association between contaminant exposure and the risk of male fertility impairments.
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Dioxin and dioxin-like compounds are ubiquitous environmental contaminants that induce toxicity by binding to the aryl hydrocarbon receptor (AHR), a ligand activated transcription factor. The zebrafish model has been used to define the developmental toxicity observed following exposure to exogenous AHR ligands such as the potent agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin, TCDD). While the model has successfully identified cellular targets of TCDD and molecular mechanisms mediating TCDD-induced phenotypes, fundamental information such as the body burden produced by standard exposure models is still unknown. We performed targeted gas chromatography (GC) high-resolution mass spectrometry (HRMS) in tandem with non-targeted liquid chromatography (LC) HRMS to quantify TCDD uptake, model the elimination dynamics of TCDD, and determine how TCDD exposure affects the zebrafish metabolome. We found that 50 ppt, 10 ppb, and 1 ppb waterborne exposures to TCDD during early embryogenesis produced environmentally relevant body burdens: 38 ± 4.34, 26.6 ± 1.2, and 8.53 ± 0.341 pg/embryo, respectively, at 24 hours post fertilization. TCDD exposure was associated with the dysregulation of metabolic pathways that are associated with the AHR signaling pathway as well as pathways shown to be affected in mammals following TCDD exposure. In addition, we discovered that TCDD exposure affected several metabolic pathways that are critical for brain development and function including glutamate metabolism, chondroitin sulfate biosynthesis, and tyrosine metabolism. Together, these data demonstrate that existing exposure methods produce environmentally relevant body burdens of TCDD in zebrafish and provide insight into the biochemical pathways impacted by toxicant-induced AHR activation.
Preprint
Dioxin and dioxin-like compounds are ubiquitous environmental contaminants that induce toxicity by binding to the aryl hydrocarbon receptor (AHR), a ligand activated transcription factor. The zebrafish model has been used to define the developmental toxicity observed following exposure to exogenous AHR ligands such as the potent agonist 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin, TCDD). While the model has successfully identified cellular targets of TCDD and molecular mechanisms mediating TCDD-induced phenotypes, fundamental information such as the body burden produced by standard exposure paradigms is still unknown. We performed targeted gas chromatography (GC) high-resolution mass spectrometry (HRMS) in tandem with non-targeted liquid chromatography (LC) HRMS to quantify TCDD uptake, model the elimination dynamics of TCDD, and determine how TCDD exposure affects the zebrafish metabolome. We found that 10 ppb, 1 ppb, and 50 ppt waterborne exposures during early embryogenesis produced environmentally relevant body burden of TCDD: 38 ± 4.34, 26.6 ± 1.2, and 8.53 ± 0.341 pg/embryo, respectively, at 24 hours post fertilization. In addition, we discovered that TCDD exposure was associated with the dysregulation of several metabolic pathways that are critical for brain development and function including glutamate metabolism, chondroitin sulfate biosynthesis, and tyrosine metabolism pathways. Together, these data demonstrate that existing exposure paradigms produce environmentally relevant body burdens of TCDD in zebrafish and provide insight into the biochemical pathways impacted by toxicant-induced AHR activation. HIGHLIGHTS Historical TCDD exposure paradigms produce environmentally relevant body burdens in zebrafish embryos. TCDD elimination for high doses can be modeled using an exponential regression. Exposure to TCDD alters metabolic pathways that are essential for brain development and function. GRAPHICAL ABSTRACT
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Reproductive disorders of various severity levels can arise from the earliest stages of gamete formation: from primary germ cells to mature follicles and sperm and be provoked by internal (genetic, hormonal) and environmental (chemical and physical effects, biotoxins, etc.) factors. The study of the mechanisms and sequence of pathological changes in the course of toxicant-induced processes will make it possible to approach the regulation (prevention, compensation) of these disorders. In male gametogenesis, there is a natural mechanism for restoring disturbed reproductive properties. Thus, severe exposure of male rats to the known reprotoxicant doxorubicin leads to complete emptying of the seminal tubules and loss of fertility, but the presence of insensitive spermatogenic stem cells and Sertoli cells allows for the subsequent two to four periods of the rat spermatogenic cycle to restore the pool of seminal epithelial cells and the ability of males to fertilize.
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This review is based primarily on the recent epidemiological studies conducted in occupational settings in order to explore the relationship between exposures to chemical agents and the possible effects on male reproductive function. The paper examines evidence of the effects of metals, solvents, pesticides and dioxin. The effects considered are primarily the possible alterations of sperm quality and reduction of fertility. Many studies have identified small groups of workers with exposures to these agents, presenting some alteration in the spermatological or fertility profile, but the results are difficult to replicate in other settings with different individuals and different levels of exposure. From examination of the concentrations of environmental and occupational pollutants in the blood and in the seminal fluid of exposed individuals, it appears that, in general, the concentrations are much lower in the seminal fluid and in sperm cells, making this a less useful marker of exposure.
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Over the last few decades, there have been numerous reports of adverse effects on the reproductive health of wildlife and laboratory animals caused by exposure to endocrine disrupting chemicals (EDCs). The increasing trends in human male reproductive disorders and the mounting evidence for causative environmental factors have therefore sparked growing interest in the health threat posed to humans by EDCs, which are substances in our food, environment and consumer items that interfere with hormone action, biosynthesis or metabolism, resulting in disrupted tissue homeostasis or reproductive function. The mechanisms of EDCs involve a wide array of actions and pathways. Examples include the estrogenic, androgenic, thyroid and retinoid pathways, in which the EDCs may act directly as agonists or antagonists, or indirectly via other nuclear receptors. Dioxins and dioxin-like EDCs exert their biological and toxicological actions through activation of the aryl hydrocarbon-receptor, which besides inducing transcription of detoxifying enzymes also regulates transcriptional activity of other nuclear receptors. There is increasing evidence that genetic predispositions may modify the susceptibility to adverse effects of toxic chemicals. In this review, potential consequences of hereditary predisposition and EDCs are discussed, with a special focus on the currently available publications on interactions between dioxin and androgen signaling.
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The aryl hydrocarbon receptor (AHR) is known for its roles in xenobiotic metabolism and essential physiologic processes such as cell growth, death, and differentiation. AHR is also an important regulator of male reproductive processes. However, no studies have characterized the consequences of loss of AHR in spermatogenesis. We used Ahr knockout (Ahr(-/-)) mice to assess the effects of loss of AHR on the architecture and gene expression of the seminiferous epithelium and functional sperm outcomes. The histopathological defects of the Ahr(-/-)seminiferous epithelium included vacuoles, multi-nucleated giant cells, hypocellularity with widened inter-cellular spaces, apical sloughing, and an excess number of retained elongated spermatids. QRT-PCR revealed significant down-regulation of Testin and Magea4, indicating Sertoli cell and spermatogenic dysregulation. Moreover, the reduced expression of Hspa2, Prm1, and Prm2 as well as decreased expression of Nrf2, Sod2, and Ucp2 suggested poorly remodeled germ cells with increased vulnerability to oxidative stress. In wild-type sperm, AHR protein was localized to the acrosome and the principal piece of the mature sperm flagellum. The IVF fertilization rate was significantly lower with Ahr(-/-) sperm as compared to WT sperm, and there were morphologic abnormalities of the Ahr(-/-) sperm head and tail. Taken together, our data indicate that AHR plays an important role in normal sperm development.
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To provide information of semen quality among normal young Japanese men and indicate the frequency of reduced semen quality. Cross-sectional, coordinated studies of Japanese young men included from university areas. The men had to be 18-24 years, and both the man and his mother had to be born in Japan. Background information was obtained from questionnaires. Standardised and quality-controlled semen analyses were performed, reproductive hormones analysed centrally and results adjusted for confounding factors. Four study centres in Japan (Kawasaki, Osaka, Kanazawa and Nagasaki). 1559 men, median age 21.1 years, included during 1999-2003. Semen volume, sperm concentration, total sperm count, sperm motility, sperm morphology and reproductive hormone levels. Median sperm concentration was 59 (95% CI 52 to 68) million/ml, and 9% and 31.9% had less than 15 and 40 million/ml, respectively. Median percentage of morphologically normal spermatozoa was 9.6 (8.8 to 10.3)%. Small, but statistically significant, differences were detected for both semen and reproductive hormone variables between men from the four cities. Overall, the semen values were lower than those of a reference population of 792 fertile Japanese men. Assuming that the investigated men were representative for young Japanese men, a significant proportion of the population had suboptimal semen quality with reduced fertility potential, and as a group they had lower semen quality than fertile men. However, the definitive role-if any-of low semen quality for subfertility and low fertility rates remain to be investigated.
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Study question: Are temporal trends and values of semen quality parameters in France identifiable in partners of totally infertile women? Summary answer: Among a sample of 26 609 partners of totally infertile women undergoing an assisted reproductive technology (ART) procedures in the whole of France over a 17-year period, there was a continuous decrease in semen concentration of about 1.9% per year and a significant decrease in the percentage with morphologically normal forms but no global trend for motility. What is known already: A global decrease in human sperm quality is still debated as geographical differences have been shown, and many criticisms have risen concerning studies with small and biased study populations or inappropriate statistical methodology. However, growing biological, toxicological, experimental and human exposure data support the endocrine disruptors' hypothesis assuming that fetal exposure to endocrine disruptors could impair reproductive outcomes. Study design, size, duration: This was a retrospective and descriptive study using data registered by Fivnat, the professional association in charge of statistics for ART in France during the 1989-2005 study period. Data were provided by 126 main ART centres over the whole metropolitan territory. The source population included 154 712 men, aged 18-70, who were partners of couples undergoing their first ART cycle and for whom semen quality indicators (concentration, total motility and percentage of morphologically normal forms), measured on fresh ejaculated semen, were available. Participants/materials, setting, methods: The study population was 26 609 partners of women who had both tubes either absent or blocked. The temporal trends for each indicator of semen quality were modelled using a generalized additive model that allowed for nonlinear relationships between variables and were adjusted for season and age. In-depth sensitivity analyses included the reiteration of the analysis on data from a second spermiogram available for each man and on another subsample of men diagnosed as fertile. Variables such as centre, technique (standard in vitro fertilization or intra-cytoplasmic sperm injection) and an interaction factor between technique and time were also included in the model. Main results and the role of chance: There was a significant and continuous decrease in sperm concentration of 32.2% [26.3-36.3] during the study period. Projections indicate that concentration for a 35-year-old man went from an average of 73.6 million/ml [69.0-78.4] in 1989 to 49.9 million/ml [43.5-54.7] in 2005. A significant, but not quantifiable, decrease in the percentage of sperm with morphologically normal forms along the 17-year period was also observed. There was no global trend but a slight, significant increase in total motility between 1994 and 1998 was observed. The results were robust after sensitivity analysis. Limitations, reasons for caution: Socioeconomic status could not be controlled for. Despite universal access to medical services in France, couples undergoing ART are expected to have a higher educational level on average compared with those of the general population. Therefore, the real values in the general population could be slightly lower than those presented and the decrease possibly stronger, as the population study is less likely to smoke or be overweight, two factors known to impair semen quality. Wider implications of the findings: As the men were selected without a priori knowledge regarding their semen quality characteristics, the results are expected to be close to the values in the general French population. The very large sample size and the robustness of the results confer great statistical power and credibility to the results. To our knowledge, it is the first study concluding a severe and general decrease in sperm concentration and morphology at the scale of a whole country over a substantial period. This constitutes a serious public health warning. The link with the environment particularly needs to be determined.
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Explores the latest science on dioxins and other POPs, and their impact on human health Now in its third edition, Dioxins and Health is the most respected reference of its kind, presenting the latest scientific findings on dioxins, dibenzofurans, polychlorinated biphenyls and related compounds, and their impact on human health. The book fully examines the many toxicological effects-including immunological, neurological, developmental, dermatological, and cardiological-these chemicals have on health. This Third Edition has been greatly expanded with the latest research findings on dioxins and related compounds. Moreover, it now includes coverage of other persistent organic pollutants (POPs) and endocrine disruptors, including: • Brominated flame retardants, such as polybrominated diphenyl ethers and hexabromocyclododecane • Perfluorinated chemicals such as perfluorooctanoic acid and perfluorooctanesulfonic acid • Other endocrine disrupting chemicals similar to POPs such as bisphenol A Readers will also learn about the latest findings on the long-term impacts caused by the use of Agent Orange in Vietnam. Other chapters review the Seveso disaster in Italy and the Yusho and Yucheng rice oil poisoning incidents in Japan and Taiwan. In addition, there is a full chapter dedicated to the dioxin poisoning of former Ukraine President Victor Yushchenko. All the chapters in the book have been written by leading international experts. References at the end of each chapter guide readers to the primary literature in the field. Expertly organized in one volume, Dioxins and Health offers readers quick access to essential information about dioxins and related compounds written in clear, simple language that is accessible to not only scientists, clinicians and public health professionals, but also general readers.
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Oxidative stress is a common pathology seen in approximately half of all infertile men. Peroxides causing infertility are generated by sperm and seminal leukocytes. Oxidative stress occurs when production of potentially destructive reactive oxygen species exceeds natural antioxidant defenses resulting in cellular damage. The causes of the oxidative stress include environmental factors (phthalates et al.), chronic inflammation of the prostate, varicocele, autoimmune response to seminal antigens.