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Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Lashkari M.H.,Tehran University of Medical Sciences | Asgari S.A.,Guilan University | Farshi A.,Tabriz University of Medical Sciences | Babaei A.R.,Tehran University of Medical Sciences
Human Fertility | Year: 2013

Objective: To compare the outcomes of macroscopic one-layer vasovasostomy (MOLVV) with those of two-layer microsurgical vasovasostomy (TLMVV). Methods: Standard TLMVV was performed in 112 men (Group 1), while MOLVV was performed in 94 patients. All of the MOLVVs were performed with number 1 nylon suture as a temporary stent. The outcome measures were as follows: patency rate, pregnancy rate, operation time, total procedure cost, and complications. Results: The mean operation duration was 114 ± 10 min for the TLMVV technique, and 74 ± 5 min for the MOLVV procedure (P = 0.024). In patients who underwent vasal patency at 6-month postoperative period, the median sperm density (10 6/mL) was 28.3 and 27.7 in Groups 1 and 2, respectively (P = 0.62). At the same time, the median total motile sperm count (× 106) was 39.4 and 32.6 in two-layer microsurgical and one-layer macroscopic groups, respectively (P = 0.47). Patency rates were 82.1% in Group 1 and 77.7% in Group 2, which were not significantly different (P = 0.21). The pregnancy rate was 28.4% for patients in Group 1 and 26.7% for patients in Group 2 (P = 0.38). Conclusions: There were no significant differences in terms of patency and pregnancy rates between MOLVV and TLMVV methods, but the MOLVV technique offers a decreased cost and operative time, and a simplified procedure. © 2013 The British Fertility Society.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Shafiei N.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis
Reproductive Sciences | Year: 2013

We wanted to determine whether genetic polymorphisms of aryl hydrocarbon receptor (AhR) gene are associated with susceptibility to male infertility. This study comprised 176 men with idiopathic infertility and 352 healthy fertile men who served as controls. Seven single-nucleotide polymorphisms (SNPs) of the AhR gene (rs2066853, rs1476080, rs10250822, rs10247158, rs2282885, rs6960165, and rs7811989) were selected and genotyped by the polymerase chain reaction-restriction fragment length polymorphism analysis. The serum levels of reproductive and thyroid hormones and inhibin B were also measured. After multiple regression analysis, 2 of the 7 studied SNPs were significantly associated with the occurrence of male infertility. Men with rs2066853 AA genotype had 33% decreased risk of being infertile (odds ratio [OR] = 0.67, 95% confidence interval [CI]: 0.46-0.87; P =.003). The C allele of rs2282885 was significantly associated with infertility risk, with an OR of 2.14 (95% CI: 1.64-3.72) for heterozygotes and 3.54 (95% CI: 2.25-5.84) for homozygotes. When haplotypes were composed of 7 AhR SNP sites, patients with AACACAG haplotype harbored more than 75% decreased risk of being infertile (OR = 0.21, 95% CI: 0.11-0.32; P =.001). Conversely, carriers of the AACACGA haplotype had more than 12-fold increased risk of being infertile (OR = 12.62, 95% CI: 2.77-52.74; P =.00001). Homozygosity for the rs2066853 A allele and rs2282885 C allele decreases and increases the risk of developing male infertility, respectively. © The Author(s) 2013.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis | Shafiei N.,Clinical Center for Urological Disease Diagnosis
Fertility and Sterility | Year: 2013

Objective: To investigate the association between G-protein β3 (GNB3) subunit gene 825C/T polymorphism and vasculogenic ED (VED). Design: Case-control study. Setting: Private urology and andrology clinic. Patient(s): The study included 246 patients with VED and 492 healthy controls, Caucasians of Iranian descent. Intervention(s): Typing of the polymorphism was performed using the polymerase chain reaction restriction fragment length polymorphism technique. Main Outcome Measure(s): To test the hypothesis of whether the presence of the 825T allele of the GNB3 gene is associated with an increased risk of VED. Result(s): The CT genotype was more prevalent in VED patients relative to healthy controls (adjusted odds ratio [OR] = 2.34; 95% confidence interval [CI], 1.10-4.26). Interaction between T allele carriership and VED was significant. The dominant model CT + TT variant was associated with a 3.74-fold increase in the adjusted risk (OR = 3.74; 95% CI, 1.11-12.4) for the occurrence of VED. Our results indicate that the GNB3 polymorphism is associated with higher systolic blood pressure, higher dyslipidemia, and higher body mass index. The 825TT genotype was associated with a more than five-fold increased risk of severe VED compared with the 825CC genotype (OR = 5.62; 95% CI, 3.54-9.25). Significantly different onset of age of VED was not found between the genotypes for the GNB3 polymorphism. Conclusion(s): The GNB3 polymorphism is an independent risk factor for VED in Iranian males. Our findings confirm a role of GNB3 in the genetic susceptibility of VED and suggest that GNB3 polymorphism should be taken into consideration to improve the assessment of an individual's risk of VED. Copyright © 2013 American Society for Reproductive Medicine, Published by Elsevier Inc.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis | Shafiei N.,Clinical Center for Urological Disease Diagnosis
Journal of Urology | Year: 2012

Purpose: We investigated the effects of the administration of ubiquinol (a reduced form of coenzyme Q10) on semen parameters and seminal plasma antioxidant capacity in infertile men with idiopathic oligoasthenoteratozoospermia. Materials and Methods: A total of 228 men with unexplained infertility were randomly assigned 1:1 into 2 groups. Group 1 (114) received 200 mg ubiquinol daily by mouth for 26 weeks and group 2 (114) received a similar regimen of placebo. After completion of the 26-week treatment phase, all participants were followed for another 12-week off-drug period. Primary outcomes were improvement in sperm density, sperm motility and sperm strict morphology. Results: At the end of the 26-week treatment period mean ± SD sperm density in the ubiquinol and placebo groups was 28.7 ± 4.6 × 106/ml and 16.8 ± 4.4 × 106/ml (p = 0.005), sperm motility was 35.8% ± 2.7% and 25.4% ± 2.1% (p = 0.008), and sperm strict morphology was 17.6% ± 4.4% and 14.8% ± 4.1% (p = 0.01) of normal sperm, respectively. During the treatment period serum follicle-stimulating hormone levels decreased significantly (p = 0.02) and serum inhibin B concentrations increased significantly (p = 0.01). During the off-drug period semen parameters gradually returned to baseline values but the differences were still significant for sperm density (p = 0.03) and sperm motility (p = 0.03). The correlation coefficients analysis revealed a positive association between the duration of treatment with ubiquinol and sperm density (r = 0.74, p = 0.017), sperm motility (r = 0.66, p = 0.024) and sperm morphology (r = 0.57, p = 0.027). Conclusions: Ubiquinol was significantly effective in men with unexplained oligoasthenoteratozoospermia for improving sperm density, sperm motility and sperm morphology. © 2012 American Urological Association Education and Research, Inc.


Reza Safarinejad M.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis
Asian Journal of Andrology | Year: 2012

Omega-3 fatty acids found in some foods have a wide-range of health benefits. The omega-3 supplementation results in higher antioxidant activity in human seminal fluid and enhanced sperm count, sperm motility, and sperm morphology. Considerable number of infertile men with idiopathic oligoasthenoteratozoospermia might be benefit from omega-3 fatty acids administration. © 2012 AJA, SIMM & SJTU. All rights reserved.


Safarinejad M.R.,Clinical center for urological disease diagnosis | Safarinejad S.,Clinical center for urological disease diagnosis | Shafiei N.,Clinical center for urological disease diagnosis
Urologic Oncology: Seminars and Original Investigations | Year: 2013

Several studies have shown that nitric oxide (NO) and nitric oxide synthase (NOS) system plays an important role in carcinogenesis. Endothelial nitric oxide synthase (eNOS) gene polymorphisms significantly affects serum NO concentrations. Studies addressing the relationship between eNOS gene polymorphisms and prostate cancer (CaP) are very scarce. We examined the association between the 3 eNOS gene polymorphisms (T-786C, G894T, and 4a/b) with risk and clinical features of CaP. One hundred seventy patients with CaP (mean age 63.6 ± 12.4 years) and 340 age-matched healthy controls (mean age 64.9 ± 12.9 years) were recruited in this case-control study. Genotyping was performed by polymerase chain reaction restriction fragment length polymorphism (PCR-RLFP) technique. For T-786C polymorphism, we found that CC genotype was associated to CaP risk [odds ratio (OR) = 3.62, 95% confidence interval (CI): 1.89-7.74, P = 0.002), high grade tumor (OR = 2.46, 95% CI:1.78-4.72; P = 0.006), and advanced disease (OR = 4.67, 95% CI: 2.64-8.61; P = 0.002). Neither the CaP risk nor clinical features of CaP were associated with the G894T polymorphism. It was found that, compared with 4a/b bb genotype, the 4a/b "a" variant genotypes were associated with an increased risk of CaP in an allele dose dependent manner (OR = 2.12, 95% CI: 1.68-3.44; P = 0.031 for 4a/b ab genotype, and OR = 4.32, 95% CI: 2.21-6.08; P = 0.001 for 4a/b aa genotype). In addition, genotypes with the "a" allele of the eNOS 4a/b polymorphism predispose the patients to high grade (OR = 4.76, 95% CI: 2.74-8.62; P = 0.001) and advanced CaP (OR = 5.28, 95% CI: 3.64-8.72; P = 0.001). Furthermore, the T-Asp-b and C-Asp-b haplotypes were associated with a significantly decreased risk of CaP (OR = 0.44, 95% CI: 0.33-0.77; P = 0.004, and OR = 0.39, 95% CI: 0.26-0.61; P = 0.001, respectively). We found significant differences in genotype distribution and allelic frequencies between CaP patients and controls for the T-786C, and 4a/b eNOS polymorphisms. © 2013 Elsevier Inc.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis
International Urology and Nephrology | Year: 2012

Objective It has been shown that coenzyme Q 10 (CoQ 10) supplementation in men with idiopathic oligoasthenoteratozoospermia (OAT) results in improved semen parameters. In present study, we evaluated the effects of coenzyme CoQ 10 supplementation on semen parameters and pregnancy rates in infertile men with idiopathic OAT. Patients and methods Two hundred and eightyseven infertile men with idiopathic OAT were recruited in this study. These patients were treated with CoQ 10 300 mg orally twice daily for 12 months. Two semen analyses and determination of resting levels of sex hormones were done in all participants. Patients were followed up for another 12 months after CoQ 10 discontinuation. Results Mean sperm concentration, sperm progressive motility, and sperm with normal morphology improved significantly after 12-month CoQ 10 therapy by 113.7, 104.8, and 78.9%, respectively (all Ps< 0.05). The overall pregnancy rate was 34.1% within a mean of 8.4 ± 4.7 months. Conclusions CoQ 10 supplementation improves semen quality with beneficial effect on pregnancy rate. © Springer Science+Business Media, B.V. 2011.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis | Shafiei N.,Clinical Center for Urological Disease Diagnosis
Molecular Carcinogenesis | Year: 2012

We evaluated the effect of estrogen receptor (ER)-α and ER-β genes polymorphisms on development of prostate cancer (PCa) and its correlation with serum reproductive hormones and with clinicopathological characteristics in a sample of Iranian men. One hundred sixty-two men with PCa (mean age 63.7±13.4 years) and 324 age-matched healthy controls (mean age 63.1±13.2 years) were recruited in this study. Genotypes for ER-α and ER-β genes polymorphisms were identified by the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Serum levels of reproductive hormones were also measured. Of PCa patients, 38.3%, and 61.7% had localized and advanced tumor, and 45.7%, and 54.3%, had low grade and high-grade cancer, respectively. There was a significant difference in genotype frequency distribution of ER-α gene polymorphism (P=0.002), and ER-β gene polymorphism (P=0.003) between cancer patients and controls. The ER-α Pvull C allele carriers (TC or CC) had a significantly increased risk of PCa compared with the TT homozygotes [odds ratio (OR) 3.12; 95% confidence interval (CI) 1.87-5.84, and OR=4.73, 95% CI:2.44-7.33, respectively]. It was also found that the ER-α XbaI AG (OR=4.36; 95% CI:2.47-6.68; P=0.001) and ER-β AluI AG (OR=2.66, 95% CI:1.61-4.16; P=0.004) genotypes were significantly associated with increased risk of PCa. The ER-β RsaI genotype was not associated with PCa. Baseline serum free E2 levels tended to be lower in men with PCa (0.35±0.04pg/ml) compared to healthy men (0.48±0.05pg/ml). Genotypes which confer susceptibility for developing PCa, accompanied with lowest serum levels of free E2. In the Iranian population, genetic polymorphisms of the ER-α and ER-β genes may be involved in the etiology of PCa. © 2012 Wiley Periodicals, Inc.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Shafiei N.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis
Urological Research | Year: 2013

We examined whether single nucleotide polymorphisms (SNPs) in SPP1 gene are associated with risk of calcium oxalate urolithiasis (COU). We genotyped nine known SNPs in SPP1 gene (rs11739060, rs28357094, rs2728127, rs11730582, rs1126772, rs9138, rs2853744, rs4754=p.Asp80Asp, and rs1126616=p.Ala236Ala). Genomic DNA from 1,026 individuals (n = 342 patients with first episode COU, and n = 684 healthy unrelated controls) was analyzed for nine SPP1 SNPs using polymerase chain reaction and melting curve analysis by means of a pair of fluorescence resonance energy transfer probes. Serum and urine osteopontin (OPN) levels were also measured using enzyme-linked immunosorbent assay kits. rs9138 AA genotype was protective (OR 0.62, 95 % CI 0.47-0.81; P = 0.004). rs28357094 TT genotype (OR 2.52, 95 % CI 1.74-3.79; P = 0.021), rs2728127 GG genotype (OR 2.64, 95 % CI 1.42-4.81; P = 0.002), and rs2853744 GG genotype (OR 1.68, 95 % CI 1.22-3.87; P = 0.003) were predisposing. None of the other examined SPP1 SNPs was associated with COU susceptibility. Subjects with protective and predisposing polymorphisms had increased and decreased serum levels of OPN, respectively. Urinary calcium/ OPN ratios were higher and lower in subjects with predisposing and protective SNPs of SPP1 gene, respectively. Of 28 constructed haplotypes, 6 demonstrated significant association with COU risk. There was no sex difference in the obtained results. The SPP1 gene polymorphisms are associated with the COU susceptibility. © Springer-Verlag Berlin Heidelberg 2013.


Safarinejad M.R.,Clinical Center for Urological Disease Diagnosis | Shafiei N.,Clinical Center for Urological Disease Diagnosis | Safarinejad S.,Clinical Center for Urological Disease Diagnosis
Journal of Urology | Year: 2013

Purpose: We studied whether the IGFBP-3 gene polymorphism rs2854744 is associated with erectile dysfunction. Materials and Methods: We investigated the association of this polymorphism with erectile dysfunction in 176 cases and 352 controls. We genotyped rs2854744 using polymerase chain reaction-restriction fragment length polymorphism. Circulating concentrations of IGF-I and IGFBP-3 were also measured. Results: Allelic frequencies were 0.474 (A allele) and 0.526 (C allele) in men with erectile dysfunction, and 0.457 (A allele) and 0.543 (C allele) in normal controls (adjusted OR 1.74, 95% CI 0.82-2.43, p = 0.08). The frequency of the IGFBP-3 A-202C polymorphism genotype was 0.273 (CC), 0.506 (AC) and 0.221 (AA) in the case group, and 0.296 (CC), 0.494 (AC) and 0.210 (AA) in the control group (chi-square test p = 0.08). Neither the IGFBP-3 A-202C polymorphism nor serum IGF-I and IGFBP-3 levels were significantly associated with the risk of erectile dysfunction. Carriers of the AA genotype had the highest age adjusted serum IGFBP-3. This demonstrated a stepwise decrease in the presence of 1 or 2 copies of the C allele (mean ± SD 4,541 ± 796.2, 3,552 ± 642.4 and 3,314 ± 669.3 ng/ml, respectively). There was a positive correlation between serum IGFBP-3 and serum IGF-I concentrations (Spearman correlation coefficient r = 0.34, p for trend = 0.001). Conclusions: The IGFBP-3 gene A-202C polymorphism does not modulate the risk of erectile dysfunction. © 2013 American Urological Association Education and Research, Inc.

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