Effects of short and long incubations on DNA fragmentation of testicular sperm

Sperm deoxyribonucleic acid fragmentation dynamics in fertile donors

OBJECTIVE

To study the velocity of sperm DNA fragmentation in frozen-thawed sperm samples from male sperm donors of proved fertility.

DESIGN

Sperm DNA fragmentation assessment with use of sperm chromatin dispersion methodology after 0, 4, 8, and 24 hours of incubation in IVF medium.

SETTING

Academic biology and reproductive medicine centers.

PATIENT(S)

Twenty male fertility donors with proved fertility for a maximum of six births at the reproductive medicine center.

INTERVENTION(S)

None.

MAIN OUTCOME MEASURE(S)

The velocity of sperm DNA fragmentation between two consecutive incubations was scored. Best adjustment of sperm DNA fragmentation index versus incubation time for linear, logarithmic, or exponential function was tested.

RESULT(S)

Increase of sperm DNA fragmentation through time accounted for a substantial percentage of the overall variation. The highest velocity of sperm DNA fragmentation was observed in the first 4 hours of incubation, decreasing by 50% during the second incubation period and being of the order of 1% in the final experimental period. The tendency to increase in sperm DNA fragmentation is not homogeneous among donors; they may adjust to a logarithmic, linear, or exponential function rendering high values for R(2).

CONCLUSION(S)

Sperm DNA fragmentation occurs rapidly after thawing, and it is an important cause of the rapid decline of sperm quality. Thus, the use of sperm samples as quickly as possible after thawing is highly recommended in clinical practice. Different sperm DNA fragmentation dynamics among individuals were observed.

Redox considerations in female reproductive function and assisted reproduction: from molecular mechanisms to health implications

Physiological levels of reactive oxygen species (ROS) play an important regulatory role through various signaling transduction pathways in folliculogenesis, oocyte maturation, endometrial cycle, luteolysis, implantation, embryogenesis, and pregnancy. Persistent and elevated generation of ROS leads to a disturbance of redox potential that in turn causes oxidative stress (OS). Our literature review captures the role of ROS in modulating a range of physiological functions and pathological processes affecting the female reproductive life span and even thereafter (i.e., menopause). The role of OS in female reproduction is becoming increasingly important, as recent evidence suggest that it plays a part in conditions such as polycystic ovarian disease, endometriosis, spontaneous abortions, preeclampsia, hydatidiform mole, embryopathies, preterm labor, and intrauterine growth retardation. OS has been implicated in different reproductive scenarios and is detrimental to both natural and assisted fertility. Many extrinsic and intrinsic conditions exist in assisted reproduction settings that can be tailored to reduce the toxic effects of ROS. Laboratory personnel should avoid procedures that are known to be deleterious, especially when safer procedures that can prevent OS are available. Although antioxidants such as folate, zinc, and thiols may help enhance fertility, the available data are contentious and must be evaluated in controlled studies with larger populations.

Is fine morphology of the human sperm nuclei affected by in vitro incubation at 37°C?

OBJECTIVE

Incubation of ejaculated spermatozoa at 37 degrees C is recommended for IVF-intracytoplasmic sperm injection. Preselection of sperm cells with morphologically normal nuclei before microinjection, adapted in our laboratory, is usually a time-consuming procedure. Therefore, we aimed to verify whether incubation at 37 degrees C could affect the morphologic integrity of sperm nuclei.

DESIGN

Time-kinetics studies testing fine morphology of the sperm nuclei upon prolonged in vitro incubation.

SETTING

Male Fertility Laboratory at Bar-Ilan University, Ramat Gan, Israel.

PATIENT(S)

Forty-two males selected at random, who were referred for sperm preselection before ICSI.

MAIN OUTCOME MEASURE(S)

Morphologic integrity of the sperm nuclei, obtained by motile sperm organelle morphology examination.

RESULT(S)

After 2 hours of incubation at 37 degrees C a significant decrease occurred in the morphologic integrity of the sperm nuclei, compared with the initial state (4.7% +/- 2.8% vs. 6.8% +/- 3.5%, t = 3.2, P<or=.01). Correspondingly, a significant increase occurred in the frequency of vacuolated nuclei (80.8% +/- 7.2% vs. 75.0% +/- 7.6%, t = -2.8, P<or=.01). No significant morphologic changes in sperm nuclei were observed upon prolonged incubation at 21 degrees C. After 2 hours of incubation, the incidence of spermatozoa with vacuolated nuclei was significantly higher at 37 degrees C compared with 21 degrees C (56.5% +/- 10.8% vs. 45.5% +/- 10%, t = 6.6, P<or=.01).

CONCLUSION(S)

Prolonged (>or=2 hours) sperm manipulations for assisted reproduction therapy should be performed at 21 degrees C rather than 37 degrees C.

Is sperm evaluation useful in predicting human fertility?

Traditionally, the diagnosis of male infertility has relied upon microscopic assessment and biochemical assays to determine human semen quality. The conventional parameters given most importance have been the concentration, motility, and morphology of sperm in the ejaculate. Most laboratories also include ‘sperm suitability’ tests where the subpopulations of sperm more likely to finish the marathon journey to the oocyte are separated by density centrifugation. These tests are essential to provide the fundamental information on which clinicians base their initial diagnosis. However, none of these parameters addresses sperm function and their clinical value in predicting fertility is questionable. The advent of intracytoplasmic sperm injection (ICSI) has further reduced the significance and perceived need for sperm quality tests since ICSI requires only one sperm, not subject to classic, or indeed any, tests for the procedure to be successful. Over the past decade, a number of laboratory tests have been developed to determine properties of sperm function. These include quantitative sperm motion parameters, capacitation, basal and induced acrosome reactions, sperm–zona pellucida interactions and nuclear and mitochondrial sperm DNA but few have been adopted into routine clinical use. International collaborations should be initiated to develop clinically relevant molecular and functional tests with agreed protocols and clinical thresholds as a matter of urgency.

The role of oxidative stress in spontaneous abortion and recurrent pregnancy loss: a systematic review

Human reproduction is not considered a highly efficient biological process. Before the end of the first trimester, 30%-50% of conceptions end in spontaneous abortion. Most losses occur at the time of implantation. 15%-20% of clinical pregnancies end in spontaneous abortions. Recurrent pregnancy loss is a frustrating clinical problem both for clinicians and patients. Recurrent pregnancy loss affects 0.5%-3% of women in the reproductive age group, and between 50%-60% of recurrent pregnancy losses are idiopathic. Oxidative stress-induced damage has been hypothesized to play a role in spontaneous abortion, idiopathic recurrent pregnancy loss, hydatidiform mole, defective embryogenesis, and drug-induced teratogenicity. Some studies implicate systemic and placental oxidative stress in the pathophysiology of abortion and recurrent pregnancy loss. Oxidant-induced endothelial damage, impaired placental vascularization and immune malfunction have all been proposed to play a role in the pathophysiology of idiopathic recurrent pregnancy loss. Oxidative stress-induced placental dysfunction may be a common cause of the multifactorial and polygenic etiologies of abortion, recurrent pregnancy loss, defective embryogenesis, hydatidiform mole, and drug-induced teratogenic effects. Oxidative stress-induced modification of phospholipids has been linked to the formation of antiphospholipid antibodies in the antiphospholipid syndrome. The objective of this review was to examine the association between oxidative stress, spontaneous abortion and recurrent pregnancy loss, based on the published literature. We conducted an extensive literature search utilizing the databases of Medline, CINAHL, and Cochrane from 1986 to 2005. The following keywords were used: oxidative stress, abortion, recurrent pregnancy loss, reactive oxygen species, antioxidants, fetal development, and embryopathies. We conducted an electronic search, as well as a manual search of cross-references. We have included all studies in the English language found in the literature focusing on oxidative stress and its association with abortions, recurrent pregnancy loss and drug-induced teratogenicity. The role of antioxidant vitamins for primary prevention of oxidative stress-induced pathologies needs to be investigated further.

TARGET AUDIENCE

Obstetricians & Gynecologists, Family Physicians.

LEARNING OBJECTIVES

After completion of this article, the reader should be able to state that the causes of spontaneous and recurrent abortion are multifaceted, however, some of the causes may be preventable and also explain that the role of oxidative stress during pregnancy and adverse pregnancy outcomes has a basis in pathophysiology, although the role of oxidative stress and the treatment of oxidative stress during or before pregnancy remains speculative.

Oxidative stress in an assisted reproductive techniques setting

OBJECTIVE

The manipulation of gametes and embryos in an in vitro environment when performing assisted reproductive techniques (ART) carries the risk of exposure of these cells to supraphysiological levels of reactive oxygen species (ROS). The main objective of this review is to provide ART personnel with all the necessary information regarding the development of oxidative stress in an ART setting, as well as the sources of ROS and the mechanisms of oxidative stress-induced damage during ART procedures. The impact of oxidative stress on ART outcome and the different strategies designed to prevent it are also discussed.

DESIGN

Review of international scientific literature. A question-and-answer format was adopted in an attempt to convey comprehensive information in a simple yet focused manner.

RESULT(S)

The pO(2) to which gametes and the embryo are normally exposed in vivo is significantly lower than in vitro. This results in increased production of ROS. Increase in levels of ROS without a concomitant rise in antioxidant defenses leads to oxidative stress. Lipid, protein, and DNA damage have all been associated with oxidative stress. This may ultimately result in suboptimal ART success rates.

CONCLUSION(S)

Many modifiable conditions exist in an ART setting that may aid in reducing the toxic effects of ROS.

Outcomes in couples undergoing ICSI: comparison between fresh and frozen-thawed surgically retrieved spermatozoa

We retrospectively evaluated the impact of cryopreservation on spermatozoa obtained from patients with azoospermia and used for intracytoplasmic sperm injection (ICSI). Frozen-thawed epididymal spermatozoa (FTEPS) was used in 34 couples, whereas frozen-thawed testicular spermatozoa (FTTS) was used in 50 couples for ICSI during assisted conception, and these results were compared with results using fresh spermatozoa for ICSI in the same individuals. The fertilization rate (FR) was significantly lower for FTTS (65.8%) but not for FTEPS (73.1%) compared with the FR using fresh spermatozoa (72.3% and 73.2% respectively). In contrast, neither the implantation nor the pregnancy rate was altered when FTEPS or FTTS was used. In conclusion, our results indicate that surgically retrieved spermatozoa can be efficiently used for ICSI after freezing and thawing without compromising the outcome.