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Lin M, Zhang Y, Wang H, Wang Y, Wang Y, Feng N, He Q. Multivariate analyses on male factors and construction of a nomogram for predicting low in vitro fertilization rate. Heliyon 2024; 10:e29271. [PMID: 38623219 PMCID: PMC11016707 DOI: 10.1016/j.heliyon.2024.e29271] [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] [Received: 01/08/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/17/2024] Open
Abstract
Low fertilization rate (LFR) and total fertilization failure (TFF) are often encountered in routine in vitro fertilization (IVF) procedure. To solve this problem, multivariate analyses on the relationship between male factors and in vitro fertilization rate were performed, and a nomogram for prediction of LFR was constructed. This retrospective study contained 2011 couples who received IVF treatment from January 2017 to December 2021. Man factors and in vitro fertilization rate were collected. Among these couples, 1347 cases had in vitro fertilization rates ≥30 % (control group), and 664 cases had in vitro fertilization rates <30 % (LFR group). Univariate analyses of male factors found that between the two groups there were significant differences (p < 0.05) in sperm progressive motility (SPR), sperm concentration (SC), total sperm number, normal sperm morphology rate (NSMR), DNA fragmentation index (DFI), sperm acrosin activity (SAA) and the clinical diagnosis of primary or secondary infertility. Multivariate logistic regression analyses showed that SPR, SAA, and SC were independent risk factors for LFR. An algorithm and a correspondent nomogram for predicting high LFR risk were constructed using data from the training cohort. The LFR nomogram exhibited an excellent discrimination power and a high fitting degree in both the training cohort (AUC = 0.90, 95 % CI: 0.88-0.92), (H-L: x2 = 5.43, p = 0.71) and validation cohort (AUC = 0.89, 95 % CI:0.87-0.92), (H-L: x2 = 7.85, p = 0.45), respectively. The decision curve analysis (DCA) demonstrated a high efficiency of the LFR nomogram for clinical utility. SPR, SAA, and SC are independent risk factors for LFR. The LFR nomogram established based on these factors could be a useful tool to predict high risk of LFR, and patients with high risk of LFR can be guided to direct ICSI procedure. Clinical application of the LFR nomogram may increase the in vitro fertilization rate by facilitating the decision making in IVF service.
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Affiliation(s)
- Mengyuan Lin
- Center of Reproductive Medicine, Women's Hospital of Jiangnan University, Wuxi, Jiangsu, China
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
| | - Yuwei Zhang
- Medical School of Nantong University, Nantong, China
| | - Honghua Wang
- Center of Reproductive Medicine, Women's Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Yan Wang
- Center of Reproductive Medicine, Women's Hospital of Jiangnan University, Wuxi, Jiangsu, China
| | - Yang Wang
- Department of Urology, Jiangnan University Medical Center, Wuxi, China
| | - Ninghan Feng
- Wuxi School of Medicine, Jiangnan University, Wuxi, China
- Department of Urology, Jiangnan University Medical Center, Wuxi, China
| | - Qingwen He
- Department of Public Health, Women's Hospital of Jiangnan University, Wuxi, Jiangsu, China
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Du C, Yu Y, Fan X. Analysis of research trends (2014-2023) on oxidative stress and male fertility based on bibliometrics and knowledge graphs. Front Endocrinol (Lausanne) 2024; 15:1326402. [PMID: 38323105 PMCID: PMC10846311 DOI: 10.3389/fendo.2024.1326402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
Background Oxidative stress (OS) is considered one of the major factors affecting male fertility, and research in this field has seen constant growth year by year. Currently, around 700 relevant papers are published each year, with a trend of further growth. Therefore, this study systematically summarizes the literature published in the last decade from a bibliometric perspective, revealing the dynamic development of the field, identifying research hotspots, analyzing future trends, and providing reference for further research. Methods Relevant literature on oxidative stress and male fertility was retrieved from the Web of Science Core Collection (WoSCC) database, covering the timespan from 2014 to 2023 and including two types, articles and reviews. CiteSpace and VOSviewer were used for bibliometric analysis, including cluster analysis, co-occurrence analysis, co-citation analysis, and burst analysis of countries/regions, institutions, journals, authors, references, and keywords. Results This paper studied a total of 5,301 papers involving 107 countries/regions, with China having the highest number of publications (898 papers) and the United States having the highest centrality (0.62). Burst analysis of journal citations revealed the emergence of many new journals (e.g., Antioxidants-Basel, Front Endocrinol) after 2021, indicating continuous expansion and development in this field. Cluster analysis of co-cited references and co-occurring keywords divided the research into areas such as oxidative stress and male infertility, oxidative stress level detection, and antioxidants. The keywords associated with research hotspots shifted from oxidative stress detection, sperm DNA damage, apoptosis, and redox potential to DNA methylation, embryonic development, infection, polyunsaturated fatty acids, and antioxidants. Conclusion Bibliometric methods provide an intuitive reflection of the development process in the field of oxidative stress and male fertility, as well as the analysis of research hotspots in different periods. Research on oxidative stress and embryonic development, as well as antioxidant health management, may become hotspots in future research.
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Affiliation(s)
- Chao Du
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
- Department of Histology and Embryology, School of Basic Medicine, China Medical University, Shenyang, Liaoning, China
| | - Yuexin Yu
- Department of Reproductive Medicine, General Hospital of Northern Theater Command, Shenyang, Liaoning, China
| | - Xinyue Fan
- Student Affairs Department of Shengjing Hospital, China Medical University, Shenyang, Liaoning, China
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AmirJannati N, Mohazzab A, Fathalian M, Akhavizadegan H. Comparison of Embryological Results of Microinjection in Two Groups of Men with and without Requesting Sperm DNA Fragmentation Index Measurement. BIOMED RESEARCH INTERNATIONAL 2024; 2024:6769510. [PMID: 38213385 PMCID: PMC10783986 DOI: 10.1155/2024/6769510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/13/2024]
Abstract
Introduction The sperm DNA fragmentation index (DFI) is considered a valuable measure to assess male fertility, but the predictive value of DFI for the outcomes in assisted reproductive technology (ART) is still controversial. Therefore, this study is aimed at investigating the effect of requesting a DFI test or performing ART without DFI on the results observed in the embryology laboratory (number of embryos, fertilization rate, and embryo quality) after intracytoplasmic sperm injection (ICSI). Methods This retrospective study was conducted on infertile men who underwent ICSI and were referred to the Avicenna Infertility and Recurrent Abortion Treatment Center in Tehran from 2019 to 2022. The samples were categorized into two groups: a case group with DFI measurement and a control group without DFI measurement. We conducted a comparative analysis of the embryology results between the two groups, focusing on parameters such as fertilization rate, number of embryos, and embryo quality. t-tests and Mann-Whitney U tests were used to conduct single variable analysis. Potential confounding effects were adjusted to use the multivariate linear and logistic regression. Results Data analysis showed no significant statistical difference between the case group and the control group in terms of the number of embryos (95% confidence interval for the regression coefficient (β) = -0.257-0.123), and embryo quality (95% confidence interval for β = -0.199-0.114). There was no significant statistical difference between the two groups due to the fertilization rate (95% confidence interval for β = -3.42-3.42), except for the variables of woman's age and sperm count after ICSI, as determined by adjusted linear regression. Conclusions Although DFI measurement is used to assess male infertility, its importance as a predictor for the embryology outcomes after ICSI requires further evaluation and the determination of a cut-off point for predicting results. This study was based on retrospectively collected DFI data, and prospective studies confirming the superiority of ICSI outcomes are necessary.
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Affiliation(s)
- Naser AmirJannati
- Reproductive Biotechnology Research Center, Avicenna Research Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
| | - Arash Mohazzab
- Reproductive Biotechnology Research Center, Avicenna Research Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Manizheh Fathalian
- Reproductive Biotechnology Research Center, Avicenna Research Institute, Academic Center for Education, Culture and Research (ACECR), Tehran, Iran
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Amano K, Oigawa S, Ichizawa K, Tokuda Y, Unagami M, Sekiguchi M, Furui M, Nakaoka K, Ito A, Hayashi R, Tamaki Y, Hayashi Y, Fukuda Y, Katagiri Y, Nakata M, Nagao K. Swim-up method is superior to density gradient centrifugation for preserving sperm DNA integrity during sperm processing. Reprod Med Biol 2024; 23:e12562. [PMID: 38288089 PMCID: PMC10823384 DOI: 10.1002/rmb2.12562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/27/2023] [Accepted: 01/09/2024] [Indexed: 01/31/2024] Open
Abstract
Purpose This study aimed to evaluate the effects of swim-up and density gradient centrifugation methods on sperm DNA fragmentation. Methods Nineteen normozoospermic patient samples with ≥100 × 106 motile sperms were included in this study. Sperm DNA fragmentation, progressive motility, and progressive motile sperm number were measured before and after the swim-up method or density gradient centrifugation. Results Sperm DNA fragmentation was not statistically different between swim-up-(14.4 ± 2.1%, p = 0.32) and density gradient centrifugation-processed (25.0 ± 3.0%, p = 0.20) and unprocessed semen samples (19.2 ± 1.9%). Sperm DNA fragmentation was significantly lower in swim-up-than in density gradient centrifugation-processed samples (p < 0.05). Sperm progressive motility was significantly higher (p < 0.05) in swim-up-(92.9 ± 1.0%) and density gradient centrifugation-processed (81.3 ± 2.0%) samples, with the former being higher, than in unprocessed semen samples (53.1 ± 3.7%). The recovery rate of progressive motile sperms was significantly lower in swim-up-(9.7 ± 1.4%) than in density gradient centrifugation-processed samples (17.2 ± 1.8%, p < 0.05). Conclusions The swim-up method is superior to density gradient centrifugation, evidenced by less sperm DNA fragmentation and higher sperm progressive motility. The recovery rate of progressive motile sperms was better after density gradient centrifugation than after swim-up.
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Affiliation(s)
- Kenji Amano
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
| | - Satoko Oigawa
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
| | | | - Yukiko Tokuda
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
| | - Mami Unagami
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
| | - Mami Sekiguchi
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Mayuko Furui
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Kentaro Nakaoka
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Ayumu Ito
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Rika Hayashi
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Yuko Tamaki
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Yuko Hayashi
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Yusuke Fukuda
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Yukiko Katagiri
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Masahiko Nakata
- Department of Obstetrics and Gynecology, Faculty of MedicineToho UniversityTokyoJapan
| | - Koichi Nagao
- Reproduction Center, Toho University Omori Medical CenterTokyoJapan
- Department of Urology, Faculty of MedicineToho UniversityTokyoJapan
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Yan B, Fan H, Ji H, Li S, Hu H, Gu X, Jia S, Liu Y, Guo J, Yang Z, Zhou L, Xiao X, Li L, Mao Z. DNA strand displacement and TdT-Mediated DNA extension for swift, convenient, and quantitative evaluation of sperm DNA integrity and its clinical implications. Anal Chim Acta 2023; 1280:341821. [PMID: 37858544 DOI: 10.1016/j.aca.2023.341821] [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: 06/25/2023] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 10/21/2023]
Abstract
DNA integrity is crucial for the clinical pregnancy outcome and offspring health, while detection methods currently used (comet assay, TUNNEL assay, SCSA, etc.) can only provide the ratio of positive sperms at the cellular level and are unable to quantitatively detect the breakpoints at the DNA molecular level. Herein, we developed a detection system based on terminal deoxynucleotidyl transferase and DNA strand displacement fluorescent probe, which could efficiently and conveniently measure the number of 3'-OH (equivalent to the number of breakpoints). We further investigated the use of this technique in assisted reproduction after completing the principle verification, system optimization, and research on analytical performance. The detection system was shown to have a good linear range from 0.01 nM to 4 nM, using single-stranded DNA with 3'-OH end as the calibrator. The system underwent thorough optimization for stability and accuracy. In comparison to the widely accepted index DFI detected by SCSA, the new system demonstrated reasonable correlation and better prediction efficiency. Its applicability was also proven through its use in assisted reproductive technology procedures.
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Affiliation(s)
- Bei Yan
- Human Sperm Bank, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, 750004, China; Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; 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, 410007, China
| | - Heng Fan
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Hanxu Ji
- School of Life Science and Technology, Wuhan Poly-technic University, Wuhan, 430023, China
| | - Siqi Li
- School of Life Science and Technology, Wuhan Poly-technic University, Wuhan, 430023, China
| | - Hao Hu
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiuli Gu
- Wuhan Huake Reproductive Hospital, Wuhan, 430030, China
| | - Shaotong Jia
- Human Sperm Bank, Institute of Medical Sciences, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Ying Liu
- Wuhan Biobank, Wuhan, 430070, China
| | - Jing Guo
- Wuhan Biobank, Wuhan, 430070, China
| | | | | | - Xianjin Xiao
- Institute of Reproductive Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China; Anhui Province Key Laboratory of Reproductive Health and Genetics, Anhui Medical University, Hefei, 230031, China.
| | - Longjie Li
- School of Life Science and Technology, Wuhan Poly-technic University, Wuhan, 430023, China; Wuhan Huchuang United Technology Co., Ltd, Wuhan, 430070, 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, 410007, China.
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Punjabi U, Goovaerts I, Peeters K, De Neubourg D. Antioxidants in Male Infertility-If We Want to Get This Right We Need to Take the Bull by the Horns: A Pilot Study. Antioxidants (Basel) 2023; 12:1805. [PMID: 37891884 PMCID: PMC10603832 DOI: 10.3390/antiox12101805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 09/23/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Antioxidant therapy should be reserved for infertile patients who actually exhibit signs of oxidative stress (OS). Nevertheless, there is no consensus regarding the measure of the primary endpoint and the assay that should be used. The formation of 8-hydroxy-2'-deoxyguanosine (8-OHdG), an early marker of sperm DNA oxidation (SDO), was analyzed using flow cytometry, in men at a University hospital setup for infertility treatment. Similar to conventional semen parameters, 8-OHdG assay was validated on fresh semen samples to reduce the variability of results. SDO was associated with semen volume, sperm concentration, leucocytes and round cells, but not with age, body mass index, sperm DNA fragmentation (SDF) or OS. Whether the semen samples were normal or subnormal according to the WHO criteria, the expression of 8-OHdG was not different. Receiver operating characteristic curve analysis could discriminate two independent populations. Both SDF and SDO were independently expressed. A high SDF did not reveal a high SDO and vice versa. The thresholds for SDO have been established, but vary with the techniques used. The methodology for SDO needs to be further validated and optimized on a larger clinically defined patient population before the outcome measure is fit to monitor antioxidant therapy in male infertility.
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Affiliation(s)
- Usha Punjabi
- Centre for Reproductive Medicine, Antwerp University Hospital, 2650 Edegem, Belgium; (I.G.); (K.P.); (D.D.N.)
- Department of Reproductive Medicine, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Ilse Goovaerts
- Centre for Reproductive Medicine, Antwerp University Hospital, 2650 Edegem, Belgium; (I.G.); (K.P.); (D.D.N.)
- Department of Reproductive Medicine, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Kris Peeters
- Centre for Reproductive Medicine, Antwerp University Hospital, 2650 Edegem, Belgium; (I.G.); (K.P.); (D.D.N.)
- Department of Reproductive Medicine, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Diane De Neubourg
- Centre for Reproductive Medicine, Antwerp University Hospital, 2650 Edegem, Belgium; (I.G.); (K.P.); (D.D.N.)
- Department of Reproductive Medicine, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
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Zarén P, Turesson C, Giwercman A. Methotrexate use among men-association with fertility and the perinatal health of their children: a Swedish nationwide register study. Fertil Steril 2023; 120:661-669. [PMID: 37395690 DOI: 10.1016/j.fertnstert.2023.05.005] [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: 11/17/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVE To study the effect of methotrexate on male fertility and subsequent effects on their children, for which data are scarce and contradictory. DESIGN Nationwide multiregister cohort study. SETTING Not applicable. SUBJECT(S) All children born alive in Sweden between 2006 and 2014 and their fathers. Three cohorts were defined: children to fathers with periconceptional methotrexate exposure (exposed cohort), children whose fathers stopped methotrexate intake ≥2 years before conception (previously exposed cohort), and children to fathers with no methotrexate exposure (control cohort). EXPOSURE(S) The father having at least one dispensed methotrexate prescription from pharmacies 0-3 months before conception, along with at least one more dispensed methotrexate prescription 0-12 months before conception (periconceptional exposure). Previously exposed cohort: the father having no dispensed methotrexate prescriptions in the 2 years before conception, but having at least two dispensed prescriptions before that. MAIN OUTCOME MEASURES Congenital anomalies (major and any; primary outcomes), preterm birth (PTB) and being small for gestational age (SGA; secondary outcomes), as well as need of intracytoplasmic sperm injection (ICSI) to achieve pregnancy (primary outcome in exposed cohort vs. controls, exploratory outcome in previously exposed cohort vs. controls). Outcomes were analyzed using logistic regression. RESULTS A total of 223 children to fathers with periconceptional methotrexate exposure were identified, along with 356 children whose fathers stopped methotrexate intake ≥2 years before conception and 809,706 not methotrexate-treated controls. In children with fathers periconceptionally exposed to methotrexate, the adjusted and unadjusted odds ratios (95% confidence intervals) for major congenital anomalies were 1.1 (0.4-2.6) and 1.1 (0.4-2.4), any congenital anomalies 1.3 (0.7-2.4) and 1.4 (0.7-2.3), PTB 1.0 (0.5-1.8) and 1.0 (0.5-1.8), SGA 1.1 (0.4-2.6) and 1.0 (0.4-2.2), and conception by use of ICSI 3.9 (2.2-7.1) and 4.6 (2.5-7.7). Use of ICSI was not increased among fathers who stopped methotrexate intake ≥2 years before conception, having adjusted and unadjusted odds ratios 0.9 (0.4-1.9) and 1.5 (0.6-2.9). CONCLUSION This study suggests that paternal periconceptional methotrexate use does not increase risk of congenital anomalies, PTB, or SGA in the offspring but may temporarily reduce fertility.
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Affiliation(s)
- Peter Zarén
- Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden; Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden.
| | - Carl Turesson
- Rheumatology, Department of Clinical Sciences, Lund University, Malmö, Sweden; Department of Rheumatology, Skåne University Hospital, Malmö, Sweden
| | - Aleksander Giwercman
- Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden; Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
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Chua SC, Yovich SJ, Hinchliffe PM, Yovich JL. The Sperm DNA Fragmentation Assay with SDF Level Less Than 15% Provides a Useful Prediction for Clinical Pregnancy and Live Birth for Women Aged under 40 Years. J Pers Med 2023; 13:1079. [PMID: 37511693 PMCID: PMC10381567 DOI: 10.3390/jpm13071079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/23/2023] [Accepted: 06/25/2023] [Indexed: 07/30/2023] Open
Abstract
This retrospective cohort study was conducted on 1148 males who presented along with their partners for infertility management at the PIVET Medical Centre between 2013 and 2022 and had a sperm DNA fragmentation (SDF) assay performed by Halosperm, thereafter participating in 1600 assisted reproductive technology (ART) cycles utilising one of three modalities, namely, IVF-Only, ICSI-Only or IVF-ICSI Split cycles. The outcomes from the ART cycles were then analysed as two groups based on SDF levels <15% and ≥15%. The study showed the unadjusted fertilization rates were not different between the groups, neither across the four female age ranges. However, when the fertilization rates were adjusted for the mature oocytes (metaphase-II oocytes), there was a highly significant difference in fertilization rates in favour of the group with SDF levels < 15% where the women were in the younger age grouping of <35 years (78.4% vs. 73.0%; p < 0.0001). Overall, there was no difference in the rates of blastocyst development nor clinical pregnancy rates between the two SDF groups, but there was a significantly higher pregnancy rate for the younger women (<35 years) with the group of SDF level < 15% (44.1% vs. 37.4%; p = 0.04). Similarly, there was no difference in the miscarriage rates overall with respect to SDF groups, and no clear picture could be deciphered among the women's age groups. With respect to cumulative live births, this reflected the pregnancy rates with no overall difference between the two SDF groups, but there was a significantly higher cumulative live birth rate for women <35 years where the SDF level was <15% (38.6% vs. 28.6%; p < 0.01). Among the three modalities, the highest cumulative live birth rate occurred within the group with SDF level < 15%, being highest with the IVF mode, particularly for women aged <40 years (43.0% vs. 37.7% for IVF-ICSI Split and 27.9% for ICSI; p = 0.0002), noting that the IVF case numbers were disproportionately low.
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Affiliation(s)
- Shiao Chuan Chua
- PIVET Medical Centre, Perth, WA 6007, Australia
- Hospital Shah Alam, Shah Alam 40000, Malaysia
| | | | | | - John Lui Yovich
- PIVET Medical Centre, Perth, WA 6007, Australia
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia
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Trautman A, Gurumoorthy A, Hansen KA. Effects of alcohol use on sperm chromatin structure, a retrospective analysis. Basic Clin Androl 2023; 33:14. [PMID: 37286947 DOI: 10.1186/s12610-023-00189-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/30/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The evaluation of the infertile couple is often complex as multiple factors in both the male and female can contribute, including social history. Previous studies have displayed that male ethanol consumption can disturb sperm motility, nuclear maturity, and deoxyribonucleic acid (DNA) integrity. The main purpose of this study is to evaluate the effects of male alcohol use on sperm chromatin structure analysis (SCSA®). This study was a retrospective chart review of 209 couples that presented to a midsize infertility clinic in the Midwest and had a semen analysis and SCSA® performed. Data extracted from the electronic medical record included demographics, tobacco use, alcohol use, occupational exposures, semen analysis results, and SCSA® results (DNA Fragmentation index (DFI) and High DNA stainability (HDS)). Statistical analysis was performed on this data set to determine significance with a p-level of 0.05, with the primary input being level of alcohol use and primary outcome being the SCSA® parameters. RESULTS Overall, 11% of the cohort had heavy alcohol use (> 10 drinks/week), 27% moderate (3-10/week), 34% rare (0.5- < 3/week), and 28% none. 36% of the cohort had HDS > 10% (a marker of immature sperm chromatin). Level of alcohol use was not significantly associated with HDS > 10% or DFI. Heavier alcohol use was significantly associated with lower sperm count (p = 0.042). Increasing age was significantly associated with increasing DNA Fragmentation Index (p = 0.006), increased sperm count (p = 0.002), and lower semen volume (p = 0.022). Exposure to heat at work was significantly associated with lower semen volume (p = 0.042). Tobacco use was associated with lower sperm motility (p < 0.0001) and lower sperm count (p = 0.002). CONCLUSIONS There was not a significant association between the level of alcohol use and the High DNA Stainability or DNA Fragmentation Index of sperm. Increasing age was associated with semen parameters as expected, heat exposure was associated with lower semen volume, and tobacco use was associated with lower sperm motility and density. Further studies could investigate alcohol use and reactive oxidative species in sperm.
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Affiliation(s)
- Ariadne Trautman
- University of South Dakota Sanford School of Medicine, Suite 2400, 409 Summit St, Yankton, SD, USA.
| | | | - Keith A Hansen
- Fertility and Reproductive Medicine Physician at Sanford Fertility & Reproductive Medicine, 1500 W 22Nd St Suite 102, Sioux Falls, SD, 57105, USA
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Alvarez JG, García-Peiró A, Barros A, Ferraz L, Sousa M, Sakkas D. Double strand DNA breaks in sperm: the bad guy in the crowd. J Assist Reprod Genet 2023; 40:745-751. [PMID: 36823317 PMCID: PMC10224897 DOI: 10.1007/s10815-023-02748-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE The main objective of this opinion paper was to bring to light and enhance our understanding of the amount of double-strand DNA breaks in sperm and whether there is a threshold of no return when considering repair by the oocyte/embryo. METHODS A brief review of literature related to the theories proposed for the appearance of double-strand breaks in human spermatozoa. Further commentary regarding their detection, how oocytes or embryos may deal with them, and what are the consequences if they are not repaired. Finally, a strategy for dealing with patients who have higher levels of double-strand DNA breaks in sperm is proposed by reviewing and presenting data using testicular extracted sperm. RESULTS We propose a theory that a threshold may exist in the oocyte that allows either complete or partial DNA repair of impaired sperm. The closer that an embryo is exposed to the threshold, the more the effect on the ensuing embryo will fail to reach various milestones, including blastocyst stage, implantation, pregnancy loss, an adverse delivery outcome, or offspring health. We also present a summary of the role that testicular sperm extraction may play in improving outcomes for couples in which the male has a high double-strand DNA break level in his sperm. CONCLUSIONS Double-strand DNA breaks in sperm provide a greater stress on repair mechanisms and challenge the threshold of repair in oocytes. It is therefore imperative that we improve our understanding and diagnostic ability of sperm DNA, and in particular, how double-strand DNA breaks originate and how an oocyte or embryo is able to deal with them.
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Affiliation(s)
| | - Agustin García-Peiró
- Centro de Infertilidad Masculina y Análisis de Barcelona (CIMAB), Barcelona, Spain
| | - Alberto Barros
- Department of Genetics, Faculty of Medicine, University of Porto, Porto, Portugal
- Centro de Genética da Reprodução Alberto Barros, Porto, Portugal
- Institute for Research and Innovation in Health (i3S), University of Porto, Porto, Portugal
| | - Luís Ferraz
- Department of Urology, Hospital Centre of Vila Nova de Gaia/Espinho, Unit 1, Rua Conceição Fernandes 1079, 4434-502 Vila Nova de Gaia, Portugal
| | - Mário Sousa
- Laboratory of Cell Biology, Department of Microscopy, ICBAS-School of Medicine and Biomedical Sciences, University of Porto, Porto, Portugal
- UMIB-Unit for Multidisciplinary Research in Biomedicine/ITR-Laboratory for Integrative and Translational Research in Population Health, University of Porto, Porto, Portugal
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11
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Zhu CH, Wei Y, Chen F, Li F, Zhang SM, Dong NJ, Xue TM, Liu KF, Cui HM, Lu JC. Investigation on the mechanisms of human sperm DNA damage based on the proteomics analysis by SWATH-MS. Clin Proteomics 2023; 20:2. [PMID: 36609216 PMCID: PMC9817420 DOI: 10.1186/s12014-022-09391-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 12/29/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Spermatozoa have the task of delivering an intact paternal genome to the oocyte and supporting successful embryo development. The detection of sperm DNA fragmentation (SDF) has been emerging as a complementary test to conventional semen analysis for male infertility evaluation, but the mechanism leading to SDF and its impact on assisted reproduction remain unclear. Therefore, the study identified and analyzed the differentially expressed proteins of sperm with high and low SDF. METHODS Semen samples from men attended the infertility clinic during June 2020 and August 2020 were analyzed, and sperm DNA fragmentation index (DFI) was detected by the sperm chromatin structure assay. Semen samples with low DFI (< 30%, control group) and high DFI (≥ 30%, experimental group) were optimized by density gradient centrifugation (DGC), and the differentially expressed proteins of obtained sperm were identified by the Sequential Window Acquisition of All Theoretical Mass Spectra Mass Spectrometry (SWATH-MS) and performed GO and KEGG analysis. RESULTS A total of 2186 proteins were identified and 1591 proteins were quantified, of which 252 proteins were identified as differentially expressed proteins, including 124 upregulated and 128 downregulated. These differentially expressed proteins were involved in metabolic pathways, replication/recombination/repair, acrosomal vesicles, kinase regulators, fertilization, tyrosine metabolism, etc. Western blotting results showed that the expression levels of RAD23B and DFFA proteins and the levels of posttranslational ubiquitination and acetylation modifications in the experimental group were significantly higher than those in the control group, which was consistent with the results of proteomics analysis. CONCLUSIONS Proteomic markers of sperm with high DNA fragmentation can be identified by the SWATH-MS and bioinformatic analysis, and new protein markers and posttranslational modifications related to sperm DNA damage are expected to be intensively explored. Our findings may improve our understanding of the basic molecular mechanism of sperm DNA damage.
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Affiliation(s)
- Chun-Hui Zhu
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China ,grid.268415.cInstitute of Epigenetics and Epigenomics, College of Animal Science and Technology, Yangzhou University, 48 Wenhui Road, Yangzhou, 225009 Jiangsu China
| | - Ye Wei
- grid.268415.cInstitute of Epigenetics and Epigenomics, College of Animal Science and Technology, Yangzhou University, 48 Wenhui Road, Yangzhou, 225009 Jiangsu China
| | - Fang Chen
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China
| | - Feng Li
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China
| | - Sheng-Min Zhang
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China
| | - Nai-Jun Dong
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China
| | - Tong-Min Xue
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China
| | - Kai-Feng Liu
- grid.268415.cCenter for Reproductive Medicine, Northern Jiangsu People’s Hospital Affiliated to Yangzhou University/Clinical Medical College, Yangzhou University, Yangzhou, 225001 Jiangsu China
| | - Heng-Mi Cui
- grid.268415.cInstitute of Epigenetics and Epigenomics, College of Animal Science and Technology, Yangzhou University, 48 Wenhui Road, Yangzhou, 225009 Jiangsu China
| | - Jin-Chun Lu
- grid.452290.80000 0004 1760 6316Center for Reproductive Medicine, Zhongda Hospital, Southeast University, 3 Xinmofan Road, Nanjing, 210037 Jiangsu China
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12
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Peuranpää P, Gissler M, Peltopuro P, Tiitinen A, Hautamäki H. The effect of paternal and maternal factors on the prognosis of live birth in couples with recurrent pregnancy loss. Acta Obstet Gynecol Scand 2022; 101:1374-1385. [PMID: 36210542 PMCID: PMC9812203 DOI: 10.1111/aogs.14469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/25/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Currently, recurrent pregnancy loss (RPL) examinations focus on the woman, although paternal factors are also involved. Men in couples with RPL have higher sperm DNA fragmentation levels than fertile men, but the effect of sperm DNA damage on couple's later prognosis is unknown. Advanced maternal age and obesity are associated with RPL, but paternal lifestyle factors are less studied. Therefore, we aimed to study the associations of couples' lifestyle factors, causes of RPL, and sperm DNA fragmentation with their prognosis of future live birth. MATERIAL AND METHODS This descriptive cohort study comprised 506 couples investigated for RPL at Helsinki University Hospital, Finland, between 2007 and 2016, linked with national health and population registers. The primary outcome was couple's live birth after RPL investigations. Data on couple's background factors, including age, body mass index, smoking, and alcohol use, were collected from medical records. Sperm DNA fragmentation index was analyzed from 211 men using the sperm chromatin dispersion test. The associations between background factors, sperm DNA fragmentation, and cumulative probability of live birth over time were analyzed using cross-tabulations and age-adjusted Cox regression. RESULTS In all, 352 of 506 couples (69.6%) achieved live birth. Maternal age, unexplained RPL, prolonged pregnancy attempts before investigations, paternal obesity, and maternal smoking were associated with prognosis: unadjusted hazard ratio for couple's live birth for women aged 35-39 vs younger than 30 years was 0.63 (95% confidence interval [CI] 0.47-0.84), and for 40 years or older was 0.36 (95% CI 0.22-0.58). Age-adjusted hazard ratio for unexplained vs explained RPL was 1.39 (95% CI 1.12-1.72), for couple's pregnancy attempt at least 4 years vs less than 2 years was 0.50 (95% CI 0.33-0.76), for paternal body mass index at least 30 kg/m2 vs less than 25 kg/m2 was 0.67 (95% CI 0.46-0.98), and for maternal smoking was 0.71 (95% CI 0.51-0.99). Altogether, 96/135 (71.1%) couples with normal (<15%), 38/60 (63.3%) with intermediate (15-30%), and 11/16 (68.8%) with high sperm DNA fragmentation index achieved live birth (p = 0.56). CONCLUSIONS In couples with RPL, prolonged pregnancy attempts, a cause found in RPL examinations, lifestyle factors, and maternal age are negatively associated with their prognosis of future live birth. Sperm DNA fragmentation was not associated, but the number of men with damaged spermatozoa was small. We suggest that clinicians include women and men in RPL counseling because couple's joint lifestyle seems to determine their later prognosis.
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Affiliation(s)
- Pirkko‐Liisa Peuranpää
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Mika Gissler
- Finnish Institute for Health and WelfareHelsinkiFinland,Academic Primary Health Care Center, Region Stockholm & Department of Molecular Medicine and SurgeryKarolinska InstituteStockholmSweden
| | - Paula Peltopuro
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Aila Tiitinen
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Hanna Hautamäki
- The Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
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13
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Pallotti F, Barbonetti A, Rastrelli G, Santi D, Corona G, Lombardo F. The impact of male factors and their correct and early diagnosis in the infertile couple's pathway: 2021 perspectives. J Endocrinol Invest 2022; 45:1807-1822. [PMID: 35349114 PMCID: PMC8961097 DOI: 10.1007/s40618-022-01778-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE The current clinical practice in reproductive medicine should pose the couple at the centre of the diagnostic-therapeutic management of infertility and requires intense collaboration between the andrologist, the gynaecologist and the embryologist. The andrologist, in particular, to adequately support the infertile couple, must undertake important biological, psychological, economical and ethical task. Thus, this paper aims to provide a comprehensive overview of the multifaceted role of the andrologist in the study of male factor infertility. METHODS A comprehensive Medline, Embase and Cochrane search was performed including publications between 1969 and 2021. RESULTS Available evidence indicates that a careful medical history and physical examination, followed by semen analysis, always represent the basic starting points of the diagnostic work up in male partner of an infertile couple. Regarding treatment, gonadotropins are an effective treatment in case of hypogonadotropic hypogonadism and FSH may be used in men with idiopathic infertility, while evidence supporting other hormonal and nonhormonal treatments is either limited or conflicting. In the future, pharmacogenomics of FSHR and FSHB as well as innovative compounds may be considered to develop new therapeutic strategies in the management of infertility. CONCLUSION To provide a high-level of care, the andrologist must face several critical diagnostical and therapeutical steps. Even though ART may be the final and decisive stage of this decisional network, neglecting to treat the male partner may ultimately increase the risks of negative outcome, as well as costs and psychological burden for the couple itself.
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Affiliation(s)
- F Pallotti
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - A Barbonetti
- Andrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - G Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Careggi Hospital-Department of Experimental, Clinical and Biomedical Sciences, University of Florence, Florence, Italy
| | - D Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - G Corona
- Endocrinology Unit, Medical Department, Maggiore-Bellaria Hospital, Azienda-Usl Bologna, 40139, Bologna, Italy
| | - F Lombardo
- Laboratory of Seminology-Sperm Bank "Loredana Gandini", Department of Experimental Medicine, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
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14
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Zhao S, Tang L, Fu J, Yang Z, Su C, Rao M. Subclinical Hypothyroidism and Sperm DNA Fragmentation: A Cross-sectional Study of 5401 Men Seeking Infertility Care. J Clin Endocrinol Metab 2022; 107:e4027-e4036. [PMID: 35906991 DOI: 10.1210/clinem/dgac458] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Our previous study showed that paternal subclinical hypothyroidism (SCH) had a detrimental effect on the clinical outcomes of assisted reproductive technologies. However, it remains to be determined whether paternal SCH affects sperm DNA integrity. OBJECTIVE To investigate the association between SCH and sperm DNA fragmentation in men seeking infertility care. METHODS This cross-sectional study included 4983 men with euthyroidism and 418 men with SCH seeking infertility treatment in a tertiary care academic medical center between January 2017 and December 2021. The outcome measures were the absolute DNA fragmentation index (DFI) and the risk of abnormal DFI (defined as DFI ≥ 25% or ≥ 30%). RESULTS The mean (SD) age of men with euthyroidism and men with SCH was 34.20 (5.97) and 35.35 (6.48) years, respectively (P < 0.001). The difference in DFI was not statistically significant (adjusted mean: 19.7% vs 18.9% in the SCH and euthyroidism groups, respectively; P = 0.07) after confounder adjustment. A DFI ≥25% was significantly more frequent in men with SCH (20.57%) than in men with euthyroidism (14.49%) after confounder adjustment [odds ratio (OR) 1.43 (95% CI 1.09-1.88)]. DFI ≥ 30% was also significantly more common in men with SCH (11.72%) than in men with euthyroidism [6.74%; OR 1.84 (95% CI 1.34-2.52)]. In addition, thyroid-stimulating hormone concentration was significantly associated with an increased risk of having a DFI ≥25% (P < 0.001) or ≥30% (P = 0.011). CONCLUSION SCH was significantly associated with an increased risk of an abnormal DFI.
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Affiliation(s)
- Shuhua Zhao
- Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Li Tang
- Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jingyun Fu
- Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Zexing Yang
- Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Cunmei Su
- Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Meng Rao
- Department of reproduction and genetics, the First Affiliated Hospital of Kunming Medical University, Kunming, China
- Department of Endocrinology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
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15
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Abstract
The Sperm Chromatin Structure Assay (SCSA® ) is a federally registered protocol for simultaneous flow cytometric measures of sperm DNA integrity and chromatin structure. Fresh or frozen/thawed raw semen samples are diluted in buffer to a sperm concentration of ∼1-2×106 /ml and then treated with a pH 1.20 buffer for 30 s to open the DNA strands at sites of DNA strand breaks. The sperm are then stained with acridine orange (AO) that intercalates into double-strand DNA and fluoresces green (515-530 BP filter) and stacks on single-strand DNA that fluoresces red (630 LP filter) upon excitation from a 488 nm laser. The extent of single and double DNA strand breaks (DNA fragmentation index, %DFI) and level of excess nuclear histones (high DNA stainable sperm, %HDS) are simultaneously measured in individual sperm. From the time a fresh or frozen/thawed semen sample is received at the site of a flow cytometer (FCM) programmed for the SCSA protocol, data can be obtained within about 10 min on 5-10×103 sperm. The %DFI and %HDS can be determined by computer-gated regions on the green versus red cytogram. Alternatively, a determination is made by transforming the green versus red cytogram to a total DNA stainability (red + green fluorescence) versus red/red + green fluorescence cytogram from which a frequency histogram is produced and the %DFI calculated from it. The clinical threshold for human natural or IUI fertilization is 25% DFI at which point the ART lab should consider moving to ICSI fertilization. The clinical threshold for HDS is also 25%; values above this level may result in early embryo death due to abnormal gene readout caused by the abnormal tertiary structure of chromatin. Numerous lifestyle and environmental factors cause sperm DNA fragmentation. Reactive oxygen species (ROS) play a significant role in DNA breakage. © 2022 The Authors. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: Sperm Chromatin Structure Assay (SCSA®) Basic Protocol 2: SCSA data analysis: Calculations of %DFI and %HDS of semen samples by one of two methods Support Protocol 1: SCSA sample collection and shipping Support Protocol 2: Flow cytometer set up Support Protocol 3: Selection and use of reference samples.
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Affiliation(s)
- Donald P Evenson
- SCSA Diagnostics, Brookings, South Dakota
- Department of OB/GYN, Sandford Medical School, University of South Dakota, Sioux Falls, South Dakota
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16
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Lewis SEM, Esteves SC. Is the term 'Non-Male Factor' evidence-based? Andrology 2022; 10:1237-1239. [PMID: 35849603 DOI: 10.1111/andr.13232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Sheena E M Lewis
- Honorary Professor, Queens University Belfast and CEO Examenlab Ltd, Unit 18A, Block K, Weavers Court Business Park, Linfield Road, Belfast, BT12 5GH
| | - Sandro C Esteves
- Medical Director, ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, Brazil.,Professor of Urology, Department of Surgery (Division of Urology), University of Campinas (UNICAMP), Campinas, SP, Brazil.,Honorary Professor of Reproductive Endocrinology, Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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17
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Kups M, Gill K, Rosiak-Gill A, Harasny P, Machalowski T, Grabowska M, Kurzawa R, Sipak O, Piasecka M. Evaluation of selected semen parameters and biomarkers of male infertility - preliminary study. F1000Res 2022; 11:591. [PMID: 38434001 PMCID: PMC10905134 DOI: 10.12688/f1000research.121622.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 03/05/2024] Open
Abstract
Background: Because the etiopathogenesis of male infertility is multifactorial our study was designed to clarify the relationship between standard semen parameters, testicular volume, levels of reproductive hormones and the fragmentation of sperm nuclear DNA (SDF). Methods: Patients (n = 130) were clustered as subjects: 1) with an abnormal volume (utrasonography) of at least one testis (<12 mL) or with a normal volume of testes and 2) with abnormal levels of at least one of the reproductive hormones (FSH, LH, PRL, TSH, total T - electrochemiluminescence method) or with normal hormonal profiles and 3) with high level of SDF (>30%), moderate (>15-30%) or low (≤15%) (sperm chromatin dispersion test). Results: In subjects with a decreased testicular volume and in subjects with abnormal levels of reproductive hormones, decreased basic semen parameters were found. Participants with abnormal testicular volume had a higher percentage of SDF and a higher level of FSH (Mann-Whitney U test). In turn, men with a high level of SDF had lower testicular volume and conventional sperm parameters than men with a low level of SDF (Kruskal-Wallis test). Conclusions: We showed that spermatogenesis disorders coexisted with decreased testicular volume and increased FSH levels. The disorders of spermatogenesis were manifested by reduced basic sperm characteristics and a high level of sperm nuclear DNA damage.
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Affiliation(s)
- Michal Kups
- The Fertility Partnership Vitrolive in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-483, Poland
- Department of Urology and Oncological Urology, Regional Specialist Hospital in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-455, Poland
| | - Kamil Gill
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Aleksandra Rosiak-Gill
- The Fertility Partnership Vitrolive in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-483, Poland
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Patryk Harasny
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
- Department of Urology and Urological Oncology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-111, Poland
| | - Tomasz Machalowski
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
- Department of Perinatology, Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Police, West Pomeranian Voivodeship, 72-010, Poland
| | - Marta Grabowska
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Rafal Kurzawa
- The Fertility Partnership Vitrolive in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-483, Poland
- Department of Gynecology and Reproductive Health, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Olimpia Sipak
- Department of Obstetrics and Pathology of Pregnancy, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Malgorzata Piasecka
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
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18
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Monachesi NE, Gallelli MF, Neild DM, Carretero MI. Evaluation of DNA fragmentation in dog sperm using the sperm chromatin dispersion test. Reprod Domest Anim 2022; 57:893-901. [PMID: 35474618 DOI: 10.1111/rda.14136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 04/04/2022] [Accepted: 04/25/2022] [Indexed: 11/28/2022]
Abstract
The study's objective was to adapt the Sperm Chromatin Dispersion (SCD) protocol to evaluate sperm DNA fragmentation and implement a fragmentation control in dogs. Correlation between DNA status and routine sperm parameters was also analysed. To adapt the SCD, two different mercaptoethanol (ME) concentrations were assayed (2.5 and 5%) in fourteen ejaculates from seven dogs and semen incubation with 0.3 M NaOH for 15 min at room temperature was assayed as a control for sperm DNA fragmentation. Data were analysed using a Mann-Whitney test and either Pearson's or Spearman's correlation. The selected ME concentration to use in the SCD test was 5%, as it produced the largest DNA dispersion halo while preserving the core nucleus structure. Four DNA halo patterns were identified: large dispersion halos, medium halos, small halos and nuclei without halos. Semen incubated with NaOH showed 100% sperm without halos (damaged DNA). A significant positive correlation was observed between sperm with fragmented DNA and sperm with coiled tails. Thus, it was possible to adapt the SCD protocol to evaluate dog sperm DNA fragmentation in raw semen without using a commercial kit and establish incubation with NaOH as a DNA fragmentation control. Only coiled tails showed correlation with DNA fragmentation.
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Affiliation(s)
- Norma Estela Monachesi
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Instituto de Investigación y Tecnología en Reproducción Animal, Argentina
| | - María Florencia Gallelli
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Instituto de Investigación y Tecnología en Reproducción Animal, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Deborah Margarita Neild
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Instituto de Investigación y Tecnología en Reproducción Animal, Argentina
| | - María Ignacia Carretero
- Universidad de Buenos Aires, Facultad de Ciencias Veterinarias, Instituto de Investigación y Tecnología en Reproducción Animal, Argentina.,Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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19
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Zhu C, Chen F, Zhang S, She H, Ju Y, Wen X, Yang C, Sun Y, Dong N, Xue T, Liu K, Li F, Cui H. Influence of sperm DNA fragmentation on the clinical outcome of in vitro fertilization-embryo transfer (IVF-ET). Front Endocrinol (Lausanne) 2022; 13:945242. [PMID: 35909570 PMCID: PMC9329669 DOI: 10.3389/fendo.2022.945242] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate the effect of elevated sperm DNA fragmentation index (DFI) on fresh and frozen embryo transfer cycles. METHODS A retrospective study was performed with 549 fresh embryo transfer cycles and 1340 frozen embryo transfer cycles after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) from 2016 to 2021. RESULTS The statistical results of 549 fresh embryo transfer cycles showed that the delivery rate in the normal sperm DFI group (43.9% vs. 27.1%, P = 0.014) was significantly higher than that in the abnormal sperm DFI group, and there were no significant differences in the biochemical pregnancy rate (59.0% vs. 50.8%, P = 0.232), clinical pregnancy rate (53.1% vs. 40.7%, P = 0.072), or miscarriage rate (17.3% vs. 33.3%, P = 0.098) between the two groups. The results of 1340 frozen embryo transfer cycles showed that the biochemical pregnancy rate (57.9% vs. 45.6%, P = 0.006) and clinical pregnancy rate (50.3% vs. 40.7%, P = 0.027) in the normal sperm DFI group were significantly higher than those in the abnormal sperm DFI group. The delivery rate (40.9% vs. 33.3%, P = 0.074) and miscarriage rate (18.6% vs. 18.0%, P = 0.919) were not significantly different between the two groups. CONCLUSION The increase of sperm DFI significantly reduced the delivery rate of fresh embryo transfer cycles and the biochemical pregnancy rate and clinical pregnancy rate of frozen embryo transfer cycles.
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Affiliation(s)
- Chunhui Zhu
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
- Institute of Epigenetics and Epigenomics, College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Fang Chen
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Shengmin Zhang
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Hong She
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yun Ju
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xidong Wen
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Chunxia Yang
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Yan Sun
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Naijun Dong
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Tongmin Xue
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Kaifeng Liu
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Feng Li
- Department of Reproductive Medicine Center, Clinical Medical College, Yangzhou University, Yangzhou, China
- *Correspondence: Feng Li, ; Hengmi Cui,
| | - Hengmi Cui
- Institute of Epigenetics and Epigenomics, College of Animal Science and Technology, Yangzhou University, Yangzhou, China
- *Correspondence: Feng Li, ; Hengmi Cui,
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20
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Ghasemian F, Bahadori MH, Hosseini Kolkooh SZ, Esmaeili M. Using Deep Learning Algorithm: The Study of Sperm Head Vacuoles and Its Correlation with Protamine mRNA Ratio. CELL JOURNAL 2022; 24:7-14. [PMID: 35182059 PMCID: PMC8876261 DOI: 10.22074/cellj.2022.7448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 08/15/2020] [Indexed: 12/31/2022]
Abstract
Objective It is necessary to evaluate fertility effective agents to predict assisted reproduction outcomes. This study was
designed to examine sperm vacuole characteristics, and its association with sperm chromatin status and protamine-1
(PRM1) to protamine-2 (PRM2) ratio, to predict assisted pregnancy outcomes.
Materials and Methods In this experimental study, ninety eight semen samples from infertile men were classified based
on Vanderzwalmen’s criteria as follows: grade I: no vacuoles; grade II: <2 small vacuoles; grade III: <1 large vacuole
and grade IV: large vacuole with other abnormalities. The location, frequency and size of vacuoles were assessed
using high magnification, a deep learning algorithm, and scanning electron microscopy (SEM). The chromatin integrity,
condensation, viability and acrosome integrity, and protamination status were evaluated for vacuolated samples
by toluidine blue (TB) staining, aniline blue, triple staining, and CMA3 staining, respectively. Also, Protamine-1 and
protamine-2 genes expression was analysed by reverse transcription-quantitative polymerase chain reaction (PCR).
The assisted reproduction outcomes were also followed for each cycle.
Results The results show a significant correlation between the vacuole size (III and IV) and abnormal sperm chromatin
condensation (P=0.03 and P=0.02, respectively), and also, protamine-deficient (P=0.04 and P=0.03, respectively).
The percentage of reacting acrosomes was significantly higher in the grades III and IV spermatozoa in comparison
with normal group. The vacuolated spermatozoa with grade IV showed a high protamine mRNA ratio (PRM-2 was
underexpressed, P=0.01). In the IVF cycles, we observed a negative association between sperm head vacuole and
fertilization rate (P=0.01). This negative association was also significantly observed in pregnancy and live birth rate in
the groups with grade III and IV (P=0.04 and P=0.03, respectively).
Conclusion The results of our study highlight the importance sperm parameters such as sperm head vacuole
characteristics, particularly those parameters with the potency of reflecting protamine-deficiency and in vitro fertilization/
intracytoplasmic sperm injection (IVF/ICSI) outcomes predicting.
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Affiliation(s)
- Fatemeh Ghasemian
- Department of Biology, Faculty of Science, University of Guilan, Rasht, Iran.
| | - Mohammad Hadi Bahadori
- Cellular and Molecular Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyedeh Zahra Hosseini Kolkooh
- Reproductive Health Research Center (IVF Center), Alzahra Educational and Remedial Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Maryam Esmaeili
- Reproductive Health Research Center (IVF Center), Alzahra Educational and Remedial Center, Guilan University of Medical Sciences, Rasht, Iran
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21
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Farkouh A, Finelli R, Agarwal A. Beyond conventional sperm parameters: the role of sperm DNA fragmentation in male infertility. Minerva Endocrinol (Torino) 2021; 47:23-37. [PMID: 34881857 DOI: 10.23736/s2724-6507.21.03623-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Infertility is a condition that widely affects the couples all over the world. In this regard, sperm DNA fragmentation can lead to harmful reproductive consequences, including male infertility and poor outcomes after assisted reproductive techniques. The investigation of SDF in male infertility diagnostics has constantly increased over time, becoming more common in clinical practice with the recent publication of several guidelines regarding its testing. This narrative review aims to provide a comprehensive overview of the pathogenesis and causes of sperm DNA fragmentation, as well as the assays which are more commonly performed for testing. Moreover, we discussed the most recently published evidence regarding the use of SDF testing in clinical practice, highlighting the implications of high sperm DNA fragmentation rate on human reproduction, and the therapeutic approaches for the clinical management of infertile patients. Our review confirms a significant harmful impact of sperm DNA fragmentation on reproduction, and points out several interventions which can be applied in clinics to reduce sperm DNA fragmentation and improve reproductive outcomes. Sperm DNA fragmentation has been shown to adversely impact male fertility potential. As high sperm DNA fragmentation levels have been associated with poor reproductive outcomes, its testing may significantly help clinicians in defining the best therapeutic strategy for infertile patients.
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Affiliation(s)
- Ala'a Farkouh
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA -
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22
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Mortimer R, James K, Bormann CL, Harris AL, Yeh J, Toth TL, Souter I, Roberts DJ, Sacha CR. Male factor infertility and placental pathology in singleton live births conceived with in vitro fertilization. J Assist Reprod Genet 2021; 38:3223-3232. [PMID: 34704166 PMCID: PMC8666390 DOI: 10.1007/s10815-021-02344-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/15/2021] [Indexed: 12/23/2022] Open
Abstract
PURPOSE We sought to determine whether pregnancies conceived in those with male factor infertility have unique placental pathology profiles compared to those undergoing infertility treatments for other indications. METHODS This was a retrospective cohort study of placental pathology from 464 live births conceived from autologous fresh IVF cycles at an academic fertility center from 2004 to 2017. Placental pathology was compared between live births arising from patients with male factor infertility alone and those with another infertility diagnosis. Placental outcomes were compared with parametric or non-parametric tests; logistic regression was performed to account for potential confounders. RESULTS Compared to cycles performed for a non-male factor diagnosis, male factor infertility cycles had a higher mean paternal age (38.2 years vs. 36.5 years, p < 0.001), a higher female mean BMI (24.3 vs. 23.3 kg/m2, p = 0.01), and a lower day 3 follicle stimulating hormone (FSH) level (6.8 vs. 7.3 IU/mL, p = 0.02). The mean numbers of embryos transferred, and day of transfer were similar between groups, and more cycles used ICSI in the male factor infertility group (90.6% vs. 22.5%, p < 0.001). Placental pathology in our adjusted model was similar between the male factor and non-male factor groups. In our unadjusted subgroup analysis, cycles for male factor using ICSI appeared to lead to more small placentas by weight compared to cycles performed with conventional insemination (45.8% < 10th percentile vs. 18.8%, p = 0.04). CONCLUSION Male factor infertility is not associated with significantly different placental pathology compared to other infertility diagnoses.
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Affiliation(s)
- Roisin Mortimer
- Department of OB/GYN, Massachusetts General Hospital and Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA.
| | - K James
- Center for Outcomes Research, Department of OB/GYN, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - C L Bormann
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA
| | - A L Harris
- Department of Women's Health, Wright Patterson Air Force Base, Wright Patterson AFB, Dayton, OH, USA
- Department of OB/GYN, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - J Yeh
- Division of Reprod Endo & Infertil, UMass Medical, Worcester, MA, USA
| | - T L Toth
- Boston IVF, Department of OB/GYN, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - I Souter
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA
| | - D J Roberts
- Department of Pathology, Harvard Medical School and Massachusetts General, Boston Hospital, Boston, MA, USA
| | - C R Sacha
- Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA
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23
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De Win G, De Neubourg D, De Wachter S, Vaganée D, Punjabi U. Peak retrograde flow a potential objective management tool to identify young adults with varicocele 'at risk' for a high sperm DNA fragmentation. J Pediatr Urol 2021; 17:760.e1-760.e9. [PMID: 34627700 DOI: 10.1016/j.jpurol.2021.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 07/30/2021] [Accepted: 09/19/2021] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Determining which patients are negatively affected by varicocele would enable clinicians to better select those men who would benefit most from surgery. Since conventional semen parameters, have been limited in their ability to evaluate the negative effects of varicocele on fertility, specialized laboratory tests have emerged. OBJECTIVE To identify clinical and ultrasound parameters (including PRF) which would negatively influence standard and functional semen variables in young adults with a varicocele. DESIGN Prospective, cross-sectional observational study. SETTING Antwerp University Hospital, Belgium. PATIENT(S) Young volunteers between 16 and 26 years, Tanner 5, were recruited. INTERVENTION(S) Every participant had a scrotal ultrasound to calculate testicular volumes. If a varicocele was present, the grade, vein diameter, peak retrograde flow (PRF) in supine position and spontaneous reflux in standing position were measured. All participants provided a semen sample. Standard semen parameters were analyzed and sperm DNA fragmentation. MAIN OUTCOME MEASURE(S) Of all clinical and ultrasound parameters tested, PRF was an objective tool identifying young adults with a varicocele. PRF was highlighted by the prevalence of SDF, both in the total and vital fractions of the spermatozoa, providing opportunities to manage such 'at-risk' adolescents/young adults. RESULT(S) Total SDF was significantly increased in grade 3 varicocele compared to grade 1 and 2 but no significant difference with vital SDF or standard descriptive semen parameters was seen. Total and vital SDF on the other hand were significantly increased when PRF was above 38.4 cm/s. Standard semen analysis showed no difference with PRF as an independent predictor. Testicular atrophy index, varicocele vein diameter and spontaneous reflux revealed no significant differences in both the descriptive and functional semen variables. DISCUSSION Descriptive semen parameters showed no significant difference between the non-varicocele controls and the varicocele group with low and high PRF. Increased PRF negatively influenced sperm quality via increased DNA fragmentation both in the total as in the vital fractions of the semen. CONCLUSION(S) Of all clinical and ultrasound parameters tested, PRF was an objective non-invasive tool to identify varicocele patients at risk for a high SDF.
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Affiliation(s)
- G De Win
- Department of Urology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, Wilrijk, Belgium.
| | - D De Neubourg
- Centre for Reproductive Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium; Department of Reproductive Medicine, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, Wilrijk, Belgium
| | - S De Wachter
- Department of Urology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium; Department of Urology, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, Wilrijk, Belgium
| | - D Vaganée
- Department of Urology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - U Punjabi
- Centre for Reproductive Medicine, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium; Department of Reproductive Medicine, Antwerp Surgical Training, Anatomy and Research Centre (ASTARC), Faculty of Medicine and Health Sciences, Wilrijk, Belgium
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24
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Sadeghi N, Tavalaee M, Kiani-Esfahani A, Moazamian A, Gharagozloo P, Aitken RJ, Drevet JR, Nasr-Esfahani MH. Apoptotic M540 bodies present in human semen interfere with flow cytometry-assisted assessment of sperm DNA fragmentation and oxidation. Basic Clin Androl 2021; 31:23. [PMID: 34670490 PMCID: PMC8529777 DOI: 10.1186/s12610-021-00143-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022] Open
Abstract
Background The use of flow cytometry (FC) to evaluate sperm DNA fragmentation via deoxynucleotidyl transferase terminal fluorescein dUTP nick-end labeling (TUNEL) has shown inconsistencies compared with conventional fluorescent microscopic analyses. It has been hypothesized that the observed discrepancies could be attributed to the presence of apoptotic bodies that can be labeled with merocyanine 540, the so-called M540 bodies. In order to verify this hypothesis and determine the accuracy of our in-house FC-assisted evaluation of spermatozoa parameters, we used FC to evaluate both the fragmentation of sperm DNA using the TUNEL assay and the oxidation of sperm DNA using the 8-OHdG assay on semen samples with or without M540 bodies. Results We show that the presence of M540 bodies lead to underestimation of both the level of sperm DNA fragmentation and sperm DNA oxidation when using FC assisted detection systems. We also observed that this situation is particularly pertinent in semen samples classified as abnormal with respect to the routine WHO semen evaluation as they appear to contain more M540 bodies than normal samples. Conclusions We conclude that M540 bodies interfere with both FC-conducted assays designed to evaluate sperm nuclear/DNA integrity. Exclusion of these contaminants in unprepared semen samples should be performed in order to correctly appreciate the true level of sperm DNA/nuclear damage which is known to be a critical male factor for reproductive success. Supplementary Information The online version contains supplementary material available at 10.1186/s12610-021-00143-7.
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Affiliation(s)
- Niloofar Sadeghi
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Marziyeh Tavalaee
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Abbas Kiani-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Aron Moazamian
- CelloXess LLC, 830 Bear Tavern Road, Ewing, NJ, 08628, USA.,Priority Research Centre for Reproductive Sciences, Faculty of Science and Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia
| | | | - Robert J Aitken
- Priority Research Centre for Reproductive Sciences, Faculty of Science and Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW, 2308, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia
| | - Joël R Drevet
- GReD Institute, CRBC, Faculté de Médecine, INSERM U1103-CNRS UMR6293-Université Clermont Auvergne, 28 Place Henri-Dunant, 63000, Clermont-Ferrand, France.
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran. .,Isfahan Fertility and Infertility Center, Isfahan, Iran.
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25
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Lower Spermatozoal PIWI-LIKE 1 and 2 Transcript Levels Are Significantly Associated with Higher Fertilization Rates in IVF. Int J Mol Sci 2021; 22:ijms222111320. [PMID: 34768750 PMCID: PMC8583392 DOI: 10.3390/ijms222111320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/15/2021] [Accepted: 10/16/2021] [Indexed: 02/04/2023] Open
Abstract
The four human PIWI-LIKE gene family members PIWI-LIKE 1–4 play a pivotal role in stem cell maintenance and transposon repression in the human germline. Therefore, dysregulation of these genes negatively influences the genetic stability of the respective germ cell and subsequent development and maturation. Recently, we demonstrated that a lower PIWI-LIKE 2 mRNA expression in ejaculated spermatozoa is more frequent in men with oligozoospermia. In this study, we analysed how PIWI-LIKE 1–4 mRNA expression in ejaculated spermatozoa predicts ART outcome. From 160 IVF or ICSI cycles, portions of swim-up spermatozoa used for fertilization were collected, and the total RNA was isolated. PIWI-LIKE 1–4 mRNA expression was measured by qPCR using TaqMan probes with GAPDH as a reference gene. PIWI-LIKE 1 and 2 transcript levels in the spermatozoa of the swim-up fraction were positively correlated to each other (rS = 0.78; p < 0.001). Moreover, lower PIWI-LIKE 2 mRNA levels, as well as lower PIWI-LIKE 1 mRNA levels, in these spermatozoa were positively associated with a fertilization rate ≥ 50% in the respective ART cycles (p = 0.02 and p = 0.0499, Mann–Whitney U-Test). When separately analysing IVF and ICSI cycles, PIWI-LIKE 1 and 2 transcript levels were only significantly associated to increased fertilization rates in IVF, yet not in ICSI cycles. Spermatozoal PIWI-LIKE 3 and 4 transcript levels were not significantly associated to fertilization rates in ART cycles. In conclusion, lower levels of spermatozoal PIWI-LIKE 1 and 2 mRNA levels are positively associated with a higher fertilization rate in IVF cycles.
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Vončina SM, Stenqvist A, Bungum M, Schyman T, Giwercman A. Sperm DNA fragmentation index and cumulative live birth rate in a cohort of 2,713 couples undergoing assisted reproduction treatment. Fertil Steril 2021; 116:1483-1490. [PMID: 34376283 DOI: 10.1016/j.fertnstert.2021.06.049] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/26/2021] [Accepted: 06/30/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study how the choice of the first assisted reproductive technology treatment type affects the cumulative live birth rate (CLBR) in couples with high sperm DNA fragmentation index (DFI). DESIGN Longitudinal cohort study. SETTING University-affiliated fertility clinic. PATIENT(S) A total of 2,713 infertile couples who underwent assisted reproductive technology treatment between 2007 and 2017 were included in the study. All in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatments (up to three fresh treatments and all associated frozen-thawed embryo transfers) offered to the couples by the public health care system were included, in total 5,422 cycles. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The primary outcome was the CLBR. The secondary outcomes were the fertilization rate and the miscarriage rate. The IVF and ICSI groups were defined according to the method applied in the first treatment cycle. RESULT(S) In the IVF group, the CLBR values were higher for couples with normal DFI compared with those for couples with high DFI (≥20%) (48.1% vs. 41.6% for conservative CLBR estimate and 55.6% vs. 51.4% for optimal CLBR estimate after adjustment for female age, respectively). No DFI-dependent difference was seen in the ICSI group. CONCLUSION(S) Our results demonstrated that a high DFI predicts a statistically significantly lower CLBR if IVF and not ICSI is applied in the first cycle of assisted reproduction.
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Affiliation(s)
- Sladjana Malić Vončina
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden; Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
| | - Amelie Stenqvist
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden; Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden; Department of Gynecology and Obstetrics, Skåne University Hospital, Malmö, Sweden.
| | | | - Tommy Schyman
- Clinical Studies Sweden - Forum South, Skåne University Hospital, Lund, Sweden
| | - Aleksander Giwercman
- Molecular Reproductive Medicine, Department of Translational Medicine, Lund University, Malmö, Sweden; Reproductive Medicine Centre, Skåne University Hospital, Malmö, Sweden
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27
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Lipovac M, Nairz V, Aschauer J, Riedl C. The effect of micronutrient supplementation on spermatozoa DNA integrity in subfertile men and subsequent pregnancy rate. Gynecol Endocrinol 2021; 37:711-715. [PMID: 34184957 DOI: 10.1080/09513590.2021.1923688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Male infertility has been related to an increased sperm DNA fragmentation index (DFI). Nutritional factors may improve sperm nuclear DNA integrity and thus pregnancy rates. Objective: To evaluate the effect of micronutrient supplementation on sperm DNA integrity in subfertile men and subsequent pregnancy rates. METHODS In this retrospective comparative study 339 subfertile males were included on whom a sperm chromatin dispersion test (SCD) was performed as a method to detect DNA fragmentation, as well as an initial semen analysis. Of all, n = 162 received a nutritional management program for three months, consisting of two daily capsules of a standardized combined micronutrient formulation together with a guidance to diet modification and to lifestyle changes (study group). Each capsule contained L-carnitine, L-arginine, coenzyme Q10, zinc, vitamin E, folic acid, glutathione, and selenium. The control group consisted of those patients who did not receive the active treatment (n = 177), yet were instructed to engage in a healthy lifestyle, including a modification of their regular diet. The SCD test was repeated for both groups after three months. As part of the routine follow up, pregnancy rate was assessed six months after the second SCD test. Males with complete follow up and healthy female partners (aged 18 to 40 years) where included. RESULTS Data of men with an initial mean DFI of >15% were analyzed first (n = 81;46 study and 35 control patients). After three months, both groups displayed a significant decrease of mean DFI values; however, the mean percent difference was higher in the study group (10.46 ± 1.20 % vs. 5.29 ± 0.57 %; p < .001). Then, the entire population was considered (n = 339). After three months, only the study group displayed a significant decrease of mean DFI initial values (10.48 ± 7.76 % to 6.51 ± 4.61%; p < .001); and the percent difference was higher in the study group (3.97 ± 0.28 % vs. 0.91 ± 0.28 %; p < .001). At six months follow-up, pregnancy rate was higher in the study group (27.78% vs. 15.25%, p = .002). CONCLUSION Both regimes significantly reduced sperm DNA fragmentation among subfertile men with a DFI >15%; however, when any baseline DFI value was considered, only micronutrient supplementation achieved a better result on DFI and thus pregnancy rate was higher.
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Affiliation(s)
- Markus Lipovac
- IMI Fertility Center, Vienna, Austria
- Karl Landsteiner Institute for cell-based therapy in Gynecology, Korneuburg, Austria
| | | | | | - Claus Riedl
- Department of Urology, General Public Hospital Baden, Austria
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28
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ELANGO KAMARAJ, KUMARESAN ARUMUGAM, ASHOKAN MANOKARAN, KARUTHADURAI THIRUMALAISAMY, NAG PRADEEP, BHASKAR MULINTI, PRASAD BAKTHAVATHSALAMARUN, JEYAKUMAR SAKTHIVEL, MANIMARAN AYYASAMY, BHAT VINOD, RAMESHA KEREKOPPA. Dynamics of mitochondrial membrane potential and DNA damage during cryopreservation of cattle and buffalo bull spermatozoa. THE INDIAN JOURNAL OF ANIMAL SCIENCES 2021. [DOI: 10.56093/ijans.v91i1.113218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Understanding the changes in the spermatozoa during cryopreservation is indispensable for tailoring and increasing the efficiency of cryopreservation process success. However, the dynamics of damage to sperm organelles during different stages of cryopreservation is underexplored. This study assessed the mitochondrial membrane potential (MMP) and DNA damage during different stages of cryopreservation, viz. immediately after ejaculation, after equilibration and after freezing and thawing in cattle and buffalo spermatozoa using flow cytometry. Proportion of spermatozoa with high MMP decreased significantly after equilibration (from 66.06±4.59 to 42.58±6.30 in Holstein bulls and from 60.32±5.51 to 39.98±7.58 in buffalo bulls). Sperm DNA integrity [DNA fragmentation index (DFI %)] in Holstein Friesian (HF) bulls did not differ significantly between fresh and equilibrated samples but a significantly higher % DFI was observed in frozen-thawed semen samples as compared to both fresh and equilibrated samples. In contrast, % DFI in buffalo spermatozoa did not differ among the three stages of cryopreservation. It was concluded that mitochondrial damages occur during equilibration while chromatin damages occur during freezing and thawing of cattle bull spermatozoa; whereas buffalo bull spermatozoa were lesser susceptible to DNA damage during cryopreservation as compared to cattle spermatozoa.
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29
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Rex AS, Wu C, Aagaard J, Fedder J. Implementation of an in-house flow cytometric analysis of DNA fragmentation in spermatozoa. Asian J Androl 2021; 22:246-251. [PMID: 31339111 PMCID: PMC7275795 DOI: 10.4103/aja.aja_51_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
An increased amount of DNA fragmentation in the spermatozoa (SDF) is linked to male infertility. The Sperm Chromatin Structure Assay (SCSA) is widely used for analysis of SDF. However, the current software (SCSASoft®) linked to this assay is licensed and often located within larger diagnostic centers. In this study, we present a protocol for using other types of software than SCSASoft® to determine the SDF index (DFI) with clinical relevance. This protocol is engineered after collecting and analyzing 254 samples from fertility patients and sperm donors over a 15-month period. DFI is analyzed using a strict protocol where the spermatozoa are treated with a strong acid (pH 1.2) followed by acridine orange. DFI is determined by a standard flow cytometric software, FACSDiva 6.1.3. Analysis of the outcome of the fertility treatment is included for 137 patients receiving either intrauterine inseminations (IUI) or timed coitus (TC). The results show that the chance of pregnancy declines as DFI increases. We also found that the male DFI affects the chance of pregnancy independent of the female age. We have shown that a standard flow cytometric software can be used when determining a clinical relevant DFI. These findings are a significant step toward implementing the analysis as a part of the routine, in-house diagnosing of the male fertility patient and subsequently optimizing the treatment course of the couple with reduced human and financial costs.
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Affiliation(s)
- Anne Sofie Rex
- Centre of Andrology and Fertility Clinic, Odense University Hospital, Odense 5000, Denmark.,Aagaard Gynaecological Clinic, Skejby 8200, Aarhus, Denmark.,Research Unit of Gynaecology and Obstetrics, Faculty of Health, University of Southern Denmark, Odense 5000, Denmark
| | - Chunsen Wu
- Centre of Andrology and Fertility Clinic, Odense University Hospital, Odense 5000, Denmark.,Research Unit of Gynaecology and Obstetrics, Faculty of Health, University of Southern Denmark, Odense 5000, Denmark
| | - Jørn Aagaard
- Aagaard Gynaecological Clinic, Skejby 8200, Aarhus, Denmark
| | - Jens Fedder
- Centre of Andrology and Fertility Clinic, Odense University Hospital, Odense 5000, Denmark.,Research Unit of Gynaecology and Obstetrics, Faculty of Health, University of Southern Denmark, Odense 5000, Denmark
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30
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Upadhyay VR, Ramesh V, Dewry RK, Kumar G, Raval K, Patoliya P. Implications of cryopreservation on structural and functional attributes of bovine spermatozoa: An overview. Andrologia 2021; 53:e14154. [PMID: 34143907 DOI: 10.1111/and.14154] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/12/2021] [Accepted: 06/03/2021] [Indexed: 01/31/2023] Open
Abstract
Sperm cryopreservation is an important adjunct to assisted reproduction techniques (ART) for improving the reproductive efficiency of dairy cattle and buffaloes. Improved understanding of mechanisms and challenges of bovine semen cryopreservation is vital for artificial insemination on a commercial basis. Although cryopreservation of bovine spermatozoa is widely practiced and advanced beyond that of other species, there are still major gaps in the knowledge and technology. Upon cryopreservation, disruption of spermatozoal plasma membrane configuration due to alterations in metabolic pathways, enzymes and antioxidants activity add to lower efficiency with loss of sperm longevity and fertilising ability. Therefore, the effective amalgamation of cryo-variables like ambient temperature, cooling and thawing rates, nucleation temperature, type and concentration of the cryoprotectant, seminal plasma composition, free radicals and antioxidant status are required to optimise cryopreservation. Novel strategies like supplementation of cholesterol-loaded cyclodextrins (CLC), nanovesicles, osteopontin, antioxidants, etc., in an extender and recent techniques like nano-purification and modified packaging have to be optimised to ameliorate the cryodamage. This article is intended to describe the basic facts about the sperm cryopreservation process in bovine and the associated biochemical, biophysical, ultra-structural, molecular and functional alterations.
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Affiliation(s)
| | - Vikram Ramesh
- Animal Reproduction and Gynecology, ICAR-National Research Centre on Mithun, Medziphema, India
| | - Raju Kumar Dewry
- Artificial Breeding Research Centre, ICAR-National Dairy Research Institute, Karnal, India
| | - Gaurav Kumar
- Division of Animal Physiology, ICAR-National Dairy Research Institute, Karnal, India
| | - Kathan Raval
- Artificial Breeding Research Centre, ICAR-National Dairy Research Institute, Karnal, India
| | - Priyanka Patoliya
- Division of Livestock Production Management, ICAR-National Dairy Research Institute, Karnal, India
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31
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Pennings G, Couture V, Ombelet W. Social sperm freezing. Hum Reprod 2021; 36:833-839. [PMID: 33501976 DOI: 10.1093/humrep/deaa373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/17/2020] [Indexed: 12/31/2022] Open
Abstract
Increased paternal age has been associated with lower fertility and higher genetic risk for the offspring. One way to prevent these consequences is to freeze sperm at a young age. Social sperm freezing could be developed in a way similar to social oocyte freezing. The main difference between freezing oocytes and sperm is that social sperm freezing is much less focussed on fertility preservation and much more on avoiding increased genetic risk. Contrary to what some people seem to believe, sperm freezing is more complicated than it looks at first sight. This article considers three practical aspects: freezing, storage and testing. It is concluded that the remedy (cryopreservation) may itself cause damage to the quality of the spermatozoon and to its genetic integrity, thus undoing the possible benefits in terms of fertility and health of offspring.
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Affiliation(s)
- Guido Pennings
- Department of Philosophy and Moral Science, Bioethics Institute Ghent (BIG), Ghent University, Ghent B-9000, Belgium
| | - Vincent Couture
- Faculty of Nursing, Université Laval, Québec, QC G1V 0A6, Canada.,Research Center of the CHU de Québec-Université Laval, Québec, QC G1L 3L5, Canada
| | - Willem Ombelet
- Genk Institute for Fertility Technology, ZOL Hospitals, Genk B-3600, Belgium.,Faculty of Medicine and Life Sciences, Hasselt University, Hasselt B-3500, Belgium
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32
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Habibi M, Sadeghi N, Tavalaee M, Shahverdi A, Ghorban Z, Nasr-Esfahani MH. Sperm chromatin integrity in a man with macrocephaly syndrome. Andrologia 2021; 53:e14100. [PMID: 33961714 DOI: 10.1111/and.14100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 02/04/2023] Open
Abstract
This study reports chromatin status and ICSI outcomes in a case of sperm macrocephaly syndrome(SMS), showing 100% of spermatozoa with abnormal morphology. Percentages of sperm DNA fragmentation for TUNEL (31.7% versus 6.5%), SCSA (33% versus 25%) assays, chromatin maturity tests, CMA3 (58% versus 29%) and aniline blue (63% versus 35%) staining were higher in case sample compared to the fertile sample. Artificial oocyte activation resulted in a similar fertilisation rate between case and control samples (71% versus 66.7%), but the case showed delayed embryo development on day 3 post-insemination. Unlike fertile case, no embryos reached the blastocyst stage. The result of this case study shows that macrocephaly is associated with reduced chromatin maturity and DNA integrity. Although both cases showed a similar chance for fertilisation through artificial chemical activation for only macrocephalic man, the developmental competency is jeopardised in such cases.
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Affiliation(s)
- Masoud Habibi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Niloofar Sadeghi
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Marziyeh Tavalaee
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Zahra Ghorban
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - Mohammad Hossein Nasr-Esfahani
- Department of Animal Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran.,Isfahan Fertility and Infertility Center, Isfahan, Iran
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33
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Vaughan DA, Tirado E, Garcia D, Datta V, Sakkas D. DNA fragmentation of sperm: a radical examination of the contribution of oxidative stress and age in 16 945 semen samples. Hum Reprod 2021; 35:2188-2196. [PMID: 32976601 DOI: 10.1093/humrep/deaa159] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/28/2020] [Indexed: 02/07/2023] Open
Abstract
STUDY QUESTION What is the relationship between sperm DNA fragmentation and oxidative stress (OS) with increasing male age? SUMMARY ANSWER Sperm DNA fragmentation increases with age and is likely related to both defective spermatogenesis and increasing OS levels. WHAT IS KNOWN ALREADY Sperm quality declines with age. The presence of DNA damage in a high fraction of spermatozoa from a raw semen sample is associated with lower male fertility in natural conception and intrauterine insemination. STUDY DESIGN, SIZE, DURATION A retrospective cohort study of 16 945 semen samples analysed at a single reference laboratory between January 2010 and December 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS All males were undergoing an infertility evaluation. The cohort was divided into seven age categories: <30, 30-34, 35-39, 40-44, 45-49, 50 to <54 and ≥55 years. The mean age was 37.6 years (SD 6.8). Sperm DNA fragmentation index (DFI) and high DNA stainability (HDS) were calculated using flow cytometry. OS levels were measured using the oxidative stress adducts (OSA) test, by spectrophotometry. ANOVA with weighted polynomial contrast analysis was used to evaluate trends for DFI, OSA and HDS values across age categories. MAIN RESULTS AND THE ROLE OF CHANCE Mean DFI significantly increased across all age groups (Ptrend < 0.001). OSA was lowest in patients <30 years old (mean 3.6, SD 1.0) and also increased as age increased (Ptrend < 0.001). There was a statistically significant difference between age groups for each of the three parameters (P < 0.001). There was a significant linear trend for DFI, OSA and HDS across the seven age categories (P < 0.001). Among patients with high DFI, there was a decreasing age-dependent trend in the patients observed with high OSA (P < 0.001). LIMITATIONS, REASONS FOR CAUTION This is a retrospective study. All males included in the study were undergoing a work-up for infertility and may not be representative of a fertile population. Additional patient demographics and clinical data were not available. WIDER IMPLICATIONS OF THE FINDINGS DNA and/or oxidative damage in sperm may be just as important to understand as the chromosomal aberrations that are carried in the oocyte. Further studies are needed to evaluate the effect of advancing paternal age on the male genome and, ultimately, on the health of the offspring. STUDY FUNDING/COMPETING INTEREST(S) No funding was obtained for this study. V.D. is an employee of Reprosource/Quest Diagnostics. D.S. reports he was a Scientific Advisor to Cooper Surgical. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- D A Vaughan
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA 02115, USA.,Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School, Boston, MA 02115, USA.,Boston IVF, Waltham, MA 02445, USA
| | - E Tirado
- ReproSource Fertility Diagnostics, Marlborough, MA 01752, USA
| | - D Garcia
- Clinica EUGIN, Barcelona 08029, Spain
| | - V Datta
- ReproSource Fertility Diagnostics, Marlborough, MA 01752, USA
| | - D Sakkas
- Boston IVF, Waltham, MA 02445, USA
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Ribas-Maynou J, Yeste M, Becerra-Tomás N, Aston KI, James ER, Salas-Huetos A. Clinical implications of sperm DNA damage in IVF and ICSI: updated systematic review and meta-analysis. Biol Rev Camb Philos Soc 2021; 96:1284-1300. [PMID: 33644978 DOI: 10.1111/brv.12700] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/13/2022]
Abstract
The clinical effect of sperm DNA damage in assisted reproduction has been a controversial topic during recent decades, leading to a variety of clinical practice recommendations. While the latest European Society of Human Reproduction and Embryology (ESHRE) position report concluded that DNA damage negatively affects assisted reproduction outcomes, the Practice Committee of the American Society for Reproductive Medicine (ASRM) does not recommend the routine testing of DNA damage for in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI). Herein, our aim was to perform a systematic review and meta-analysis of studies investigating whether sperm DNA damage affects clinical outcomes in IVF and ICSI, in order to contribute objectively to a consistent clinical recommendation. A comprehensive systematic search was conducted according to PRISMA guidelines from the earliest available online indexing year until March 2020, using the MEDLINE-PubMed and EMBASE databases. We included studies analysing IVF and/or ICSI treatments performed in infertile couples in which sperm DNA damage was well defined and assessed. Studies also had to include information about pregnancy, implantation or live birth rates as primary outcomes. The NHLBI-NIH quality assessment tool was used to assess the quality of each study. Meta-analyses were conducted using the Mantel-Haenszel method with random-effects models to evaluate the Risk Ratio (RR) between high-DNA-damage and control groups, taking into account the 95% confidence intervals. Heterogeneity among studies was evaluated using the I2 statistic. We also conducted sensitivity analyses and post-hoc subgroup analyses according to different DNA fragmentation assessment techniques. We identified 78 articles that met our inclusion and quality criteria and were included in the qualitative analysis, representing a total of 25639 IVF/ICSI cycles. Of these, 32 articles had sufficient data to be included in the meta-analysis, comprising 12380 IVF/ICSI cycles. Meta-analysis revealed that, considering IVF and ICSI results together, implantation rate (RR = 0.74; 95% CI = 0.61-0.91; I2 = 69) and pregnancy rate (RR = 0.83; 0.73-0.94; I2 = 58) are negatively influenced by sperm DNA damage, although after adjustment for publication bias the relationship for pregnancy rate was no longer significant. The results showed a non-significant but detrimental tendency (RR = 0.78; 0.58-1.06; I2 = 72) on live birth rate. Meta-analysis also showed that IVF outcomes are negatively influenced by sperm DNA damage, with a statistically significant impact on implantation (RR = 0.68; 0.52-0.89; I2 = 50) and pregnancy rates (RR = 0.72; 0.55-0.95; I2 = 72), although the latter was no longer significant after correction for publication bias. While it did not quite meet our threshold for significance, a negative trend was also observed for live birth rate (RR = 0.48; 0.22-1.02; I2 = 79). In the case of ICSI, non-significant trends were observed for implantation (RR = 0.79; 0.60-1.04; I2 = 72) or pregnancy rates (RR = 0.89; 0.78-1.02; I2 = 44), and live birth rate (RR = 0.92; 0.67-1.27; I2 = 70). The current review provides the largest evidence to date supporting a negative association between sperm DNA damage and conventional IVF treatments, significantly reducing implantation and pregnancy rates. The routine use of sperm DNA testing is therefore justified, since it may help improve the outcomes of IVF treatments and/or allow a given couple to be advised on the most suitable treatment. Further well-designed controlled studies on a larger number of patients are required to allow us to reach more precise conclusions, especially in the case of ICSI treatments.
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Affiliation(s)
- Jordi Ribas-Maynou
- Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Jaume Casadamont Building, Door E, 15 Pic de Peguera St, Girona, ES-17003, Spain.,Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, Sciences Building, 69 Maria Aurèlia Capmany, Girona, ES-17003, Spain
| | - Marc Yeste
- Biotechnology of Animal and Human Reproduction (TechnoSperm), Institute of Food and Agricultural Technology, University of Girona, Jaume Casadamont Building, Door E, 15 Pic de Peguera St, Girona, ES-17003, Spain.,Unit of Cell Biology, Department of Biology, Faculty of Sciences, University of Girona, Sciences Building, 69 Maria Aurèlia Capmany, Girona, ES-17003, Spain
| | - Nerea Becerra-Tomás
- Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició, St/Sant Llorenç, 21, Reus, ES-43201, Spain.,Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain.,Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain.,Department of Preventive Medicine and Public Health, School of Medicine, University of Valencia, Valencia, ES-46010, Spain
| | - Kenneth I Aston
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, 675 Arapeen Drive, Salt Lake City, UT, US-84108, U.S.A
| | - Emma R James
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, 675 Arapeen Drive, Salt Lake City, UT, US-84108, U.S.A.,Department of Human Genetics, University of Utah School of Medicine, 15 N 2030 E, Salt Lake City, UT, US-84112, U.S.A
| | - Albert Salas-Huetos
- Andrology and IVF Laboratory, Division of Urology, Department of Surgery, University of Utah School of Medicine, 675 Arapeen Drive, Salt Lake City, UT, US-84108, U.S.A
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35
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Esteves SC, Zini A, Coward RM, Evenson DP, Gosálvez J, Lewis SEM, Sharma R, Humaidan P. Sperm DNA fragmentation testing: Summary evidence and clinical practice recommendations. Andrologia 2021; 53:e13874. [PMID: 33108829 PMCID: PMC7988559 DOI: 10.1111/and.13874] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/06/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022] Open
Abstract
We herein summarise the evidence concerning the impact of sperm DNA fragmentation in various clinical infertility scenarios and the advances on sperm DNA fragmentation tests. The collected evidence was used to formulate 41 recommendations. Of these, 13 recommendations concern technical aspects of sperm DNA fragmentation testing, including pre-analytical information, clinical thresholds and interpretation of results. The remaining 28 recommendations relate to indications for sperm DNA fragmentation testing and clinical management. Clinical scenarios like varicocele, unexplained infertility, idiopathic infertility, recurrent pregnancy loss, intrauterine insemination, in vitro fertilisation/intracytoplasmic sperm injection, fertility counselling for men with infertility risk factors and sperm cryopreservation have been contemplated. The bulk evidence supporting the recommendations has increased in recent years, but it is still of moderate to low quality. This guideline provides clinicians with advice on best practices in sperm DNA fragmentation testing. Also, recommendations are provided on possible management strategies to overcome infertility related to sperm DNA fragmentation, based on the best available evidence. Lastly, we identified gaps in knowledge and opportunities for research and elaborated a list of recommendations to stimulate further investigation.
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Affiliation(s)
- Sandro C. Esteves
- ANDROFERT, Andrology and Human Reproduction ClinicReferral Center for Male ReproductionCampinasSPBrazil
- Department of Surgery (Division of Urology)University of Campinas (UNICAMP)CampinasSPBrazil
- Faculty of HealthAarhus UniversityAarhusDenmark
| | - Armand Zini
- Division of UrologyDepartment of SurgerySt. Mary's HospitalMcGill UniversityMontrealQuébecCanada
| | - Robert Matthew Coward
- Department of UrologyUniversity of North CarolinaChapel HillNCUSA
- UNC FertilityRaleighNCUSA
| | - Donald P. Evenson
- SCSA DiagnosticsBrookingsSDUSA
- Sanford Medical SchoolUniversity of South DakotaSioux FallsSDUSA
| | - Jaime Gosálvez
- Unit of GeneticsDepartment of BiologyUniversidad Autónoma de MadridMadridSpain
| | | | - Rakesh Sharma
- American Center for Reproductive MedicineCleveland ClinicClevelandOHUSA
| | - Peter Humaidan
- Faculty of HealthAarhus UniversityAarhusDenmark
- Fertility Clinic SkiveSkive Regional HospitalSkiveDenmark
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Gao J, Yuan R, Yang S, Wang Y, Huang Y, Yan L, Jiang H, Qiao J. Age-related changes in human conventional semen parameters and sperm chromatin structure assay-defined sperm DNA/chromatin integrity. Reprod Biomed Online 2021; 42:973-982. [PMID: 33785305 DOI: 10.1016/j.rbmo.2021.02.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/05/2021] [Accepted: 02/09/2021] [Indexed: 12/14/2022]
Abstract
RESEARCH QUESTION What are the correlations between male age, traditional semen parameters, sperm DNA fragmentation index (DFI) and high DNA stainability (HDS) in a sufficiently large sample size? DESIGN Retrospective cohort study of 18,441 semen samples, with data divided into seven age groups according to male age: ≤25, 26-30, 31-35, 36-40, 41-45, 46-50 and ≥51 years. RESULTS Age was negatively correlated with semen volume, total sperm count, motility and HDS, and positively correlated with sperm concentration and DFI (P < 0.001). After 35 years of age, semen volume and total sperm count began to decline. After 30 years of age, motility and HDS decreased consistently. Sperm concentration and DFI increased from 26-30 years of age. DFI was negatively correlated with sperm concentration, total sperm count, motility and normal morphology (P < 0.001) and positively correlated with semen volume and HDS (P < 0.001). HDS was negatively correlated with all parameters (P < 0.001) except semen volume (r = -0.013, P = 0.074) and DFI (r = 0.124, P < 0.001). Patients aged ≥40 years had higher DFI than those aged <40 years in the entire cohort, in the abnormal semen parameters cohort, and in the normal semen parameters cohort (OR 2.145, 2.042, 1.948, respectively, P < 0.001). The ≥40 years age group had a lower HDS than the <40 years age group in the entire cohort and abnormal semen parameters cohort (OR 0.719, 0.677, respectively, P < 0.001). CONCLUSIONS Ageing is a negative effector of sperm quantity and quality, and routine sperm parameters have weak but significant correlations with sperm DNA/chromatin integrity.
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Affiliation(s)
- Jiangman Gao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing 100191, China
| | - Renpei Yuan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Siwei Yang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Yuanyuan Wang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing 100191, China
| | - Ying Huang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing 100191, China
| | - Hui Jiang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; National Clinical Research Center for Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China; Key Laboratory of Assisted Reproduction, Peking University, Ministry of Education, Beijing 100191, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing 100191, China.
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37
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Rashki Ghaleno L, Alizadeh A, Drevet JR, Shahverdi A, Valojerdi MR. Oxidation of Sperm DNA and Male Infertility. Antioxidants (Basel) 2021; 10:antiox10010097. [PMID: 33445539 PMCID: PMC7827380 DOI: 10.3390/antiox10010097] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/05/2021] [Accepted: 01/08/2021] [Indexed: 12/29/2022] Open
Abstract
One important reason for male infertility is oxidative stress and its destructive effects on sperm structures and functions. The particular composition of the sperm membrane, rich in polyunsaturated fatty acids, and the easy access of sperm DNA to oxidative damage due to sperm cell specific cytologic and metabolic features (no cytoplasm left and cells unable to mount stress responses) make it the cell type in metazoans most susceptible to oxidative damage. In particular, oxidative damage to the spermatozoa genome is an important issue and a cause of male infertility, usually associated with single- or double-strand paternal DNA breaks. Various methods of detecting sperm DNA fragmentation have become important diagnostic tools in the prognosis of male infertility and such assays are available in research laboratories and andrology clinics. However, to date, there is not a clear consensus in the community as to their respective prognostic value. Nevertheless, it is important to understand that the effects of oxidative stress on the sperm genome go well beyond DNA fragmentation alone. Oxidation of paternal DNA bases, particularly guanine and adenosine residues, the most sensitive residues to oxidative alteration, is the starting point for DNA damage in spermatozoa but is also a danger for the integrity of the embryo genetic material independently of sperm DNA fragmentation. Due to the lack of a spermatozoa DNA repair system and, if the egg is unable to correct the sperm oxidized bases, the risk of de novo mutation transmission to the embryo exists. These will be carried on to every cell of the future individual and its progeny. Thus, in addition to affecting the viability of the pregnancy itself, oxidation of the DNA bases in sperm could be associated with the development of conditions in young and future adults. Despite these important issues, sperm DNA base oxidation has not attracted much interest among clinicians due to the lack of simple, reliable, rapid and consensual methods of assessing this type of damage to the paternal genome. In addition to these technical issues, another reason explaining why the measurement of sperm DNA oxidation is not included in male fertility is likely to be due to the lack of strong evidence for its role in pregnancy outcome. It is, however, becoming clear that the assessment of DNA base oxidation could improve the efficiency of assisted reproductive technologies and provide important information on embryonic developmental failures and pathologies encountered in the offspring. The objective of this work is to review relevant research that has been carried out in the field of sperm DNA base oxidation and its associated genetic and epigenetic consequences.
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Affiliation(s)
- Leila Rashki Ghaleno
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran 16635-148, Iran; (L.R.G.); (A.A.); (A.S.)
| | - AliReza Alizadeh
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran 16635-148, Iran; (L.R.G.); (A.A.); (A.S.)
| | - Joël R. Drevet
- Faculty of Medicine, GReD Institute, INSERM U1103—CNRS UMR6293—Université Clermont Auvergne, CRBC Building, 28 Place Henri Dunant, 63001 Clermont-Ferrand, France
- Correspondence: (J.R.D.); or (M.R.V.); Tel.: +33-47-340-7413 (J.R.D.); +98-21-223-07735 or +98-21-828-83897 (M.R.V.); Fax: +33-47-340-7042 (J.R.D.); +98-21-223-06480 or +98-21-880-13030 (M.R.V.)
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran 16635-148, Iran; (L.R.G.); (A.A.); (A.S.)
| | - Mojtaba Rezazadeh Valojerdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran 16635-148, Iran; (L.R.G.); (A.A.); (A.S.)
- Department of Anatomy, Faculty of Medical Science, Tarbiat Modares University, Tehran 14155-6343, Iran
- Correspondence: (J.R.D.); or (M.R.V.); Tel.: +33-47-340-7413 (J.R.D.); +98-21-223-07735 or +98-21-828-83897 (M.R.V.); Fax: +33-47-340-7042 (J.R.D.); +98-21-223-06480 or +98-21-880-13030 (M.R.V.)
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38
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Chang HC, Huang WL, Chang YK, Tung SY, Peng BH. Sperm motility is the best semen parameter to predict sperm DNA fragmentation. UROLOGICAL SCIENCE 2021. [DOI: 10.4103/uros.uros_175_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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39
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Huyghe E, Boitrelle F, Methorst C, Mieusset R, Ray PF, Akakpo W, Koscinski I, Chalas C, Rives N, Plotton I, Robin G, El Osta R, Hennebicq S, Eustache F, Marcelli F, Lejeune H. [AFU and SALF recommendations for the evaluation of male infertility]. Prog Urol 2020; 31:131-144. [PMID: 33309127 DOI: 10.1016/j.purol.2020.09.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/20/2020] [Accepted: 09/10/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND The aim of these Association Française d'Urologie (AFU) and Société d'Andrologie de Langue Française (SALF) common recommendations are to provide practice guidelines for the French Urological and Andrological community regarding the evaluation of infertile men. MATERIAL AND METHODS Literature search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2020. To inform the level of evidence, the HAS grading system (2013) was applied. RESULTS Concerning the evaluation of infertile men, the AFU and the SALF recommend : (1) a systematic interview exploring the family history, the fertility history of the man outside the couple, the patient's personal history that may have an impact on his fertility, lifestyle habits, treatments, symptoms and possible sexual difficulties of the couple; (2) a general physical examination to assess signs of hypogonadism and secondary sexual characters; (3) a scrotal physical examination performed by an urologist or andrologist to assess (i) the testes for volume and consistency, (ii) vas deferens and epididymes for total or partial absence or nodules, and (iii) presence of varicoceles; (4) Performing two semen analyses, according to World Health Organization guidelines, if the first one has at least one abnormaly; (5) a scrotal ultrasound as part of routine investigation, that can be completed with an endorectal pelvic ultrasound according to the clinic; (6) an endocrine evaluation with at least a Testosterone and FSH serum determination; (7) Karyotype analysis in infertile men with a sperm concentration ≤10 106/mL; (8) assessment of Yq microdeletions in infertile men with a sperm concentration ≤1 106/mL; (9) Cystic fibrosis transmembrane conductance regulator gene evaluation in case of suspicion for bilateral or unilateral congenital agenesis of vas deferens and seminal vesicles. The interest of tests analyzing DNA fragmentation (TUNEL, SCSA) is still under investigation. CONCLUSION These guidelines can be applied in routine clinical practice in all infertile men.
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Affiliation(s)
- Eric Huyghe
- Département d'Urologie, Transplantation Rénale et Andrologie, CHU de Toulouse, site de Rangueil, Toulouse, France; Médecine de la Reproduction, CHU de Toulouse, site de Paule de Viguier, Toulouse, France.
| | - Florence Boitrelle
- Service de gynécologie-obstétrique, CHI Poissy/Saint-Germain-en-Laye, Poissy, France
| | | | - Roger Mieusset
- Médecine de la Reproduction, CHU de Toulouse, site de Paule de Viguier, Toulouse, France
| | - Pierre F Ray
- Service de Biologie, Génétique de la reproduction, CHU de Grenoble, France
| | - William Akakpo
- Service d'Urologie, Hôpital universitaire de la Pitié Salpêtrière, APHP, Paris, France
| | | | - Céline Chalas
- Service d'Histologie, embryologie, cytologie, Hôpital Cochin, APHP, Paris, France
| | - Nathalie Rives
- Laboratoire de Biologie de la Reproduction, CECOS, CHU de Rouen, France
| | - Ingrid Plotton
- Service de médecine de la reproduction, Hôpital Femme Mère Enfant, HCL, Bron, France
| | - Geoffroy Robin
- Service de gynécologie, Médecine de la reproduction, Hôpital Jeanne de Flandres, CHRU de Lille, France
| | | | | | | | | | - Hervé Lejeune
- Service de médecine de la reproduction, Hôpital Femme Mère Enfant, HCL, Bron, France
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Deenadayal Mettler A, Govindarajan M, Srinivas S, Mithraprabhu S, Evenson D, Mahendran T. Male age is associated with sperm DNA/chromatin integrity. Aging Male 2020; 23:822-829. [PMID: 30964371 DOI: 10.1080/13685538.2019.1600496] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The diagnosis of sperm DNA integrity is increasingly recognized as being crucial to inform the clinical course in infertile couples. An internationally accepted sperm DNA fragmentation assay that determines the proportion of sperm and degree of broken sperm nuclear DNA with recognised clinical thresholds for identifying men at risk of infertility is the Sperm Chromatin Structure Assay (SCSA®). In this study, SCSA® test was utilised to evaluate the relevance of male age on sperm DNA quality in total of 6881 males of Indian origin. Analysis of proportions of DNA fragmentation index (%DFI) and high DNA stainability (%HDS) was performed based on four groups (<35, 35-40, 40-45, and >45 years of age). The impact of increasing male age on %DFI revealed that males >45 years of age had the highest %DFI and lowest %HDS compared to all other age groups (p<.001). This study is the largest population study and first of its kind in India that utilises SCSA® to assess the relevance of %DFI and %HDS to increasing age with potentially important implications for the choice of clinical course based on age and sperm quality of infertile males in India.
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Affiliation(s)
| | | | - Sapna Srinivas
- Infertility Institute and Research Centre, Secunderabad, India
| | - Sridurga Mithraprabhu
- Womens Center, Coimbatore, India
- Australian Centre for Blood Diseases, Alfred Hospital - Monash University, Melbourne, Australia
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B VL, Stephen S, Devaraj R, Mithraprabhu S, Bertolla RP, Mahendran T. Sperm chromatin structure assay versus sperm chromatin dispersion kits: Technical repeatability and choice of assisted reproductive technology procedure. Clin Exp Reprod Med 2020; 47:277-283. [PMID: 33227185 PMCID: PMC7711102 DOI: 10.5653/cerm.2020.03860] [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] [Received: 06/02/2020] [Accepted: 07/27/2020] [Indexed: 12/02/2022] Open
Abstract
Objective The sperm DNA fragmentation index (DFI) guides the clinician’s choice of an appropriate assisted reproductive technology (ART) procedure. The DFI can be determined using commercially available methodologies, including sperm chromatin dispersion (SCD) kits and sperm chromatin structure assay (SCSA). Currently, when DFI is evaluated using SCD kits, the result is analyzed in reference to the SCSA-derived threshold for the choice of an ART procedure. In this study, we compared DFI values obtained using SCSA with those obtained using SCD and determined whether the difference affects the choice of ART procedure. Methods We compared SCSA to two SCD kits, CANfrag (n=36) and Halosperm (n=31), to assess the DFI values obtained, the correlations between tests, the technical repeatability, and the impact of DFI on the choice of ART. Results We obtained higher median DFI values using SCD kits than when using SCSA, and this difference was significant for the CANfrag kit (p<0.001). The SCD kits had significantly higher coefficients of variation than SCSA (p<0.001). In vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) would be chosen for a significantly higher proportion of patients if a decision were made based on DFI derived from SCD rather than DFI determined using SCSA (p=0.003). Conclusion Our results indicate that SCD kit-specific thresholds should be established in order to avoid the unnecessary use of IVF/ICSI based on sperm DNA damage for the management of infertility. Appropriate measures should be taken to mitigate the increased variability inherent to the methods used in these tests.
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Affiliation(s)
| | | | | | - Sridurga Mithraprabhu
- Australian Centre for Blood Diseases, Alfred Hospital, Monash University, Melbourne, Australia
| | - Ricardo P Bertolla
- Department of Surgery, Division of Urology, Sao Paulo Federal University, Sao Paulo, Brazil
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Alharbi M, Almarzouq A, Zini A. Sperm retrieval and intracytoplasmic sperm injection outcomes with testicular sperm aspiration in men with severe oligozoospermia and cryptozoospermia. Can Urol Assoc J 2020; 15:E272-E275. [PMID: 33119503 DOI: 10.5489/cuaj.6798] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Several studies addressed the role of testicular sperm aspiration with intracytoplasmic sperm injection (ICSI) in azoospermic men, but few have included non-azoospermic men. The aim of this study was to evaluate testicular sperm aspiration (TESA) sperm retrieval rates and ICSI outcomes in men with severe oligozoospermia. METHODS Data were collected retrospectively from 88 consecutive, non-azoospermic, infertile men with idiopathic severe oligozoospermia who underwent TESA between January 2011 and January 2018. Patients were categorized into four groups according to sperm concentration: <5 and >1 million/ml (group 1), <1 and > 0.1 million/ml (group 2), <0.1 million/ml (group 3), and cryptozoospermia (group 4). RESULTS Mean male age was 37±7 years and the mean female age was 33±4 years. Sperm was recovered successfully in 90% (79/88) of the men overall and in 100% (30/30) of the men in group 1, 97% (29/30) of the men in group 2, 88% (15/17) of the men in group 3, and 45% (5/11) of the men in group 4. Most (65%, 57/88) of the couples had an embryo transfer (ET). The overall clinical pregnancy rate per ET was 46% (26/57). The clinical pregnancy rates (per ET) were 43% (9/21) in group 1, 65% (13/20) in group 2, 36% (4/11) in group 3, and 0% (0/5) in group 4. CONCLUSIONS Our data indicate TESA allows for high sperm retrieval rates and acceptable ICSI pregnancy rates in men with severe oligozoospermia. However, in our experience, TESA sperm retrieval rates and ICSI outcomes are poor in cryptozoospermic men.
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Affiliation(s)
- Mohannad Alharbi
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,Department of Surgery, College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Ahmad Almarzouq
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada
| | - Armand Zini
- Division of Urology, Department of Surgery, McGill University, Montreal, QC, Canada.,OVO Fertility Clinic, Montreal, QC, Canada
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Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho CL, Henkel R, Finelli R, Leisegang K, Sengupta P, Barbarosie C, Parekh N, Alves MG, Ko E, Arafa M, Tadros N, Ramasamy R, Kavoussi P, Ambar R, Kuchakulla M, Robert KA, Iovine C, Durairajanayagam D, Jindal S, Shah R. Sperm DNA Fragmentation: A New Guideline for Clinicians. World J Mens Health 2020; 38:412-471. [PMID: 32777871 PMCID: PMC7502318 DOI: 10.5534/wjmh.200128] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations. This article provides an overview of SDF types, origin and comparative analysis of various SDF assays while primarily focusing on the clinical indications of SDF testing. Importantly, we report four clinical cases where SDF testing had played a significant role in improving fertility outcome. In light of these clinical case reports and recent scientific evidence, this review provides expert recommendations on SDF testing and examines the advantages and drawbacks of the clinical utility of SDF testing using Strength-Weaknesses-Opportunities-Threats (SWOT) analysis.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Chak Lam Cho
- Department of Surgery, Union Hospital, Hong Kong
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Ralf Henkel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Malaysia
| | - Catalina Barbarosie
- Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Neel Parekh
- Department of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Marco G Alves
- Department of Microscopy, Laboratory of Cell Biology & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Edmund Ko
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Andrology Department, Cairo University, Giza, Egypt
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | - Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Rafael Ambar
- Urology Department of Centro Universitario em Saude do ABC, Santo André, Brazil
| | | | - Kathy Amy Robert
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Concetta Iovine
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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Lu R, Chen X, Yu W, Jiang F, Zhou X, Xu Y, Wang F. Analysis of age-associated alternation of SCSA sperm DNA fragmentation index and semen characteristics of 1790 subfertile males in China. J Clin Lab Anal 2020; 34:e23548. [PMID: 32926480 PMCID: PMC7755769 DOI: 10.1002/jcla.23548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/01/2020] [Accepted: 08/06/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND It has been identified that incidence of infertility was about 20% among couples worldwide, about 50% caused by male elements. However, conventional semen laboratory detections could not handle clinical needs, which led to more comprehensive parameters for male fertility evaluation. We aimed to investigate the clinical relationship of age-linked changes and the sperm chromatin structure assay (SCSA) sperm DNA fragmentation index (DFI), and routine semen characteristics among subfertile Chinese males. METHODS 1790 clinical semen specimens were enrolled from February 2018 to October 2019. Clinical and laboratory data including routine semen analyses, sperm DFI, and sperm morphology were collected and showed age-related alterations in semen parameters. RESULTS Our results, displayed an increase in sperm DFI with age, were demonstrated in three age-groups, particularly within the ≥35-year cohort. There were positive and inverse correlations of sperm DFI with abnormal semen characteristics and with normal morphological parameters, respectively. Furthermore, age, sperm morphology, concentration, and progressive motility, immotile sperm percentage, semen volume, sperm survival, and high acridine orange DNA stainability (indicating immature forms) were found to be independent risk factors affecting sperm DNA integrity. Likewise, men aged ≥35 years had a higher sperm DFI than did normozoospermic men in the overall cohort. Routine semen characteristics, sperm DFI, and morphology tended to alter with age. CONCLUSIONS The SCSA sperm DFI showed the greatest clinical application in the assessment of male fertility in this study, which should help infertility clinics decide on reproductive options for the treatment of older infertile couples.
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Affiliation(s)
- Ruijing Lu
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Xian Chen
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Weijian Yu
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Fan Jiang
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Xiyou Zhou
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Yang Xu
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
| | - Feng Wang
- Department of Laboratory Medicine, Shenzhen Baoan Women's and Children's Hospital, Jinan University, Shenzhen, China
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Rosen EM, Mínguez-Alarcón L, Meeker JD, Williams PL, Milne GL, Hauser R, Ferguson KK. Urinary oxidative stress biomarker levels and reproductive outcomes among couples undergoing fertility treatments. Hum Reprod 2020; 34:2399-2409. [PMID: 31887223 DOI: 10.1093/humrep/dez228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 09/04/2019] [Indexed: 01/12/2023] Open
Abstract
STUDY QUESTION Are urinary levels of oxidative stress biomarkers associated with reproductive outcome success following fertility treatments? SUMMARY ANSWER Levels of oxidative stress in the middle tertile for women are associated with the highest levels of reproductive success while no associations were noted for men. WHAT IS KNOWN ALREADY Oxidative stress may contribute to adverse fertility outcomes in the general population, but findings from couples undergoing fertility treatments are sparse. STUDY DESIGN, SIZE, DURATION This prospective cohort study included 481 women and 249 of their male partners undergoing fertility treatments from 2007 to 2015, from the Environment and Reproductive Health (EARTH) study in Boston, MA. PARTICIPANTS/MATERIALS, SETTING, METHODS One urine sample per participant was collected at each cycle and analysed for two oxidative stress markers: 8-isoprostane-PGF2α (8-iso-PGF2α) and 8-isoprostane-PGF2α metabolite (F2-isoP-M). Reproductive outcomes were abstracted from medical records and included the fertilization rate, for IVF (oocytes fertilized/mature oocytes retrieved), and rates of implantation, clinical pregnancy and live birth, for both IVF and IUI. Cluster-weighted generalized estimating equations were used to analyse adjusted associations between exposure tertiles and outcomes. MAIN RESULTS AND THE ROLE OF CHANCE Levels of F2-isoP-M in the middle tertile were associated with the most success among women. Women in the upper tertile of F2-isoP-M had an adjusted mean live birth rate after IVF and IUI of 23% (95% CI: 17, 29) compared to 38% (95% CI: 31, 45) for women in the middle tertile and 27% (95% CI: 21, 34) in the lower tertile. The fertilization rate during IVF was higher for women with 8-iso-PGF2α in the middle tertile (0.77 [95% CI: 0.73, 0.80]) compared to women in the lower (0.69 [95% CI: 0.64, 0.73]) or upper tertiles (0.66 [95% CI: 0.61, 0.71]). No significant associations were found for other measured outcomes with 8-iso-PGF2α, or between any oxidative stress biomarker in men and reproductive outcomes in their partners. LIMITATIONS, REASONS FOR CAUTION Isoprostanes are short-lived biomarkers and this study may not have captured the most relevant window of susceptibility for oxidative stress on the outcomes of interest. Findings from this study may not be generalizable to couples attempting conception without fertility assistance. WIDER IMPLICATIONS OF THE FINDINGS This study suggests that a non-linear association may exist between oxidative stress and reproductive outcomes in a population undergoing fertility treatment, a finding not previously identified in the literature. Oxidative stress may represent the mechanism through which environmental chemicals are associated with adverse reproductive outcomes. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Intramural Research Program of the National Institutes of Environmental Health Sciences (NIEHS) (ZIA ES103314) and by NIEHS grants R01ES022955, R01ES009718 and R01ES00002. There are no competing interests to report. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- E M Rosen
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA 27709
| | - L Mínguez-Alarcón
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA 02115
| | - J D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA 41809
| | - P L Williams
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA 02115.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA 02115
| | - G L Milne
- Division of Clinical Pharmacology, Vanderbilt University School of Medicine, Nashville, TN, USA 37232
| | - R Hauser
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA 02115.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA 02115
| | - K K Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, USA 27709
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Cheng H, Han M, Ding J, Wang F, Wang G, Shen L, Wang J, Zheng B, Meng Q, Wang W, Yang S, Li H. Importance of a semen analysis report for determining the relationship between SCSA sperm DNA fragmentation index and assisted reproductive technology pregnancy rate. Reprod Biol 2020; 20:460-464. [PMID: 32798137 DOI: 10.1016/j.repbio.2019.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 08/28/2019] [Accepted: 09/05/2019] [Indexed: 10/23/2022]
Abstract
In the past, semen parameters have been the primary diagnostic criteria used to establish male infertility. However, with the exception of sperm motility, which is known to be linked to rates of in vitro fertilization success, these parameters are generally unreliable at accurately predicting the potential fertility of a couple. More recent research has suggested that sperm DNA fragmentation index (DFI) may be a more robust and reliable means of predicting assisted reproductive outcomes. The present study aimed to assess the relationship between sperm motility, sperm DFI, and rates of clinical pregnancy by analyzing data from 3000 couples dealing with infertility. Using the most recent semen analysis reports available from male partners in these couples, we assessed these parameters and found that the lower the sperm DFI value, the higher the rate of clinical pregnancy. When we assessed the correlation between sperm DFI, sperm motility, and clinical pregnancy, we observed a strong negative correlation between DFI and motility, but observed no significant relationship between sperm motility and pregnancy rates. These results thus indicate that the measurement of DFI via a sperm chromatin structure assay (SCSA) may be a valuable tool for analyzing semen in order to better predict and improve pregnancy rates in infertile couples.
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Affiliation(s)
- Hongbo Cheng
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Mutian Han
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Jie Ding
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Fuxin Wang
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Gaigai Wang
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Liyan Shen
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Jiaxiong Wang
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Bo Zheng
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Qingxia Meng
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Wei Wang
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Shenmin Yang
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China
| | - Hong Li
- Center for Reproduction and Genetics, Nanjing Medical University Affiliated Suzhou Hospital, China.
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Evenson DP, Djira G, Kasperson K, Christianson J. Relationships between the age of 25,445 men attending infertility clinics and sperm chromatin structure assay (SCSA®) defined sperm DNA and chromatin integrity. Fertil Steril 2020; 114:311-320. [DOI: 10.1016/j.fertnstert.2020.03.028] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 01/04/2023]
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Hu W, Yu Z, Gao X, Wu Y, Tang M, Kong L. Study on the damage of sperm induced by nickel nanoparticle exposure. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2020; 42:1715-1724. [PMID: 31278585 DOI: 10.1007/s10653-019-00364-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 06/26/2019] [Indexed: 06/09/2023]
Abstract
As a new type of nanomaterials, nickel nanoparticles (Ni NPs) have been widely used by human beings, whose exposure probability was greatly increasing. Many studies have shown that Ni NPs can induce apoptosis, oxidative stress and DNA damage. Nowadays, male reproductive health is an important public health problem, which is a hot topic in toxicological research. In the present study, to protect reproductive health, the effect of Ni NPs exposure on spermatogenesis injury was assessed, understanding the toxicity and safety of Ni NPs. Sixty ICR male mice with 20 ± 2 g were randomly divided into five groups. The experimental groups were treated with 5 mg/kg, 15 mg/kg and 45 mg/kg Ni NPs. The reproductive toxicity of Ni NPs on male mice was evaluated by the indexes of testicular organ coefficient, testicular marker enzyme, sperm motility and histopathology. As a result, the somatic index of testis and epididymis increased in each group. Compared with the control group, the activity of testicular markers increased and the sperm motility index decreased in the low-, middle- and high-dose groups. Pathological results indicated that various cell apoptosis and disordered arrangement of cells occurred in the seminiferous tubules of the exposed groups. In conclusion, the findings of this study suggest that Ni NPs have certain damage to spermatogenesis in mice.
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Affiliation(s)
- Wangcheng Hu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Zhou Yu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Xiaojie Gao
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Yongya Wu
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Meng Tang
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Lu Kong
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China.
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Delbarba A, Arrighi N, Facondo P, Cappelli C, Ferlin A. Positive effect of nutraceuticals on sperm DNA damage in selected infertile patients with idiopathic high sperm DNA fragmentation. MINERVA ENDOCRINOL 2020; 45:89-96. [PMID: 32340427 DOI: 10.23736/s0391-1977.20.03188-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND The use of nutraceuticals to improve sperm parameters and male fertility is debatable, even if evidence suggests that selected infertile patients might benefit from their use. In particular, oxidative stress might play a role in idiopathic male infertility, leading to sperm membrane damage and high sperm DNA fragmentation (SDF). The aim of this study was to evaluate, in selected idiopathic infertile men with high SDF, the effect on sperm DNA damage and on standard semen parameters of a nutraceutical formulation containing myoinositol, alpha lipoic acid, coenzyme Q10, selenium, zinc and B vitamins. METHODS The study included 60 idiopathic infertile men with DNA fragmentation index (DFI) >20%. Semen analysis and DFI determination were assessed at baseline and after three months of nutraceutical treatment. Primary outcome was change in DFI. RESULTS Semen volume, sperm concentration, total sperm count, sperm motility and sperm morphology did not change after treatment. Instead, sperm vitality significantly increased (65.9±11.8% pre-treatment vs. 69.4±9.4% post-treatment, P<0.05) and DFI significantly decreased (33.5±10.1% pre-treatment vs. 26.8±8.7% post-treatment, P=0.0001) after treatment. The percentage of men with normal standard sperm parameters significantly increased (15% vs. 30%, P<0.05). The mean decrease in DFI was -6.7±1.4% and the percentage of men with DFI ≤30% after treatment was 75.0% compared to 48.3% pre-treatment (P<0.005). Higher pre-treatment DFI (and no other parameters) correlated with greater DFI reduction after treatment. CONCLUSIONS Nutraceuticals might be effective in idiopathic infertile men with high DFI to reduce SDF, increase sperm vitality and globally improve semen parameters.
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Affiliation(s)
- Andrea Delbarba
- Unit of Endocrinology and Metabolism, Department of Medicine, ASST Spedali Civili Brescia, Brescia, Italy
| | - Nicola Arrighi
- Division of Urology, Istituto Clinico Città di Brescia, Brescia, Italy
| | - Paolo Facondo
- Department of Clinical and Experimental Sciences, University of Brescia and Unit of Endocrinology and Metabolism, ASST Spedali Civili Brescia, Brescia, Italy
| | - Carlo Cappelli
- Department of Clinical and Experimental Sciences, University of Brescia and Unit of Endocrinology and Metabolism, ASST Spedali Civili Brescia, Brescia, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia and Unit of Endocrinology and Metabolism, ASST Spedali Civili Brescia, Brescia, Italy -
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Abstract
With the increasing incidence of male infertility, routine detection of semen is insufficient to accurately assess male fertility. Infertile men, who have lower odds of conceiving naturally, exhibit high levels of sperm DNA fragmentation (SDF). The mechanisms driving SDF include abnormal spermatogenesis, oxidative stress damage, and abnormal sperm apoptosis. As these factors can induce SDF and subsequent radical changes leading to male infertility, detection of the extent of SDF has become an efficient routine method for semen analysis. Although it is still debated, SDF detection has become a research hotspot in the field of reproductive medicine as a more accurate indicator for assessing sperm quality and male fertility. SDF may be involved in male infertility, reproductive assisted outcomes, and growth and development of offspring. The effective detection methods of SDF are sperm chromatin structure analysis (SCSA), terminal transferase-mediated dUTP end labeling (TUNEL) assay, single-cell gel electrophoresis (SCGE) assay, and sperm chromatin dispersion (SCD) test, and all of these methods are valuable for assisted reproductive techniques. Currently, the preferred method for detecting sperm DNA integrity is SCSA. However, the regulation network of SDF is very complex because the sperm DNA differs from the somatic cell DNA with its unique structure. A multitude of molecular factors, including coding genes, non-coding genes, or methylated DNA, participate in the complex physiological regulation activities associated with SDF. Studying SDF occurrence and the underlying mechanisms may effectively improve its clinical treatments. This review aimed to outline the research status of SDF mechanism and detection technology-related issues, as well as the effect of increased SDF rate, aiming to provide a basis for clinical male infertility diagnosis and treatment.
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Affiliation(s)
- Ying Qiu
- The Reproductive Medical Center, Nanning Second People's Hospital, Nanning, Guangxi, China (mainland)
| | - Hua Yang
- The Reproductive Medical Center, Nanning Second People's Hospital, Nanning, Guangxi, China (mainland)
| | - Chunyuan Li
- The Reproductive Medical Center, Nanning Second People's Hospital, Nanning, Guangxi, China (mainland)
| | - Changlong Xu
- The Reproductive Medical Center, Nanning Second People's Hospital, Nanning, Guangxi, China (mainland)
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