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Mu Y, Zhou X, Li L, Liu X, Wen X, Zhang L, Yan B, Zhang W, Dong K, Hu H, Liao Y, Ye Z, Deng A, Wang Y, Mao Z, Yang M, Xiao X. Automatic high-throughput and non-invasive selection of sperm at the biochemical level. MED 2024; 5:603-621.e7. [PMID: 38608708 DOI: 10.1016/j.medj.2024.03.008] [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: 07/19/2023] [Revised: 11/06/2023] [Accepted: 03/11/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Sperm selection, a key step in assisted reproductive technology (ART), has long been restrained at the preliminary physical level (morphology or motility); however, subsequent fertilization and embryogenesis are complicated biochemical processes. Such an enormous "gap" poses tough problems for couples dealing with infertility, especially patients with severe/total asthenozoospermia . METHODS We developed a biochemical-level, automatic-screening/separation, smart droplet-TO-hydrogel chip (BLASTO-chip) for sperm selection. The droplet can sense the pH change caused by sperm's respiration products and then transforms into a hydrogel to be selected out. FINDINGS The BLASTO-chip system can select biochemically active sperm with an accuracy of over 90%, and its selection efficiency can be flexibly tuned by nearly 10-fold. All the substances in the system were proven to be biosafe via evaluating mice fertilization and offspring health. Live sperm down to 1% could be enriched by over 76-fold to 76%. For clinical application to patients with severe/total asthenozoospermia, the BLASTO-chip could select live sperm from human semen samples containing 10% live but 100% immotile sperm. The rates of fertilization, cleavage, early embryos, and blastocysts were drastically elevated from 15% to 70.83%, 10% to 62.5%, 5% to 37.5%, and 0% to 16.67%, respectively. CONCLUSIONS The BLASTO-chip represents a real biochemical-level technology for sperm selection that is completely independent of sperm's motility. It can be a powerful tool in ART, especially for patients with severe/total asthenozoospermia. FUNDING This work was funded by the Ministry of Science and Technology of China, the Ministry of Education of China, and the Shenzhen-Hong Kong Hetao Cooperation Zone.
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Affiliation(s)
- Yaoqin Mu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiaoyu Zhou
- Department of Precision Diagnostic and Therapeutic Technology (FRI), Department of Biomedical Sciences and Tung Biomedical Sciences Centre, Key Laboratory of Biochip Technology and Biotech and Health Centre (SRI), City University of Hong Kong, Hong Kong, China
| | - Longjie Li
- School of Life Science and Technology, Wuhan Polytechnic University, Wuhan 430023, China
| | - Xiaowen Liu
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, China
| | - Xu Wen
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Lei Zhang
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bei Yan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430023, China
| | - Kejun Dong
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430023, China
| | - Hao Hu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yangwei Liao
- Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhengxin Ye
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Aimin Deng
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, China
| | - Yuan Wang
- Department of Precision Diagnostic and Therapeutic Technology (FRI), Department of Biomedical Sciences and Tung Biomedical Sciences Centre, Key Laboratory of Biochip Technology and Biotech and Health Centre (SRI), City University of Hong Kong, Hong Kong, China
| | - Zenghui Mao
- Hunan Provincial Key Laboratory of Regional Hereditary Birth Defects Prevention and Control, Changsha Hospital for Maternal & Child Health Care Affiliated to Hunan Normal University, Changsha, China.
| | - Mengsu Yang
- Department of Precision Diagnostic and Therapeutic Technology (FRI), Department of Biomedical Sciences and Tung Biomedical Sciences Centre, Key Laboratory of Biochip Technology and Biotech and Health Centre (SRI), City University of Hong Kong, Hong Kong, China.
| | - Xianjin Xiao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
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Xue Y, Xiong Y, Cheng X, Li K. Applications of laser technology in the manipulation of human spermatozoa. Reprod Biol Endocrinol 2023; 21:93. [PMID: 37865766 PMCID: PMC10589983 DOI: 10.1186/s12958-023-01148-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/08/2023] [Indexed: 10/23/2023] Open
Abstract
The application of laser technology in the field of assisted reproductive technology (ART) has experienced rapid growth over the past decades owing to revolutionary techniques such as intracytoplasmic sperm injection (ICSI), preimplantation genetic testing (PGT), and in vitro manipulation of gametes and embryos. For male gametes, in vitro manipulation techniques include spermatozoa selection, sorting, immobilization, and quality assessment. A number of studies have been conducted to investigate the application of different laser technologies in the manipulation of human spermatozoa. However, there is a lack of a unified understanding of laser application in the in vitro manipulation of sperm and safety considerations in ART and, subsequently, the inability to make clear and accurate decisions on the clinical value of these laser technologies. This review summarizes the advancements and improvements of laser technologies in the manipulation of human spermatozoa, such as photobiomodulation therapy, laser trap systems for sperm analysis and sorting, laser-assisted selection of immotile sperm and laser-assisted immobilization of sperm prior to ICSI. The safety of those technologies used in ART is also discussed. This review will provide helpful and comprehensive insight into the applications of laser technology in the manipulation of human spermatozoa.
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Affiliation(s)
- Yamei Xue
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuping Xiong
- Institute for Reproductive Health, School of Pharmacy, Hangzhou Medical College, Hangzhou, China
| | - Xiaohong Cheng
- Institute for Reproductive Health, School of Pharmacy, Hangzhou Medical College, Hangzhou, China
| | - Kun Li
- Institute for Reproductive Health, School of Pharmacy, Hangzhou Medical College, Hangzhou, China.
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3
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Horta F, Fernando D, Lantsberg D, Holden S, Katz DJ, Green MP, McLachlan R, Zander-Fox D, Rombauts L. Are Clinical Outcomes of Micro-TESE in Non-obstructive Azoospermic Men Affected by the Use of Fresh or Frozen Gametes? FERTILITY & REPRODUCTION 2022. [DOI: 10.1142/s2661318222500086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: The combination of microsurgical testicular sperm extraction (mTESE) and intracytoplasmic sperm injection (ICSI) has become a common management option, with sperm motility being positively associated with successful outcomes. However, few studies have investigated whether the use of fresh or thawed gamete combinations affect clinical outcomes. Objectives: To determine whether the clinical outcomes of ICSI cycles using mTESE recovered testicular sperm of non-obstructive azoospermia (NOA) patients are affected by using fresh or thawed gametes. Material and Methods: A retrospective study was conducted of NOA patients who underwent mTESE between 2017 and 2020 at Monash IVF assisted reproductive clinics in Melbourne, Australia. The impact of gamete fresh/frozen status and sperm motility was investigated on clinical outcomes such as fertilization, blastocyst formation, clinical pregnancy, and live birth rates (LBRs). Results:A total of 103 NOA patients underwent mTESE, with a 65.1% successful surgical-sperm-retrieval. In total 56 patients contributed to 68 ICSI cycles, with a 35.1% fertilization rate and 25% LBR per embryo transfer. Compared with fresh testicular sperm, thawed testicular sperm did not affect clinical outcomes, including LBRs [16.7% vs 12.0%; odds ratio (OR) 0.68 (0.18–2.70)]. However, the use of thawed oocytes had a negative effect on fertilization rates [fresh-oocytes, 37.8%; vitrified-oocytes, 34.5%; OR 0.86 (0.02–0.48)]. Cycles using only motile sperm had a greater fertilization rate than those using a combination of motile and non-motile sperm (49.6% vs 37.2%, p ¡ 0.05). Importantly, when exclusively non-motile sperm were available (n = 26 cycles) their injection resulted in a very low fertilization rate (2.7%) and no live births were recorded. Conclusion: Micro-TESE is an effective treatment for NOA patients, with no clear advantage of using fresh over thawed sperm, however, the use of vitrified compared with fresh oocytes requires further investigation. Importantly, patients should be informed of the poor outcomes with the use of non-motile sperm in mTESE ICSI cycles.
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Affiliation(s)
- Fabrizzio Horta
- Monash IVF, Clayton, Victoria 3168, Australia
- Monash University, Clayton, Victoria 3168, Australia
| | - Dhanushi Fernando
- Monash IVF, Clayton, Victoria 3168, Australia
- Monash Health, Clayton, Victoria 3168, Australia
| | - Daniel Lantsberg
- Men’s Heath Melbourne, Melbourne, Australia
- The Royal Women’s Hospital, Melbourne 3052, Australia
- University of Melbourne, Melbourne 3010, Australia
| | | | - Darren J. Katz
- Men’s Heath Melbourne, Melbourne, Australia
- University of Melbourne, Melbourne 3010, Australia
- Department of Urology, Western Health, Victoria, Australia
| | - Mark P. Green
- Monash IVF, Clayton, Victoria 3168, Australia
- University of Melbourne, Melbourne 3010, Australia
| | - Robert McLachlan
- Monash IVF, Clayton, Victoria 3168, Australia
- Monash Health, Clayton, Victoria 3168, Australia
- Hudson Institute of Medical Research, Monash University, Clayton, Victoria 3168, Australia
| | - Deirdre Zander-Fox
- Monash IVF, Clayton, Victoria 3168, Australia
- Monash University, Clayton, Victoria 3168, Australia
- University of Adelaide, Adelaide, South Australia 5000, Australia
- University of South Australia, Adelaide, South Australia 5095, Australia
| | - Luk Rombauts
- Monash IVF, Clayton, Victoria 3168, Australia
- Monash University, Clayton, Victoria 3168, Australia
- Monash Health, Clayton, Victoria 3168, Australia
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Liu HJ, Ma JH, Liu RM, Liu ZG, Huang HJ, Zou JQ, Liu JX, Zhang XF. Evaluation of fertilization capability of frozen-thawed completely immotile spermatozoa collected from a white bengal tiger after interspecific ICSI with bovine oocytes. Anim Reprod 2022; 19:e20220034. [PMID: 35847560 PMCID: PMC9276013 DOI: 10.1590/1984-3143-ar2022-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022] Open
Abstract
The objective of this study was to evaluate the fertilization capability of White Bengal Tiger frozen-thawed completely immotile spermatozoa after interspecific intracytoplasmic sperm injection (ICSI) with bovine oocytes. The fertilization status of presumptive zygotes was assessed 18 h after ICSI by immunofluorescence staining and confocal microscopy. The fertilization rate was 34.8% (8/23), as confirmed by the extrusion of two polar bodies, or male and female pronuclei formation. For unfertilized oocytes (65.2%, 15/23), one activated oocyte had an activated spermatozoon but most were unactivated oocytes with unactivated spermatozoa (1/15, 6.7% vs 10/15, 66.7%, respectively, p < 0.05). These results showed that White Bengal Tiger frozen-thawed completely immotile spermatozoa retained the capacity to fertilize bovine oocytes after interspecific ICSI. This is the first report of in vitro produced zygotes using tiger immotile sperm with bovine oocytes by interspecific ICSI technique, which provides an efficient and feasible method for preservation and utilization of endangered feline animals.
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Affiliation(s)
- Hai-Jun Liu
- Zhejiang Agriculture & Forestry University, China
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5
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Sperm Selection for ICSI: Do We Have a Winner? Cells 2021; 10:cells10123566. [PMID: 34944074 PMCID: PMC8700516 DOI: 10.3390/cells10123566] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 12/26/2022] Open
Abstract
In assisted reproductive technology (ART), the aim of sperm cells’ preparation is to select competent spermatozoa with the highest fertilization potential and in this context, the intracytoplasmic sperm injection (ICSI) represents the most applied technique for fertilization. This makes the process of identifying the perfect spermatozoa extremely important. A number of methods have now been developed to mimic some of the natural selection processes that exist in the female reproductive tract. Although many studies have been conducted to identify the election technique, many doubts and disagreements still remain. In this review, we will discuss all the sperm cell selection techniques currently available for ICSI, starting from the most basic methodologies and continuing with those techniques suitable for sperm cells with reduced motility. Furthermore, different techniques that exploit some sperm membrane characteristics and the most advanced strategy for sperm selection based on microfluidics, will be examined. Finally, a new sperm selection method based on a micro swim-up directly on the ICSI dish will be analyzed. Eventually, advantages and disadvantages of each technique will be debated, trying to draw reasonable conclusions on their efficacy in order to establish the gold standard method.
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6
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Chen H, Wang C, Zhou H, Shu J, Gan X, Xu K, Wu Z, Deng X, Huang G, Lin R. Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies. Reprod Biol Endocrinol 2021; 19:159. [PMID: 34641894 PMCID: PMC8507098 DOI: 10.1186/s12958-021-00835-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Azoospermic patients have benefited from both epididymal and testicular spermatozoa intracytoplasmic sperm injection (ICSI) treatment and lasers have been used to identify viable, immotile spermatozoa before the procedure. There are limited studies on the safety of laser-assisted selection of immotile spermatozoa. The aim of this study was to investigate the impact of laser-assisted selection of immotile spermatozoa on the obstetric and neonatal outcomes after ICSI. METHODS A retrospective comparative study was conducted on outcomes of ICSI cycles with testicular spermatozoa from June 2014 to June 2018. Of 132 cycles, 33 were allocated to the test group and oocytes were injected with immotile spermatozoa selected by laser, 99 cycles were allocated as control group. RESULTS Compared with the control group, no significant differences were found in the pregnancy, implantation, miscarriage and live birth rates in the test group in either fresh or frozen transfer cycles. The cumulative live birth rate in the test group was 69.70%, which was slightly higher than in the control group (60.61%), but this was not statistically different. There were no differences in the average gestational age, premature birth rate, neonatal birth weight, and the malformation rate between the test and control groups (P > 0.05). In addition, the obstetric outcome between the two groups were not different (P > 0.05). CONCLUSIONS No negative effect on perinatal and neonatal outcomes was seen by using laser-assisted selection of immotile spermatozoa for TESA-ICSI. This study endorses the use of laser-assisted selection of viable spermatozoa for ICSI cycles.
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Affiliation(s)
- Huanhua Chen
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Caizhu Wang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Hong Zhou
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Jinhui Shu
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Xianyou Gan
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Kongrong Xu
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Zhulian Wu
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Xihe Deng
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Guiting Huang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China
| | - Ruoyun Lin
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003, China.
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7
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Ambar RF, Gava MM, Ghirelli-Filho M, Yoshida IH, De Paula TS, Glina S. Tissue and sperm handling before assisted reproductive technology (ART): A systematic review. Arab J Urol 2021; 19:238-246. [PMID: 34552775 PMCID: PMC8451624 DOI: 10.1080/2090598x.2021.1954801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective : To explore the medical literature on techniques of tissue and sperm handling after surgical retrieval for intracytoplasmic sperm injection (ICSI). Methods : A search was performed in PubMed and Google Scholar databases, according to a modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guideline, considering the studies investigating tissue handling and sperm selection techniques for ICSI. Results : Overall, 42 articles were included in this study, investigating sample handling, methods for sperm selection, and the use of chemical compounds to improve sperm motility and fertilisation rates. Conclusion : The ideal sperm handling method should provide a high sperm count, high vitality and appropriate sperm function, without side-effects. In this review the most common and useful techniques are described and the best combination strategies discussed in clinical scenarios.
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Affiliation(s)
- Rafael Favero Ambar
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil.,Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Marcello M Gava
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil.,Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Milton Ghirelli-Filho
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil.,Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Ivan H Yoshida
- Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | | | - Sidney Glina
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil
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8
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["Practical spermiogram"-semen analysis according to WHO recommendations]. Urologe A 2021; 60:647-656. [PMID: 33929550 DOI: 10.1007/s00120-021-01537-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
Semen analysis (spermiogram) is a crucial component of the diagnostic work-up of infertile patients, in cases of cryopreservation of semen for fertility protection prior to potentially gonadotoxic treatment or for the assessment of sperm quality for sperm donation. Practical semen analysis follows the recommendations of the WHO laboratory manual for the examination and processing of human sperm. The aim of semen analysis is to characterize the fertility potential of the male, which is supplemented by clinical and endocrine investigations before a final decision on treatment options is made. Since 2014, semen analysis has been subject to the guidelines on quality assurance in laboratory diagnostics of the Federal Medical Board (Rili-BÄK). In practical terms, the detailed performance of a macroscopic and microscopic analysis of semen is decisive for valid results and subsequent treatment decisions. Additional tests can help to make a better estimation of the fertility parameters.
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9
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Male Factors: the Role of Sperm in Preimplantation Embryo Quality. Reprod Sci 2020; 28:1788-1811. [DOI: 10.1007/s43032-020-00334-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/25/2020] [Indexed: 12/19/2022]
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10
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Pinto S, Carrageta DF, Alves MG, Rocha A, Agarwal A, Barros A, Oliveira PF. Sperm selection strategies and their impact on assisted reproductive technology outcomes. Andrologia 2020; 53:e13725. [PMID: 32596880 DOI: 10.1111/and.13725] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/28/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022] Open
Abstract
The application of assisted reproductive technologies (ART) has revolutionised the treatment of human infertility, giving hope to the patients previously considered incapable of establishing pregnancy. While semen analysis is performed to access whether a sample has an adequate number of viable, motile and morphologically normal sperm cells able to achieve fertilisation, sperm selection techniques for ART aim to isolate the most competent spermatozoon which is characterised by the highest fertilising potential. Based on the semen analysis results, the correct sperm selection technique must be chosen and applied. In this review, different sperm selection strategies for retrieving spermatozoa with the highest fertilising potential and their impact on ART outcomes are discussed. In addition, advantages and disadvantages of each method and the best suited techniques for each clinical scenario are described.
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Affiliation(s)
- Soraia Pinto
- Centre for Reproductive Genetics A. Barros, Porto, Portugal
| | - David F Carrageta
- Department of Microscopy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Marco G Alves
- Department of Microscopy and Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - António Rocha
- CECA/ICETA - Centro de Estudos de Ciência Animal, Universidade do Porto & Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Alberto Barros
- Centre for Reproductive Genetics A. Barros, Porto, Portugal.,Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Pedro F Oliveira
- QOPNA & LAQV, Department of Chemistry, University of Aveiro, Aveiro, Portugal
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11
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Chen W, Bai MZ, Yang Y, Sun D, Wu S, Sun J, Wu Y, Feng Y, Wei Y, Chen Z, Zhang Z. ART strategies in Klinefelter syndrome. J Assist Reprod Genet 2020; 37:2053-2079. [PMID: 32562095 DOI: 10.1007/s10815-020-01818-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/10/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Patients with Klinefelter syndrome (KS) who receive assisted reproductive technology (ART) treatment often experience poor pregnancy rates due to decreased fertilization, cleavage, and implantation rates and even an increased miscarriage rate. Mounting evidence from recent studies has shown that various technological advances and approaches could facilitate the success of ART treatment for KS patients. In this review, we summarize the methods for guiding KS patients during ART and for developing optimal strategies for preserving fertility, improving pregnancy rate and live birth rate, and avoiding the birth of KS infants. METHODS We searched PubMed and Google Scholar publications related to KS patients on topics of controlled ovarian stimulation protocols, sperm extraction, fertility preservation, gamete artificial activation, round spermatid injection (ROSI), and non-invasive prenatal screening (PGD) methods. RESULTS This review outlines the different ovulation-inducing treatments for female partners according to the individual sperm status in the KS patient. We further summarize the methods of retrieving sperm, storing, and freezing rare sperm. We reviewed different methods of gamete artificial activation and discussed the feasibility of ROSI for sterile KS patients who absolutely lack sperm. The activation of eggs in the process of intracytoplasmic sperm injection and non-invasive PGD are urgently needed to prevent the birth of KS infants. CONCLUSION The integrated strategies will pave the way for the establishment of ART treatment approaches and improve the clinical outcome for KS patients.
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Affiliation(s)
- Wei Chen
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Ming Zhu Bai
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Yixia Yang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Di Sun
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Sufang Wu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Jian Sun
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Yu Wu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Youji Feng
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China
| | - Youheng Wei
- Institute of Bioscience and Biotechnology, Yangzhou University, Yangzhou, 225009, China
| | - Zijiang Chen
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, 250021, China
| | - Zhenbo Zhang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, 200080, China.
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Marzano G, Chiriacò MS, Primiceri E, Dell’Aquila ME, Ramalho-Santos J, Zara V, Ferramosca A, Maruccio G. Sperm selection in assisted reproduction: A review of established methods and cutting-edge possibilities. Biotechnol Adv 2020; 40:107498. [DOI: 10.1016/j.biotechadv.2019.107498] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 11/26/2019] [Accepted: 12/06/2019] [Indexed: 12/31/2022]
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13
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Oseguera-López I, Ruiz-Díaz S, Ramos-Ibeas P, Pérez-Cerezales S. Novel Techniques of Sperm Selection for Improving IVF and ICSI Outcomes. Front Cell Dev Biol 2019; 7:298. [PMID: 31850340 PMCID: PMC6896825 DOI: 10.3389/fcell.2019.00298] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022] Open
Abstract
Almost 50% of the infertility cases are due to male factors. Assisted reproductive technologies (ARTs) allow to overcome the incapacity of these patients' spermatozoa to fertilize the oocyte and produce a viable and healthy offspring, but the efficiency of the different techniques has still the potential to improve. According to the latest reports of the European Society of Human Reproduction and Embryology (ESHRE) and the Centers for Disease Control and Prevention of the United States (CDC), the percentages of deliveries per ART cycle in 2014 and 2016 were 21 and 22%, respectively. Among the reasons for this relatively low efficiency, the quality of the spermatozoa has been pointed out as critical, and the presence of high percentages of DNA-damaged spermatozoa in patients' ejaculates is possibly one of the main factors reducing the ARTs outcomes. Thus, one of the main challenges in reproductive medicine is to ensure the highest quality of the spermatozoa used in ARTs, and specifically, in terms of genetic integrity. The latest techniques for the preparation and selection of human spermatozoa are herein discussed focusing on those proven to improve one or several of the following parameters: sperm genetic integrity, fertilization capacity, embryo production, and in vitro survival, as well as pregnancy and delivery rates following in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). In addition, we discuss the potential of techniques developed in non-human mammals that could be further transferred to the clinic.
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Affiliation(s)
| | - Sara Ruiz-Díaz
- Mistral Fertility Clinics S.L., Clínica Tambre, Madrid, Spain
- Department of Animal Reproduction, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
| | - Priscila Ramos-Ibeas
- Department of Animal Reproduction, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
| | - Serafín Pérez-Cerezales
- Department of Animal Reproduction, Instituto Nacional de Investigación y Tecnología Agraria y Alimentaria, Madrid, Spain
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Schuppe HC, Pilatz A, Fietz D, Diemer T, Köhn FM, Tüttelmann F, Kliesch S. Kinderwunsch bei Azoospermie. GYNAKOLOGISCHE ENDOKRINOLOGIE 2019. [DOI: 10.1007/s10304-019-00271-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Nordhoff V, Kliesch S. Das eine unter vielen – Spermienqualität und Möglichkeiten der Selektion. GYNAKOLOGISCHE ENDOKRINOLOGIE 2019. [DOI: 10.1007/s10304-019-00274-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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16
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Davidson LM, Liu Y, Griffiths T, Jones C, Coward K. Laser technology in the ART laboratory: a narrative review. Reprod Biomed Online 2019; 38:725-739. [DOI: 10.1016/j.rbmo.2018.12.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 11/01/2018] [Accepted: 12/11/2018] [Indexed: 11/27/2022]
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17
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Chen H, Zhou H, Shu J, Gan X, Wang C, Lin R. A point of confusion for embryologists in the identification of viable spermatozoa by the eosin-nigrosin test. Clin Exp Reprod Med 2019; 46:36-40. [PMID: 30827076 PMCID: PMC6436465 DOI: 10.5653/cerm.2019.46.1.36] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/16/2018] [Indexed: 11/25/2022] Open
Abstract
A viable spermatozoon is a prerequisite for fertilization in intracytoplasmic sperm injection (ICSI). Thus, it is crucial to select viable but immotile spermatozoa on the day of ICSI. We report conflicting results in the identification of viable but immotile spermatozoa between the eosin-nigrosin staining and the laser test, which resulted in confusion for embryologists during assisted reproductive technology (ART). Three patients’ semen samples that showed no motile spermatozoa are described in this report. To identify viable spermatozoa, we used both the eosin-nigrosin test and the laser test for each sample, and repeated the semen analysis twice in each patient. Viable but immotile spermatozoa selected by the laser test were used for ICSI. Viable spermatozoa were detected by both the eosin-nigrosin and laser tests in two patients (case 1, 95.00% vs. 24.21% and 92.68% vs. 22.22%; case 2, 41.18% vs. 23.48% and 39.81% vs. 22.52%), indicating consistent results between the two methods. In the third patient, the eosin-nigrosin test yielded viability rates of 20.75% and 19.14%, while the result of the laser test was 0%. Thus, testicular aspiration was performed to collect viable sperm from this patient. Normal fertilization was achieved after the injection of viable but immotile spermatozoa selected from these patients by the laser test, resulting in the birth of two healthy babies. Our study documents a case where the eosin-nigrosin test showed a limitation in identifying viable but immotile spermatozoa for ART, while the laser test may overcome this limitation. Larger samples may be required to corroborate the clinical value of the laser test.
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Affiliation(s)
- Huanhua Chen
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hong Zhou
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinhui Shu
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xianyou Gan
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Caizhu Wang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Ruoyun Lin
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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18
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Chen H, Feng G, Zhang B, Zhou H, Wang C, Shu J, Gan X, Lin R, Huang D, Huang Y. A new insight into male fertility preservation for patients with completely immotile spermatozoa. Reprod Biol Endocrinol 2017; 15:74. [PMID: 28923067 PMCID: PMC5604404 DOI: 10.1186/s12958-017-0294-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/12/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sperm cryopreservation is the most effective method to preserve male fertility but this is normally used for motile spermatozoa. Thus, only motile spermatozoa are used for cryopreservation in most reproductive medicine centers worldwide. The immotile spermatozoa from some problematic patients are usually discarded, resulting in a missed opportunity of sterility cryopreservation for future assisted reproductive treatments. Many studies have shown that successful fertilization can be obtained after selection of viable sperm from the completely immotile spermatozoa before ICSI. Whether the completely immotile spermatozoa are worth of freezing has not been realized The aim of this study is to explore the clinical value of cryopreservation of immotile spermatozoa. METHODS Completely immotile spermatozoa were collected and frozen, and subsequently viable but immotile frozen-thawed spermatozoa were selected by laser plus for ICSI. Main outcomes included spermatozoa survival index, fertilization rate and good quality embryo rate. RESULTS After identification by laser, the fresh samples of spermatozoa presented with a mean survival rate of 54.86% and 26.05%, and this was reduced to 44.13% and 18.13% in frozen-thawed spermatozoa samples, which showed a frozen-thawed spermatozoa survival index of 0.80 and 0.70 in the testicular and ejaculate sperm, respectively. There were no statistically differences in fertilization rate (80% vs80.51%, 75.00% vs 81.48%), cleavage rate (95.45% vs 98.95%, 100.00% vs 95.45%) and good quality embryo rate (40.48% vs 52.13%, 33.33%vs38.10%) between the frozen-thawed immotile spermatozoa group and the routine fresh immotile spermatozoa ICSI group in both testicular and ejaculate sperm, respectively. CONCLUSIONS The results of the study show that completely immotile spermatozoa can be frozen in order to preserve male fertility as long as viable spermatozoa are present. This procedure provides a further possibility for fertility preservation for patients with completely immotile spermatozoa.
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Affiliation(s)
- Huanhua Chen
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Guixue Feng
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Bo Zhang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Hong Zhou
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Caizhu Wang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Jinhui Shu
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Xianyou Gan
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Ruoyun Lin
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Dongmei Huang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
| | - Yingqin Huang
- Reproductive Medicine Center, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530003 China
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Chen H, Feng G, Zhang B, Zhou H, Shu J, Gan X. A successful pregnancy using completely immotile but viable frozen-thawed spermatozoa selected by laser. Clin Exp Reprod Med 2017; 44:52-55. [PMID: 28428945 PMCID: PMC5395553 DOI: 10.5653/cerm.2017.44.1.52] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 01/19/2017] [Accepted: 01/19/2017] [Indexed: 11/06/2022] Open
Abstract
The aim of this study was to report a successful pregnancy using completely immotile frozen-thawed spermatozoa selected by laser. A single laser shot was used to detect the presence of viable immotile spermatozoa in fresh and frozen-thawed testicular spermatozoa. The viability rate was 55.8% after the laser detection, and cryopreservation was carried out immediately. The thawing test was performed on the day of oocyte pick-up, and no motile sperm were observed after extending the culture for another 4 hours, while a survival rate of 39.8% was detected using the laser. In all, five mature oocytes were injected, resulting in four cases of normal fertilization (80%) on day 1. Further, two high-quality day 3 embryos were transferred, which resulted in a singleton pregnancy. Our study demonstrates that completely immotile spermatozoa are worth cryopreserving for further intracytoplasmic sperm injection, which provides a new insight into male fertility preservation in cases of completely immotile spermatozoa.
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Affiliation(s)
- Huanhua Chen
- Center for Reproductive Medicine, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Guixue Feng
- Center for Reproductive Medicine, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.,Center for Reproductive Medicine, The Obstetrics and Gynecology Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Bo Zhang
- Center for Reproductive Medicine, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Hong Zhou
- Center for Reproductive Medicine, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Jinhui Shu
- Center for Reproductive Medicine, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xianyou Gan
- Center for Reproductive Medicine, The Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
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20
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Verheyen G, Popovic-Todorovic B, Tournaye H. Processing and selection of surgically-retrieved sperm for ICSI: a review. Basic Clin Androl 2017; 27:6. [PMID: 28331619 PMCID: PMC5360083 DOI: 10.1186/s12610-017-0050-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 03/01/2017] [Indexed: 12/30/2022] Open
Abstract
Although the technique of intracytoplasmic sperm injection (ICSI) has been a revolution in the alleviation of male infertility, the use of testicular sperm for ICSI was a formerly unseen breakthrough in the treatment of the azoospermic man with primary testicular failure. At the clinical level, different procedures of testicular sperm retrieval (conventional TESE, micro-TESE, FNA/TESA, MESA, PESA) are being performed, the choice is mainly based on the cause of azoospermia (obstructive versus non-obstructive) and the surgeon's skills. At the level of the IVF laboratory, mechanical procedures to harvest the sperm from the tissue may be combined with enzymatic treatment in order to increase the sperm recovery rates. A number of techniques have been developed for viable sperm selection in males with only immotile testicular sperm available. However, large, well-designed studies on the benefit and safety of one over the other technique are lacking. Despite all the available methods and combinations of laboratory procedures which have a common goal to maximize sperm recovery from testicular samples, a large proportion of NOA patients fail to father a genetically own child. Advanced technology application may improve recovery rates by detection of the testicular foci with active spermatogenesis and/or identification of the rare individual sperm in the testicular suspensions. On the other hand, in vitro spermatogenesis or sperm production from embryonic stem cells or induced pluripotent stem cells might be future options. The present review summarizes the available strategies which aim to maximize sperm recovery from surgically retrieved samples.
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Affiliation(s)
- Greta Verheyen
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
| | | | - Herman Tournaye
- Centre for Reproductive Medicine, UZ Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium
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21
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Dumont A, Barbotin AL, Lefebvre-Khalil V, Mitchell V, Rigot JM, Boitrelle F, Robin G. [Necrozoospermia: From etiologic diagnosis to therapeutic management]. ACTA ACUST UNITED AC 2017; 45:238-248. [PMID: 28697346 DOI: 10.1016/j.gofs.2017.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 01/19/2017] [Indexed: 12/11/2022]
Abstract
This review describes necrospermia, its diagnosis, causes and management. Sperm vitality is commonly assessed in the laboratory of reproductive biology, with the eosin test or with the hypo-osmotic swelling test. Necrospermia is defined by a percentage of living spermatozoa inferior to 58%, and can be related to male infertility. Several pathological mechanisms may be involved and can be classified either in testicular causes (hyperthyroidism, local hyperthermia, varicocele), or post-testicular causes (epididymal necrospermia, dysregulation of seminal plasma, adult polycystic kidney disease, vasectomy reversal, anti-sperm antibodies) or both (infection, toxic, age, spinal cord injury). The first treatment is to correct the underlying cause, if possible. Repetitive ejaculation has demonstrated to be effective as well. Many drugs would also improve the sperm vitality (antioxidants, non-and-steroidal anti-inflammatory drugs) but there is currently no guideline to recommend their use. With necrospermia, fertilization rates are lower but in vitro fertilization (IVF) with Intracytoplasmic sperm injection (ICSI) improves the chances of conception.
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Affiliation(s)
- A Dumont
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 2, avenue Oscar-Lambret, 59000 Lille, France.
| | - A-L Barbotin
- Service de biologie de la reproduction-spermiologie-CECOS, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59000 Lille, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - V Lefebvre-Khalil
- Service de biologie de la reproduction-spermiologie-CECOS, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59000 Lille, France
| | - V Mitchell
- Service de biologie de la reproduction-spermiologie-CECOS, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 59000 Lille, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - J-M Rigot
- EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France; Service d'andrologie, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
| | - F Boitrelle
- Service de biologie de la reproduction et de cytogénétique, centre hospitalier Poissy-Saint-Germain-en-Laye, 78303 Poissy, France
| | - G Robin
- Service de gynécologie endocrinienne et médecine de la reproduction, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire, 2, avenue Oscar-Lambret, 59000 Lille, France; EA 4308 gamétogenèse et qualité du gamète, institut de biologie de la reproduction-spermiologie-CECOS, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France; Service d'andrologie, hôpital Albert-Calmette, centre hospitalier régional universitaire, 59000 Lille, France
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22
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Rubino P, Viganò P, Luddi A, Piomboni P. The ICSI procedure from past to future: a systematic review of the more controversial aspects. Hum Reprod Update 2015; 22:194-227. [DOI: 10.1093/humupd/dmv050] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022] Open
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23
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Hessel M, Robben JC, D'Hauwers KW, Braat DD, Ramos L. The influence of sperm motility and cryopreservation on the treatment outcome after intracytoplasmic sperm injection following testicular sperm extraction. Acta Obstet Gynecol Scand 2015; 94:1313-21. [DOI: 10.1111/aogs.12769] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 08/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Marloes Hessel
- Department of Obstetrics and Gynecology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Johanna C.M. Robben
- Department of Obstetrics and Gynecology; Radboud University Medical Center; Nijmegen The Netherlands
| | | | - Didi D.M. Braat
- Department of Obstetrics and Gynecology; Radboud University Medical Center; Nijmegen The Netherlands
| | - Liliana Ramos
- Department of Obstetrics and Gynecology; Radboud University Medical Center; Nijmegen The Netherlands
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24
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Picton HM, Wyns C, Anderson RA, Goossens E, Jahnukainen K, Kliesch S, Mitchell RT, Pennings G, Rives N, Tournaye H, van Pelt AMM, Eichenlaub-Ritter U, Schlatt S. A European perspective on testicular tissue cryopreservation for fertility preservation in prepubertal and adolescent boys. Hum Reprod 2015; 30:2463-75. [PMID: 26358785 DOI: 10.1093/humrep/dev190] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/08/2015] [Indexed: 12/25/2022] Open
Abstract
STUDY QUESTION What clinical practices, patient management strategies and experimental methods are currently being used to preserve and restore the fertility of prepubertal boys and adolescent males? SUMMARY ANSWER Based on a review of the clinical literature and research evidence for sperm freezing and testicular tissue cryopreservation, and after consideration of the relevant ethical and legal challenges, an algorithm for the cryopreservation of sperm and testicular tissue is proposed for prepubertal boys and adolescent males at high risk of fertility loss. WHAT IS KNOWN ALREADY A known late effect of the chemotherapy agents and radiation exposure regimes used to treat childhood cancers and other non-malignant conditions in males is the damage and/or loss of the proliferating spermatogonial stem cells in the testis. Cryopreservation of spermatozoa is the first line treatment for fertility preservation in adolescent males. Where sperm retrieval is impossible, such as in prepubertal boys, or it is unfeasible in adolescents prior to the onset of ablative therapies, alternative experimental treatments such as testicular tissue cryopreservation and the harvesting and banking of isolated spermatogonial stem cells can now be proposed as viable means of preserving fertility. STUDY DESIGN, SIZE, DURATION Advances in clinical treatments, patient management strategies and the research methods used to preserve sperm and testicular tissue for prepubertal boys and adolescents were reviewed. A snapshot of the up-take of testis cryopreservation as a means to preserve the fertility of young males prior to December 2012 was provided using a questionnaire. PARTICIPANTS/MATERIALS, SETTING, METHODS A comprehensive literature review was conducted. In addition, survey results of testis freezing practices in young patients were collated from 24 European centres and Israeli University Hospitals. MAIN RESULTS AND THE ROLE OF CHANCE There is increasing evidence of the use of testicular tissue cryopreservation as a means to preserve the fertility of pre- and peri-pubertal boys of up to 16 year-old. The survey results indicate that of the 14 respondents, half of the centres were actively offering testis tissue cryobanking as a means of safeguarding the future fertility of boys and adolescents as more than 260 young patients (age range less than 1 year old to 16 years of age), had already undergone testicular tissue retrieval and storage for fertility preservation. The remaining centres were considering the implementation of a tissue-based fertility preservation programme for boys undergoing oncological treatments. LIMITATIONS, REASONS FOR CAUTION The data collected were limited by the scope of the questionnaire, the geographical range of the survey area, and the small number of respondents. WIDER IMPLICATIONS OF THE FINDINGS The clinical and research questions identified and the ethical and legal issues raised are highly relevant to the multi-disciplinary teams developing treatment strategies to preserve the fertility of prepubertal and adolescent boys who have a high risk of fertility loss due to ablative interventions, trauma or genetic pre-disposition.
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Affiliation(s)
- Helen M Picton
- Division of Reproduction and Early Development, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Clarendon Way, Leeds LS2 9JT, UK
| | - Christine Wyns
- Université Catholique de Louvain (UCL), Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique (IREC), 1200 Brussels, Belgium Department of Gynecology-Andrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - Richard A Anderson
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Ellen Goossens
- Research Group Biology of the Testis (BITE), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Kirsi Jahnukainen
- Children's Hospital, Helsinki University Central Hospital, Helsinki, Finland Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Sabine Kliesch
- Centre of Reproductive Medicine and Andrology, University Münster, Domagkstraße 11, 48149 Münster, Germany
| | - Rod T Mitchell
- MRC Centre for Reproductive Health, Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - G Pennings
- Bioethics Institute Ghent (BIG), Faculty of Philosophy and Moral Science, Ghent University, Ghent, Belgium
| | - Natalie Rives
- Laboratoire de Biologie de la Reproduction - CECOS, Research Team EA 4308 'Gametogenesis and gamete quality', IRIB, Rouen University Hospital, University of Rouen, 76031 Rouen Cedex, France
| | - Herman Tournaye
- Centre for Reproductive Medicine, University Hospital of the Brussels Free University, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Ans M M van Pelt
- Center for Reproductive Medicine, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Ursula Eichenlaub-Ritter
- Faculty of Biology, Gene Technology/Microbiology, University of Bielefeld, Bielefeld 33501, Germany
| | - Stefan Schlatt
- Centre of Reproductive Medicine and Andrology, University Münster, Domagkstraße 11, 48149 Münster, Germany
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Nordhoff V, Fricke RK, Schüring AN, Zitzmann M, Kliesch S. Treatment strategies for severe oligoasthenoteratozoospermia (OAT) (<0.1 million/mL) patients. Andrology 2015; 3:856-63. [PMID: 26266459 DOI: 10.1111/andr.12077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 05/27/2015] [Accepted: 06/20/2015] [Indexed: 12/23/2022]
Abstract
Intracytoplasmic sperm injection (ICSI) using spermatozoa from patients with severe oligoasthenoteratozoospermia is still a challenge. Although spermatozoa are available, lower fertilisation rates as well as compromised pregnancy rates are observed after ICSI. We aimed at identifying respective parameters in the pre-values of ejaculate samples used for couple counselling. The clinical pre-values of 121 patients and their corresponding 228 ICSI cycles performed between 2002 and 2010 were retrospectively analysed. Patients were divided into three groups: (i) group 1 (G1, n = 51) where all patients showed at least once <0.1 million/mL and ICSI was performed using ejaculate alone; (ii) group 2 (G2, n = 14) patients had once <0.1 Mill/mL or azoospermia and a testicular biopsy before start of ICSI; (iii) group 3 (G3, n = 56) patients were azoospermic and directed immediately to testicular sperm extraction (TESE). The pre-values of G2 differed significantly from G1 in terms of volume and motility. Lutenizing hormone (LH) and follicle-stimulating hormone (FSH) values were equal in G1 and G2, but showed significant differences in comparison to G3. Testis volume was significantly higher in G3. In the corresponding ICSI cycles, the percentage of cancelled embryo transfers was highest in G3. We did not find any correlations of hormonal markers or sperm pre-values with the success rates of ICSI. In our patient cohort, spermatozoa retrieved either from ejaculate or testicular biopsies have nearly identical chances in achieving pregnancies. Patients in need of TESE before ICSI have significantly lower sperm counts. However, it is not possible to calculate threshold values as indicator for TESE.
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Affiliation(s)
- V Nordhoff
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
| | - R K Fricke
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
| | - A N Schüring
- UKM Kinderwunschzentrum, Department of Gynaecology and Obstetrics, University Hospital of Münster, Münster, Germany
| | - M Zitzmann
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
| | - S Kliesch
- Department of Clinical Andrology, Centre of Reproductive Medicine and Andrology, University Hospital of Münster, Münster, Germany
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Desch L, Bruno C, Herbemont C, Michel F, Bechoua S, Girod S, Sagot P, Fauque P. Impact on ICSI outcomes of adding 24 h of in vitro culture before testicular sperm freezing: a retrospective study. Basic Clin Androl 2015; 25:6. [PMID: 26085932 PMCID: PMC4470024 DOI: 10.1186/s12610-015-0022-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 06/01/2015] [Indexed: 11/22/2022] Open
Abstract
Purpose To compare sperm parameters and intracytoplasmic sperm injection (ICSI) outcomes for testicular spermatozoa frozen on the day of the biopsy (DO) with those frozen after 24 h of in vitro culture (D1). Methods In this retrospective study, from 1999 to 2012, forty-nine azoospermic patients were included to compare sperm (motility and viability) and outcomes (fertilization (FR), implantation (IR), pregnancy (PR) and delivery rates (DR)). Results The in vitro culture increased total motility (+2.8 %, p = 0.0161) but decreased viability (−8.3 %, p = 0.007). After 24 h of culture, the post-thaw changes in motility and viability were not significant. Twenty-six couples underwent ICSI: thirty–four ICSI were performed with spermatozoa cryopreserved at D0 and eighteen with spermatozoa frozen at D1. Cumulated IR and DR were lower for ICSI with D1 spermatozoa than with D0 spermatozoa (IR: 21.6 % with D0 vs. 9.8 % with D1, p = 0.102; DR: 27.5 % with D0 vs. 8.3 % with D1, p = 0.049). Conclusion Despite improving motility, freezing spermatozoa 24 h after testicular biopsy had a potential negative effect on ICSI outcomes, notably on delivery rates. These results may be related to the detrimental impact of the additional culture on the nuclear integrity of sperm.
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Affiliation(s)
- Laurent Desch
- Laboratoire de Biologie de la Reproduction, Hôpital de Dijon, Université de Bourgogne, 2 Bd Mal De Lattre De Tassigny, 21079 Dijon, France
| | - Céline Bruno
- Laboratoire de Biologie de la Reproduction, Hôpital de Dijon, Université de Bourgogne, 2 Bd Mal De Lattre De Tassigny, 21079 Dijon, France
| | - Charlène Herbemont
- Laboratoire de Biologie de la Reproduction, Hôpital de Dijon, Université de Bourgogne, 2 Bd Mal De Lattre De Tassigny, 21079 Dijon, France
| | - Frédéric Michel
- Service de Chirurgie Urologique-Andrologie, Hôpital de Dijon, Université de Bourgogne, Dijon, France
| | - Shaliha Bechoua
- Laboratoire de Biologie de la Reproduction, Hôpital de Dijon, Université de Bourgogne, 2 Bd Mal De Lattre De Tassigny, 21079 Dijon, France
| | - Sophie Girod
- Service de Gynécologie-Obstétrique, Hôpital de Dijon, Université de Bourgogne, Dijon, France
| | - Paul Sagot
- Service de Gynécologie-Obstétrique, Hôpital de Dijon, Université de Bourgogne, Dijon, France
| | - Patricia Fauque
- Laboratoire de Biologie de la Reproduction, Hôpital de Dijon, Université de Bourgogne, 2 Bd Mal De Lattre De Tassigny, 21079 Dijon, France
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Nordhoff V. How to select immotile but viable spermatozoa on the day of intracytoplasmic sperm injection? An embryologist's view. Andrology 2014; 3:156-62. [DOI: 10.1111/andr.286] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 09/05/2014] [Accepted: 09/08/2014] [Indexed: 11/27/2022]
Affiliation(s)
- V. Nordhoff
- Department of Clinical Andrology; Centre of Reproductive Medicine and Andrology; University Hospital of Münster; Münster Germany
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Montjean D, Courageot J, Altié A, Amar-Hoffet A, Rossin B, Geoffroy-Siraudin C, Tourame P, Boyer P. Normal live birth after vitrified/warmed oocytes intracytoplasmic sperm injection with immotile spermatozoa in a patient with Kartagener's syndrome. Andrologia 2014; 47:839-45. [PMID: 25269826 DOI: 10.1111/and.12331] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/25/2014] [Indexed: 12/01/2022] Open
Abstract
The present article is a report on two cases of male Kartagener's syndrome enrolled in intraconjugal IVF programme due to akinetospermia. Viable spermatozoa were selected using a hypo-osmotic swelling test (HOST) and pentoxifylline activation and subsequently microinjected into vitrified/warmed oocytes. The treatment enabled one of these two couples to achieve a pregnancy and to give birth to a healthy baby girl.
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Affiliation(s)
- D Montjean
- Service of Medicine and Reproductive Biology, Saint-Joseph Hospital, Marseille, France
| | - J Courageot
- Electron microscopy Department, Medicine faculty of La Timone, Aix-Marseille University, Marseille, France
| | - A Altié
- Electron microscopy Department, Medicine faculty of La Timone, Aix-Marseille University, Marseille, France
| | - A Amar-Hoffet
- Service of Medicine and Reproductive Biology, Saint-Joseph Hospital, Marseille, France
| | - B Rossin
- Service of Medicine and Reproductive Biology, Saint-Joseph Hospital, Marseille, France
| | - C Geoffroy-Siraudin
- Service of Medicine and Reproductive Biology, Saint-Joseph Hospital, Marseille, France
| | - P Tourame
- Service of Medicine and Reproductive Biology, Saint-Joseph Hospital, Marseille, France
| | - P Boyer
- Service of Medicine and Reproductive Biology, Saint-Joseph Hospital, Marseille, France
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Wöber M, Ebner T, Steiner SL, Strohmer H, Oppelt P, Plas E, Obruca A. A new method to process testicular sperm: combining enzymatic digestion, accumulation of spermatozoa, and stimulation of motility. Arch Gynecol Obstet 2014; 291:689-94. [DOI: 10.1007/s00404-014-3458-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 08/29/2014] [Indexed: 12/01/2022]
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