vitamin-b-12 and Infertility--Male

Management of male infertility is always a difficult task. In recent years booming of artificial reproductive technologies (ART) has put infertologists and andrologists in front of a million dollar question whether to treat the person or the gametes. A basic andrology laboratory at present has become part and parcel of an infertility clinic. Hence treatment of male infertility has become institutional and collective for clinicians and basic scientists. The basic approach towards management of male infertility includes confirmation of diagnosis and to find out the cause for which pathological, endocrinological and biochemical tests are essential. In this series specific defects causing seminopathy has been found in 18% cases where treatment is straightforward and towards the cause. The main bulk of idiopathic seminal defects (82%) really poses challenge to the infertologists so far management is concerned. In this study commonest seminal defect has been found to be oligoasthenozoospermia which amounts to 63% cases. For medical management purpose drugs commonly used are clomiphene, gonadotrophins, bromocriptine, L-thyroxine, vitamin E, B12, etc. When they fail the main approach remains to be intra-uterine insemination (IUI) and ART eg, in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI).

Topics: Androgens; Clomiphene; Estrogen Antagonists; Humans; Infertility, Male; Male; Oligospermia; Prospective Studies; Reproductive Techniques, Assisted; Vitamin B 12; Vitamin E

Studies demonstrate that getting antioxidants in the course of treatment has a positive impact beneficial effect on fertility, especially on the quality of sperm. Because of that reason antioxidants are recommended as a potentially influential treatment for infertility in men. However, it is argued that this treatment is not based on sufficient evidence and has no effect on the rate of healthy pregnancy.. In this study, two different antioxidant combinations with different doses and contents were evaluated in terms of their effect on sperm parameters.. A total of 122 patients diagnosed with idiopathic infertility were enrolled in our multicenter study. The patients were divided into two different groups: The first group used a combination 2 × 1 sachet form (l-carnitine 1 g, acetyl-l-carnitine 0.5 g, fructose 1 g, citric acid 0.50 mg, selenium 50 µg, coenzyme Q10 20 mg, vitamin C 90 mg, zinc 10 mg, folic acid 200 µg, and vitamin B12 1.5 µg) and the second group used a combination tablets form 2 × 1 (l-carnitine 500 mg, selenium 50 µg, coenzyme Q10 20 mg, vitamin C 60 mg, zinc 15 mg, folic acid 400 µg, vitamin E, and ginseng 15 µg) for 6 months. The total semen volume, the total sperm number, sperm concentration, sperm motility, and lastly morphological findings of the patients were compared at the end of 6 months.. The mean age of the patients participating in the study was 30.8 ± 6.05 years. No significant difference was found between the two groups in terms of baseline sperm count. There was a significant difference between the baseline and sixth-month values of the patients using both combinations. However, no significant statistical difference was found between the groups according to the sixth-month data. The combinations of both antioxidants had a positive effect on sperm parameters, and the use of different doses and contents had a similar effect.. Both antioxidants respectively had a positive effect on sperm parameters and also the use of different doses and contents had a similar effect.

Topics: Acetylcarnitine; Adult; Antioxidants; Ascorbic Acid; Carnitine; Citric Acid; Female; Folic Acid; Fructose; Humans; Infertility, Male; Male; Pregnancy; Selenium; Semen; Sperm Motility; Spermatozoa; Vitamin B 12; Vitamin E; Young Adult; Zinc

This study aimed to analyze the incidence of azoospermia factor a (AZFa) microdeletions in the Y chromosome and their association with male infertility in a population with azoospermia and severe oligozoospermia from Iraq.. A total of 75 infertile Iraqi males and 25 healthy controls were included in this study. The semen analysis was performed to determine the azoospermia, severe oligozoospermia, or normal cases. The AZFa microdeletions were investigated using the real-time polymerase chain reaction (real-time PCR). Then, AZFa sub-region deletions were investigated by a conventional PCR.. In total, 40 men with azoospermia and 35 men with severe oligozoospermia were selected. Out of 75 infertile males, 46 (61.3%) individuals had AZFa microdeletions, of whom 32 (69.6%) had partial deletion, while 14 (30.4%) males had complete deletion using real-time PCR. The frequency of microdeletions was significantly different between the infertile and control group (p-value < 0.00001). The proportion of AZFa microdeletions appeared higher in azoospermia men (72.5%, n = 29/40) than severe oligozoospermia men (48.6%, n = 17/35), but based on the conventional PCR results, only one azoospermia patient (2.2%) was shown to have complete AZFa deletion, while the other 45 patients (97.8%) had partial AZFa deletions.. In this study, the partial AZFa microdeletions were more numerous than complete AZFa deletion. According to our results, the AZFa microdeletions might be associated with male infertility and spermatogenic failure. It is recommended to investigate the AZFa sub-region microdeletions in patients that shown AZFa microdeletions in primary screening.

Topics: Azoospermia; Chromosome Deletion; Chromosomes, Human, Y; Humans; Infertility, Male; Iraq; Male; Oligospermia; Sex Chromosome Aberrations; Sex Chromosome Disorders of Sex Development; Vitamin B 12

To investigate the correlation of seminal plasma homocysteine (Hcy) and its metabolic factors folate (FA) and cobalamin (VB12) with semen quality in obese men.. We randomly selected 83 male patients with idiopathic infertility for this study and, according to the body mass index (BMI), divided them into a normal BMI (n = 28), an overweight (n = 28) and an obesity group (n = 27). We determined the levels of Hcy, FA and VB12 in the seminal plasma by ELISA and analyzed their correlation with the semen parameters of the patients in different groups.. Compared with the normal BMI group, the obese males showed significant decreases in the semen volume (［3.23 ± 0.86］ vs ［2.58 ± 0.77］ ml, P < 0.05), total sperm count (［191.35 ± 103.00］ vs ［121.55 ± 88.08］ ×106, P < 0.05), percentage of progressively motile sperm (［52.88 ± 15.58］ % vs ［38.97 ± 16.52］ %, P < 0.05), seminal plasma Hcy (［7.41 ± 1.29］ vs ［6.62 ± 0.85］ μmol/L, P < 0.05), and VB12 (［282.41 ± 30.38］ vs ［230.07 ± 37.75］ pmol/L, P < 0.05). There were no statistically significant differences in the semen parameters between the overweight group and the normal BMI or the obese group (P > 0.05), or in sperm concentration or the FA level among the three groups of patients (P > 0.05). The levels of seminal plasma Hcy and VB12 were correlated positively with the semen volume (r = 0.281 and 0.242, P < 0.05) and total sperm count (r = 0.229 and 0.258, P < 0.05) but negatively with BMI (r = －0.293 and －0.238, P < 0.05). No correlation, however, was found either between sperm concentration and the percentage of progressively motile sperm (P > 0.05) or between the FA level and BMI or semen parameters (P > 0.05).. The levels of seminal plasma Hcy and VB12 are correlated with BMI, semen volume and total sperm count, which suggests that the concentrations of seminal plasma Hcy and VB12 may be associated with the fertility of obese men.

Topics: Folic Acid; Homocysteine; Humans; Infertility, Male; Male; Obesity; Semen; Semen Analysis; Sperm Count; Sperm Motility; Spermatozoa; Vitamin B 12

Although methylenetetrahydrofolate reductase, a folate enzyme gene, has been associated with idiopathic male infertility, few studies have examined other folate-related metabolites and genes. We investigated whether idiopathic male infertility is associated with variants in folate, vitamin B(12) (B12) and total homocysteine (tHcy)-related genes and measured these metabolites in blood. We conducted a case-control study that included 153 men with idiopathic infertility and 184 fertile male controls recruited at the Fertility Center and Antenatal Care Center, University Hospital, Malmö and Lund, Sweden. Serum folate, red cell folate (RCF), serum B12, plasma tHcy and semen quality were measured. Subjects were genotyped for 20 common variants in 12 genes related to folate/B12/homocysteine metabolism. Metabolite concentrations and genotype distributions were compared between cases and controls using linear and logistic regression with adjustment for covariates. The phosphatidylethanolamine N-methyltransferase (PEMT) M175V and TCblR rs173665 polymorphisms were significantly associated with infertility (P=0.01 and P=0.009, respectively), but not with semen quality. Among non-users of supplements, infertile men had lower serum folate concentrations than fertile men (12.89 vs. 14.73 nmol l(-1); P=0.02), but there were no significant differences in RCF, B12 or tHcy. Folate, B12 and tHcy concentrations were not correlated with any semen parameters. This study provides little support for low folate or B12 status in the pathogenesis of idiopathic male infertility. Although additional data are needed to confirm these initial findings, our results suggest that PEMT and TCblR, genes involved in choline and B12 metabolism, merit further investigation in idiopathic male infertility.

Topics: Adult; Case-Control Studies; Folic Acid; Homocysteine; Humans; Infertility, Male; Male; Middle Aged; Sweden; Vitamin B 12

A high prevalence of low levels of cobalamin had been found in a survey of multi-ethnic normal individuals in Israel. The purpose of this study was to investigate the incidence of cobalamin deficiency among Israeli couples suffering from infertility. All couples seen at the in vitro fertilization clinic at an urban hospital (Shaare Zedek Medical Center) in Jerusalem for a 6-month period were invited. Mean cobalamin levels were 259.2 pg ml(-1) in males and 275.1 pg ml(-1) in females (normal >200 pg ml(-1)), 35.5% of 172 men and 23.3% of 223 females had cobalamin deficiency (P = 0.01). There were 171 couples with complete demographic questionnaires and cobalamin values for each partner. In 74 couples (43.3%), one partner was cobalamin deficient, with no significant difference between those with unexplained infertility versus those with explained infertility; and in 13 couples, both partners were cobalamin deficient. Thirty-nine per cent of all men with an abnormal semen analysis had cobalamin deficiency, a finding that requires further investigation. This study questions whether higher rates of male infertility in Israel are partially ascribable to cobalamin deficiency. Recommendation for supplementation in both males and females to achieve high-normal levels of cobalamin would be prudent.

Topics: Adult; Female; Humans; Infertility, Female; Infertility, Male; Israel; Male; Middle Aged; Prevalence; Vitamin B 12; Vitamin B 12 Deficiency

Methylenetetrahydrofolate (MTHFR) and DNMT3b play imperative roles in DNA synthesis and de novo methylation. GSTM1 is involved in detoxification of carcinogens. Mitochondrial DNA deletion has been associated with lower motility in human sperm. We analysed if polymorphisms in MTHFR (C677T and A1298C) and DNMT3b (C46359T) are associated with non-obstructive male infertility. We also analysed if folate, vitamin B(12), homocysteine (Hcy), 8'-hydroxy-2'-deoxygnanosine (8-OHdG) levels, dietary folate intake and mtDNA deletion (4977 bp) affects fertility, such interactions are modified by deletion and methylation of GSTM1. In this case-control study, we included 179 oligoasthenoteratozoospermia patients and 200 fertile men. Single-nucleotide polymorphism analysis was performed by PCR-restriction fragment length polymorphism. The MTHFR (C677T and A1298C) and DNMT3b (C46359T) frequencies did not differ significantly in two groups. GSTM1 in association with mtDNA 4977 deletion is significantly associated with infertility. Plasma folate and vitamin B(12) levels are decreased and total Hcy is elevated in infertile men. GSTM1 methylation status was investigated by methylation-specific PCR. Methylation is significantly correlated with GSTM1 reduced/loss of expression in infertile men. Infertile men have significantly higher 8-OHdG levels. Dietary folate intake is not linked with GSTM1 methylation. Low folate intake in association with CT + TT genotypes (C677T) has significant protective effect on GSTM1 methylation. Results indicate that micronutrients, 8-OHdG levels, mtDNA deletion and GSTM1 promoter methylation are frequent alterations in infertility.

Topics: 8-Hydroxy-2'-Deoxyguanosine; Adult; Base Sequence; Case-Control Studies; CpG Islands; Deoxyguanosine; DNA (Cytosine-5-)-Methyltransferases; DNA Methylation; DNA Methyltransferase 3B; DNA, Mitochondrial; Folic Acid; Gene Frequency; Genetic Predisposition to Disease; Glutathione Transferase; Homocysteine; Humans; India; Infertility, Male; Male; Methylenetetrahydrofolate Reductase (NADPH2); Polymorphism, Restriction Fragment Length; Polymorphism, Single Nucleotide; Promoter Regions, Genetic; Reverse Transcriptase Polymerase Chain Reaction; Risk Factors; Sequence Deletion; Vitamin B 12; White People

Vitamin B12(VB12), folate and reactive oxygen species(ROS) in human semen from both fertile and infertile males, and their relationships with other parameters were observed. Semen samples from 44 infertile and 176 fentile control subjects were collected and measured based on the guidelines issued by WHO. The results showed that no significant differences on semen VB12 and folate were observed between fertile and infertile groups(P > 0.05). However, the levels of ROS in infertile group were significantly higher than those in fertile group(P < 0.01). The morphological defects and low motility of sperm in infertile group was significantly higher than those in fertile group(P < 0.01). A positive relation was observed between the levels of ROS production and the morphological defect of sperm(P < 0.01). There was a significant negative correlation between the levels of VB12, folate and ROS(P < 0.01) in semen. It is interesting to note that the values of ROS also show a significantly positive correlation with sperm motility (P < 0.01). A significant differences of ROS levels between fertile and infertile group with negative white blood cells in sperm was also observed. It is concluded that the increase of ROS on the morphological defect of sperm is one of the most important factors related to poor sperm quality and human infertility.

Topics: Adult; Folic Acid; Humans; Infertility, Male; Male; Reactive Oxygen Species; Semen; Sperm Count; Sperm Motility; Spermatozoa; Vitamin B 12

Topics: Drug Evaluation; Humans; Infertility, Male; Male; Oligospermia; Sperm Count; Sperm Motility; Time Factors; Vitamin B 12

Infertile men (excluding azoospermia) were divided into three groups to test methylcobalamin (CH3-B12) + clomiphene citrate (Clomid) treatment. Group M: CH3-B12 (1,500 micrograms/day, daily for 8 to 60 weeks), Group C: Clomid (25 mg/day for 25 days followed by a 5-day rest period, for 8 to 48 weeks), and Group MC: CH3-B12 + Clomid (CH3-B12: 1,500 micrograms/day, daily and Clomid: 25 mg/day for 25 days followed by a 5-day rest period, for 12 to 24 weeks semen analysis was conducted before and after these administrations. Judging by our criteria, 60.0% (24/40) of the cases in Group M, 71.4%(25/35) in Group C, and 66.7% (8/12) in Group MC were improved. However, in patients whose sperm concentrations were over 10 X 10(6)/ml, 61.9% (13/21) of the cases in Group M, 69.2% (9/13) in Group C, and 80.0% (4/5) in Group MC were improved. Therefore, CH3-B12 + Clomid treatment was successful for patients whose sperm concentrations was over 10 X 10(6)/ml.

Topics: Adult; Clomiphene; Drug Administration Schedule; Drug Therapy, Combination; Humans; Infertility, Male; Male; Sperm Count; Sperm Motility; Vitamin B 12

CH3-B12 was administered daily (1,500 micrograms/day, for 4 to 24 weeks) to 26 infertile male patients who visited our clinic from January to December, 1982. It was not administered, however, to patients with azoospermia. Semen analysis was conducted from 8 weeks after the administration of CH3-B12. Sperm concentration increased in 10 cases (38.4%), total sperm counts increased in 14 cases (53.8%), sperm motility increased in 13 cases (50.0%) and total motile sperm count increased in 13 cases (50.0%). Semen volume, however, could not be evaluated due to wide variation. Serum LH, FSH and testosterone were unchanged. Judging by our criteria, 11 cases (42.3%) improved, 11 cases (42.3%) were unchanged and the remaining 4 cases (15.4%) had aggravated.

Topics: Adult; Drug Evaluation; Humans; Infertility, Male; Male; Sperm Count; Sperm Motility; Vitamin B 12

Topics: Antibodies; Biopsy; Clomiphene; Fluoxymesterone; Humans; Infertility, Male; Klinefelter Syndrome; Male; Semen; Spermatozoa; Testis; Vitamin B 12

Topics: Arginine; Biopsy; Cell Count; Cell Movement; Chorionic Gonadotropin; Cortisone; Culture Techniques; Germ Cells; Humans; Infertility, Male; Male; Microscopy, Electron; Spermatogenesis; Spermatozoa; Testicular Diseases; Testis; Testosterone; Vitamin B 12

Topics: Adult; Humans; Infertility, Male; Male; Middle Aged; Vitamin B 12

Topics: Adult; Female; Humans; Infertility, Male; Male; Orotic Acid; Pregnancy; Ubiquinone; Vitamin B 12; Vitamin E

Topics: Diethylstilbestrol; Humans; Infertility; Infertility, Male; Male; Oligospermia; Spermatozoa; Vitamin B 12

Topics: Corrinoids; Humans; Infertility; Infertility, Male; Male; Semen; Vitamin B 12; Vitamins

Topics: Hematinics; Humans; Infertility; Infertility, Male; Male; Spermatozoa; Vitamin B 12; Vitamins

Topics: Hematinics; Infertility; Infertility, Male; Semen; Vitamin B 12