1
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
2
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
3
|
Aydos K, Aydos OS. Sperm Selection Procedures for Optimizing the Outcome of ICSI in Patients with NOA. J Clin Med 2021; 10:jcm10122687. [PMID: 34207121 PMCID: PMC8234729 DOI: 10.3390/jcm10122687] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/13/2021] [Accepted: 06/16/2021] [Indexed: 12/19/2022] Open
Abstract
Retrieving spermatozoa from the testicles has been a great hope for patients with non-obstructive azoospermia (NOA), but relevant methods have not yet been developed to the level necessary to provide resolutions for all cases of NOA. Although performing testicular sperm extraction under microscopic magnification has increased sperm retrieval rates, in vitro selection and processing of quality sperm plays an essential role in the success of in vitro fertilization. Moreover, sperm cryopreservation is widely used in assisted reproductive technologies, whether for therapeutic purposes or for future fertility preservation. In recent years, there have been new developments using advanced technologies to freeze and preserve even very small numbers of sperm for which conventional techniques are inadequate. The present review provides an up-to-date summary of current strategies for maximizing sperm recovery from surgically obtained testicular samples and, as an extension, optimization of in vitro sperm processing techniques in the management of NOA.
Collapse
Affiliation(s)
- Kaan Aydos
- Department of Urology, Reproductive Health Research Center, School of Medicine, University of Ankara, 06230 Ankara, Turkey
- Correspondence: ; Tel.: +90-533-748-8995
| | - Oya Sena Aydos
- Department of Medical Biology, School of Medicine, University of Ankara, 06230 Ankara, Turkey;
| |
Collapse
|
4
|
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: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
5
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
6
|
Gu YF, Zhou QW, Zhang SP, Lu CF, Gong F, Shi Y, Lu GX, Lin G. The clinical and neonatal outcomes after stimulation of immotile spermatozoa using SperMagic medium. Andrologia 2018; 50:e13056. [PMID: 29862537 DOI: 10.1111/and.13056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 04/23/2018] [Indexed: 11/29/2022] Open
Abstract
To evaluate the efficiency and safety of SperMagic medium on stimulating the immotile spermatozoa in testicular sperm extraction (TESE) and absolute asthenozoospermia, 96 patients with TESE and 106 patients with absolute asthenozoospermia were enrolled in this study. The motile spermatozoa were detected in 47 TESE patients and 68 absolute asthenozoospermia and these patients were assigned to control group. The immotile spermatozoa in 49 TESE patients and 34 absolute asthenozoospermia were stimulated with SperMagic medium. Patients were treated by standard intracytoplasmic sperm injection (ICSI). There were no significant differences in fertilisation, cleavage, implantation, pregnancy, live birth and neonatal outcomes. SperMagic medium does not increase incidence of adverse neonatal outcomes and is a reliable tool for selection of viable spermatozoa in ICSI.
Collapse
Affiliation(s)
- Yi-Fan Gu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, China
| | - Qin-Wei Zhou
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Shuo-Ping Zhang
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, China
| | - Chang-Fu Lu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, China
| | - Fei Gong
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, China
| | - Yun Shi
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China
| | - Guang-Xiu Lu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, China.,National Engineering and Research Center of Human Stem Cell, Changsha, China.,Key Laboratory of Reproductive and Stem Cell Engineering, National Health and Family Planning Commission, Changsha, China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Central South University, Changsha, China.,Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, China.,National Engineering and Research Center of Human Stem Cell, Changsha, China.,Key Laboratory of Reproductive and Stem Cell Engineering, National Health and Family Planning Commission, Changsha, China
| |
Collapse
|
7
|
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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022] Open
|
8
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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
| |
Collapse
|
9
|
Asokan Y, Honguntikar SD, Uppangala S, Salian SR, Kumar D, Kalthur G, Adiga SK. In situviability detection assays induce heat-shock protein 70 expression in spermatozoa without affecting the chromatin integrity. Andrologia 2014; 47:958-65. [DOI: 10.1111/and.12364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2014] [Indexed: 11/29/2022] Open
Affiliation(s)
- Y. Asokan
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| | - S. D. Honguntikar
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| | - S. Uppangala
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| | - S. R. Salian
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| | - D. Kumar
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| | - G. Kalthur
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| | - S. K. Adiga
- Division of Clinical Embryology; Department of Obstetrics and Gynecology; Kasturba Medical College; Manipal University; Manipal India
| |
Collapse
|
10
|
|
11
|
Ebner T, Tews G, Mayer RB, Ziehr S, Arzt W, Costamoling W, Shebl O. Pharmacological stimulation of sperm motility in frozen and thawed testicular sperm using the dimethylxanthine theophylline. Fertil Steril 2011; 96:1331-6. [DOI: 10.1016/j.fertnstert.2011.08.041] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/11/2011] [Accepted: 08/30/2011] [Indexed: 10/17/2022]
|
12
|
Abstract
BACKGROUND Complete asthenozoospermia, i.e. 100% immotile spermatozoa in the ejaculate, is reported at a frequency of 1 of 5000 men. Its diagnosis implies a poor fertility prognosis even with ICSI. It is extremely important to distinguish between two different groups of patients with complete asthenozoospermia, i.e. virtual or absolute asthenozoospermia. With the former group having some motile spermatozoa after extensive processing of the semen, absolute asthenozoospermia can be associated with metabolic deficiencies, ultrastructural abnormalities of the sperm flagellum, necrozoospermia otherwise it can be idiopathic. In the management of persistent absolute asthenozoospermia, it is very important to elucidate its nature and whenever possible to correct the potential causes. METHODS We reported data published in the literature on the aetiology of absolute asthenozoospermia and the different techniques to improve ICSI outcome. We propose an algorithm for diagnosis and treatment of this condition. RESULTS Different results regarding fertilization, cleavage and pregnancy rate have been published in patients with absolute asthenozoospermia undergoing ICSI. However, the results vary widely depending on the sperm origin and the technique applied for immotile sperm selection. The percentage of viable spermatozoa varies between 0 and 100%. CONCLUSIONS Absolute immotile spermatozoa is one of the most important causes of reduced fertilization and pregnancy rates after ICSI and different techniques are used to improve ICSI outcomes. However, it still remains unclear which is the best technique to improve the pregnancy outcomes in these couples.
Collapse
Affiliation(s)
- C Ortega
- Centre for Reproductive Medicine, University Hospital Dutch-speaking Brussels Free University, Laarbeeklaan 101, Brussels, Belgium.
| | | | | | | | | | | |
Collapse
|
13
|
Mangoli V, Mangoli R, Dandekar S, Suri K, Desai S. Selection of viable spermatozoa from testicular biopsies: a comparative study between pentoxifylline and hypoosmotic swelling test. Fertil Steril 2011; 95:631-4. [PMID: 21074155 DOI: 10.1016/j.fertnstert.2010.10.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Revised: 09/06/2010] [Accepted: 10/07/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To compare fertilization, cleavage, and pregnancy outcome using pentoxifylline and a hypoosmotic swelling (HOS) test to select viable spermatozoa from testicular biopsy specimens. DESIGN Open, comparative, prospective study. SETTING G.S. Medical College and Fertility clinic, Mumbai, India. PATIENT(S) A total of 50 couples enrolled for infertility treatment having a male factor indication of nonobstructive azoospermia. INTERVENTION(S) Assessment of viable spermatozoa using pentoxifylline and using an HOS test from a population of nonmotile spermatozoa obtained from testicular biopsies. MAIN OUTCOME MEASURE(S) Comparison of fertilization, cleavage, and clinical pregnancy rates using viable sperms recovered using pentoxifylline and an HOS test. RESULT(S) Viable spermatozoa were obtained in both the study groups. Significantly higher fertilization rates (pentoxifylline 62.05% vs. HOS 41.07%) and clinical pregnancy rates (pentoxifylline 32% vs. HOS 16%) were observed. There was no significant difference in cleavage rates among both groups. CONCLUSION(S) We found that obtaining viable spermatozoa using pentoxifylline was more effective in terms of fertilization and pregnancies than obtaining it through an HOS test.
Collapse
|
14
|
Sereni E, Bonu MA, Fava L, Sciajno R, Serrao L, Preti S, Distratis V, Borini A. Freezing spermatozoa obtained by testicular fine needle aspiration: a new technique. Reprod Biomed Online 2008; 16:89-95. [DOI: 10.1016/s1472-6483(10)60560-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
15
|
Abstract
Intracytoplasmic sperm injection (ICSI) has become the method of choice to overcome male infertility when all other forms of assisted fertilization have failed. Animals in which ICSI has produced normal offspring include many species. Success rate with normal spermatozoa is well above 50% in the mouse but ICSI success rates in other animals have been low, ranging from 0.3 to 16.5%. Mouse ICSI revealed that spermatozoa that cannot participate in normal fertilization can produce normal offspring by ICSI, provided their nuclei are genomically intact. Human ICSI using infertile spermatozoa has been highly successful perhaps because of the intrinsic instability of human sperm plasma membrane. The health of children born after ICSI and other assisted fertilization techniques is of major concern. Careful analyses suggest that higher incidences of congenital malformations and/or low birth weights after assisted fertilization are largely attributable to parental genetic background and increased incidence of multiple births, rather than to the techniques of assisted fertilization. Since the physiological and nutritional environments of developing embryos may cause persisting alteration in DNA methylation, extreme caution must be exercised in handling gametes and embryos in vitro. In the mouse, round spermatid injection (ROSI) has been routinely successful but its use in humans is controversial. Whether human ROSI and assisted fertilization involving younger spermatogenic cells are medically safe must be the subject of further investigations.
Collapse
Affiliation(s)
- Ryuzo Yanagimachi
- Institute for Biogenesis Research, University of Hawaii Medical School, Honolulu, Hawaii 96822, USA.
| |
Collapse
|
16
|
Abstract
The onset of clinical assisted reproduction, a quarter of a century ago, required the isolation of motile spermatozoa. As the indication of assisted reproduction shifted from mere gynaecological indications to andrological indications during the years, this urged andrological research to understand the physiology of male germ cell better and develop more sophisticated techniques to separate functional spermatozoa from those that are immotile, have poor morphology or are not capable to fertilize oocytes. Initially, starting from simple washing of spermatozoa, separation techniques, based on different principles like migration, filtration or density gradient centrifugation evolved. The most simple and cheapest is the conventional swim-up procedure. A more sophisticated and most gentle migration method is migration-sedimentation. However, its yield is relatively small and the technique is therefore normally only limited to ejaculates with a high number of motile spermatozoa. Recently, however, the method was also successfully used to isolate spermatozoa for intracytoplasmic sperm injection (ICSI). Sperm separation methods that yield a higher number of motile spermatozoa are glass wool filtration or density gradient centrifugation with different media. Since Percoll as a density medium was removed from the market in 1996 for clinical use in the human because of its risk of contamination with endotoxins, other media like IxaPrep, Nycodenz, SilSelect, PureSperm or Isolate were developed in order to replace Percoll. Today, an array of different methods is available and the selection depends on the quality of the ejaculates, which also includes production of reactive oxygen species (ROS) by spermatozoa and leukocytes. Ejaculates with ROS production should not be separated by means of conventional swim-up, as this can severely damage the spermatozoa. In order to protect the male germ cells from the influence of ROS and to stimulate their motility to increase the yield, a number of substances can be added to the ejaculate or the separation medium. Caffeine, pentoxifylline and 2-deoxyadenosine are substances that were used to stimulate motility. Recent approaches to stimulate spermatozoa include bicarbonate, metal chelators or platelet-activating factor (PAF). While the use of PAF already resulted in pregnancies in intrauterine insemination, the suitability of the other substances for the clinical use still needs to be tested. Finally, the isolation of functional spermatozoa from highly viscous ejaculates is a special challenge and can be performed enzymatically to liquefy the ejaculate. The older method, by which the ejaculate is forcefully aspirated through a narrow-gauge needle, should be abandoned as it can severely damage spermatozoa, thus resulting in immotile sperm.
Collapse
Affiliation(s)
- Ralf R Henkel
- Department of Dermatology and Andrology, Justus Liebig University, Giessen, Gaffkystr. 14, Germany
| | - Wolf-Bernhard Schill
- Department of Dermatology and Andrology, Justus Liebig University, Giessen, Gaffkystr. 14, Germany
| |
Collapse
|
17
|
Correa-Pérez JR, Fernández-Pelegrina R, Zarmakoupis-Zavos PN, Zavos PM. The effect of colloid osmotic pressure in human spermatozoa exposed to hypoosmotic conditions. Andrologia 2003; 35:117-20. [PMID: 12653786 DOI: 10.1046/j.1439-0272.2003.00542.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The use of a protein source such as serum and albumin had been extensively employed as supplements of culture media for handling and culture of gametes and embryos. Protein molecules behave as colloids in solution and contribute to the osmotic pressure of fluids. The interaction of proteins in solution and spermatozoa needs to be assessed in order to determine their possible role in osmoregulation. The aim of this study was to assess possible osmoregulatory mechanisms of protein supplementation against exposure to hypoosmotic conditions by assessing the sperm's response to those environments. A stock hypoosmotic solution (HOS) was prepared by using a mixture of fructose and sodium citrate and adjusted to an osmotic pressure of 150 mOsm l-1. Another stock solution was prepared by diluting a preparation of synthetic serum supplement [SSS; 6% (v/v) total protein] with distilled water to obtain an osmotic pressure of 150 mOsm l-1 (hypoosmotic SSS or H-SSS). Three additional solutions were prepared by mixing the stock HOS and H-SSS solutions in the following proportions (v/v): (i) 75% H-SSS/25% HOS, (ii) 50% H-SSS/50% HOS and (iii) 25% H-SSS/75% HOS. Aliquots of washed spermatozoa from 18 men were diluted 1 : 10 (v/v) with each of the testing solutions and incubated for 60 min. Specimens were assessed on wet mounts for total and specific swelling patterns. Swelling patterns were classified as maximal (>50% tail length swollen) and minimal (<50% tail length swollen) swelling with or without associated sperm motility. The major finding of this study was that increasing the concentration of protein supplementation resulted in a decrease in the proportion of maximal sperm tail swelling patterns and an increase in the proportion of minimal tail swelling patterns. A proportion of spermatozoa which exhibited minimal swelling patterns were still motile in all solutions tested, and the percentage of those spermatozoa increased as the protein supplementation was also increased in the testing solutions. Incorporation of protein supplementation as described in this study delays the effect of sperm swelling in hypoosmotic conditions.
Collapse
Affiliation(s)
- J R Correa-Pérez
- Centro de Fertilidad del Caribe, Torre San Francisco Suite 606, 3659 Ave de Diego, Río Piedras, Puerto Rico 00923.
| | | | | | | |
Collapse
|
18
|
El-Nour AM, Al Mayman HA, Jaroudi KA, Coskun S. Effects of the hypo-osmotic swelling test on the outcome of intracytoplasmic sperm injection for patients with only nonmotile spermatozoa available for injection: a prospective randomized trial. Fertil Steril 2001; 75:480-4. [PMID: 11239527 DOI: 10.1016/s0015-0282(00)01762-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Hypo-osmotic swelling test (HOST) has been shown to be an effective method for the selection of live sperm. On-going pregnancies were obtained by using HOST-selected sperm. The aim of this study was to evaluate the effect of using HOST-selected "live" sperm versus nonselected sperm on the outcome of intracytoplasmic sperm injection cycles when only nonmotile sperm were available for injection. DESIGN Prospective randomized study. SETTING Governmental tertiary care hospital. PATIENT(S) Thirty ICSI cycles with no motile sperm were included in this study. INTERVENTION(S) For the HOST group, potentially live spermatozoa detected by hypo-osmotic reaction of the tail were injected into oocytes. For the No-HOST group, the sperm were randomly injected into the oocytes without checking the viability. MAIN OUTCOME MEASURE(S) The fertilization, cleavage, embryo quality, pregnancy, and implantation rates were assessed for the two groups. RESULT(S) Among 30 cycles, 15 fall into each group. Fertilization, cleavage rates, and the number of good quality embryos were similar between two groups. CONCLUSION(S) HOST-selected live spermatozoa can be safely used for intracytoplasmic sperm injection to establish pregnancies. There is a tendency for higher pregnancy and implantation rates to result, but it does not reach statistical significance.
Collapse
Affiliation(s)
- A M El-Nour
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Reseach Center, Riyadh, Saudi Arabia
| | | | | | | |
Collapse
|
19
|
Abstract
Men with non-obstructive azoospermia exhibit different histopathologic syndromes in the testicle biopsy, varying from aplasia, Sertoli cell only syndrome, maturation arrest and hypoplasia. The genetic basis of these syndromes is discussed. We present the diagnostic testicle biopsies performed on 160 consecutive non-obstructive azoospermic patients, and these results were correlated with the findings after multiple bilateral treatment testicle biopsy. Each syndrome had to be reevaluated as for the presence of at least one focus of spermatogenesis up to the primary spermatocyte, round spermatid, elongating spermatid, elongated spermatid, or spermatozoa stages. The clinical outcome using donor sperm-IVF, spermatid or sperm intracytoplasmic injection is thereafter presented. A new prognosis based on the findings of this large clinical series coupled to results obtained with Y chromosome molecular screening is offered. Alternative treatments to donor sperm for men without spermatids are discussed.
Collapse
Affiliation(s)
- M Sousa
- Laboratory of Cell Biology, Institute of Biomedical Sciences Abel Salazar, University of Porto, Lg. Prof. Abel Salazar 2, 4099-003, Porto, Portugal.
| | | | | |
Collapse
|
20
|
de Mendoza MV, González-Utor AL, Cruz N, Gutiérrez P, Cascales F, Sillero JM. In situ use of pentoxifylline to assess sperm vitality in intracytoplasmic sperm injection for treatment of patients with total lack of sperm movement. Fertil Steril 2000; 74:176-7. [PMID: 10907916 DOI: 10.1016/s0015-0282(00)00559-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
21
|
Angelopoulos T, Adler A, Krey L, Licciardi F, Noyes N, McCullough A. Enhancement or initiation of testicular sperm motility by in vitro culture of testicular tissue. Fertil Steril 1999; 71:240-3. [PMID: 9988391 DOI: 10.1016/s0015-0282(98)00434-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe different techniques of testicular tissue culture and their effect on sperm motility, mainly in cases of totally immotile spermatozoa, and to compare the effect of in vitro culture with that of motility stimulants. DESIGN Prospective study. SETTING University teaching hospital. PATIENT(S) Ten patients undergoing testicular biopsy for diagnostic purposes or for intracytoplasmic sperm injection. INTERVENTION(S) Dissected testicular biopsy samples and tissue blocks were cultured at 37 degrees C for up to 96 hours. Immediately after dissection, immotile testicular spermatozoa were incubated for 30 minutes in pentoxifylline and 2-deoxyadenosine. MAIN OUTCOME MEASURE(S) Sperm motility and vitality. RESULT(S) Overall, dissected samples showed improved sperm motility, which peaked within 48 hours of culture. Unlike motility, vitality declined linearly, from 56.3%+/-19% at initial assessment to 18.8%+/-11% at 96 hours. Five samples had initially immotile spermatozoa, of which four acquired motility at 48 hours. In vitro culture showed results comparable with those of incubation with pentoxifylline and 2-deoxyadenosine. Culture of tissue blocks did not improve motility or vitality compared with dissected tissue. CONCLUSION(S) The motility of testicular spermatozoa was enhanced or initiated after in vitro culture. Testicular biopsy culture may be an alternative to the use of motility stimulants to obtain motile spermatozoa for intracytoplasmic sperm injection, particularly when oocytes are not immediately available.
Collapse
Affiliation(s)
- T Angelopoulos
- Department of Obstetrics and Gynecology, New York University Medical Center, New York 10016, USA
| | | | | | | | | | | |
Collapse
|