Andrology最新文献

{"title":"Prospective Short- and Long-Term Changes in Cardiometabolic Risk Markers Following Gender-Affirming Hormone Therapy.","authors":"Louise Lehmann Christensen, Camilla Viola Palm, Marianne S Andersen, Guy T'Sjoen, Jan Frystyk, Tine Taulbjerg Kristensen, Rikke Hjortebjerg, Dorte Glintborg","doi":"10.1111/andr.70335","DOIUrl":"https://doi.org/10.1111/andr.70335","url":null,"abstract":"<p><strong>Introduction: </strong>Gender-affirming hormone therapy (GAHT) may be associated with increased cardiometabolic disease (CMD) risk. Prospective CMD risk screening is recommended, but long-term data are needed regarding changes in CMD markers.</p><p><strong>Objectives: </strong>To evaluate prospective changes in CMD risk markers during GAHT.</p><p><strong>Methods: </strong>Transgender persons initiating (GAHT naïve) or on current GAHT (GAHT ongoing) were included in a 36-month prospective study at a Danish gender identity clinic. Participants were categorized as transmasculine (TransM, N = 245: GAHT naïve, N = 129, ongoing, N = 116) and transfeminine (TransF, N = 250: GAHT naïve, N = 157, ongoing, N = 93) persons. BMI, waist-hip-ratio, lipids, blood pressure (BP), and HbA1c were measured annually.</p><p><strong>Results: </strong>In TransM, the baseline median age (interquartile range) was 23 (20-28) years in GAHT naïve and 25 (21-29) years in GAHT ongoing with median GAHT duration of 3.1 years. Masculinizing GAHT up to 36 months in GAHT naïve and ongoing TransM (N = 84) was associated with increased LDL and triglycerides, whereas GAHT naïve TransM (N = 53) in addition developed significantly increased waist, and HbA1c and decreased HDL. In TransF, the median age at baseline was 25 (22-30) years in GAHT naïve and 27 (23-36) years in GAHT ongoing with GAHT duration of median 2.2 years. In GAHT naïve, 36 months of feminizing GAHT (N = 38) was associated with increased weight, BMI, waist and hip and decreased total cholesterol and triglycerides, whereas CMD risk markers were unchanged in TransF GAHT ongoing.</p><p><strong>Conclusion: </strong>Masculinizing GAHT was predominantly associated with long-term adverse changes in lipid status, whereas initializing feminizing GAHT was associated with metabolically unfavorable changes in body composition.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ZAN, IZUMO1, and TMEM95 Protein Domains Identify the Physiological Status of the Sperm.","authors":"Miranda Hernández-Falcó, Paula Sáez-Espinosa, Alejandro Romero, Andrea López-Botella, Laura Robles-Gómez, María José Gómez-Torres","doi":"10.1111/andr.70336","DOIUrl":"https://doi.org/10.1111/andr.70336","url":null,"abstract":"<p><strong>Background: </strong>Infertility is a growing concern, which has led to an increase in the use of assisted reproductive techniques, involving in vitro sperm capacitation. Nonetheless, the optimal capacitation time remains a matter of debate, and it is unknown whether it has an impact on the localization of key membrane proteins.</p><p><strong>Objective: </strong>This study aimed to evaluate the distribution and dynamics of membrane protein domains zonadhesin (ZAN), izumo sperm-egg fusion 1 (IZUMO1), and transmembrane protein 95 (TMEM95) in sperm following 1 and 4 h of in vitro capacitation and subsequent induction of the acrosome reaction.</p><p><strong>Materials and methods: </strong>Sperm from 16 humans under five physiological conditions were used: noncapacitation, 1- and 4 h in vitro capacitation, and acrosome reaction induction. Immunolocalization of ZAN, IZUMO1, and TMEM95 was assessed using confocal microscopy.</p><p><strong>Results: </strong>The univariate and multivariate statistical analysis revealed a clear relationship between physiological conditions and protein dynamics. In particular, noncapacitated spermatozoa were characterized by an absence of ZAN and TMEM95. Whereas, regardless of the capacitation time (1 h vs. 4 h), there was an increase in the key protein presence with ZAN and IZUMO1 in the acrosomal region and TMEM95 in the equatorial region. After induction of acrosome reaction, IZUMO1 was relocated to the equatorial region.</p><p><strong>Conclusion: </strong>Here we illustrate the potential to quantify physiological differences among human spermatozoa by a multibiomarker approach. However, no evidence supports that capacitation time influences ZAN, IZUMO1, and TMEM95 distribution.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sperm Selection Using Micro Swim-Up: Improvement of Chromatin Integrity Compared to Density Gradient Centrifugation.","authors":"Simone Palini, Serena Benedetti, Silvia De Stefani, Luca Galluzzi, Mariangela Primiterra, Sara Rita D'Errico, Michele Tanturli, Monica Muratori","doi":"10.1111/andr.70327","DOIUrl":"https://doi.org/10.1111/andr.70327","url":null,"abstract":"<p><strong>Background: </strong>Selecting high-quality spermatozoa with optimal nuclear integrity is a crucial step in assisted reproductive technologies (ART). While density gradient centrifugation (DGC) is widely used, the associated centrifugation steps may induce cell stress, potentially damaging sperm DNA. Conversely, micro swim-up (MSU) is an innovative, centrifugation-free procedure using autonomous gamete migration in a polyvinylpyrrolidone medium.</p><p><strong>Objectives: </strong>This study aimed to compare the sperm selection technique MSU with the conventional method DGC in terms of sperm chromatin integrity in 90 semen samples.</p><p><strong>Materials and methods: </strong>Rapid progressive motility, sperm DNA fragmentation (sDF; SCD test), nuclear immaturity (aniline blue [AB] staining), and chromatin decondensation (chromomycin A3 [CMA3] staining) were evaluated before and after selection.</p><p><strong>Results: </strong>Both procedures significantly improved motility and nuclear parameters compared to unselected samples. However, MSU outperformed DGC across all nuclear integrity markers. Specifically, sDF decreased from 18.50% (14.63-26.25) to 9.25% (6.00-16.00) with DGC and 1.00% (0.00-2.00) with MSU (p < 0.0001 MSU vs. DGC). Regarding nuclear immaturity, values improved from 21.00% (15.00-27.50) to 15.00% (8.00-18.00) with DGC and 5.00% (4.00-10.00) with MSU (p = 0.012 MSU vs. DGC). Similarly, chromatin decondensation decreased from 18.25% (10.88-23.63) to 13.50% (7.00-15.63) with DGC and 5.50% (2.75-10.00) with MSU (p = 0.0001 MSU vs DGC).</p><p><strong>Discussion and conclusion: </strong>MSU selects spermatozoa with significantly superior nuclear integrity compared to DGC, markedly reducing DNA fragmentation and improving chromatin maturation. Given the direct impact of these parameters on ART outcomes, MSU might represent a valuable alternative to traditional centrifugation-based methods in clinical settings.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of ANO1-Expressing PDGFRα⁺ Smooth Muscle Cells in Generating Spontaneous Phasic Contractions of the Rodent Epididymis.","authors":"Wataru Kudo, Hiromichi Takano, Toshiya Izuchi, Retsu Mitsui, Kyoko Miwa-Nishimura, Hikaru Hashitani","doi":"10.1111/andr.70323","DOIUrl":"https://doi.org/10.1111/andr.70323","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous phasic contractions (SPCs) in the epididymal duct play an important role in transport and maturation of sperm. In proximal cauda of the rat epididymis, platelet-derived growth factor receptor α (PDGFRα)-positive smooth muscle cells (SMCs) generate ANO1 Ca²⁺-activated chloride channels (CaCCs)-dependent spontaneous transient inward currents (STICs) to electrically drive SPCs.</p><p><strong>Objective: </strong>Here, we explored whether epididymal ANO1⁺, PDGFRα⁺ cells may have region-specific functions in generating SPCs.</p><p><strong>Materials and methods: </strong>Patch clamp technique was applied to isolated epididymal cells dispersed from the rat epididymis. Membrane potential changes and SPCs were recorded from epididymal tissue preparations using an intracellular microelectrode and video imaging, respectively. To verify ANO1 currents in PDGFRα⁺ SMCs, patch clamp recordings and immunohistochemistry were performed using PDGFRα-eGFP mice.</p><p><strong>Results: </strong>Rat epididymal cells of both proximal cauda and caput developed spontaneous transient depolarizations (STDs) that were inhibited by Ani9 (3 µM), the ANO1-specific inhibitor, CPA (10 µM), a sarco/endoplasmic reticulum Ca²⁺-ATPase (SERCA) inhibitor, or nifedipine (1 µM), an L-type voltage-dependent Ca²⁺ channel (LVDCC) inhibitor. Ani9 (10 µM) slowed slow waves and associated SPCs in proximal cauda but not the caput. In the mouse epididymis, the proximal cauda consisted of a few layers of SMCs where SMCs in the innermost layer primarily expressed PDGFRα, whereas the caput was composed of one or two layers of PDGFRα⁺ SMCs. In both regions, Ani9 (3 µM) abolished STICs in PDGFRα⁺ SMCs that co-expressed ANO1. However, Ani9 (10 µM) slowed SPCs in the proximal cauda but not the caput.</p><p><strong>Discussion and conclusion: </strong>Despite the fact that epididymal PDGFRα⁺ SMCs in both the proximal cauda and caput develop ANO1-dependent STICs, they appear to serve as pacemaker cells driving SPCs in the proximal cauda, whereas corresponding cells in the caput have a role other than SPCs' pacemaking.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential Effects of Sperm Deoxyribonucleic Acid Fragmentation Index on Cumulative Live Birth Rate per Complete Cycle Following IVF and ICSI Treatment in Patients Without Severe Male Infertility.","authors":"Kaijie Chen, Luxiang Pan, Jiali Cai, Qiaobin Liu, Liye Xue, Lanlan Liu, Zhenfang Liu, Jianzhi Ren, Xiaoming Jiang","doi":"10.1111/andr.70338","DOIUrl":"https://doi.org/10.1111/andr.70338","url":null,"abstract":"<p><strong>Background: </strong>Infertility impacts 10%-15% of the population, with prominent male contributions. Routine semen analysis fails to fully evaluate male fertility. Sperm DNA fragmentation (SDF) links to poor reproductive outcomes. Although intracytoplasmic sperm injection (ICSI) is recommended for high SDF, its overuse in nonsevere male infertility is controversial. The divergent impacts of SDF on in vitro fertilization (IVF) and ICSI cumulative live birth rate (CLBR) remain unclear.</p><p><strong>Objective: </strong>To evaluate the effect of SDF on the CLBR in couples undergoing IVF and ICSI, and to explore the optimal choice of assisted reproductive fertilization methods under different levels of SDF in nonsevere male infertility.</p><p><strong>Materials and methods: </strong>Sperm chromatin structure assay, propensity score matching (PS-matching), generalized additive model (GAM), and causal forest (CF) model analysis.</p><p><strong>Result(s): </strong>After PS-matching: 398 cases in both IVF and ICSI groups (standardized difference <0.1). GAM: IVF group's CLBR decreased with DFI; ICSI group had no correlation. IVF's CLBR was higher when DFI < 14.3%, lower when DFI > 47.9%. CF model: DFI was a top predictor; SHAP analysis: DFI < 14.2% favored IVF, DFI > 14.2% favored ICSI.</p><p><strong>Conclusion(s): </strong>For nonsevere male infertility, IVF yields superior baseline CLBR at DFI < 14.3%. Rising DFI impairs IVF outcomes, whereas ICSI remains unaffected. Pretreatment DFI enables individualized IVF/ICSI selection.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endogenous Testosterone Recovery after Enucleation for BPH: Clinical Insights into the Concept of \"Normal\" Testosterone.","authors":"Po-Ting Lin, Tzu-Chi Teng, Yu-Ting Chen, Chen-Pang Hou, Chien-Lun Chen, Horng-Heng Juang, Yu-Hsiang Lin","doi":"10.1111/andr.70342","DOIUrl":"https://doi.org/10.1111/andr.70342","url":null,"abstract":"<p><strong>Background: </strong>Lower urinary tract symptoms (LUTS), particularly nocturia, may disrupt sleep and have been hypothesized to suppress the hypothalamic-pituitary-gonadal axis. Although anatomical endoscopic enucleation of the prostate (AEEP) has been associated with increased testosterone in men with low baseline levels, its effect in men with \"biochemically normal\" preoperative testosterone remains unclear.</p><p><strong>Objectives: </strong>To evaluate postoperative total testosterone (TT) changes after AEEP and to identify a preoperative TT threshold that predicts clinically meaningful TT elevation.</p><p><strong>Materials and methods: </strong>We conducted a single-center retrospective cohort study of men undergoing AEEP between 2018 and 2021. Of 560 cases, 304 met inclusion criteria. Morning TT was measured preoperatively and 6-12 months postoperatively. Clinically significant TT elevation was defined as a ≥20% increase from baseline. Receiver operating characteristic (ROC) analysis identified the optimal preoperative TT cut-off for predicting TT elevation, and multivariable logistic regression evaluated independent predictors.</p><p><strong>Results: </strong>The mean age was 69.7 years, and 92 of 304 patients (30.3%) achieved postoperative TT elevation. ROC analysis demonstrated moderate discrimination (AUC 0.737; 95% CI 0.678-0.797), with a Youden-optimal TT cut-off of 4.525 ng/mL (sensitivity 72.8%, specificity 64.2%). On bootstrap internal validation, the optimism-corrected AUC was 0.738, and the optimal cut-off varied across resamples (95% range 3.13-5.07 ng/mL), indicating that the threshold is exploratory. Preoperative TT <4.5 ng/mL independently predicted TT elevation (adjusted OR 4.345; 95% CI 2.533-7.453; p < 0.001), as did TT <3.5 ng/mL (adjusted OR 3.682; 95% CI 2.158-6.283; p < 0.001).</p><p><strong>Discussion: </strong>AEEP was associated with meaningful TT increases not only in hypogonadal men but also in those with conventionally normal baseline TT, particularly within the 3.5-4.5 ng/mL range.</p><p><strong>Conclusion: </strong>In this uncontrolled cohort, a preoperative TT threshold around 4.5 ng/mL identified men more likely to show postoperative TT elevation; this exploratory finding warrants prospective, controlled validation before the current \"normal\" TT range is reconsidered.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148597767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explainable AI in Male Infertility: A Clinical Roadmap for Shared Decision-Making.","authors":"Stjepan Škudar","doi":"10.1111/andr.70334","DOIUrl":"https://doi.org/10.1111/andr.70334","url":null,"abstract":"<p><p>Artificial intelligence (AI) is increasingly entering male infertility care through semen image analysis, sperm-selection support, prediction of sperm retrieval, and decision-support tools for assisted reproduction. Yet clinical value will depend less on algorithmic novelty than on explainability, governance, and safe integration into existing andrology practice. This Perspective proposes a pragmatic roadmap for explainable AI in male infertility, moving from laboratory quality support to externally validated prediction tools and shared decision-making. Explainability methods such as feature importance, SHAP, LIME, and saliency maps may help clinicians understand which semen, hormonal, imaging, or clinical variables influence an AI output. However, these methods must be combined with privacy protection, bias assessment, laboratory-specific validation, and transparent reporting. AI should support, not replace, standardized semen analysis, urological evaluation, and patient-centered counseling. A responsible implementation pathway should align with medical-device regulation, reporting standards for AI studies, and local audits of performance across diverse populations.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity Is an Independent Risk Factor for Oligozoospermia, With Co-Existing Hyperglycemia Exacerbating Risks of Asthenozoospermia and Elevated Sperm DNA Fragmentation.","authors":"Rubing Hu, Haijiao Zou, Qiaodan Li, Weihong Fan, Jian Xu","doi":"10.1111/andr.70324","DOIUrl":"https://doi.org/10.1111/andr.70324","url":null,"abstract":"<p><strong>Background: </strong>Metabolic health plays a critical role in maintaining male fertility and may influence offspring health. Therefore, it is necessary to incorporate metabolic indicators into the clinical assessment of male fertility. However, the relationships between different metabolic abnormalities and semen quality remain incompletely understood.</p><p><strong>Methods: </strong>In this retrospective cohort study, clinical data from men who underwent semen analysis and blood biochemical testing at the Fourth Affiliated Hospital of Zhejiang University School of Medicine between July 2022 and November 2025 were analyzed. Clinical characteristics, semen parameters (WHO fifth edition), and metabolic indicators were collected. Participants were classified as obese (BMI ≥ 28 kg/m²) or non-obese according to Chinese criteria. Further stratified analysis was conducted according to the presence of concomitant metabolic abnormalities (elevated fasting blood glucose or hypertension). Multivariate logistic regression and stratified analysis methods were employed to evaluate the association between obesity, its associated metabolic abnormalities, and semen quality, as well as sperm DNA fragmentation index (DFI).</p><p><strong>Results: </strong>This study included 1048 men, comprising 765 non-obese individuals and 283 obese individuals. Obese men had a significantly higher prevalence of oligozoospermia than non-obese men, whereas other semen parameters and DFI did not differ significantly. Multivariate analysis identified obesity as an independent risk factor for oligozoospermia. Among obese men, those with elevated fasting blood glucose had significantly higher rates of asthenozoospermia and high DFI compared to those with normal glucose levels. However, no statistically significant differences were observed in the distribution of oligozoospermia, asthenozoospermia, teratozoospermia, or high DFI.</p><p><strong>Conclusions: </strong>Obesity is an independent risk factor for oligozoospermia. In obese men with elevated fasting blood glucose, sperm function impairment is further exacerbated, manifesting as asthenozoospermia and increased sperm DFI. This study highlights the cumulative adverse effects of metabolic disorders on male reproductive function.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational Physical Activity Is Negatively Associated With Semen Quality.","authors":"Michal Efrat, Sharon Barak, Anat Stein, Haim Pinkas, Ron Unger, Ruth Birk","doi":"10.1111/andr.70326","DOIUrl":"https://doi.org/10.1111/andr.70326","url":null,"abstract":"<p><strong>Background: </strong>Lifestyle factors have been associated with semen quality and have been implicated in the reported global decline in semen parameters. Moderate physical activity has been linked to improved semen quality; however, the association between occupational physical activity and semen quality is limited.</p><p><strong>Objective: </strong>To study the association between male occupational physical activity and semen quality parameters.</p><p><strong>Methods: </strong>A cross-sectional single-center study, with final study cohort of 280 males (after applying inclusion and exclusion criteria on n = 593) attending routine semen analysis at sperm laboratory, was subject to WHO criteria semen quality analysis (semen volume, sperm concentration, total sperm count, percentage sperm motility/morphology) and self-filled validated physical activity, lifestyle, and demographic questionnaires. Statistical analyses were done using SPSS Statistics (version 23).</p><p><strong>Results: </strong>All occupational physical activity characteristics, except for sitting, were significantly associated with semen parameters. Sweating at work and physical tiredness were significantly and negatively associated with multiple semen parameters. Specifically, sweating at work was negatively associated with sperm concentration, morphology, and motility (Spearman r = -0.14 to -0.18, all p < 0.05). Physical tiredness at work was negatively associated with total sperm count, sperm concentration, morphology, and motility (Spearman r = -0.15 to -0.26, all p < 0.05). In hierarchical multiple regression analyses controlling for potential confounders, occupational physical activity expressed as physical tiredness independently predicted lower sperm concentration and morphology (β = -0.17 and -0.29, respectively; p < 0.01).</p><p><strong>Discussion: </strong>Occupational physical activities are negatively associated with semen quality parameters, suggesting a potential adverse effect of work-related physical exertion on male reproductive function.</p><p><strong>Conclusions: </strong>The negative association between occupational physical activity characteristics and semen quality parameters highlights the importance of considering work-related physical exertion in the context of male fertility assessment, once evidence-based thresholds and standardized assessment protocols are established.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired Cardiorespiratory Fitness in Adolescents and Young Adults With 47,XXY/Klinefelter Syndrome.","authors":"Karli Swenson, Samantha Bothwell, Amelia Middleton, Nicole R Tartaglia, Philip S Zeitler, Kristen J Nadeau, Shanlee M Davis","doi":"10.1111/andr.70307","DOIUrl":"https://doi.org/10.1111/andr.70307","url":null,"abstract":"<p><strong>Background: </strong>47,XXY/Klinefelter syndrome is associated with high rates of obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease.</p><p><strong>Objective: </strong>This study compared cardiorespiratory fitness (CRF) in adolescents and young adults (AYA) with and without XXY and investigated the relationship between CRF and other biomarkers of cardiometabolic health. We hypothesized that CRF would be lower in XXY compared to healthy male controls.</p><p><strong>Materials and methods: </strong>This cross-sectional analysis included AYA with non-mosaic 47,XXY (n = 56) and 46, XY male controls (n = 37) without hypertension, diabetes, or exercise restrictions. Participants completed graded exercise testing with oxygen consumption (VO₂) measured continuously. The primary outcome was VO₂ peak, with secondary outcomes including other CRF test parameters at maximal exertion and at the anaerobic threshold; as well as the prevalence of chronotropic incompetence defined as failure to achieve ≥85% of age-predicted maximal heart rate during maximal exercise. Body composition completed via dual-energy X-ray absorptiometry (DXA), habitual physical activity, and serum biomarkers including lipids, hemoglobin A1c, hematocrit, and total testosterone were explored as covariates.</p><p><strong>Results: </strong>Compared with controls, CRF was markedly reduced in XXY despite similar effort, with 24% lower peak VO₂ (31.2 ± 8.3 vs. 41.2 ± 7.9 mL/kg/min, p < 0.001). Chronotropic incompetence was more common in XXY (30.4% vs. 8.1%, p = 0.018) and associated with lower VO₂ peak. Anaerobic threshold occurred earlier and at lower oxygen consumption in XXY. Individuals with XXY had higher adiposity with 7.0 ± 1.3% greater body fat for a given BMI, and in multivariable models, percent fat mass was the only independent predictor of VO₂ peak (p < 0.001). CRF was not associated with testosterone treatment status nor testosterone concentrations.</p><p><strong>Discussion: </strong>AYA with XXY demonstrated reduced CRF and earlier anaerobic threshold compared with controls, indicating diminished physiologic reserve. Higher adiposity and presence of chronotropic incompetence were associated with lower fitness, suggesting multifactorial mechanisms. These results support the need for prospective studies and targeted exercise-based interventions to improve cardiometabolic health in this population.</p><p><strong>Conclusions: </strong>AYA with XXY have markedly reduced CRF driven primarily by excess adiposity, identifying an underrecognized target for early intervention to reduce cardiometabolic risk.</p>","PeriodicalId":7898,"journal":{"name":"Andrology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148560813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}