Infertility Clinical Trial
Official title:
Impact of Male Smoking on the Couple's Infertility: Two-centre Case-control Study
About 15% of couples consult for difficulties achieving pregnancy. In about two-thirds of
cases, a male component is identified, but is not always sufficient to explain infertility.
In the majority of cases, the cause cannot be clearly identified and multiple abnormalities
may be detected in both partners.
Many factors concerning lifestyle and environment (medications, alcohol, smoking, pollution,
exposure to heat, toxins, xenobiotic oestrogens, etc.) may impact on fertility. These factors
may also impact on the fertility of the children conceived, which is described as an
intergenerational effect (alteration of the fertility of boys exposed to smoking in utero).
Few scientific studies with a high level of proof have been published on the impact of
smoking on the couple's fertility. Gonadal functioning and the quality of gametes can be
altered by these environmental factors, which may trigger a process of apoptosis or
alteration of the DNA of gametes (sperm DNA fragmentation). Other modifications include DNA
methylation and histone acetylation, which control gene expression and are grouped under the
term epigenetic modifications. More recently, oestrogens has been shown to be involved in
male reproductive function by acting on spermatogenesis, spermiogenesis and epididymal
maturation. Demonstration of an active aromatase (Arom) (mRNA, protein and activity) in
ejaculated human spermatozoa suggests the synthesis of small quantities of oestrogens in
spermatozoa. The study of transcript profiles could provide information about the quality of
spermatogenesis and/or spermiogenesis and during the first steps of embryonic development.
Confocal microscopy has colocalized the aromatase on the head, midpiece and tail and can be
used to assess the quality of the acrosome with anti-CD-46 monoclonal antibody. Even low
concentrations of xenobiotic oestrogens can exert biological effects on certain functions of
murine or human spermatozoa, accelerating capacitation and the acrosome reaction. These
factors are all the more effective when they act in combination, as human gametes appear to
be more sensitive to their action than murine gametes All studies conducted to date have
investigated the impact of toxins either on one of the partners or in the children born to
the couple. No detailed and high-level scientific study has studied both partners and the
quality of their embryos.
The Amiens University Hospital Cytogenetic, CECOS Reproduction Biology, and the assisted
reproductive technology departments in collaboration with Caen University Hospital (members
of G4) want to conduct this type of routine clinical practice follow-up study in the context
of an inter-regional research grant (PHRC). These 2 University Hospitals are situated in
agricultural regions with potential polluting industries. The recruitment of these centres
comprises younger couples presenting with infertility for which a cause cannot always be
demonstrated and in which the percentage of ART by ICSI is higher than the national average
(close to 75% vs 60%). This population also presents a higher cancer risk than in other
regions.
This research project concerns evaluation of the impact of male smoking on the couple's
fertility and will consist of a two-centre case-control study.
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