Infertility/Andrology: Statins linked to decreased ejaculate volume

Mary Katherine Samplaski, MDA study documenting that male paternal age is increasing across the U.S. and a finding that men with Sertoli cell-only syndrome have increased damage to seminiferous tubules with aging are among the take-homes in infertility/andrology at the AUA annual meeting in Boston. The take-home messages were presented by Mary Katherine Samplaski, MD, of the University of Southern California, Los Angeles.

Paternal age in the U.S. is increasing across all races, level of education, and regions, and the proportion of births involving men >40 and >50 years has doubled over the past 40 years.

Men with Sertoli cell-only syndrome (SCOS) have increased damage to seminiferous tubules with aging, suggesting a need for men with SCOS to consider early surgical sperm retrieval to maximize the potential for successful retrieval.

A study of the association between aging and genetics documented the presence of a distinct micro-RNA profile in aging mice and an age-dependent decrease in RNA surveillance for transposable elements, suggesting potential implications for the quality of sperm RNA passed from older fathers to progeny.

Men who had a history of statin use had a small but significant decrease in ejaculate volume versus nonusers and a significant increase in sperm viability, but otherwise no differences in standard semen parameters. Use of proton pump inhibitors or statins by subfertile men did not adversely affect semen parameters.

Off-label use of clomiphene to treat male infertility and hypogonadism did not increase the risk of deep-vein thrombosis, ischemic heart disease, or cancer in a review involving 12,318 men.

Reliance on vasal fluid characteristics alone may miss unrecognized epididymal obstruction in about 10% of men who undergo vasectomy reversal.

More than half of men undergoing varicocelectomy had improved semen parameters, which were associated with higher pregnancy rates but occurred more than 3 months after surgery in a fourth of cases.

A randomized study of men with recurrent or persistent varicocele showed that redo surgery, as compared with observation, was associated with higher sperm counts and pregnancy rates and lower miscarriage rates.

Use of fluorescence activated cell sorting (FACS) of spermatozoa from testis tissue may improve sperm identification in microsurgical testicular sperm extraction specimens.

A survey of 2,506 couples evaluated by obstetrician/gynecologists at infertility clinics showed that 11% of couples underwent intrauterine implantation and 10% underwent in vitro fertilization without a male-factor evaluation.

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