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Cakir C, Kuspinar G, Ganiyev A, Aslan K, Kasapoglu I, Kilicarslan H, Ata B, Uncu G, Avcı B. Reliability of hypo-osmotic swelling test on fresh and frozen-thawed ejaculated or testicular immotile sperm: A sibling oocyte study. Eur J Obstet Gynecol Reprod Biol 2024; 293:132-141. [PMID: 38159442 DOI: 10.1016/j.ejogrb.2023.12.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/05/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
The viability of sperm is a crucial factor for achieving a successful pregnancy in intracytoplasmic sperm injection (ICSI) cycles. The aim of this study was to evaluate the accuracy of the hypo-osmotic swelling test (HOST) in fresh and frozen-thawed sperm samples of different origins (ejaculated/testicular). A retrospective analysis was conducted on the outcomes of 2167 oocytes subjected to ICSI using motile and immotile-HOST-positive sperm from 2011 to 2023. We evaluated embryonic development, as well as clinical, obstetric, and neonatal outcomes in four groups based on different sperm origins (ejaculated/testicular) and processing (fresh/frozen). When comparing the results of ICSI between motile and immotile-HOST-positive sperm within each group, it was observed that there were no significant differences in the outcomes for fresh samples. However, for frozen-thawed samples, fertilization rates and blastocyst development rates were significantly lower when ICSI was performed with immotile-HOST-positive sperm compared to motile sperm. Of note, clinical, obstetric, and neonatal outcomes were statistically similar across all groups. Our findings indicate that HOST is more reliable in fresh samples than in those subjected to the freeze-thaw process. Nonetheless, HOST is considered a safe method for selecting viable sperm in all subgroups.
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Affiliation(s)
- Cihan Cakir
- Bursa Uludag University School of Medicine, ART Center, Department of Histology and Embryology, Bursa, Turkey.
| | - Goktan Kuspinar
- Bursa Uludag University School of Medicine, ART Center, Department of Histology and Embryology, Bursa, Turkey
| | - Alim Ganiyev
- Bursa Uludag University School of Medicine, ART Center, Department of Histology and Embryology, Bursa, Turkey
| | - Kiper Aslan
- Bursa Uludag University School of Medicine, ART Center, Department of Obstetrics and Gynecology, Bursa, Turkey
| | - Isil Kasapoglu
- Bursa Uludag University School of Medicine, ART Center, Department of Obstetrics and Gynecology, Bursa, Turkey
| | - Hakan Kilicarslan
- Bursa Uludag University School of Medicine, Department of Urology, Bursa, Turkey
| | - Baris Ata
- Koc University School of Medicine, ART Center, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Gurkan Uncu
- Bursa Uludag University School of Medicine, ART Center, Department of Obstetrics and Gynecology, Bursa, Turkey
| | - Berrin Avcı
- Bursa Uludag University School of Medicine, ART Center, Department of Histology and Embryology, Bursa, Turkey
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Tsukamoto J, Enatsu N, Nakahara E, Furuhashi K, Chiba K, Enatsu Y, Mizusawa Y, Okamoto E, Kokeguchi S, Shiotani M. Differences in clinical outcomes between men with mosaic Klinefelter syndrome and those with non-mosaic Klinefelter syndrome. Reprod Med Biol 2024; 23:e12579. [PMID: 38756694 PMCID: PMC11097125 DOI: 10.1002/rmb2.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose This study compared the clinical outcomes of men with Klinfelter syndrome based on karyotype. Methods The authors analyzed the outcomes of microdissection testicular sperm extraction (micro-TESE) performed on 57 patients with Klinfelter syndrome (KS) at our clinic. Results The average ages of the non-mosaic and mosaic KS groups were 32.2 ± 4.8 and 45.9 ± 13.1 years, respectively. The sperm retrieval rates of the non-mosaic and mosaic KS groups were 46.5% (20/43) and 50.0% (7/14), respectively. The fertilization rates after intracytoplasmic sperm injection did not significantly differ between the non-mosaic and mosaic KS groups. The mosaic KS group had higher cleavage and blastocyst development rates than the non-mosaic KS group (72.2% vs. 96.2% and 30.5% vs. 44.7%, respectively). The group using motile sperm had better outcomes than the group using immotile sperm. The embryo transfer outcomes of the non-mosaic and mosaic KS groups did not significantly differ (clinical pregnancy rate: 28.0% vs. 20.7%, miscarriage rate: 14.3% vs. 33.3%, production rate per transfer: 22.0% vs. 13.8%, and production rate per case: 58.8% vs. 57.1%). Conclusions Compared with the non-mosaic KS group, the mosaic KS group had significantly better intracytoplasmic sperm injection outcomes because of the higher utilization rate of motile sperm.
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Affiliation(s)
| | | | | | | | - Koji Chiba
- Hanabusa Women's ClinicKobeHyogoJapan
- Division of UrologyKobe University Graduate School of MedicineKobeHyogoJapan
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3
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Cryopreservation of Human Spermatozoa: Functional, Molecular and Clinical Aspects. Int J Mol Sci 2023; 24:ijms24054656. [PMID: 36902084 PMCID: PMC10002855 DOI: 10.3390/ijms24054656] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/04/2023] Open
Abstract
Cryopreservation is an expanding strategy to allow not only fertility preservation for individuals who need such procedures because of gonadotoxic treatments, active duty in dangerous occupations or social reasons and gamete donation for couples where conception is denied, but also for animal breeding and preservation of endangered animal species. Despite the improvement in semen cryopreservation techniques and the worldwide expansion of semen banks, damage to spermatozoa and the consequent impairment of its functions still remain unsolved problems, conditioning the choice of the technique in assisted reproduction procedures. Although many studies have attempted to find solutions to limit sperm damage following cryopreservation and identify possible markers of damage susceptibility, active research in this field is still required in order to optimize the process. Here, we review the available evidence regarding structural, molecular and functional damage occurring in cryopreserved human spermatozoa and the possible strategies to prevent it and optimize the procedures. Finally, we review the results on assisted reproduction technique (ARTs) outcomes following the use of cryopreserved spermatozoa.
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4
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Fatira E, Havelka M, Saito T, Landeira J, Rodina M, Gela D, Pšenička M. Intracytoplasmic sperm injection in sturgeon species: A promising reproductive technology of selected genitors. Front Vet Sci 2022; 9:1054345. [PMID: 36619956 PMCID: PMC9816131 DOI: 10.3389/fvets.2022.1054345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Sturgeons are the most endangered species group and their wild populations continue to decrease. In this study, we apply intracytoplasmic sperm injection (ICSI), an assisted reproductive technology, for the first time in endangered and critically endangered sturgeons. Using various egg-sperm species combinations we performed different ICSI experiments with immobilized pre- or non-activated spermatozoa, single or many, fresh or cryopreserved. Then we evaluated the fertilization success as well as the paternity of the resultant embryos and larvae. Surprisingly, all experimental groups exhibited embryonic development. Normal-shaped feeding larvae produced in all egg-sperm species-combination groups after ICSI using single fresh-stripped non-activated spermatozoa, in one group after ICSI using single fresh-stripped pre-activated spermatozoa, and in one group after ICSI using multiple fresh-stripped spermatozoa. ICSI with single cryopreserved non-activated spermatozoa produced neurula stage embryos. Molecular analysis showed genome integration of both egg- and sperm-donor species in most of the ICSI transplants. Overall, ICSI technology could be used as an assisted reproduction technique for producing sturgeons to rescue valuable paternal genomes.
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Affiliation(s)
- Effrosyni Fatira
- Research Institute of Fish Culture and Hydrobiology, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, University of South Bohemia Ceske Budejovice, Ceské Budějovice, Czechia,Instituto de Oceanografía y Cambio Global, IOCAG, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain,*Correspondence: Effrosyni Fatira ✉
| | - Miloš Havelka
- Nishiura Station, South Ehime Fisheries Research Center, Ehime University, Matsuyama, Japan
| | - Taiju Saito
- Research Institute of Fish Culture and Hydrobiology, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, University of South Bohemia Ceske Budejovice, Ceské Budějovice, Czechia,Nishiura Station, South Ehime Fisheries Research Center, Ehime University, Matsuyama, Japan
| | - José Landeira
- Instituto de Oceanografía y Cambio Global, IOCAG, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Marek Rodina
- Research Institute of Fish Culture and Hydrobiology, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, University of South Bohemia Ceske Budejovice, Ceské Budějovice, Czechia
| | - David Gela
- Research Institute of Fish Culture and Hydrobiology, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, University of South Bohemia Ceske Budejovice, Ceské Budějovice, Czechia
| | - Martin Pšenička
- Research Institute of Fish Culture and Hydrobiology, South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses, University of South Bohemia Ceske Budejovice, Ceské Budějovice, Czechia
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5
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Can sperm quality influence embryo development and its ploidy? Analysis of 811 blastocysts obtained from different sperm sources. ZYGOTE 2022; 30:648-655. [PMID: 35677962 DOI: 10.1017/s0967199422000119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The aim of our study was to evaluate the correlation between sperm quality and ploidy status of the derived blastocysts. We performed a retrospective analysis on a restricted pool of patients enrolling only those who had no female factors. Male patients with genetic factors affecting spermatogenesis were also excluded. We chose a maternal age ≤38 years to decrease the female factor, therefore the male factor was the main component of sterility. We divided the patients in four groups based on semen quality and comparing fertilization, pregnancy and euploidy rates above all. In total, 201 intracytoplasmic sperm injection (ICSI) cycles were enrolled in the study. Cycles were divided into four groups, according to semen source: normal semen, oligoasthenoteratozoospermia (OAT), cryptospermia or non-obstructive azoospermia (NOA). An extremely statistically lower fertilization rate was found in NOA patients. Unexpectedly, no differences were detected in blastocyst formation, euploidy, aneuploidy and mosaicism rates among the four groups. Interestingly, we also found a higher abortion rate comparing NOA to normal semen with an odds ratio of 4.67. In our study no statistically significant differences among the analyzed groups were found, showing little or no effect at all using spermatozoa from different semen sources or quality. This may be linked to the oocyte competence of fixing sperm DNA damage and it could be hypothesized that only sperm with a good rate of DNA integrity are able to fertilize the oocyte, explaining why poor quality semen is reflected in a low fertilization rate without effect on ploidy.
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Wang C, Wang F, Zheng M, Wu R, Yang T, Chen X, Shu J. Effect of Sperm 26S Proteasome on Embryo Formation and Development in In Vitro Fertilization. Reprod Sci 2022; 29:1844-1850. [PMID: 35384636 DOI: 10.1007/s43032-022-00916-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/12/2022] [Indexed: 11/28/2022]
Abstract
The aim of this study was to evaluate the effects of sperm proteasome activity on fertilization outcome and embryo development after IVF. Following density gradient centrifugation for IVF purpose, the spermatozoa of 84 infertile patients with tubal factor were evaluated by luciferase enzymatic activity to assess the proteasome quantity. The mean age of patients was 33.8 years, and the mean concentration of human spermatozoa 26S proteasome was 674.53 ng/ml. After IVF, the embryos were scored for morphology. The spermatozoa proteasome activity was both positively correlated with fertilization rate in vitro (P = 0.0003) and 2PN rate (P = 0.0007). Compared to low fertilization rate group, the high fertilization rate group showed a significantly higher level of spermatozoa proteasome activity (P = 0.002). In conclusion, sperm proteasome activity provides additional data on sperm functional capacity in terms of fertilization during IVF.
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Affiliation(s)
- Chenglu Wang
- Reproductive Medicine Center, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310058, China
| | - Fangyu Wang
- Division of Surgical Gynecology, Hefei Cancer Hospital, Chinese Academy of Sciences, Hefei, 230031, China
| | - Min Zheng
- Reproductive Medicine Center, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310058, China
| | - Ruifang Wu
- Reproductive Medicine Center, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310058, China
| | - Tianyun Yang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Xiaopan Chen
- Reproductive Medicine Center, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310058, China. .,Department of Genetic and Genomic Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310058, China.
| | - Jing Shu
- Reproductive Medicine Center, Department of Reproductive Endocrinology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, 310058, China. .,The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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7
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Chen T, Fan D, Wang X, Mao C, Chu Y, Zhang H, Liu W, Ding S, Liu Q, Yuan M, Lu J. ICSI outcomes for infertile men with severe or complete asthenozoospermia. Basic Clin Androl 2022; 32:6. [PMID: 35382740 PMCID: PMC8981622 DOI: 10.1186/s12610-022-00155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 02/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe or complete asthenozoospermia is a rare entity that can lead to male infertility. In this study, we explored whether different extents of severe or complete asthenozoospermia could affect intracytoplasmic sperm injection (ICSI) outcomes and compared the ICSI outcomes using testicular spermatozoa with those using ejaculated spermatozoa in couples with complete asthenozoospermia. RESULTS Ninety-seven couples with severe or complete asthenozoospermia who underwent ICSI between January 2014 and December 2018 were included. According to the sperm category used in ICSI, patients were categorized into four groups: ejaculated progressive motile sperm group (Ep-group), ejaculated non-progressive motile sperm group (En-group), ejaculated immotile sperm group (Ei-group), and testicular sperm group (TESE-group). We compared the baseline characteristics, hormone profile, semen parameters, normal fertilization, good-quality embryos on day 3, transferred embryos, and ICSI outcomes in the four groups. The clinical pregnancy rate was significantly increased in the Ep-group (65.4%, P = 0.019) and TESE-group (63.6%, P = 0.035) compared with that in the Ei-group (23.1%). The ongoing pregnancy rate in the Ei-group was significantly lower than that in the Ep-group (23.1% vs. 61.5%, P = 0.041). Moreover, the biochemical pregnancy rate, ongoing pregnancy rate, and live birth rate were much lower in the Ei-group than in the TESE-group (30.8% vs. 63.6%, 23.1% vs. 40.4% and 23.1% vs. 40.4%, respectively). CONCLUSIONS In couples with complete asthenozoospermia, testicular spermatozoa should be preferred to ejaculated spermatozoa for obtaining a better ICSI outcome. With the appropriate selection of testicular spermatozoa, the extent of severe or complete asthenozoospermia may not affect the ICSI outcomes. Future studies with a larger sample size are warranted to validate these findings.
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Affiliation(s)
- Tong Chen
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China. .,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250000, Jinan, Shandong, P.R. China. .,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, 210000, Nanjing, P.R. China. .,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, 210029, Nanjing, P.R. China.
| | - Demin Fan
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China.,Department of Urology, Cheeloo College of Medicine, Shandong Qianfoshan Hospital, Shandong University, 250000, Jinan, Shandong, P.R. China
| | - Xianlong Wang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250000, Jinan, Shandong, P.R. China
| | - Changlin Mao
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China.,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, 210000, Nanjing, P.R. China
| | - Yaru Chu
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China.,Department of Urology, The First Affiliated Hospital of Nanjing Medical University, 210000, Nanjing, P.R. China
| | - Haobo Zhang
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250000, Jinan, Shandong, P.R. China
| | - Wen Liu
- Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250000, Jinan, Shandong, P.R. China
| | - Sentai Ding
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China
| | - Qingyong Liu
- Department of Urology, Cheeloo College of Medicine, Shandong Qianfoshan Hospital, Shandong University, 250000, Jinan, Shandong, P.R. China
| | - Mingzhen Yuan
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China.,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250000, Jinan, Shandong, P.R. China
| | - Jiaju Lu
- Department of Urology, Cheeloo College of Medicine, Shandong Provincial Hospital, Shandong University, 324 Jingwu Road, 250021, Jinan, Shandong, P. R. China. .,Center for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, 250000, Jinan, Shandong, P.R. China.
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8
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Yanagimachi R. Mysteries and unsolved problems of mammalian fertilization and related topics. Biol Reprod 2022; 106:644-675. [PMID: 35292804 PMCID: PMC9040664 DOI: 10.1093/biolre/ioac037] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 11/13/2022] Open
Abstract
Mammalian fertilization is a fascinating process that leads to the formation of a new individual. Eggs and sperm are complex cells that must meet at the appropriate time and position within the female reproductive tract for successful fertilization. I have been studying various aspects of mammalian fertilization over 60 years. In this review, I discuss many different aspects of mammalian fertilization, some of my laboratory's contribution to the field, and discuss enigmas and mysteries that remain to be solved.
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Affiliation(s)
- Ryuzo Yanagimachi
- Institute for Biogenesis Research, University of Hawaii Medical School, Honolulu, Hawaii, USA
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9
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Boursier A, Dumont A, Boitrelle F, Prasivoravong J, Lefebvre-Khalil V, Robin G, Barbotin AL. Necrozoospermia: The tree that hides the forest. Andrology 2022; 10:642-659. [PMID: 35246969 DOI: 10.1111/andr.13172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 02/21/2022] [Accepted: 02/28/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Necrozoospermia is a condition found in 0.2 to 0.4 % of male infertility cases. The causes of necrozoospermia are multiple: they can be related to testicular and/or post-testicular damage. Additionally, these causes most often involve the production of reactive oxygen species (ROS) and/or sperm DNA fragmentation (SDF) which can reduce the chances of spontaneous pregnancy or affect the outcome of assisted reproductive technologies. OBJECTIVE To focus on potential etiologies of necrozoospermia, its diagnosis and its therapeutic management especially before the employment of ICSI. METHODS Authors searched PubMed/Medline, Web of Science, Cochrane Library, Google and Institutional websites for medical subheading terms and free text words referred to "necrozoospermia", "sperm vitality", "sperm viability", "sperm DNA fragmentation" and "ICSI". RESULTS We identified twelve main etiologies of necrozoospermia responsible for either a decrease of sperm vitality, a mild a moderate or a severe necrozoospermia. In case of a confirmed decreased vitality, a thorough check-up should be conducted and if available, etiological treatment should be proposed. Therapeutic management could also include repeated ejaculations, drug treatments, the use of ICSI with ejaculated or surgically extracted spermatozoa in case of a non-treatable necrozoospermia. DISCUSSION AND CONCLUSION The potential causes of necrozoospermia should be investigated because many of them could be corrected, thus avoiding the use of ICSI. Moreover, if ICSI procedure remains necessary, the therapeutic management of necrozoospermia could also improve the chances of success by reducing oxidative stress and/or sperm DNA fragmentation. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Angele Boursier
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, F-59000, France
| | - A Dumont
- Service de Gynécologie Endocrinienne et Médecine de La Reproduction, Assistance Médicale à La Procréation et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, CHU Lille, Lille, F-59000, France
| | - F Boitrelle
- Service de Biologie de la Reproduction et de Cytogénétique, Centre Hospitalier Poissy-Saint-Germain-en-Laye, Poissy, 78303, France
| | | | - V Lefebvre-Khalil
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, F-59000, France
| | - Geoffroy Robin
- Service de Gynécologie Endocrinienne et Médecine de La Reproduction, Assistance Médicale à La Procréation et Préservation de La Fertilité, Hôpital Jeanne de Flandre, Avenue Eugène Avinée, CHU Lille, Lille, F-59000, France.,Service d'Andrologie, Hôpital Huriez, CHU Lille, Lille, F-59000, France.,EA 4308 Gamètogenèse Et Qualité du Gamète, Université de Lille Et CHU de Lille, Lille, F-59000, France
| | - Anne-Laure Barbotin
- Institut de Biologie de La Reproduction-Spermiologie-CECOS, Hôpital Jeanne de Flandre, CHU Lille, Lille, F-59000, France.,EA 4308 Gamètogenèse Et Qualité du Gamète, Université de Lille Et CHU de Lille, Lille, F-59000, France
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10
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Del Giudice F, Belladelli F, Chen T, Glover F, Mulloy EA, Kasman AM, Sciarra A, Salciccia S, Canale V, Maggi M, Ferro M, Busetto GM, De Berardinis E, Salonia A, Eisenberg ML. The association of impaired semen quality and pregnancy rates in assisted reproduction technology cycles: Systematic review and meta-analysis. Andrologia 2022; 54:e14409. [PMID: 35244232 PMCID: PMC9540664 DOI: 10.1111/and.14409] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/03/2022] [Accepted: 02/18/2022] [Indexed: 12/29/2022] Open
Abstract
Some studies suggest a relationship between semen quality and pregnancy rates of assisted reproduction technologies (ART). Others have questioned the utility of semen quality as proxy for fertility in couples attempting to conceive with or without assistance. We aimed to investigate the current body of evidence which correlates semen parameters and clinical pregnancy among couples utilizing ART (i.e. in vitro fertilization [IVF], intracytoplasmic sperm injection [ICSI]) through a systematic review and meta‐analysis of cross‐sectional and retrospective cohort studies. Pooled Odd Ratio (OR) for oligo‐, astheno‐ and teratospermic compared to normospermic number of ART cycles were calculated among. Meta‐regression and sub‐group analysis were implemented to model the contribution of clinical/demographic and laboratory standards differences among the studies. Overall, 17 studies were analysed representing 17,348 cycles were analysed. Pooled OR for impaired sperm concentration, motility and morphology was 1 (95%Confidence Interval [CI]: 0.97–1.03), 0.88 (95%CI: 0.73–1.03) and 0.88 (95%CI: 0.75–1) respectively. Further analysis on sperm morphology showed no differences with regard of IVF versus ICSI (p = 0.14) nor a significant correlation with rising reference thresholds (Coeff: −0.02, p = 0.38). A temporal trend towards a null association between semen parameters and clinical pregnancy was observed over the 20‐year observation period (Coeff: 0.01, p = 0.014). The current analysis found no association between semen quality (as measured by concentration, motility or morphology) and clinical pregnancy rates utilizing ART. Future investigations are necessary to explore the association between semen parameters and other ART outcomes (e.g. fertilization, implantation, birth and perinatal health).
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Affiliation(s)
- Francesco Del Giudice
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.,Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Federico Belladelli
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA.,University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Tony Chen
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Frank Glover
- Emory School of Medicine - Emory University, Atlanta, Georgia, USA
| | - Evan A Mulloy
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Alex M Kasman
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
| | - Alessandro Sciarra
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Stefano Salciccia
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Vittorio Canale
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | | | - Ettore De Berardinis
- Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy
| | - Andrea Salonia
- University Vita-Salute San Raffaele, Milan, Italy.,Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS San Raffaele Hospital, Milan, Italy
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California, USA
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11
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Vogiatzi P, Pouliakis A, Sakellariou M, Athanasiou A, Athanasiou A, Colaghis A, Finelli R, Loutradis D, Henkel R, Agarwal A. Male Age and Progressive Sperm Motility Are Critical Factors Affecting Embryological and Clinical Outcomes in Oocyte Donor ICSI Cycles. Reprod Sci 2021; 29:883-895. [PMID: 34782988 DOI: 10.1007/s43032-021-00801-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
This retrospective cohort study aimed to explore whether paternal age and semen quality parameters affect the embryological and clinical outcomes of ICSI with oocyte donation. A total of 339 oocyte donation (OD)-ICSI cycles were categorized into four groups according to the semen parameter profiles of the male counterparts: normozoospermia (NS, n = 184), oligozoospermia (OS, n = 41), asthenozoospermia (AS, n = 50), and oligoasthenozoospermia (OAS, n = 64). The effect of age, total sperm count, and progressive motility was separately analyzed for reproductive outcomes and compared between the study groups: fertilization, blastulation, and top-quality embryo rate, biochemical and clinical pregnancy, live birth, and miscarriage. A negative correlation between male age and fertilization rate was observed (rs = - 0.23, p < 0.0001), while male age was a significant factor for biochemical pregnancy (p = 0.0002), clinical pregnancy (p = 0.0017), and live birth (p = 0.0038). Reduced total sperm count and lowered progressive motility led to poorer fertilization rates (rs = 0.19 and 0.35, respectively, p < 0.0001) and affected embryo quality (rs = 0.13, p = 0.02, and rs = 0.22, p < 0.0001, respectively). OD-ICSI cycles with asthenozoospermia had significantly lowered success rates in biochemical pregnancy, clinical pregnancy, and live birth (p < 0.05). Our study demonstrated that both advanced male age and reduced progressive motility of spermatozoa exert a significant negative influence on the outcome of assisted reproduction, even in controlled procedures with gamete selection and optimization such as in OD-ICSI. Improvement in treatment strategies and male fertility evaluation requires incorporation of such evidence to obtain better prognosis towards personalized management.
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Affiliation(s)
- Paraskevi Vogiatzi
- IVF Athens Reproduction Center, 5 Kifissias Avenue, 151 23, Maroussi, Greece. .,Andromed Health & Reproduction, Fertility Diagnostics Laboratory, 3 Mesogion Str, 15126, Maroussi, Greece.
| | - Abraham Pouliakis
- Second Department of Pathology, "Attikon" University Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12462, Athens, Greece
| | - Maria Sakellariou
- IVF Athens Reproduction Center, 5 Kifissias Avenue, 151 23, Maroussi, Greece
| | | | | | - Alexandros Colaghis
- IVF Athens Reproduction Center, 5 Kifissias Avenue, 151 23, Maroussi, Greece
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH, 44195, USA
| | - Dimitrios Loutradis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vassilissis Sophias Avenue, 115 28, Athens, Greece
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH, 44195, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, SW7 2BX, UK.,Department of Medical Bioscience, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH, 44195, USA
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12
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Setti AS, Braga DPDAF, Guilherme P, Provenza R, Iaconelli A, Borges E. Morphokinetic parameter comparison between embryos from couples with high or low sperm DNA fragmentation index. F&S SCIENCE 2021; 2:345-354. [PMID: 35559859 DOI: 10.1016/j.xfss.2021.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/20/2021] [Accepted: 10/06/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To study whether time-lapse imaging can identify morphokinetic events impacted by a high sperm DNA fragmentation index (DFI). DESIGN Historical cohort study. SETTING Private university-affiliated in vitro fertilization center. PATIENT(S) A total of 978 zygotes cultured until day 5 in a time-lapse imaging incubator between March 2019 and August 2020, derived from 118 patients undergoing intracytoplasmic sperm injection as a result of idiopathic male factor infertility. INTERVENTION(S) Kinetic markers from the point of insemination were recorded. Generalized linear mixed models adjusted for potential confounders followed by the Bonferroni post hoc test were used to compare the timing of specific events in patients with a low (<30%) or high (≥30%) sperm DFI. The recorded kinetic markers were the following: timing to pronuclei appearance and fading; timing to 2, 3, 4, 5, 6, 7, and 8 cells; and timing to start blastulation and blastulation. MAIN OUTCOME MEASURE(S) Timing to blastulation. RESULT(S) Embryos derived from sperm samples with ≥30% DFI showed significantly slower divisions compared with those with <30% DFI (mean differences of 0.7 hours in timing to pronuclei appearance, 1.2 hours in timing to pronuclei fading, 1.5 hours in timing to 2 cells, 2.5 hours in timing to 3 cells, 1.8 hours in timing to 4 cells, 3.3 hours in timing to 5 cells, 3.1 hours in timing to 6 cells, 3.2 hours in timing to 7 cells, 2.7 hours in timing to 8 cells, 8.4 hours in timing to start blastulation, and 3.8 hours in timing to blastulation). The incidences of reverse or direct cleavages (9.3% vs. 4.4%; odds ratio [OR], 2.24; 95% confidence interval [CI], 1.32-3.77) and multinucleation at 2-cell (18.9% vs. 12.0%; OR, 1.70; 95% CI, 1.12-2.58) and 4-cell (14.2% vs. 6.4%; OR, 2.42; 95% CI, 1.57-3.74) stages were significantly higher in embryos deriving from ≥30% DFI than from <30% DFI. The KIDScore ranked significantly different between embryos derived from samples with <30% and ≥30% DFI. Continuous DFI was positively correlated with all timings of specific events and with the incidences of abnormal cleavage patterns (OR, 1.042; 95% CI, 1.025-1.059) and multinucleation at 2-cell stage (OR, 1.053; 95% CI, 1.030-1.076) and inversely correlated with the KIDScore rank (B, -0.218; 95% CI, -0.044 to -0.007). No significant differences were observed in clinical outcomes between the groups. CONCLUSION(S) Embryo morphokinetic parameters are negatively impacted by high sperm DFI, resulting in delayed cell cleavage and blastulation.
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Affiliation(s)
- Amanda Souza Setti
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, São Paulo, Brazil; Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, São Paulo, Brazil.
| | - Daniela Paes de Almeida Ferreira Braga
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, São Paulo, Brazil; Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, São Paulo, Brazil
| | | | - Rodrigo Provenza
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, São Paulo, Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, São Paulo, Brazil; Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, São Paulo, Brazil
| | - Edson Borges
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, São Paulo, Brazil; Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, São Paulo, Brazil
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13
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Testicular sperm characteristics in men with nonobstructive azoospermia and their impact on intracytoplasmic sperm injection outcome. Fertil Steril 2021; 117:522-527. [PMID: 34674828 DOI: 10.1016/j.fertnstert.2021.09.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/13/2021] [Accepted: 09/16/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To report fertilization and clinical pregnancy rates based on sperm characteristics at the time of intracytoplasmic sperm injection (ICSI) in men with nonobstructive azoospermia (NOA) following microdissection testicular sperm extraction (mTESE). DESIGN Retrospective cohort. SETTING Tertiary hospital. PATIENT(S) Men with NOA undergoing mTESE between 2013 and 2016 who had successful sperm retrieval and subsequent spermatozoa available for ICSI. INTERVENTION(S) Sperm characteristic assessment. MAIN OUTCOME MEASURE(S) Fertilization and clinical pregnancy rates. RESULT(S) One hundred ninety-eight men with NOA and successful mTESE were included. The mean ages of the patients and their partners were 35 ± 8 and 31 ± 5 years, respectively. The overall fertilization rate was 44%, and the clinical pregnancy rate was 38%. The absence of twitching sperm motility and the presence of an acrosome defect were associated with decreased fertilization and clinical pregnancy rates on univariable analysis. On multivariable analysis, the presence of motility was associated with higher fertilization rates and greater odds of clinical pregnancy (odds ratio, 4.37; 95% confidence interval, 1.61-11.85). An abnormal acrosome was associated with reduced odds of pregnancy (odds ratio, 0.40; 95% confidence interval, 0.18-0.85). No specific anomaly or combination of sperm abnormalities precluded fertilization or clinical pregnancy with ICSI. CONCLUSION(S) To our knowledge, this is the first comprehensive study evaluating the importance of sperm characteristics and their impact on ICSI outcomes in men with NOA. The results suggest that no specific defect, including the use of nonmotile testicular spermatozoa, precluded a chance of clinical pregnancy. The study evaluated sperm characteristics at the time of ICSI injection; initial evaluation at the time of retrieval may differ significantly from that of spermatozoa selected for ICSI.
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Adiga PK, Vitthala S, Shivaranjeni. Correlation of sperm DNA damage with blastocyst formation: systematic review and meta-analysis. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2021. [DOI: 10.1186/s43043-021-00067-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The routine semen analysis fails to detect sperm DNA damage which contributes to the majority of male factor infertility. Sperm DNA fragmentation test (DFI) measures the sperm DNA damage. Blastocyst formation is an important step in IVF ± ICSI. At present, the literature lacks any data that correlates DFI and blastocyst formation.
Main body of the abstract
We searched MEDLINE and other databases till 2020 for the studies that reported on sperm DNA damage and blastocyst formation in assisted reproductive technology (ART). The outcomes analyzed were (1) a comparison of blastulation rates in high DFI and low DFI groups. (2) Comparison of blastulation rates in high DFI and low DFI groups based on (a) different sperm DNA fragmentation assays (COMET, SCD, SCSA, TUNEL), (b) different types of ART (IVF/IVF + ICSI/ICSI). 10 studies were included in this review. A non-significant increase in the blastocyst formation was observed in high DFI group (OR = 0.70; 95% CI = 0.4 to 1.21; P = 0.20) and with SCD and TUNEL assays.
Short conclusion
Our study emphasizes on sperm DNA fragmentation (sperm DNA damage) as an important marker of blastocyst formation. The results of this meta-analysis suggest that the high sperm DNA fragmentation may not adversely affect the blastocyst formation.
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Molecular Profiling of Spermatozoa Reveals Correlations between Morphology and Gene Expression: A Novel Biomarker Panel for Male Infertility. BIOMED RESEARCH INTERNATIONAL 2021; 2021:1434546. [PMID: 34604380 PMCID: PMC8485144 DOI: 10.1155/2021/1434546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/18/2022]
Abstract
Choosing spermatozoa with an optimum fertilizing potential is one of the major challenges in assisted reproductive technologies (ART). This selection is mainly based on semen parameters, but the addition of molecular approaches could allow a more functional evaluation. To this aim, we used sixteen fresh sperm samples from patients undergoing ART for male infertility and classified them in the high- and poor-quality groups, on the basis of their morphology at high magnification. Then, using a DNA sequencing method, we analyzed the spermatozoa methylome to identify genes that were differentially methylated. By Gene Ontology and protein-protein interaction network analyses, we defined candidate genes mainly implicated in cell motility, calcium reabsorption, and signaling pathways as well as transmembrane transport. RT-qPCR of high- and poor-quality sperm samples allowed showing that the expression of some genes, such as AURKA, HDAC4, CFAP46, SPATA18, CACNA1C, CACNA1H, CARHSP1, CCDC60, DNAH2, and CDC88B, have different expression levels according to sperm morphology. In conclusion, the present study shows a strong correlation between morphology and gene expression in the spermatozoa and provides a biomarker panel for sperm analysis during ART and a new tool to explore male infertility.
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16
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A cryoprotectant supplemented with pentoxifylline can improve the effect of freezing on the motility of human testicular sperm. ZYGOTE 2021; 30:92-97. [PMID: 34158133 DOI: 10.1017/s0967199421000368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examined the effect of a cryoprotectant with and without pentoxifylline supplementation on the motility and viability of human testicular sperm, both before and after freezing. Testicular samples were obtained from 68 patients with azoospermia who came to the Andrology Service of West China Second University Hospital, Sichuan University, for testicular biopsies from December 2019 to April 2020. All patients were assigned randomly to two groups: experimental, whose testicular sperm were added to the cryoprotectant with pentoxifylline, and the control, whose testicular sperm were added to the cryoprotectant without pentoxifylline. Both groups used the same freezing and thawing methods. Testicular sperm motility in the experimental group was significantly higher than that of the control group, both before and after cryopreservation. The recovery rate of sperm motility in the experimental group was significantly higher than that of the control group. The percentage of samples with motile testicular sperm in the experimental group was significantly higher than that of the control group after thawing. Sperm viability was unchanged between the experimental and control groups, both before and after freezing. Overall, a pentoxifylline-supplemented cryoprotectant can significantly improve the motility of testicular sperm before and after cryopreservation.
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17
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Chua AC, Abdul Karim AK, Tan ACC, Abu MA, Ahmad MF. The outcome of intra-cytoplasmic sperm injection (ICSI): do the sperm concentration and motility matter? Horm Mol Biol Clin Investig 2021; 42:367-372. [PMID: 34118795 DOI: 10.1515/hmbci-2020-0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 05/08/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The male-factor subfertility was reported to be 30% globally; thus, the intracytoplasmic sperm injection (ICSI) procedure was implemented to improve the overall in vitro fertilization (IVF) rates. Nevertheless, at least 10% of fertilization failure still occurs. Concerning this issue, we explored the association of sperm concentration and motility with the quality of embryo development and pregnancy outcome in IVF-ICSI cycles. METHODS Retrospective analysis of 109 couples with male factor were done over 14 months in a tertiary university hospital in Malaysia. The data were divided into four groups; Group I: normal sperm parameters, Group II: normal sperm concentration but reduced total sperm motility, Group III: reduced sperm concentration and motility, Group IV: reduced sperm concentration but normal sperm motility. Only fresh semen samples and fresh embryo transfers were included. The fertilization, cleavage rate, embryo quality and pregnancy outcome were assessed. RESULTS Overall, group I had the highest oocytes yield and ICSI attempted; (10.12 + 6.50), whereas the lowest was in group IV; (7.00 + 2.82). Group II revealed the highest fertilization and cleavage rates; (54.14 + 25.36), (55.16 + 26.06), thus not surprisingly resulting in the highest number of good embryos and highest clinical pregnancy rates. The lowest cleavage and pregnancy rates were seen in group IV. However, all the outcomes were not statically significant (p>0.05). CONCLUSIONS Similar fertilization rate and comparable pregnancy outcome was seen among couples with normal and reduced sperm concentration and motility.
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Affiliation(s)
- Ai Chen Chua
- Department of Obstetrics and Gynecology, Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia
| | - Abdul Kadir Abdul Karim
- Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia.,Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Albert Chao Chiet Tan
- Department of Obstetrics and Gynecology, Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia
| | - Muhammad Azrai Abu
- Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia.,Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Mohd Faizal Ahmad
- Advanced Reproductive Centre (ARC), Hospital Canselor Tuanku Muhriz (HCTM), Kuala Lumpur, Malaysia.,Department of Obstetrics & Gynecology, Faculty of Medicine, National University of Malaysia (UKM), Kuala Lumpur, Malaysia
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18
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Liu C, Su K, Chen L, Zhao Z, Wang X, Yuan C, Liang Y, Ji H, Li C, Zhou X. Prediction of oocyte quality using mRNA transcripts screened by RNA sequencing of human granulosa cells. Reprod Biomed Online 2021; 43:413-420. [PMID: 34400084 DOI: 10.1016/j.rbmo.2021.05.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/06/2021] [Accepted: 05/20/2021] [Indexed: 01/17/2023]
Abstract
RESEARCH QUESTION Can RNA transcripts of granulosa cells be used to assess oocyte quality? The possibility of predicting the developmental competence of oocytes by RNA sequencing analysis of granulosa cells was evaluated. DESIGN Granulosa cell samples were collected from 29 women undergoing assisted reproductive technology treatment and divided into two groups: 14 samples from the high blastocyst rate group and 15 from the low blastocyst rate group. Ten samples from each group were selected for RNA sequencing. RESULTS A total of 129 differentially expressed genes associated with high developmental competence of oocytes were identified. COL1A2, renin and COL1A1 were selected and further examined by quantitative real-time polymerase chain reaction (qRT-PCR). Expression levels of COL1A2 and renin by qRT-PCR were consistent with the results of RNA sequencing. CONCLUSION RNA sequencing data could provide novel marker genes for the non-invasive evaluation of oocyte quality and embryo developmental competence.
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Affiliation(s)
- Chengjun Liu
- College of Animal Sciences, Jilin University, Changchun 130062, China; Beijing Dairy Cattle Center, Beijing 100192, China; Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing 100095, China
| | - Ketong Su
- Reproductive Medical Center, Zhanjiang Jiuhe Hospital, Zhanjiang 524094, China
| | - Lu Chen
- College of Animal Sciences, Jilin University, Changchun 130062, China
| | - Zijiao Zhao
- College of Animal Sciences, Jilin University, Changchun 130062, China
| | - Xin Wang
- College of Animal Sciences, Jilin University, Changchun 130062, China
| | - Chenfeng Yuan
- College of Animal Sciences, Jilin University, Changchun 130062, China
| | - Yuqi Liang
- Reproductive Medical Center, Zhanjiang Jiuhe Hospital, Zhanjiang 524094, China
| | - Huili Ji
- Reproductive Medical Center, Zhanjiang Jiuhe Hospital, Zhanjiang 524094, China
| | - Chunjin Li
- College of Animal Sciences, Jilin University, Changchun 130062, China.
| | - Xu Zhou
- College of Animal Sciences, Jilin University, Changchun 130062, China.
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Abstract
Intracytoplasmic sperm injection (ICSI) is an important technique in male infertility treatment. Currently, sperm selection for ICSI in human assisted reproductive technology (ART) is subjective, based on a visual assessment by the operator. Therefore, it is desirable to develop methods that can objectively provide an accurate assessment of the shape and size of sperm heads that use low-magnification microscopy available in most standard fertility clinics. Recent studies have shown a correlation between sperm head size and shape and chromosomal abnormalities, and fertilization rate, and various attempts have been made to establish automated computer-based measurement of the sperm head itself. For example, a dictionary-learning technique and a deep-learning-based method have both been developed. Recently, an automatic algorithm was reported that detects sperm head malformations in real time for selection of the best sperm for ICSI. These data suggest that a real-time sperm selection system for use in ICSI is necessary. Moreover, these systems should incorporate inverted microscopes (×400-600 magnification) but not the fluorescence microscopy techniques often used for a dictionary-learning technique and a deep-learning-based method. These advances are expected to improve future success rates of ARTs. In this review, we summarize recent reports on the assessment of sperm head shape, size, and acrosome status in relation to fertility, and propose further improvements that can be made to the ARTs used in infertility treatments.
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20
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Oraiopoulou C, Vorniotaki A, Taki E, Papatheodorou A, Christoforidis N, Chatziparasidou A. The impact of fresh and frozen testicular tissue quality on embryological and clinical outcomes. Andrologia 2021; 53:e14040. [PMID: 33682176 DOI: 10.1111/and.14040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 02/11/2021] [Accepted: 02/21/2021] [Indexed: 12/01/2022] Open
Abstract
Our ability to predict the potential of testicular spermatozoa to support embryonic development is still limited. Although motility of testicular spermatozoa is associated with embryo development, the impact of morphology and the presence of spermatozoa in the testicular sample has not been previously researched. Moreover, while the majority of data indicate no effect of cryopreservation, there are studies reporting impaired clinical outcomes due to testicular cryopreservation. In a retrospective study, 118 ICSI-TESE cycles were analysed to study the impact of (a) total quality of testicular tissue, (b) testicular tissue cryopreservation and (c) presence/motility/morphology of testicular spermatozoa in fertilisation rate, embryonic development, clinical pregnancy (CPR), ongoing pregnancy (OPR) and live birth rate (LBR). Results showed that fertilisation rate was significantly affected by both total quality of testicular tissue (p < .05) and rare presence of spermatozoa (p < .01). Moreover, total tissue quality (p < .01), cryopreservation of low-quality samples (p < .01), absence of motile testicular spermatozoa (p < .01) and poor spermatozoa morphology (p < .05) had a negative impact on the number of good quality day 3 embryos. CPR, OPR or LBR was not affected by any parameters examined. Our data suggest that the quality of testicular tissue influences both fertilisation rate and embryo development. Moreover, cryopreservation of low-quality testicular samples has a negative impact on the number of available embryos for transfer.
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Affiliation(s)
| | | | - Eleni Taki
- Embryolab Fertility Clinic, Thessaloniki, Greece
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21
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Ranganath A, Appaneravanda L, Gerstl B, Math N, Menon J, Gunasheela D. A study to find optimal intra-cytoplasmic sperm injection timing of oocytes matured from germinal vesicle in in Vitro maturation cycles using a time lapse system. J Hum Reprod Sci 2021; 14:415-421. [PMID: 35197688 PMCID: PMC8812402 DOI: 10.4103/jhrs.jhrs_130_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/24/2021] [Accepted: 12/02/2021] [Indexed: 11/04/2022] Open
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23
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Carretero MI, Chaves MG, Arraztoa CC, Fumuso FG, Gambarotta MC, Neild DM. Air-Drying Llama Sperm Affects DNA Integrity. Front Vet Sci 2020; 7:597952. [PMID: 33363235 PMCID: PMC7758352 DOI: 10.3389/fvets.2020.597952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/19/2020] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to evaluate the effects of air-drying preservation on llama sperm DNA. Semen collections were carried out using electroejaculation under general anesthesia. A total of 16 ejaculates were processed from 4 males (n = 4, r = 4). Each sample was diluted 4:1 in a collagenase solution in TALP media, then incubated and centrifuged at 800 g for 8 min. The pellet was re-suspended to a concentration of 20 million sperm/ml in TALP. Then the samples were placed onto sterile slides forming lines and were left to dry under laminar flow for 15 min. After this, the slides were placed into Falcon centrifuge tubes and kept at 5°C. Sperm characteristics (motility, membrane function, viability and morphology) were evaluated in raw semen and in the air-dried samples kept at 5°C for 30 min. DNA evaluation (integrity and degree of chromatin condensation) was carried out in raw semen and in the air-dried samples after 30 min, 7, 14, 21, 30, and 60 days after preservation. To compare raw semen to the air-dried samples, a Wilcoxon test was used for all sperm characteristics except for DNA, where a paired Student t-test was applied. A split plot design was used to compare chromatin condensation between the different periods of preservation and a Kruskal Wallis test was used to compare DNA integrity. Motility, membrane function, viability and sperm with intact DNA decreased in the air-dried samples (p < 0.05), while morphology and chromatin condensation were not affected (p > 0.05). No significant differences were observed in the percentage of sperm with condensed chromatin between the different periods of preservation (p > 0.05). On the other hand, a significant decrease in the percentage of sperm with intact DNA was observed as from day 7 of preservation (p < 0.05). In conclusion the air-drying process has a negative effect on llama sperm DNA, hence the media used will need to be improved to protect DNA and be able to implement this technique in this species.
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Affiliation(s)
- María Ignacia Carretero
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Investigación y Tecnología en Reproducción Animal, Universidad de Buenos Aires, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - María Graciela Chaves
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Investigación y Tecnología en Reproducción Animal, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Claudia Cecilia Arraztoa
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Investigación y Tecnología en Reproducción Animal, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Fernanda Gabriela Fumuso
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Investigación y Tecnología en Reproducción Animal, Universidad de Buenos Aires, Buenos Aires, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | | | - Deborah Margarita Neild
- Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina.,Instituto de Investigación y Tecnología en Reproducción Animal, Universidad de Buenos Aires, Buenos Aires, Argentina
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Kharazi U, Badalzadeh R. A review on the stem cell therapy and an introduction to exosomes as a new tool in reproductive medicine. Reprod Biol 2020; 20:447-459. [DOI: 10.1016/j.repbio.2020.07.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 05/18/2020] [Accepted: 07/03/2020] [Indexed: 12/12/2022]
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25
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Alharbi M, Almarzouq A, Zini A. Sperm retrieval and intracytoplasmic sperm injection outcomes with testicular sperm aspiration in men with severe oligozoospermia and cryptozoospermia. Can Urol Assoc J 2020; 15:E272-E275. [PMID: 33119503 DOI: 10.5489/cuaj.6798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Several studies addressed the role of testicular sperm aspiration with intracytoplasmic sperm injection (ICSI) in azoospermic men, but few have included non-azoospermic men. The aim of this study was to evaluate testicular sperm aspiration (TESA) sperm retrieval rates and ICSI outcomes in men with severe oligozoospermia. METHODS Data were collected retrospectively from 88 consecutive, non-azoospermic, infertile men with idiopathic severe oligozoospermia who underwent TESA between January 2011 and January 2018. Patients were categorized into four groups according to sperm concentration: <5 and >1 million/ml (group 1), <1 and > 0.1 million/ml (group 2), <0.1 million/ml (group 3), and cryptozoospermia (group 4). RESULTS Mean male age was 37±7 years and the mean female age was 33±4 years. Sperm was recovered successfully in 90% (79/88) of the men overall and in 100% (30/30) of the men in group 1, 97% (29/30) of the men in group 2, 88% (15/17) of the men in group 3, and 45% (5/11) of the men in group 4. Most (65%, 57/88) of the couples had an embryo transfer (ET). The overall clinical pregnancy rate per ET was 46% (26/57). The clinical pregnancy rates (per ET) were 43% (9/21) in group 1, 65% (13/20) in group 2, 36% (4/11) in group 3, and 0% (0/5) in group 4. CONCLUSIONS Our data indicate TESA allows for high sperm retrieval rates and acceptable ICSI pregnancy rates in men with severe oligozoospermia. However, in our experience, TESA sperm retrieval rates and ICSI outcomes are poor in cryptozoospermic men.
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Affiliation(s)
- Mohannad Alharbi
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,Department of Surgery, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ahmad Almarzouq
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,OVO Fertility Clinic, Montreal, QC, Canada
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Kasman AM, Li S, Zhao Q, Behr B, Eisenberg ML. Relationship between male age, semen parameters and assisted reproductive technology outcomes. Andrology 2020; 9:245-252. [PMID: 32964702 DOI: 10.1111/andr.12908] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/11/2020] [Accepted: 09/14/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Low semen quality often obligates the use of assisted reproductive technology; however, the association between semen quality and assisted reproductive technology outcomes is uncertain. OBJECTIVES To further assess the impact of semen quality on assisted reproductive technology outcomes. MATERIALS AND METHODS A retrospective cohort study was carried out at a single academic reproductive medicine center (January 2012-December 2018). Patients undergoing at least one assisted reproductive technology cycle utilizing freshly ejaculated spermatozoa from the male partner were included. We assessed the association between semen quality (as stratified based on WHO 5th edition criteria), paternal age (< or ≥40), and reproductive/perinatal outcomes. To evaluate the differences in assisted reproductive technology outcomes by semen parameters and age, generalized estimating equations were applied for rates of fertilization, pregnancy, implantation, miscarriage, live birth, blast formation, gestational age, and normal embryo biopsy. RESULTS A total of 2063 couples were identified who underwent 4517 assisted reproductive technology cycles. Average ages of the male and female partners were 39.8 and 37.7, respectively. Lower pregnancy rates were observed in cycles with lower sperm motility (ie <40%; 39.9% vs 44.1%) and total motile count (ie <9 million; 38.3% vs 43.5%). When examining only cycles utilizing Intracytoplasmic Sperm Injection, only a lower motility count was associated with a decline in pregnancy rate (39.1% vs 44.9%). No association was identified between semen quality and gestational age or birth weight. Paternal age was not associated with ART outcomes. However, among assisted reproductive technology cycles in women <40, aneuploidy rate was higher for older men (P < .001). In cycles with women >40, no association between aneuploidy and male age was identified. DISCUSSION Sperm motility is associated with pregnancy rates, while other semen parameters are not. In cycles in women <40, paternal age is associated with embryo aneuploidy rate. CONCLUSION Paternal factors are associated with assisted reproductive technology outcomes, and future studies should explore mechanisms by which semen quality is associated with assisted reproductive technology outcomes.
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Affiliation(s)
- Alex M Kasman
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Shufeng Li
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Qianying Zhao
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Barry Behr
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael L Eisenberg
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
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Goswami G, Gouri MD. Relevance of Split In vitro Fertilization-Intracytoplasmic Sperm Injection Method of Insemination in Normozoospermic and Mildly Oligospermic Men: A Retrospective Study. J Hum Reprod Sci 2020; 13:145-149. [PMID: 32792764 PMCID: PMC7394098 DOI: 10.4103/jhrs.jhrs_19_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/01/2019] [Accepted: 02/28/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Use of intracytoplasmic sperm injection (ICSI) is generally considered redundant in cases of normozoospermia, or mild male factor cases of infertility and conventional method of insemination is advocated. However, there is a risk of low fertilization or total fertilization failure (TFF) and to avoid this, split in vitro fertilization (IVF)-ICSI method of insemination is advised. In our study, we have shown that not only TFF is avoided with split method of insemination, but also cancellation of embryo transfer (ET) can be avoided in a significant number of IVF cycles. Aims: This study aimed to assess whether the IVF-ICSI split insemination method was able to reduce the risk of ET cancellation in couples with normal or mild sperm characteristics. Settings and Design: It is a retrospective study including a total of 107 split insemination cycles done at our center. Materials and Methods: The female partner's age was under 37 years, and at least ten oocytes were retrieved in all cycles. Sibling oocytes were randomly allocated to IVF or ICSI. Statistical analysis was carried out using Graphpad Prism, Instat. Results and Conclusion: The fertilization rate in oocytes kept in conventional IVF was significantly higher (79.8%) compared to that of oocytes injected through ICSI (69.1%). Only one couple had TFF. In majority of the cycles, i.e., 97 out of 107 cycles, the mode of insemination did not affect the fertilization rate or embryo quality. Nearly 28% of the cycles were saved from ET cancellation by adopting the split insemination method. “Split IVF-ICSI” approach can save a significant number of ART cycles and is found to be cost-effective as it avoids incurring the cost of two ART cycles.
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Affiliation(s)
- Geeta Goswami
- IVF Department, Gouri Hospital, Ridge IVF Pvt. Ltd., Delhi, India
| | - M Devi Gouri
- IVF Department, Gouri Hospital, Ridge IVF Pvt. Ltd., Delhi, India
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28
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Baskaran S, Finelli R, Agarwal A, Henkel R. Diagnostic value of routine semen analysis in clinical andrology. Andrologia 2020; 53:e13614. [PMID: 32400107 DOI: 10.1111/and.13614] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/01/2020] [Indexed: 01/11/2023] Open
Abstract
Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.
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Affiliation(s)
- Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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Abstract
Sperm DNA damage reduces pregnancy rates in couples undergoing in vitro fertilization (IVF). Because it has been shown that testicular sperm have lower DNA damage than ejaculated sperm, it is an attractive idea to consider using testicular sperm for IVF for men with high sperm DNA damage. In fact, there are multiple centers throughout the world now offering sperm retrieval for IVF to manage this condition. However, there is insufficient evidence to conclude that testicular sperm improves pregnancy/live birth rates. Further studies are required before offering sperm retrieval as a standard of care to manage high sperm DNA damage.
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30
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Harada Y, Kinutani M, Horiuchi T. Time-lapse monitoring of mouse embryos produced by injecting sonicated, frozen-thawed sperm heads with high or low chromosomal integrity. Reprod Med Biol 2020; 19:171-177. [PMID: 32273823 PMCID: PMC7138947 DOI: 10.1002/rmb2.12319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 01/28/2020] [Accepted: 02/02/2020] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate the first-division kinetics and in vitro development of embryos produced by injecting sonicated sperm heads with high or low chromosomal integrity into oocytes. METHODS Mouse spermatozoa were frozen after separating the sperm heads from the tails by sonication in an EGTA solution (EGTA group) or M2 medium (M2 group). The chromosomal integrity of sonicated mouse spermatozoa was analyzed by injecting the sperm heads into fresh mouse oocytes. The developmental potential of spermatozoa was examined by injecting the sperm heads into vitrified-warming mouse oocytes. We used a time-lapse monitoring system to compare the first-division kinetics. RESULTS Chromosomal integrity was preserved significantly more frequently in the EGTA group (90.6%) than in the M2 group (32.7%). Blastocysts developed significantly more often in the EGTA group (80.8%) than in the M2 group (39.6%). In the M2 group, with frequent chromosome aberrations, the time between the sperm injection and first cleavage was delayed (18.4 hours), compared to the EGTA group (16.5 hours). All results of the EGTA group were similar to that of fresh epididymal spermatozoa. CONCLUSION The EGTA solution for sonication maintained the integrity of sperm chromosomes. Our results revealed a relationship between sperm chromosome integrity and first-division kinetics.
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Affiliation(s)
- Yoshihisa Harada
- Graduate School of Comprehensive Scientific ResearchPrefectural University of HiroshimaHiroshimaJapan
- Kinutani Women’s ClinicHiroshimaJapan
| | | | - Toshitaka Horiuchi
- Graduate School of Comprehensive Scientific ResearchPrefectural University of HiroshimaHiroshimaJapan
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31
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Setti AS, Braga DPAF, Iaconelli Junior A, Borges Junior E. Increasing paternal age and ejaculatory abstinence length negatively influence the intracytoplasmic sperm injection outcomes from egg‐sharing donation cycles. Andrology 2019; 8:594-601. [DOI: 10.1111/andr.12737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Amanda S. Setti
- Fertility Medical Group São Paulo/SP Brazil
- Sapientiae Institute São Paulo/SP Brazil
| | | | | | - Edson Borges Junior
- Fertility Medical Group São Paulo/SP Brazil
- Sapientiae Institute São Paulo/SP Brazil
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32
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Sandi-Monroy NL, Musanovic S, Zhu D, Szabó Z, Vogl A, Reeka N, Eibner K, Bundschu K, Gagsteiger F. Use of dimethylxanthine theophylline (SpermMobil ®) does not affect clinical, obstetric or perinatal outcomes. Arch Gynecol Obstet 2019; 300:1435-1443. [PMID: 31599349 DOI: 10.1007/s00404-019-05312-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/16/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate whether the use of a commercially available dimethylxanthine theophylline compound (SpermMobil®) for artificial sperm activation would negatively affect clinical, obstetric and perinatal outcomes. METHODS Artificial sperm activation (ASA) was used when sperm motility after preparation was low or absent in our clinical standard procedure practice. ICSI cycles using either testicular or ejaculated sperm with concentration smaller than 5 million/ml from August 2012 to January 2018 were retrospectively analyzed (n = 815) and divided into two groups, a control group where no ASA was needed and the SpermMobil® group with ASA. RESULTS The fertilization rate was significantly higher in the control group, but pregnancy and implantation rates did not differ significantly. Number of embryos transferred, good quality embryos for ET and number of frozen blastocysts were similar in both groups. Clinical pregnancy loss was significantly reduced in the SpermMobil® group, which was reflected in slightly better live birth rates than in the control group. Furthermore, there were no significant differences regarding gestational age, weight, height and z score for singletons or multiples in the SpermMobil® (n = 27 and n = 10) or control (n = 144 and n = 67) groups. There were no reports of malformation, perinatal mortality or intensive therapy in the SpermMobil® group, whereas in the control group, 12 babies needed intensive care, besides one intrauterine death. CONCLUSION The use of SpermMobil® in samples with mostly immotile sperm not only facilitates the embryologists work but also optimizes the treatment outcomes for those patients with a bad prognosis. This is the first report of obstetric and perinatal outcomes after applying a theophylline derivative in human clinical use.
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Affiliation(s)
- Nathallie Louise Sandi-Monroy
- IVF Laboratory, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany. .,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany.
| | - Spomenka Musanovic
- IVF Laboratory, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
| | - Dan Zhu
- IVF Laboratory, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
| | - Zsuzsanna Szabó
- IVF Laboratory, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
| | - Alexander Vogl
- IVF Laboratory, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
| | - Natalie Reeka
- Medical Department, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
| | - Kerstin Eibner
- Medical Department, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
| | - Karin Bundschu
- Medical Department, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,Universitätsklinikum Ulm, Frauenheilkunde und Geburtshilfe, Prittwitzstrasse 43, 89075, Ulm, Germany
| | - Friedrich Gagsteiger
- Medical Department, Kinderwunsch MVZ Ulm GmbH, Einsteinstrasse 59, 89077, Ulm, Germany.,NextClinics International GmbH, NextClinics, Josef-Mörtl-Straße 23, 86482, Aystetten, Germany
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Avidor-Reiss T, Mazur M, Fishman EL, Sindhwani P. The Role of Sperm Centrioles in Human Reproduction - The Known and the Unknown. Front Cell Dev Biol 2019; 7:188. [PMID: 31632960 PMCID: PMC6781795 DOI: 10.3389/fcell.2019.00188] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 08/23/2019] [Indexed: 01/02/2023] Open
Abstract
Each human spermatozoon contains two remodeled centrioles that it contributes to the zygote. There, the centrioles reconstitute a centrosome that assembles the sperm aster and participate in pronuclei migration and cleavage. Thus, centriole abnormalities may be a cause of male factor infertility and failure to carry pregnancy to term. However, the precise mechanisms by which sperm centrioles contribute to embryonic development in humans are still unclear, making the search for a link between centriole abnormalities and impaired male fecundity particularly difficult. Most previous investigations into the role of mammalian centrioles during fertilization have been completed in murine models; however, because mouse sperm and zygotes appear to lack centrioles, these studies provide information that is limited in its applicability to humans. Here, we review studies that examine the role of the sperm centrioles in the early embryo, with particular emphasis on humans. Available literature includes case studies and case-control studies, with a few retrospective studies and no prospective studies reported. This literature has provided some insight into the morphological characteristics of sperm centrioles in the zygote and has allowed identification of some centriole abnormalities in rare cases. Many of these studies suggest centriole involvement in early embryogenesis based on phenotypes of the embryo with only indirect evidence for centriole abnormality. Overall, these studies suggest that centriole abnormalities are present in some cases of sperm with asthenoteratozoospermia and unexplained infertility. Yet, most previously published studies have been restricted by the laborious techniques (like electron microscopy) and the limited availability of centriolar markers, resulting in small-scale studies and the lack of solid causational evidence. With recent progress in sperm centriole biology, such as the identification of the unique composition of sperm centrioles and the discovery of the atypical centriole, it is now possible to begin to fill the gaps in sperm centriole epidemiology and to identify the etiology of sperm centriole dysfunction in humans.
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Affiliation(s)
- Tomer Avidor-Reiss
- Department of Biological Sciences, College of Natural Sciences and Mathematics, The University of Toledo, Toledo, OH, United States.,Department of Urology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, United States
| | - Matthew Mazur
- Department of Biological Sciences, College of Natural Sciences and Mathematics, The University of Toledo, Toledo, OH, United States.,Department of Urology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, United States
| | - Emily L Fishman
- Department of Biological Sciences, College of Natural Sciences and Mathematics, The University of Toledo, Toledo, OH, United States
| | - Puneet Sindhwani
- Department of Biological Sciences, College of Natural Sciences and Mathematics, The University of Toledo, Toledo, OH, United States.,Department of Urology, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH, United States
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Borges E, Zanetti BF, Setti AS, Braga DPDAF, Provenza RR, Iaconelli A. Sperm DNA fragmentation is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in reproductive cycles of non-male factor infertility. Fertil Steril 2019; 112:483-490. [PMID: 31200969 DOI: 10.1016/j.fertnstert.2019.04.029] [Citation(s) in RCA: 78] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/22/2019] [Accepted: 04/22/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To study the implications of sperm DNA fragmentation (SDF) in intracytoplasmic sperm injection cycles for non-male factor infertility. DESIGN Prospective cohort study. SETTING Private university-affiliated IVF center. PATIENT(S) Data from 475 cycles performed from June 2016 to June 2017. INTERVENTION(S) Cycles were divided according to SDF rate into two groups: <30% SDF (n = 433) and ≥30% SDF (n = 42). Laboratory and clinical outcomes were compared between groups by generalized linear models adjusted for potential confounders. MAIN OUTCOME MEASURE(S) Embryo quality and miscarriage rates. RESULT(S) Fertilization rate was similar between groups (≥30% SDF, 85.28% ± 1.06% vs. <30% SDF, 90.68% ± 3.61%). Significantly lower rates of normal cleavage speed (≥30% SDF, 61.12% ± 4.21% vs. <30% SDF, 72.53% ± 1.24%), high-quality embryos at day 3 (≥30% SDF, 23.07% ± 5.56% vs. <30% SDF, 36.41% ± 1.53%), blastocyst formation (≥30% SDF, 39.09% ± 2.73% vs. <30% SDF, 58.83% ± 7.59%), blastocyst quality (≥30% SDF, 11.97% ± 1.22% vs. <30% SDF, 30.09% ± 2.39%), and implantation (33.24% ± 1.66% vs. <30% SDF, 46.40% ± 4.61%) were observed in cycles with higher SDF, despite similar pregnancy rates (≥30% SDF, 30.40% vs. <30% SDF, 32.40%). A 2.5-fold miscarriage rate was observed in cycles with an SDF above the established cutoff (≥30% SDF, 42.8% vs. <30% SDF, 16.8%). CONCLUSION(S) Higher SDF is correlated with poor embryo development, lower implantation rate, and higher miscarriage rate in non-male factor infertility intracytoplasmic sperm injection cycles. Since defects in sperm may be hidden, the SDF test can bring additional information to the sperm quality evaluation of men with unknown infertility history.
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Affiliation(s)
- Edson Borges
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil.
| | - Bianca Ferrarini Zanetti
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
| | | | | | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, Brazil
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35
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Oehninger S, Ombelet W. Limits of current male fertility testing. Fertil Steril 2019; 111:835-841. [DOI: 10.1016/j.fertnstert.2019.03.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/23/2022]
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36
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Mehta A, Esteves SC, Schlegel PN, Niederberger CI, Sigman M, Zini A, Brannigan RE. Use of testicular sperm in nonazoospermic males. Fertil Steril 2019; 109:981-987. [PMID: 29935657 DOI: 10.1016/j.fertnstert.2018.04.029] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 04/18/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Akanksha Mehta
- Department of Urology, Emory University School of Medicine, Atlanta, Georgia
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil; Division of Urology, Department of Surgery, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil; Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Peter N Schlegel
- Department of Urology, James Buchanan Brady Foundation and Cornell Reproductive Medicine Institute, Weill Cornell Medicine, New York, New York
| | | | - Mark Sigman
- Department of Surgery (Urology), Alpert Medical School of Brown University, Providence, Rhode Island
| | - Armand Zini
- Department of Surgery (Urology), McGill University, Montreal, Quebec, Canada
| | - Robert E Brannigan
- Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
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37
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Menéndez-Blanco I, Catala MG, Roura M, Soto-Heras S, Piras AR, Izquierdo D, Paramio MT. Intracytoplasmic sperm injection (ICSI) of prepubertal goat oocytes using fresh and frozen-thawed semen. Small Rumin Res 2019. [DOI: 10.1016/j.smallrumres.2018.11.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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38
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Alasmari W, Edris F, Albar Z, Eskandar M, Sultan C, Alboush A, Alasmari A. Comparable Reproductive Outcomes of ICSI for Couples with Unexplained Infertility and Couples with Male Factor Infertility. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2018.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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39
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Jayasena CN, Luo R, Dimakopoulou A, Dearing C, Clarke H, Patel N, Stroud T, Seyani L, Ramsay J, Dhillo WS. Prevalence of abnormal semen analysis and levels of adherence with fertility preservation in men undergoing therapy for newly diagnosed cancer: A retrospective study in 2906 patients. Clin Endocrinol (Oxf) 2018; 89:798-804. [PMID: 30204263 DOI: 10.1111/cen.13851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/07/2018] [Accepted: 09/07/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sperm cryopreservation (freezing) should be offered to all men with cancer due to risk of infertility. However, many men with cancer already have impaired spermatogenesis prior to sperm cryopreservation. Furthermore, physical ill-health may hinder attendance of freeze visits. Investigating both the distribution of sperm functions and freeze attendance rates in men with newly diagnosed cancer, may identify patients benefiting from targeted reproductive fertility support. METHODS We performed a retrospective study of 2906 male patients undergoing sperm cryopreservation prior to cancer therapy at a single UK tertiary centre between 1989 and 2013; all patients were asked to attend three hospital semen collection visits prior to cancer therapy. RESULTS Fifteen per cent (433/2906) of men with newly diagnosed cancer had severely impaired semen quality (i.e., sperm total motile count, TMC < 1 million) during the first semen collection visit. However, patients with severely impaired semen quality had the poorest attendance of subsequent semen collection visits despite being requested to do so (non-attendance in TMC < 1 million: 43.4%; TMC < 1-30 million: 35.7%, P < 0.05 vs. <1 million; TMC > 30 million: 33.2%, P < 0.01 vs. <1 million). CONCLUSIONS This study expands understanding of the semen quality of men with newly diagnosed cancer, and their ability to adhere to fertility preservation recommendations. Our data suggest that patients with the poorest semen quality paradoxically suffer the poorest attendance rates of sperm cryopreservation appointments prior to commencing cancer therapy. We suggest that additional support may be of clinical benefit to men with newly diagnosed cancer and TMC < 1 million sperm.
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Affiliation(s)
- Channa N Jayasena
- Department of Andrology, Hammersmith Hospital, London, UK
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Rong Luo
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Anastasia Dimakopoulou
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Chey Dearing
- School of Health Science and Nursing, Eastern Institute of Technology, Taradale, New Zealand
| | - Holly Clarke
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Nandita Patel
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Thomas Stroud
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
| | - Lataban Seyani
- Department of Clinical Biochemistry, Charing Cross Hospital, London, UK
| | | | - Waljit S Dhillo
- Department of Investigative Medicine, Imperial College London, Hammersmith Hospital, London, UK
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40
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Inal HA, Kahyaoglu I, Turkkani A, Tuzluoglu D, Yilmaz N. Retrospective comparison of intracytoplasmic sperm injection outcomes of sperm retrieved from a testicular biopsy and freshly ejaculated semen in oligozoospermia. Rev Int Androl 2018; 16:131-136. [PMID: 30286866 DOI: 10.1016/j.androl.2017.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 03/17/2017] [Accepted: 06/04/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The aim of this study was to compare fertilisation, pregnancy rates and perinatal outcomes in patients undergoing intracytoplasmic sperm injection (ICSI) due to oligozoospermia. METHODS A total of 166 patients with oligozoospermia who underwent an ICSI procedure were included in the study. The subjects were divided into two groups according to the sperm retrieval technique used: group 1, ejaculated semen (n=111); group 2, surgical sperm retrieval (n=55). RESULTS Although the clinical pregnancy rate was lower in group 2, the difference was not statistically significant (36.4% vs. 42.3%, p=0.460). The difference between fertilisation and take-home baby rates of the groups were not significantly different, either (p=0.486, p=0.419, consecutively). CONCLUSION Two different sperm retrieval techniques used for ICSI had no statistically significant difference on intracytoplasmic sperm injection outcomes in oligozoospermic patients.
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Affiliation(s)
| | - Inci Kahyaoglu
- Etlik Zubeyde Hanim Women's Health Education and Research Hospital, Ankara, Turkey
| | - Ayten Turkkani
- Etlik Zubeyde Hanim Women's Health Education and Research Hospital, Ankara, Turkey
| | - Deniz Tuzluoglu
- Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey
| | - Nafiye Yilmaz
- Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey
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41
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Impact of male partner characteristics and semen parameters on in vitro fertilization and obstetric outcomes in a frozen oocyte donor model. Fertil Steril 2018; 110:859-869. [DOI: 10.1016/j.fertnstert.2018.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/02/2018] [Accepted: 06/01/2018] [Indexed: 11/22/2022]
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Bartolacci A, Pagliardini L, Makieva S, Salonia A, Papaleo E, Viganò P. Abnormal sperm concentration and motility as well as advanced paternal age compromise early embryonic development but not pregnancy outcomes: a retrospective study of 1266 ICSI cycles. J Assist Reprod Genet 2018; 35:1897-1903. [PMID: 29995229 PMCID: PMC6150884 DOI: 10.1007/s10815-018-1256-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To investigate the effect of sperm concentration, motility and advanced paternal age on reproductive outcomes. METHODS A retrospective analysis of 1266 intracytoplasmic sperm injection (ICSI) cycles between 2013 and 2017. The cohort was divided into four groups according to semen concentration based on the WHO criteria (2010): group A (conc. <1 M/ml), group B (1 ≤ conc. <5 M/ml), group C (5 ≤ conc. < 15 M/ml) and the control group D (conc. ≥15 M/ml). The primary outcome investigated was the blastulation rate. Secondary outcomes were fertilization rate, top quality blastocyst formation rate and ongoing pregnancy rate. RESULTS After adjustment for maternal age and number of oocytes recovered, a significant difference was observed between group A and group D on the rate of fertilized oocytes [66.7 (40.0-80.0) vs 75.0 (57.1-90.2), adjusted p < 0.001] and the blastocyst formation rate [50.0 (33.3-66.3) vs 55.6 (40.0-75.0), adjusted p < 0.05]. However, the male factor did not affect the top quality blastocyst formation rate nor the ongoing pregnancy rate. Considering the age of the male partner as confounding factor, at the increase of each year of age, a reduction of 0.3% on the fertilization rate was observed but no other outcome was impacted. A negative correlation was also observed between sperm motility and fertilization rate in the group with a motility <5%. CONCLUSION Male factor infertility and advanced paternal age may compromise fertilization and blastulation rates but not top quality blastocyst formation rate or the establishment of pregnancy in ICSI cycles.
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Affiliation(s)
| | - Luca Pagliardini
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy
| | - Sofia Makieva
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy.
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43
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Zini A. ICSI with testicular sperm for couples with sperm DNA damage. Int Braz J Urol 2018; 44:664-666. [PMID: 30020583 PMCID: PMC6092666 DOI: 10.1590/s1677-5538.ibju.2018.04.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Armand Zini
- Department of Surgery, St. Mary's Hospital, McGill University, Montreal, Canada
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44
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Morin SJ, Scott RT. Knowledge gaps in male infertility: a reproductive endocrinology and infertility perspective. Transl Androl Urol 2018; 7:S283-S291. [PMID: 30159234 PMCID: PMC6087846 DOI: 10.21037/tau.2018.05.02] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Reproductive research has moved forward at a remarkable pace. Some of these advances are the result of a separation between male and female specialties, allowing focused study in specific areas of the field. However, the different training programs between male and female fertility specialists has created an environment in which some discoveries are not put in the greater context of clinical care. At times, interventions have been measured against surrogate markers of outcome that may not impact the most meaningful outcome for patients—the delivery of a healthy neonate. For example, medical and surgical interventions that use changes in semen parameters may have a limited impact on the likelihood of achieving a live birth due to the limitations inherent in the semen analysis for predicting outcomes. Other commonly used tests, such as sperm DNA fragmentation assays provide promising biological plausibility to account for subfertility of some male partners. However, until well defined thresholds for predicting outcomes in different treatment scenarios are available, changes in sperm DNA fragmentation testing is not an adequate outcome for measuring the utility of interventions. The biggest limitation for these tests remains their analysis of bulk semen. Tests allowing interrogation of the reproductive competence of a given sperm, while allowing that sperm to be used in assisted reproductive technology procedures remain elusive. Progress toward reaching this end (whether by hyaluronic acid binding, IMSI, or Ramen spectroscopy) is underway, but much remains to be learned. Achieving testing and capture of individual sperm would better facilitate studies that measure the most meaningful outcome for patients and providers—the delivery of a healthy baby.
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Affiliation(s)
- Scott J Morin
- IVI RMA New Jersey, Basking Ridge, NJ, USA.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Richard T Scott
- IVI RMA New Jersey, Basking Ridge, NJ, USA.,Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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45
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Silber S. The varicocele argument resurfaces. J Assist Reprod Genet 2018; 35:1079-1082. [PMID: 29589295 PMCID: PMC6030012 DOI: 10.1007/s10815-018-1160-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 03/13/2018] [Indexed: 11/19/2022] Open
Abstract
A recent series of articles and reviews published in Fertility and Sterility have rekindled the more than half century debate on varicocelectomy. Every one of these articles favored strongly the repair of varicocele for male infertility. Since my review paper on this issue in 2001, published in Human Reproduction Update, and since advent of ICSI in 1993, I had thought that most reproductive physicians felt negatively about the benefit of varicocelectomy. However, more recent urological papers are causing this negative view to be re-evaluated. It is now advocated by some urologists that varicocelectomy improves sperm count and testosterone levels, and even improves the results with ICSI. Thus, it may be appropriate to revisit older studies again and review the newer ones in this never ending controversy. Newer studies are re-opening the door to review and possibly re-instate varicocelectomy. This dilemma may never be fully resolved, but it is important to keep an open mind.
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Affiliation(s)
- Sherman Silber
- Infertility Center of St. Louis, St. Luke's Hospital, Saint Louis, MO, USA.
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46
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Öğreden E, Oğuz U, Çırakoğlu A, Benli E, Demirelli E, Yalçın O. İnfertil Erkeklerde Varikoselektominin Semen Analizi ve Gebelik Üzerine Etkileri. ACTA MEDICA ALANYA 2018. [DOI: 10.30565/medalanya.378583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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47
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Zanetti BF, Braga DPAF, Provenza RR, Figueira RCS, Iaconelli A, Borges E. Sperm morphological normality under high magnification is correlated to male infertility and predicts embryo development. Andrology 2018; 6:420-427. [PMID: 29457367 DOI: 10.1111/andr.12473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/23/2023]
Abstract
Human sperm morphology has been described as an essential parameter for the diagnosis of male infertility and a prognostic indicator of natural or assisted pregnancies. Nevertheless, standard morphological assessment remains a subjective analysis and its impact on intracytoplasmic sperm injection (ICSI) is also of limited value. The objective of this prospective cohort study was to investigate whether motile sperm organelle morphology examination (MSOME) can improve semen analysis by better defining male infertility and providing a better prognosis for ICSI up to a year later. Data were obtained from 483 patients undergoing conventional semen analysis from June 2015 to June 2017 in a private university-affiliated in vitro fertilization (IVF) center. The correlation of MSOME with seminal parameters was evaluated. One hundred and thirty patients underwent ICSI up to a year later, and the correlation between MSOME and ICSI outcomes was established. Except for volume, all seminal parameters were positively correlated with MSOME I+II. MSOME was also distinct between World Health Organization (WHO) classification groups, with normozoospermic and oligoasthenoteratozoospermic presenting the higher and the lower proportion of MSOME I+II, respectively. MSOME I+II was prognostic for fertilization rate, high-quality cleavage-stage embryos rate, and blastocyst rate. The normality cutoff value based on blastocyst rate was MSOME I+II≥ 5.5%. MSOME could be a useful tool for the diagnosis of infertility severity as it is correlated with sperm morphology, motility, and concentration. Men who had higher MSOME I+II had better ICSI outcomes. The future use of MSOME as a routine method for semen analysis may be a reliable form of assessing male infertility.
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Affiliation(s)
- B F Zanetti
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - D P A F Braga
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | | | | | - A Iaconelli
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - E Borges
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
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48
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Palermo GD, O'Neill CL, Chow S, Cheung S, Parrella A, Pereira N, Rosenwaks Z. Intracytoplasmic sperm injection: state of the art in humans. Reproduction 2017; 154:F93-F110. [PMID: 29158352 PMCID: PMC5719728 DOI: 10.1530/rep-17-0374] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/09/2017] [Accepted: 11/20/2017] [Indexed: 12/31/2022]
Abstract
Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome.
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Affiliation(s)
- G D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - C L O'Neill
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - S Chow
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - S Cheung
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - A Parrella
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - N Pereira
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - Z Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
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Ayad BM, Horst GVD, Plessis SSD. Revisiting The Relationship between The Ejaculatory Abstinence Period and Semen Characteristics. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2017; 11:238-246. [PMID: 29043697 PMCID: PMC5641453 DOI: 10.22074/ijfs.2018.5192] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 03/17/2017] [Indexed: 11/04/2022]
Abstract
Variation in the ejaculatory abstinence period suggested by different guidance bodies have resulted in a growing concern among researchers and clinicians over what the precise period of ejaculatory abstinence ought to be for an optimal semen sample. Several studies have thus been undertaken to examine the association between the length of sexual abstinence and semen characteristics. Not all studies, however, have arrived at the same conclusions. This study aims to review all existing literature published during the past few decades pertaining to the influence of ejaculatory abstinence on semen quality. For the purpose of this systematic review, all data related to sexual abstinence duration and seminal parameters were re-analysed to homogenize the current data. Thorough PubMed, MEDLINE and Google Scholar, a literature search was conducted using the keywords "sexual abstinence", "ejaculatory abstinence", "semen", "spermatozoa", "semen analysis", "sperm parameters", "motility", "reactive oxygen species (ROS)" and "DNA fragmentation". After carefully reviewing all the literature, 30 relevant papers, both written in English and published between January 1979 and December 2016, were included in this review. The weight of the evidence suggests that the decline in semen volume and sperm concentration with shorter abstinence periods is accompanied by a substantial improvement in sperm motility characteristics, especially progressive motility and velocity. Nevertheless, available data are insufficient to support definitive conclusions regarding the influence of the ejaculatory abstinence period on advanced semen parameters (ROS, DNA fragmentation and seminal plasma antioxidant capacity) and pregnancy rates. In conclusion, taking all data into account, shortening of the abstinence period may be beneficial to sperm quality. Furthermore, we recommend that the current guidelines regarding the prescribed abstinence period should be revisited.
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Affiliation(s)
- Bashir M Ayad
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Gerhard Van der Horst
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Stefan S Du Plessis
- Division of Medical Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa.
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50
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The Vienna consensus: report of an expert meeting on the development of ART laboratory performance indicators. Reprod Biomed Online 2017; 35:494-510. [PMID: 28784335 DOI: 10.1016/j.rbmo.2017.06.015] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 06/21/2017] [Indexed: 11/19/2022]
Abstract
This proceedings report presents the outcomes from an international workshop supported by the European Society of Human Reproduction and Embryology (ESHRE) and Alpha Scientists in Reproductive Medicine, designed to establish consensus on definitions and recommended values for Indicators for the assisted reproductive technology (ART) laboratory. Minimum performance-level values ('competency') and aspirational ('benchmark') values were recommended for a total of 19 Indicators, including 12 Key Performance Indicators (KPIs), five Performance Indicators (PIs), and two Reference Indicators (RIs).
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