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Examination of semen / ejaculates / sperm is the first screening examination that a subfertile / infertile couple needs to undertake in an attempt to find out the cause of infertility that may come from his side. Besides spermanalysis, it is also necessary to do physical examination, especially about internal and external genital tool because as it is known abnormal result of sperm analysis can be caused by anatomical abnormalities and or testis function. To determine the relationship of testicular volume to semen analysis on male patients in Andrology clinic RSUD Dr. Soetomo Surabaya. The research is a kind of observational analytic research to find out the correlation of testicular volume to semen analysis on male patients in Andrology clinic RSUD Dr. Soetomo Surabaya by using secondary data. Based on the results of statistical tests of 64 samples by using chi square test can be seen that the value of significance or p-value 0.005 <0.05. So it can be concluded that there is a relationship between testicular volume with morphology, motility and sperm concentration. Data were analyzed using chi square test to determine the relationship between testicular volume and semen analysis. Testicular volume is one of the risk factors of decreased semen analysis results. [ABSTRACT FROM AUTHOR]

The negative effect of advanced female age on fertility and offspring health is well understood. In comparison, much less is known about the implications of male age on fertility, with many studies showing conflicting results. Nevertheless, increasing evidence suggests that advanced paternal age has negative effects on sperm parameters, reproductive success, and offspring health. Herein, we summarize the current body of knowledge on this controversial topic, with the belief that this review will serve as a resource for the clinicians providing fertility counseling to couples with older male partners. [ABSTRACT FROM AUTHOR]

The past 50 years have seen heated debate in the reproductive sciences about global trends in human sperm count. In 2017, Levine and colleagues published the largest and most methodologically rigorous meta-regression analysis to date and reported that average total sperm concentration among men from 'Western' countries has decreased by 59.3% since 1973, with no sign of halting. These results reverberated in the scientific community and in public discussions about men and masculinity in the modern world, in part because of scientists' public-facing claims about the societal implications of the decline of male fertility. We find that existing research follows a set of implicit and explicit assumptions about how to measure and interpret sperm counts, which collectively form what we term the Sperm Count Decline hypothesis (SCD). Using the study by Levine and colleagues, we identify weaknesses and inconsistencies in the SCD, and propose an alternative framework to guide research on sperm count trends: the Sperm Count Biovariability hypothesis (SCB). SCB asserts that sperm count varies within a wide range, much of which can be considered non-pathological and species-typical. Knowledge about the relationship between individual and population sperm count and life-historical and ecological factors is critical to interpreting trends in average sperm counts and their relationships to health and fertility. [ABSTRACT FROM AUTHOR]

Objective: Our study investigated the oldest known Turkish bahname, translated by Musa b. Mes'ud, in comparison with the current literature. Material and methods: First, the original manuscript of the translation was transcribed in Latin. The final version of the text was analyzed in the results. In discussion, findings were examined and interpreted within the framework of current knowledge of sexology, urology, and andrology. Results: Although the work mostly mentions supportive and therapeutic practices in sexual health, it also provides advice on sexuality and sexual life, discussing several topics regarding sexual intercourse types, explaining which ones are good or harmful, and their timing or frequency. The author recommends many foods and compounds or specific drugs and ointments to enhance sexual stamina and avoid erectile dysfunction. In addition, he also tries to find solutions to some other sexual health problems related to men and women. These issues are generally evaluated in the context of health; a religious perspective is also provided when needed. Conclusion: Interestingly, the author's recommendations on sexual health and herbal or animal drugs are consistent with the current literature. Nevertheless, some information and suggestions in works are entirely irrational and unscientific. Consequently, this study is an original investigation of the first translated bahname into Turkish. There is no other study examining the bahnames with this method. Thus, we believe that our work will be a significant contribution to the research literature. [ABSTRACT FROM AUTHOR]

Biomedical science is rapidly developing in terms of more transparency, openness and reproducibility of scientific publications. This is even more important for all studies that are based on results from basic semen examination. Recently two concordant documents have been published: the 6th edition of the WHO Laboratory Manual for the Examination and Processing of Human Semen, and the International Standard ISO 23162:2021. With these tools, we propose that authors should be instructed to follow these laboratory methods in order to publish studies in peer-reviewed journals, preferable by using a checklist as suggested in an Appendix to this article. [ABSTRACT FROM AUTHOR]

Male factor infertility affects about 50% of infertile couples. However, male factor infertility is largely under‐evaluated due to multiple reasons. This study is to determine the time men travel for fertility evaluation, and factors associated with driving longer. Data from the Andrology Research Consortium were analysed. Driving distance and time were calculated by comparing "patient postal code" with "clinic postal code", then stratified into quartiles. Patients with the longest driving times (> 75th percentile [Q4]) were compared with those having shorter driving times. Logistic regression analysis was used to identify factors associated with longer driving times. Sixteen clinics and 3029 men were included. The median driving distance was 18.1 miles, median driving time was 32 min, and Q4 driving time was 49 min. Factors correlated with having Q4 driving time were age > 30 years, native Indian and Caucasian race, body mass index (BMI) > 30 kg/m2, history of miscarriage, children with previous partner, self‐referral, prior vasectomy, and prior marijuana use. On logistic regression, males aged < 30 years were more likely to be in Q4 for driving time versus older males. Blacks and Asians were less likely to travel further than Caucasians. Overweight/obese men, those having children with previous partner, and with prior vasectomy were more likely to be in Q4 travelling time. Factors correlated with longer driving times include younger age, native Indian and Caucasian race, higher BMI, children with prior partner, and prior vasectomy. These may reflect groups that drive long distances for reproductive care. The study provides an opportunity to better access these groups and minimise their barriers to fertility care. [ABSTRACT FROM AUTHOR]

Varicocele is a common disease in men, with a global incidence of approximately 25%. A comprehensive and systematic analysis of the knowledge map on it will help in assessing frontier research and identify knowledge gaps. In total, 4103 articles published from 2002 to 2021 in 1066 journals were included. They represent the current research status worldwide, potential hotspots and future research directions. In the past decades, the number of publications and citations of varicocele‐related studies have increased steadily. Academic institutions in the United States played a leading role in varicocele research. The country, institution, journal and author with the most publications were the United States (779), Cleveland Clinic Foundation (132), Andrologia (246) and Agarwal A (106), respectively. The most frequently used keywords were Varicocele (1620), Male Infertility (944), Varicocelectomy (288), Testis (245), Sperm (166), Oxidative Stress (144), Azoospermia (119), Semen Analysis (118), Laparoscopy (116) and Adolescent (97). Currently, the main focus of current varicocele research is its surgical treatment method and effect on sperm quality. The frontier research hotspot is the specific mechanism of varicocele‐induced decrease in sperm quality. [ABSTRACT FROM AUTHOR]

B § 13 Modification of the statutes, winding-up the EAA, and use of the EAA property b Modification of the statutes and dissolution of EAA require a two third majority of the General Assembly and can only be decided upon if the Executive Council has proposed the modification or dissolution to the General Assembly. B § 1 Name, Seat, Legal Status b The name of the society is "European Academy of Andrology" (hereinafter referred to as EAA). The chairman of the General Assembly is the President, or in his absence, another member who has been elected by the General Assembly by simple majority. The General Assembly shall at the meeting: - Receive a report from the President and the Secretary concerning the activities of EAA since the last General Assembly. [Extracted from the article]

GRAPH B Gianni Forti (Italy) b The second EAA President (1998-2006) and a long-time member of the Executive Council. The EAA bestows the title of Honorary Member upon high profile andrologists, distinguished by their great achievements in science and dedicated service to the EAA. [Extracted from the article]

EDITORIAL EVOLUTION AND EFFORTS TO IMPROVE QUALITY OF SUBMITIONS In 2017 the new Chief Editor, Manuela Simoni was appointed by EAA and joined Doug Carrell behind the wheel of I Andrology i . The current Chief Editor, Marie-Claude Hofmann and the new Deputy Editor, Aleksander Giwercman will strive to keep improving the journal for the benefit of the two organizations, EAA and ASA, entire andrology community, but also the society at large. An important part of the Academy's history is its scientific publishing activity, which started with the I International Journal of Andrology (Int J Androl) i , and continued with I Andrology i , the journal created and overseen jointly by the EAA and the American Society of Andrology (ASA). Marking the first decade of Andrology - Conception and early development of the journal. [Extracted from the article]

The next (and the last) laureate of the I IJA i award has been selected by the I IJA i 's Editorial Board and the Executive Council of EAA among the authors of papers published in I IJA i within 2010-2011 (may appear in final print in 2012). It is with great satisfaction I noticed that, in 2009, I IJA i had the highest I Impact Factor i of the andrology journals and that I IJA i up until now has been able to generate around €500 000 in revenues for the EAA. The reason for its disappearance is quite unprecedented: the two top journals in the field of andrology, I IJA i and its American counterpart, I Journal of Andrology i ( I JA i ) have decided to join forces rather than continue competing against each other. This issue of the I International Journal of Andrology i ( I IJA i ) is the last one. [Extracted from the article]

The EAA fulfils this objective by multiple means, mainly through the EAA-accredited andrology training centres. The EAA is supporting EAA members wishing to visit the EAA Centres for training or to attend the EAA Schools with scholarships and travel grants. Promotion of high-quality education in andrology is the main mission and core activity of the European Academy of Andrology (EAA). EAA SCHOLARSHIPS One of the educational goals of the EAA is to support young andrologists aspiring to engage in translational or basic research in all fields of andrology and male reproduction, with focus on areas of clinical importance. [Extracted from the article]

One of the main missions of the EAA is to provide high-quality education in clinical andrology to young physicians and to promote research in basic and translational aspects of andrology and (patho)biology of male reproduction. Clinicians receive training in all aspects of andrology, including male infertility, adolescent and adult endocrinology, erectile and sexual dysfunction, surgical andrology, including testicular and penile surgery, oncological andrology, fertility preservation and sperm cryopreservation, spermatology and - in collaboration with the woman's hospital-assisted reproduction. Andrology 2020;8:1030-1037 Da Costa R, Redmann K, Schlatt S. Simultaneous detection of sperm membrane integrity and DNA fragmentation by flow cytometry: A novel and rapid tool for sperm analysis. I B nvestigating the effects of caloric restriction of sperm gene expression and DNA methylation in obese men b This study will improve our understanding of the epigenetic effects of weight loss on sperm and potentially develop novel pharmacological approaches for treatment of infertile men. [Extracted from the article]

GLO:FSQE/03oct22:andr13244-fig-0002.jpg PHOTO (COLOR): 2 Cover page of the EAA Membership list 1997, statutes and andrology centers. gl The EAA had become a member of the International Society of Andrology (ISA) and had been affiliated with the European Federation of Endocrine Societies (EFES). EAA Clinical Andrologist examination An examination to certify trainees as EAA-certified andrologists was established in 1997 and regular sessions were scheduled annually, mainly concurrently with the European Testis Workshop or the European Congress of Andrology. Thanks to the EAA secretary, Ewa Rajpert-De Meyts, our members have been constantly informed about EAA and andrology-related issues through regular EAA Newsletters and the monthly Literature Alert. Keywords: EAA; EAA Schools; International Journal of Andrology; European Congress of Andrology EN EAA EAA Schools International Journal of Andrology European Congress of Andrology 4 9 6 11/29/22 20221003 NES 221003 THE EARLY DAYS (by Eberhard Nieschlag) GRAPH During the second half of the 20th century andrology, the discipline of male reproductive health, gained steadily in relevance as a basic and clinical field.1,2 National societies of andrology were founded in several countries in the 1970s and 1980s (e.g., Scandinavia 1973, USA 1975, Germany 1975, Italy 1976). [Extracted from the article]

Purpose: In response to the COVID-19 pandemic, the American Center for Reproductive Medicine (ACRM) transitioned its annual training in assisted reproductive technology (ART) from a hands-on, laboratory-based training course to a fully online training endorsed by the American College of Embryology. Here we describe our experience and assess the quality of an online training format based on participant outcomes for the first three modules of a planned series of online ART training. Materials and Methods: These modules included manual semen analysis, sperm morphology and ancillary semen tests (testing for leukocytospermia, sperm vitality, and anti-sperm antibody screening). The virtual format consisted of lecture presentations featuring laboratory protocols with corresponding video demonstrations of routine techniques and best practices. Practical scenarios, troubleshooting, and clinical interpretation of laboratory results were also discussed. At the end of each module, an optional multiple choice question test was held as a prerequisite to obtain certification on the topics presented. Course quality was assessed using participant responses collected via online surveys. Results: The digital delivery methods used were found to have largely or completely met the participants’ expectations for all questions (>85%). The majority (>87%) of the participants either strongly agreed or agreed that the course content was well-structured with appropriate depth, and that their overall expectations of the course had been met. Conclusions: This training format appears to be a realistic teaching option to freely share highly specialized expertise and technical knowledge with participants from anywhere in the world with varying levels of competency or experience.

Purpose: COVID pandemic significantly affected the delivery and maintenance of healthcare system, resulting in greater utilization of digital health interventions. Materials and Methods: This multi-national cross-sectional survey was administered to clinicians working in major Asia-Pacific cities during the mandatory social lockdown period in June 2020. Clinical demographics and professional data, delivery of Andrology-related healthcare services, and patient distress based on validated questionnaires such as Depression and Anxiety Stress Scales (DASS) and Decisional Engagement Scale (DES) were collected. Results: Telehealth medicine was instituted in all the centres with the majority of centres (92.9%) reported a 50% or more reduction in out-patient related services. The numbers of phone calls, emails correspondence and educational webinars have significantly increased. Despite the provision of reasons for changes in healthcare service and delay in surgery, more than half of the patients (57.1%) rated 2 on the DASS score for the item on patients over-react to situations, while a third of the patients (35.7%) scored a 2 for DASS item on patients being more demanding or unreasonable. The DES scores were more positive with most patients reported a score above 7 out of 10 in terms of items on accepting current arrangement (85.7%), confident in clinician decision-making about treatment (92.9%) and comfortable that the decision is consistent with their preferences (71.4%). Most patients (85.7%) indicated their preferences for more detailed information on healthcare provision. Conclusions: Our study showed telehealth services were integrated early and successfully during the COVID pandemic and patients were generally receptive with minimal psychosocial distress.

Urachal anomalies are rare congenital malformations resulting from the failure of the caudal portion of the allantois to obliterate, which, by stretching and narrowing, forms the urachus. Such pathologies may be both symptomatic and asymptomatic if they become infected or undergo malignant transformation. In this paper, we report an unusual form of a urachal remnant in a 68-year-old Caucasian male, detected incidentally during open, radical, non-nerve-sparing, retropubic prostatectomy, performed from the suprapubic access point. The structure attached to the anterior wall of the urinary bladder appeared to connect to a cutaneous sinus at the dorsum of the penis and posed a challenge for dissection of the retropubic space of Retzius. We discuss how surgeons could benefit from the knowledge that such structures are able to appear. [ABSTRACT FROM AUTHOR]

Background: Inclusion of ethnic/racial minorities in clinical trials is essential to fully assess therapeutic efficacy. It is well-known that populations respond dissimilarly to interventions. Our objective is to analyze the inclusion of minority men in clinical trials for erectile dysfunction (ED). Methods: We searched ClinicalTrials.gov for the disease keyword: “Erectile Dysfunction” and used “Prostate Cancer” for comparison. Completed trials which reported demographic data were included for analysis. Literature was reviewed to determine the prevalence of ED and prostate cancer (PC) among Hispanic, Black, White, and Asian men. The proportion of individuals of each group that participated in trials is divided by the proportion of each group in the disease population to calculate the “Participation to Prevalence Ratio” (PPR). PPRs between 0.8 and 1.2 indicates adequate representation, 1.2 is over-representation. Results: A total of 312 trials were assessed: 289 for prostate cancer and 23 for ED. Hispanic men comprised 11.8% of ED trial participants and 4.6% of prostate cancer trial participants, yet represented 18% of ED patients and 7.3% of PC patients. Black/African-American (AA) men accounted for 10.2% of ED trial participants and 9.4% of PC trial participants, but comprise 16% of ED patients, and 16.3% of PC patients. Hispanic and AA men are under-represented in trials for ED and Prostate Cancer (Hispanic ED PPR = 0.66; Hispanic PC PPR = 0.63; AA ED PPR = 0.64; AA PC PPR = 0.58). Conclusion: Our analysis shows that both Hispanic and AA men are underrepresented in both ED and PC clinical trials.

These guidelines update and clarify items relating to diagnostic andrology in the 2012 Association of Biomedical Andrologists Laboratory Andrology Guidelines for Good Practice Version 3. The main change separates diagnostic and therapeutic andrology into individual documents; post-vasectomy semen analysis still references the 2016 guideline. These guidelines seek to incorporate and clarify internationally agreed methodology following the World Health Organization Laboratory Manual for the Examination and Processing of Human Semen 6th edition and publication of ISO 23162:2021. Significant updates include: requiring four-category grading for motility (A, rapidly progressive; B, slowly progressive; C, non-progressive; D, immotile); a four-part morphology assessment (head, midpiece, tail, cytoplasmic droplets) as essential for quality assurance (even if only the percentage of 'normal' is reported); and specifying sperm toxicity testing procedures for diagnostic andrology. These guidelines include a section on haematospermia, an observation requiring rapid onward referral. An Association of Reproductive and Clinical Scientists (ARCS) working group wrote these guidelines, with review by ARCS members. The aim is to guide good practice in laboratories but they are not intended as a tool to judge the practice of centres within the UK or beyond. [ABSTRACT FROM AUTHOR]

Heat stress is caused by exposure of animals to high temperatures and humidity, outside their thermal comfort zone. This can have negative outcomes, including adversely affecting general well-being and reducing productive and reproductive performance. In males, heat stress can disrupt testicular thermoregulation, with deleterious effects on spermatogenesis and consequently, decreases in sperm quality and fertility potential. Thus, high environmental temperature is considered one of the most important factors that predisposes bulls to subfertility and has already been the subject of many studies, particularly in tropical or subtropical countries. It is essential to study effects of testicular heat stress in bulls, know the chronology of clinical and sperm findings, and understand the underlying pathophysiology. In addition, elucidating molecular mechanisms involved in heat stress and testicular function could provide the basis for effective, evidence-based strategies for selecting more thermotolerant animals. Excessive heat affects expression of messenger RNA (mRNA) and microRNA (miRNA) in sperm, which have important roles in regulating male fertility. Based on current trends in climate change, the incidence of chronically high temperatures that cause heat stress is expected to increase, posing increasing risks to health and survival of many species. The study of mRNAs and miRNAs can provide valuable insights to select animals that are more resilient to climate change. In addition to the search for more thermotolerant animals, other strategies to mitigate effects of heat stress include reproductive biotechniques and promotion of a better environment. • Testicular heat stress can negatively affect spermatogenesis and semen quality. • Pathophysiology of testicular heat stress: chronology and molecular mechanisms. • Sperm messenger RNA and microRNA expression can be altered by excessive heat stress. • It can be reduced by providing animals with better environmental conditions. • The selection of thermotolerant animals can mitigate the effects of climate change. [ABSTRACT FROM AUTHOR]

Objective: To study geographic variations in sperm parameters using data from the trials that defined the reference ranges of the World Health Organization 2021 manual.Design: Retrospective evaluation of the data used to define the World Health Organization reference ranges.Setting: Not applicable.Patient(s): Data from 11 studies, including 3,484 participants across 5 continents.Intervention(s): The data were divided according to geographic locations.Main Outcome Measure(s): Differences in sperm parameters.Result(s): The semen volume was significantly lower in samples from Asia and Africa than in other regions. The sperm concentration was the lowest in Africa and highest in Australia. The total motile sperm count (TMSC) and total motile progressive sperm count (TMPS) were significantly lower in Africa than in other regions. The TMSC and TMPS in Asia and the United States were significantly lower than in Europe and Australia. The 5th percentile of the sperm concentration was lowest in the United States (12.5 × 106/mL). The 5th percentile for the normal sperm morphology was lowest in the United States (3%) and highest in Asia (5%). The 5th percentile for the TMSC and TMPS were lowest in Africa (TMSC, 15.08 million; TMPS, 12.06 million) and the United States (TMSC, 18.05 million; TMPS, 16.86 million) and highest in Australia (TMSC, 29.61 million; TMPS, 25.80 million).Conclusion(s): Significant geographic differences in sperm parameters exist, and regional fertility societies should consider adding their own reference ranges on the basis of local experience and treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: Surveys of gender diversity in editorial boards of journals have been conducted in several disciplines, but not in andrology. Objectives: The present study was designed to investigate the gender distribution of editorial boards of andrology journals. Methods: A total of eight andrology journals were included in the study, and the gender information and geographical location of editors were identified based on the information obtained from the Internet. Results: A total of 382 editors' gender information was confirmed. Women made up 1 of the 9 editors‐in‐chief (11.1%), 13 of the 68 deputy/associate editors (19.1%), 37 of the 270 editorial/advisory board members (13.7%) and 0 of the 35 other types of editors (0%). There was no significant difference in the journal impact factor between male and female editors‐in‐chief (3.060 ± 1.274 vs 3.842), and no significant association was found between impact factor and the proportion of female editor (Spearman's r = −0.204, P = 0.629). Discussion and conclusion: Andrology‐related journals lacked adequate gender diversity, not all journals reserved reasonable editorial positions for women. Besides, increased impact factor did not bring additional gender bias. Women should be given more reasonable seats to improve gender diversity in andrology‐related journals. [ABSTRACT FROM AUTHOR]

Background: Transrectal ultrasound (TRUS) parameters are not standardized, especially in men of reproductive age. Hence, the European Academy of Andrology (EAA) promoted a multicenter study to assess the TRUS characteristics of healthy‐fertile men (HFM) to establish normative parameters. Objectives: To report and discuss the prostate and seminal vesicles (SV) reference ranges and characteristics in HFM and their associations with clinical, seminal, biochemical parameters. Methods: 188 men (35.6 ± 6.0 years) from a cohort of 248 HFM were studied, evaluating, on the same day, clinical, biochemical, seminal, TRUS parameters following Standard Operating Procedures. Results: TRUS reference ranges and characteristics of the prostate and SV of HFM are reported herein. The mean PV was ∼25 ml. PV lower and upper limits were 15 and 35 ml, defining prostate hypotrophy and enlargement, respectively. PV was positively associated with age, waistline, current smoking (but not with T levels), seminal volume (and negatively with seminal pH), prostate inhomogeneity, macrocalcifications, calcification size and prostate arterial parameters, SV volume before and after ejaculation, deferential and epididymal size. Prostate calcifications and inhomogeneity were frequent, while midline prostatic cysts were rare and small. Ejaculatory duct abnormalities were absent. Periprostatic venous plexus size was positively associated with prostate calcifications, SV volume and arterial peak systolic velocity. Lower and upper limits of SV anterior‐posterior diameter after ejaculation were 6 and 16 mm, defining SV hypotrophy or dilation, respectively. SV total volume before ejaculation and delta SV total volume (DSTV) positively correlated with ejaculate volume, and DSTV correlated positively with sperm progressive motility. SV total volume after ejaculation was associated negatively with SV ejection fraction and positively with distal ampullas size. SV US abnormalities were rare. No association between TRUS and time to pregnancy, number of children or history of miscarriage was observed. Conclusions: The present findings will help in better understanding male infertility pathophysiology and the meaning of specific TRUS findings. [ABSTRACT FROM AUTHOR]

Male accessory gland infection (MAGI) is a generic acronym indicating inflammatory conditions affecting the prostate gland, seminal vesicles, the ductus deferens and the epididymis. It is a frequent disease, mostly with a chronic course. Majority of the MAGIs remain asymptomatic, thereby leading to a debate whether to treat these patients or not. The primary criterion for MAGI was suggested by Comhaire and colleagues in 1980. The role of MAGI in causing infertility and sexual dysfunctions has long been a matter of debate. The most recent studies show that MAGI could alter, with various mechanisms, both conventional and biofunctional sperm parameters, and determine worst reproductive outcome. This article provides an overview of up-to-date research findings about MAGI with special focus on data published on its impact on fertility; and diagnostic criteria including cellular and seminal biomarkers along with the promising results of emerging proteomic platforms for the identification of MAGI. [ABSTRACT FROM AUTHOR]

Whilst formulating the World Health Organization reference values for semen assessment for 2021, three key challenges were identified, namely the quality of semen assessments, the transparency and reporting of data and, lastly, the paucity of studies with primary data. There is an urgent need to address these issues and we present suggested solutions that will have a real-world influence on the next iteration of the reference values for semen assessments and andrology in general. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the current landscape of andrology fellowships, characteristics of past fellows, and post-fellowship career paths of fellowship graduates.Material and Methods: The websites of the American Urological Association (AUA), Society for the Study of Male Reproduction (SSMR), and Sexual Medicine Society of North America (SMSNA) were reviewed for sponsored fellowships. Program coordinators, institutional websites, and Google were queried for information about each program in a stepwise fashion. Descriptive statistics and t-tests were used to compare outcomes by gender.Results: The SMSNA endorsed 73% of programs, and SSMR 48%, while only 45% of all programs participated in the 2021 AUA match. Nearly all programs (93%) were affiliated with an academic institution. Only 20% programs had any female andrology faculty. From 1982-2020, 324 andrology fellows were identified, 16.4% of whom were female. Of the fellows identified, 54.5% of women pursued academia versus 45.5% of men (P = .39). Men and women were equally likely to advertise an exclusive andrology practice, 65.4 and 61.4%, respectively (P = .78). There was an increase in the proportion of female fellows from 8.1%-20.7% when comparing fellows who began training prior to 2010 to those who began training in 2010 or later (P = .0038).Conclusion: National societies have taken steps towards standardizing andrology fellowship training, but much of the fellowship information is not readily available, restricting the interpretation of gender-based differences in practice environment. However, we found that there was no negative impact in female andrologists' ability to practice andrology or enter academic careers despite being in a male-dominated subspecialty. [ABSTRACT FROM AUTHOR]

Today's reproductive endocrinology and infertility providers have many tools at their disposal when it comes to achieving pregnancy. In the setting of highly efficacious assisted reproductive technology, it is natural to assume that male factor infertility can be overcome by acquiring sperm and then bypassing the male evaluation. In this review, we go through guideline statements and a stepwise male factor infertility evaluation to propose that a thorough male evaluation remains important to optimize pregnancy and live birth. The foundation of this parallel evaluation is referral to a reproductive urologist for the optimization of the male partner, for advanced diagnostics and interventions, and for the detection of other underlying male pathology. We also discuss what future developments might have an impact on the workup of the infertile male. [ABSTRACT FROM AUTHOR]

Study Question: What is the load, distribution and added clinical value of secondary findings (SFs) identified in exome sequencing (ES) of patients with non-obstructive azoospermia (NOA)?Summary Answer: One in 28 NOA cases carried an identifiable, medically actionable SF.What Is Known Already: In addition to molecular diagnostics, ES allows assessment of clinically actionable disease-related gene variants that are not connected to the patient's primary diagnosis, but the knowledge of which may allow the prevention, delay or amelioration of late-onset monogenic conditions. Data on SFs in specific clinical patient groups, including reproductive failure, are currently limited.Study Design, Size, Duration: The study group was a retrospective cohort of patients with NOA recruited in 10 clinics across six countries and formed in the framework of the international GEMINI (The GEnetics of Male INfertility Initiative) study.Participants/materials, Setting, Methods: ES data of 836 patients with NOA were exploited to analyze SFs in 85 genes recommended by the American College of Medical Genetics and Genomics (ACMG), Geisinger's MyCode, and Clinical Genome Resource. The identified 6374 exonic variants were annotated with ANNOVAR and filtered for allele frequency, retaining 1381 rare or novel missense and loss-of-function variants. After automatic assessment of pathogenicity with ClinVar and InterVar, 87 variants were manually curated. The final list of confident disease-causing SFs was communicated to the corresponding GEMINI centers. When patient consent had been given, available family health history and non-andrological medical data were retrospectively assessed.Main Results and the Role Of Chance: We found a 3.6% total frequency of SFs, 3.3% from the 59 ACMG SF v2.0 genes. One in 70 patients carried SFs in genes linked to familial cancer syndromes, whereas 1 in 60 cases was predisposed to congenital heart disease or other cardiovascular conditions. Retrospective assessment confirmed clinico-molecular diagnoses in several cases. Notably, 37% (11/30) of patients with SFs carried variants in genes linked to male infertility in mice, suggesting that some SFs may have a co-contributing role in spermatogenic impairment. Further studies are needed to determine whether these observations represent chance findings or the profile of SFs in NOA patients is indeed different from the general population.Limitations, Reasons For Caution: One limitation of our cohort was the low proportion of non-Caucasian ethnicities (9%). Additionally, as comprehensive clinical data were not available retrospectively for all men with SFs, we were not able to confirm a clinico-molecular diagnosis and assess the penetrance of the specific variants.Wider Implications Of the Findings: For the first time, this study analyzed medically actionable SFs in men with spermatogenic failure. With the evolving process to incorporate ES into routine andrology practice for molecular diagnostic purposes, additional assessment of SFs can inform about future significant health concerns for infertility patients. Timely detection of SFs and respective genetic counseling will broaden options for disease prevention and early treatment, as well as inform choices and opportunities regarding family planning. A notable fraction of SFs was detected in genes implicated in maintaining genome integrity, essential in both mitosis and meiosis. Thus, potential genetic pleiotropy may exist between certain adult-onset monogenic diseases and NOA.Study Funding/competing Interest(s): This work was supported by the Estonian Research Council grants IUT34-12 and PRG1021 (M.L. and M.P.); National Institutes of Health of the United States of America grant R01HD078641 (D.F.C., K.I.A. and P.N.S.); National Institutes of Health of the United States of America grant P50HD096723 (D.F.C. and P.N.S.); National Health and Medical Research Council of Australia grant APP1120356 (M.K.O'B., D.F.C. and K.I.A.); Fundação para a Ciência e a Tecnologia (FCT)/Ministério da Ciência, Tecnologia e Inovação grant POCI-01-0145-FEDER-007274 (A.M.L., F.C. and J.G.) and FCT: IF/01262/2014 (A.M.L.). J.G. was partially funded by FCT/Ministério da Ciência, Tecnologia e Ensino Superior (MCTES), through the Centre for Toxicogenomics and Human Health-ToxOmics (grants UID/BIM/00009/2016 and UIDB/00009/2020). M.L.E. is a consultant for, and holds stock in, Roman, Sandstone, Dadi, Hannah, Underdog and has received funding from NIH/NICHD. Co-authors L.K., K.L., L.N., K.I.A., P.N.S., J.G., F.C., D.M.-M., K.A., K.A.J., M.K.O'B., A.M.L., D.F.C., M.P. and M.L. declare no conflict of interest.Trial Registration Number: N/A. [ABSTRACT FROM AUTHOR]

Objective: The main aim of this study was to report the outcomes of azoospermic men with suspicious testicular lesions, undergoing microsurgical sperm retrieval (micro-oncoTESE) at the time of radical/partial orchidectomy. Patients and methods: Testicular lesions suspicious for cancer were confirmed on ultrasound scanning. In patients undergoing radical inguinal orchidectomy, ex vivo microdissection of the unaffected testicular parenchyma was performed. Microdissection was performed in vivo for partial orchidectomy. The primary outcome measure was surgical sperm retrieval (SSR) rate. Results: A total of 33 patients (median age 33 years, interquartile range (IQR) 22) with suspected testicular cancer (TCa) underwent micro-oncoTESE. Histological analysis confirmed TCa in 26 patients and benign pathology in 7 patients. The overall SSR rate was 39%. Sub-analysis of patients with TCa and benign histology found that the SSR was 46% and 14%, respectively. There was no significant difference in maximum tumour length between successful and unsuccessful SSR groups 33.9 mm ± 23 (SD) versus 29.8 mm ± 17.5 (SD) (p = 0.62). Conclusion: Based on our cohort, micro-oncoTESE provides an option for sperm retrieval in azoospermic men with testicular lesions. [ABSTRACT FROM AUTHOR]

The objective of this study was to establish a selection process for high quality sperm in bovine semen using sperm separation by magnetic activation (MACS). For this, semen from 21 Nellore bulls was collected using an artificial vagina. To guarantee the presence of pathologies in the ejaculate, animals previously declassified in four consecutive spermiogram were used. Semen was analyzed in five statuses: (1) fresh semen (fresh); (2) density gradient centrifugation (DGC), percoll column; (3) non-apoptotic fraction after separation by MACS (MAC); (4) apoptotic fraction from the separation (MACPOOR); and (5) MAC followed by DGC (MACDGC). Using a computerized analysis system (CASA), motility was measured. The sperm morphology was evaluated by phase contrast, and the supravital test was completed with eosin/nigrosin staining. For DGC, 20 × 106 cells were used in a gradient of 90% and 45% percoll. MACS used 10 × 106 cells with 20 μL of nanoparticles attached to annexin V, and filtered through the MiniMACS magnetic separation column. Membrane integrity was assessed with SYBR-14/IP and mitochondrial potential with JC-1 by flow cytometry. Processing sperm by MACDGC, was more effective in obtaining samples with high quality sperm, verified by the total of abnormalities in the samples: 35.04 ± 2.29%, 21.50 ± 1.47%, 17.30 ± 1.10%, 30.68 ± 1.94% and 10.50 ± 1.46%, respectively for fresh, DGC, MAC, MACPOOR, and MACDGC. The subpopulation of non-apoptotic sperm had a high number of live cells (82.65%), membrane integrity (56.60%) and mitochondrial potential (83.98%) (p < 0.05). These findings suggest that this nanotechnological method, that uses nanoparticles, is efficient in the production of high-quality semen samples for assisted reproduction procedures in cattle.

ABSTRACT The aim of this work was to compare results of breeding soundness examination (BSE) of Nellore bulls (n=1257) according to evaluation criteria from two different classification tables (traditional-Table1 used since 1997 and an updated-Table2-proposed in 2020). Data were separated into 3 categories: questionable animals in Table1 and Table2 (Q1Q2), animals approved in Table1 and questionable in Table2 (A1Q2) and animals approved in Table1 and Table2 (A1A2). BSE parameters were submitted to ANOVA (P48m=38.6±1.7cm) compared to A1Q2 (18-24m=29.05±0.98cm; 24-36m=30.3±0.6cm; 36-48m=32.9±1.0cm; >48m=34.8±1.0cm) and to Q1Q2 (24-36m=26.8±2.0cm; 36-48m=30.0±0.1cm; >48m=31.3±1.1cm), for all age groups. At the age of 36-48months (Q1Q2=2.7±0.3; A1Q2=3.2±0.3; A1A2=3.3±0.6) and >48months (Q1Q2=3.0±0.4; A1Q2=3.3±0.5; A1A2=3.4±0.5), animals with better andrological classifications presented higher (P48m, higher sperm Motility (P=0.0250) and Vigor (P=0.0335) were observed in animals A1Q2 (Mot=55.5±14.7%; V=3.21±0.82) and A1A2 (Mot=55.8±12.2%; V=3.23±0.81) compared to Q1Q2 (Mot=50.2±17.4%; V=2.77±0.82). It was concluded that bulls approved using strict selection criteria demonstrated higher PE and BCS, regardless of the age. The utilization of updated classification tables is highly recommended for further reproductive potential development of Nellore bulls in the field.

Abstract Objective To investigate the anogenital distance in patients with and without testicular microlithiasis (TML). Methods A total of 101 patients underwent a conventional standard clinical B-mode scrotal ultrasonography and scrotal MRI. The patients were divided into two groups: patients with TML and non-TML. The latter served as control group. The anogenital distance was measured by a straight line from center of the anus to the posterior base of scrotum using MRI. Results In the TML group, mean AGD was 5.4 (± 1.07) cm (range 29–79 mm), and in non-TML 5.9 (± 1.03) cm (range 35–85 mm) (p = 0.04). Conclusion MRI is a useful tool to measure the AGD. It is easy to perform without any discomfort to patients. We found AGD to be lower in patients with TML.

Purpose: The Accreditation Council of Graduate Medical Education (ACGME) establishes surgical minimum numbers of cases for urologic training. Currently there is not a requirement for microsurgery, likely from a belief that programs do not offer exposure. In an effort to evaluate the availability of microsurgery training among urology residency programs we surveyed the programs. Materials and Methods: We obtained a list of the 138 ACGME-accredited urology residencies and contact information the American Urology Association (AUA). We contacted the residency programs by phone and e-mail. For programs that did not reply, we performed a search of the program website. We answered 3-questions to assess resident subspecialty training in microsurgery and used penile implant and artificial urinary sphincters as a comparison. Data are reported as frequencies. Results: We obtained data from 134 programs (97.1%). A total of 104 programs (77.6%) had fellowship-trained physicians for training in microsurgery, 86.6% for penile implants, and 88.8% for artificial urinary sphincters. The percentage of fellowshiptrained microsurgeons per program did not vary significantly when comparing the different sections of the AUA. The northeast and southeast sections had the lowest percentage (67% and 68%). Conclusions: Nearly 80% of urology residency programs have a fellowship-trained microsurgeon on faculty, we therefore believe that microsurgery should be added as part of the ACGME minimums. In order to provide an equal exposure to all graduating urology residents, urology residency programs that lack microsurgery should identify potential faculty with fellowship training.

Human sperm cryopreservation is characterised to this day by sub-optimal success rates. Interestingly, a traditional approach to improving post-thaw outcome has been to integrate standard sperm preparation techniques into freezing protocols as a means of selecting sperm with the highest fertilisation potential prior to insemination. However, no consensus has been reached yet regarding the optimal timing (before or after freezing) of this selection step. Following analysis of a total of 20 human semen samples, which were divided into two aliquots prepared by density gradient centrifugation either before or after freezing, this study demonstrated higher post-thaw total (P < 0.0001), progressively motile (P = 0.005) and vital (P < 0.0001) sperm counts for frozen-prepared semen samples. The present study suggests that direct insemination with frozen-prepared sperm with minimal intervening post-thaw processing might be a more advantageous approach to current clinical practices, particularly for donor and patient intrauterine insemination programmes. Further research into cryopreservation-induced coiled sperm tail morphology is also warranted.