F Lanzafame

University of Catania, Catania, Sicily, Italy

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Publications (12)12.53 Total impact

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    ABSTRACT: Introduction: Since varicocele is often associated with other venous abnormalities, this study was undertaken to evaluate the frequency of dilation of the periprostatic venous plexus (DPVP) in these patients and the effects of this association on sperm parameters before and after varicocelectomy. Materials and methods: Sperm parameters were evaluated using the conventional WHO criteria, and seminal fluid viscosity was further evaluated by quantitative viscometry, in 50 patients (aged 20-38 years) who underwent surgical treatment for grade III bilateral varicocele. Results: Thirty patients with varicocele had also DPVP (DPVP+) (60 %). Sperm concentration and the percentage of spermatozoa with normal morphology did not differ significantly in patients with DPVP- or DPVP+ before or after surgical repair. On the other hand, sperm progressive motility was low in all patients and increased significantly after varicocele repair, but only in DPVP- patients. Before varicocele treatment, a significantly higher number of DPVP+ patients (25/30 = 83.3 %) had seminal fluid hyperviscosity compared to DPVP- patient (2/20 = 10.0 %). Viscosity quantitative measurement was significantly higher in DPVP+ patients both before and after varicocele repair compared to DPVP- patients. These latter showed a statistically significant reduction of sperm viscosity after varicocele surgical repair compared to pretreatment values. Finally, periprostatic venous plexus diameter and seminal fluid viscosity correlated directly in DPVP+ patients. Conclusions: In conclusion, these results showed that a large number of patients with varicocele had a concomitant DPVP. This subset of patients did not take advantage from varicocele surgical repair since only DPVP- varicocele patients showed a significant improvement of sperm progressive motility and seminal fluid viscosity. These findings suggest the evaluation of the periprostatic venous plexus and seminal fluid viscosity before patients with varicocele undergo surgical repair for asthenozoospemia.
    No preview · Article · Oct 2015 · Journal of endocrinological investigation
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    ABSTRACT: Genetic causes can be directly responsible for various clinical conditions of male infertility and spermatogenic impairment. With the increased use of assisted reproduction technologies our understanding of genetic basis of male infertility has large implications not only for understanding the causes of infertility but also in determining the prognosis and management of such couples. For these reasons, the genetic investigations represent today an essential and useful tool in the treatment of male infertility. Several evidences are available for the clinical practice regarding the diagnosis; however, there are less information relative to the treatment of the genetic causes of male infertility. Focus of this review is to discuss the main and more common genetic causes of male infertility to better direct the genetics investigation in the treatment of spermatogenic impairment.
    No preview · Article · Jan 2014 · Journal of endocrinological investigation
  • Francesco Lanzafame · Sandro La Vignera · Aldo E. Calogero
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    ABSTRACT: Oxidative stress (OS) has been recognized as one important cause of male infertility because it may damage sperm function and DNA integrity. Since antioxidants counteract the action of OS, these compounds are used in the medical treatment of male infertility. This chapter reviews the effects of the main antioxidants used in the clinical practice. We applied an evidence-based medicine criterion in the attempt to identify the molecules provided with the most effective action. Some antioxidants have been clearly shown to be effective by many well-conducted studies. These include vitamins C and E and carnitines which may be considered as a first-line treatment. Other molecules, such as glutathione and coenzyme Q10, may be proposed as a second-line treatment because their use is supported by few but well-performed studies. Lastly, the efficacy of other antioxidants, such as pycnogenol, lycopene, etc., is not yet supported by a sufficient number of studies.
    No preview · Chapter · Jan 2012
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    P Asero · S La Vignera · F Lanzafame
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    ABSTRACT: Endocrinologia della Riproduzione, Ospedale Garibaldi (centro), Università di Catania; * Respon-sabile Centro Territoriale di Andrologia, AUSL 8, Siracusa Key words Genetic causes • Male infertility • Sperma-togenesis • Medically assisted procreation techniques Summary Objectives. Genetic causes can be directly responsible for various clinical conditions of male infertility. In this review, we shall discuss the various ge-netic causes that have acquired considerable importance from the viewpoint of infertility, whether male and/or of the couple, thus contributing to accom-plishing more accurate diagnoses. Material and methods. We performed a review of published in scientific journals and literature using as key words "genetic causes" "male infertility", "spermatogenesis", "medically assisted procreation techniques" and similar words. Results. It is known that 10-15% of cases of azoospermia and severe oligozoospermia are genetically-based, represented mostly by Klinefelter's syndrome (KS) and by the microdeletions of the Y chromosome. The prevalence of KS among infertile men is considerably high: up to 5% in the cases of severe oligozoospermia and up to 10% in cases of azoospermia. The microdeletions of the AZF region, the second most common cause of male infertility, determine a severe primitive testiculopathy with consequent azoospermia or severe oligozoospermia. With regard to the chromosomal alterations, the predominating anomalies are those associated with the sex chromosomes. However, a wide range of structural autosomal anomalies has been identified such as Robertsonian and reciprocal translocations, inversions, duplications and deletions, that can be associated with infertility. Lastly, mutations in single genes can be directly responsible for male infertil-ity, such as the gene CFTR which, once mutated, causes cystic fibrosis and the 'non-formation' of the vas deferens; the gene KAL 1, which is responsible for Kallmann's syndrome; the gene which codifies the receptor of androgens that, once mutated, causes syndromes of insensitivity to androgens and alterations of spermatogenesis and lastly the genes INSL3-RXFP2, the muta-tions of which are associated with anomalies in the descent of the testicles, as in cryptorchidism. Conclusion. Genetic anomalies have assumed enormous clinical impor-tance, not only because they may cause infertility in the offspring, but also and mainly because they are capable of causing more severe illnesses. The high frequency of genetic alterations in infertile couples demands appropri-ate and correct diagnosis of these patients in order to reduce the risk of transmitting genetic anomalies to the offspring. Whether to undertake genetic investigations and if so, which in particular, may be indicated through detailed clinical assessment.
    Full-text · Article · Mar 2010 · Journal of Andrological Sciences
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    ABSTRACT: Different authors showed clear correlations between diabetic disease and male reproductive damage (es. rate of nuclear DNA fragmentation, mithocondrial DNA mutations, increased of enzymatic glication products, etc...). The aim of this observational study carried out on a selected group of diabetic patients (average age 36) with primary infertility was to determine reactive oxygen species (ROS) production in sperm in connection with duration of disease, glicemic control and seminal vescicular emptying in the post ejaculatory. All diabetic patients enrolled (20) were submitted to two consecutive spermiograms, ROS sperm analysis and transrectal ultrasound evaluation before and after ejaculation, performed according to standard conventional methods. Diabetic patients with better glicometabolic compensation (HBAI C < 7%) and duration of disease <5 years showed spermatic rate of ROS production significantly lower regarding the group with worse glicemic control and greater duration of disease. Diabetic patients with altered vescicular emptying in the post ejaculatory showed spermatic rate of ROS production significantly higher regarding patients with normal vescicular emptying. The degree of oxidative stress in sperm of diabetic patients follows the course of the other chronic complications, getting worse in connection with duration of disease and glicemic control. Altered vescicular emptying in the post ejaculatory could be an important mechanism for initiation of this higher response.
    No preview · Article · Dec 2009 · Archivio italiano di urologia, andrologia: organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia
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    Francesco M Lanzafame · Sandro La Vignera · Enzo Vicari · Aldo E Calogero
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    ABSTRACT: Oxidative stress (OS) has been recognized as one of the most important cause of male infertility. Despite the antioxidant activity of seminal plasma, epididymis and spermatozoa, OS damages sperm function and DNA integrity. Since antioxidants suppress the action of reactive oxygen species, these compounds have been used in the medical treatment of male infertility or have been added to the culture medium during sperm separation techniques. Nevertheless, the efficacy of such a treatment has been reported to be very limited. This may relate to: (i) patient selection bias; (ii) late diagnosis of male infertility; (iii) lack of double-blind, placebo-controlled clinical trial; and/or (iv) use of end-points that are not good markers of the presence of OS. This review considers the effects of the main antioxidant compounds used in clinical practice. Overall, the data published suggest that no single antioxidant is able to enhance fertilizing capability in infertile men, whereas a combination of them seems to provide a better approach. Taking into account the pros and the cons of antioxidant treatment of male infertility, the potential advantages that it offers cannot be ignored. Therefore, antioxidant therapy should remain in the forefront of preventive medicine, including human reproductive medicine.
    Full-text · Article · Nov 2009 · Reproductive biomedicine online
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    ABSTRACT: In the management of the chronic complications caused by diabetes mellitus, an important role is played to andrological problematics, which require a specialistic evaluation combined in order to concretely contribute to the improvement of quality of life of such patients. The erectile disfunction in the diabetic patient notoriously correlates with the main cardiometabolics risk factors, and recently it has been pointed out how after chronic use of inhibitors of the phospodiesterase-enzyme-5 (PDE5-I) it is possible to improve the vascular response profile, evaluated through ecolor doppler (ECD) penile dynamic. The incidence of the vascular extra-genital pathology in the patients with ED of organic arterial type has also been observed, underlining in particular the correlation with a low value of the systolic peak at penile level. Little attention has been paid to other andrologic pathologies that preliminary clinic evidences or less followed research points have individuated as real emerging problems; among them there are: 1) the hypogonadism in adult age (late onset hypogonadism); 2) the lower urinary tract symptoms (LUTS) correlated to the condition of prostatic hypertrophy; 3) the infections of the male genito-urinary tract with different characterization for imaging respect to the not diabetic population; 4) different sexual disorders; 5) implications over the male reproductive sphere. Retrospective analysis of the clinic, laboratory (spermatic, microbiologic and hormonal), ultrasonography integrated data, led on a diabetic population examined during the last 3 years; finalized at the estimation of the distribution of the andrological pathology characterizing such population, with the comparison of the data on the basis of years of duration disease, grade of glicometabolic compensation and levels of total testosterone. ED was present in 16.36% of the examined population; 50% showed vascular arterial form; hypogonadism was present in 10% of the population. A very high prevalence of subfertility was observed 51.82%. The ultrasonographic characterization of the didimo-epididimary and prostatic-vesicular regions showed reduced testicular volume the 16.36% of cases, increase of the prostatic glandular volume in 45.45% of cases, altered thickness of the seminal vesicles in the 24.45% of cases. The microbiologic characterization evidences the contemporary positivity of the 3 prechosen indicators (spermiocolture, urinocolture, leukocytospermia) in 34.55% of patients. The study has contributed to enrich the data relative to the heterogeneity of the clinic-andrological presentation of the diabetic patient.
    No preview · Article · Apr 2009 · Minerva endocrinologica
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    ABSTRACT: Objective: In male infertile patients with diabetes, there are growing evidences indicating important physiopathological connections between the mechanisms of oxidative damage in terms of rate of fragmentation of the nuclear DNA, deletions of the mithocondrial DNA, imbalance of the oxidative balance, increased levels of enzymatic glication products in testicular and epididimary region, and besides on the seminal plasma. Taken the above oxidative damage as secondary to a putative radical oxygen species hyperproduction, aim of this study was to directly assess the radical oxygen species production, in basal and after fMLP-addition (to evaluate maximal leukocyte response), in infertile, diabetic patients. To verify a relatively defective functional of radical oxygen species production, the pattern of radical oxygen species response in diabetic patients was compared to that found in two controls groups. Sperm conventional parameters, including seminal leukocytes concentration were also evaluated in patients and controls groups. Material and methods: In the present observational study, 18 selected, infertile patients with diabetes (mean age 36 years, range 28-44 years) underwent semen analysis for assessment of radical oxygen species, sperm parameters (density, motility, morphology, and seminal leukocyte concentration). The results obtained were compared with the data obtained from two control groups (analysis among groups), including a group of 28 patients with male accessory gland infection and a group of 16 healthy, volunteers subjects. Results: The mean values of semen parameters of the infertile patients with diabetes were significantly different from those found in both control groups, being together better than those of the male accessory gland infections control group but worse than those of the healthy subjects. In addition, the infertile men with diabetes had higher radical oxygen species chemiluminescent signals in all conditions (baseline and fMLP-stimulated) than those registered in the healthy subjects but lower than those found in male accessory gland infections group. Conclusions: The infertile patients with diabetes studied characterized itself differing from the group with male accessory gland infections because the low leukocyte response in part, likely explained through an immuno-pathogenetic picture (defective macrophagic response) conditioned by the same basic disease. Despite in diabetic patients, the sperm oxidative stress seem less than that observed in presence of male accessory gland infections, this can likely explain their impaired sperm data.
    No preview · Article · Mar 2009
  • F. Lanzafame · S. La Vignera · P. Asero
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    ABSTRACT: Several factors are related to sperm DNA damage and not all mechanism are known. Multiple sources have been proposed including abortive apoptosis, abnormal chromatin packaging during the transition from round to elongated spermatids and oxidative stress. Moreover, many enviromental conditions are related to reproductive toxicity, including structural and functional alterations of human sperm and particularly sperm DNA damage. Finally, several evidences suggest that infiammation/infection in the male reproductive tract may impair fertility leading to improve of DNA fragmentation. In the last years, several evidences showed like sperm DNA damage may to related to infertility leading to the insight that the assessment of sperm DNA integrity could be considered a potential new semen quality biomarker.
    No preview · Article · Jan 2009 · Journal of Andrological Sciences
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    ABSTRACT: Cryptorchidism is the most frequent defect of the male urogenital tract at birth. It represents a risk factor for primitive testiculopathy associated with long-term complications (infertility, testicular neoplasia, and hormonal changes). An only consensus exists: "children with bilateral cryptorchidism who are not treated in early age are certainly set to become infertile". The majority of Authors agrees that the cryptorchid testicle will be in for structural and functional alterations and the rate of infertility is inversely proportional to the age at the time of orchidopexy. Cryptorchidism causes secretory primitive testicular pathology responsible for infertility. It is correlated to a non-specific severe histopathological pattern that can be useful to predict future infertility at the moment of orchidopexy. Also cryptorchidism represents the major risk factor associated with germ cell testicular neoplasia (5-10 times more probably than a normal testicle) due to genetic, hormonal, environmental factors.
    Full-text · Article · Nov 2008 · European review for medical and pharmacological sciences
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    ABSTRACT: Recently, the clinic characterization of the gonadic male function has been put in tight correlation on the pathogenetic level with the main variables forming the condition of metabolic syndrome (MS); probably the serum testosterone (T) concentration in males is to be considered as an additional parameter completely related to the traditional clinical-metabolic findings. Currently the matter of the substitutive hormonal therapy with androgens is apparently influenced by some important unresolved aspects: 1) who really benefits from the T therapy? 2) are the actual dosage methods of T reliable? 3) which vascular and metabolic targets are to be monitored during the T therapy? In an analytical longitudinal study, carried out 12 months long on 60 men (average age 58 years, range 54-63 years) affected by metabolic syndrome (MS) and combined hypogonadism late onset (LOH), authors have evaluated the clinical response (androgenic asset, non-invasive hospital monitoring of the arterial pressure, lipidic asset study, body composition and the biologic resistance to the insulinic action) after conventional medical therapy (insulin-sensibilizing and anti-hypertensive) and after substitutive hormonal therapy with testosterone (T) by transdermic way. A group of five patients with MS and LOH, not treated, was used as group of control. The group of patients treated with T showed a profile of clinical response better than the group of controls. In conclusion, the seric determination of T is useful to better characterize the dismetabolic patient at the moment of the first level active medical therapy planning on the controls of the main risk factors constituting MS, expressing a potential role of conditioning.
    No preview · Article · Oct 2008 · Minerva endocrinologica
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    ABSTRACT: A method has been developed for quantifying the residual cytoplasm present in the midpiece of human spermatozoa, based upon the imaging of NADH oxidoreductase activity. This procedure used NADH and nitroblue tetrazolium as electron donor and acceptor, respectively, and resulted in the discrete staining of the entire midpiece area, including the residual cytoplasm. Image analysis techniques were then used to generate binary images of the midpiece, from which objective measurements of this cellular domain could be undertaken. Such data were found to be highly correlated with biochemical markers of the cytoplasmic space, such as creatine kinase (CK) and glucose-6-phosphate dehydrogenase (G-6-PDH), in sperm populations depleted of detectable leukocyte contamination. Morphometric analysis of the sperm midpiece was also found to reflect semen quality in that it predicted the proportion of the ejaculate that would be recovered from the high-density region of Percoll gradients and was negatively correlated with the movement and morphology of the spermatozoa in semen. Variation in the retention of excess residual cytoplasm was also associated with differences in the functional competence of washed sperm preparations, both within and between ejaculates. Thus, within-ejaculate comparisons of high- and low-density sperm subpopulations revealed a relative disruption of sperm function in the low-density fraction. This disruption was associated with the presence of excess residual cytoplasm in the midpiece, high concentrations of cytoplasmic enzymes, and the enhanced-generation reactive oxygen species (ROS). Functional differences between individual high-density Percoll preparations were also negatively correlated with the area of the midpiece and the corresponding capacity of the spermatozoa to generate ROS. These findings suggest that one of the factors involved in the etiology of defective sperm function is the incomplete extrusion of germ cell cytoplasm during spermiogenesis as a consequence of which the spermatozoa experience a loss of function associated with the induction of oxidative stress.
    Full-text · Article · May 1996 · Journal of Andrology