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Gu X, Li H, Chen X, Zhang X, Mei F, Jia M, Xiong C. PEX10, SIRPA-SIRPG, and SOX5 gene polymorphisms are strongly associated with nonobstructive azoospermia susceptibility. J Assist Reprod Genet 2019; 36:759-768. [PMID: 30863997 PMCID: PMC6505017 DOI: 10.1007/s10815-019-01417-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/01/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Male infertility is a multifactorial syndrome encompassing a wide variety of disorders. A previous Chinese genome-wide single-nucleotide polymorphism (SNP) association studies have identified four SNPs (rs12097821 in PRMT6 gene, rs2477686 in PEX10 gene, rs6080550 in SIRPA-SIRPG, and rs10842262 in SOX5 gene) as being significantly associated with risk factors for nonobstructive azoospermia (NOA). However, the results were not fully repeated in later studies, which calls for further investigations. METHODS We here performed a case-control study in a central Chinese population to explore the association between the four SNPs and male infertility, which included 631 infertile men (NOA and oligozoospermia) and 720 healthy fertile men. The genotyping was performed using the polymerase chain reaction-restriction fragment length polymorphism and confirmed by sequencing. RESULTS The results showed that rs12097821 and rs10842262 were strongly associated with the risk of NOA but not total male infertility or oligozoospermia, while rs2477686 and rs6080550 were not associated with the risk of total male infertility, NOA, or oligozoospermia. To improve the statistical strength, a meta-analysis was conducted. The results suggested that rs2477686, rs6080550, and rs10842262 were significantly associated with male infertility, especially with NOA, while rs12097821 was only found to be associated with total male infertility. CONCLUSIONS Collectively, the rs2477686, rs6080550, and rs10842262 may indeed be the genetic risk factors for NOA, which requires further investigation using larger independent sets of samples in different ethnic populations.
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Affiliation(s)
- Xiuli Gu
- Department of Reproductive Genetics, Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China.
| | - Honggang Li
- Family Planning Research Institute, Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China
| | - Xi Chen
- Department of Hospital Infection Control, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China
| | - Xue Zhang
- Department of Reproductive Genetics, Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China
| | - Fen Mei
- Department of Reproductive Genetics, Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China
| | - Mingzhu Jia
- Department of Reproductive Genetics, Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China
| | - Chengliang Xiong
- Family Planning Research Institute, Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430032, China.
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Dynamic assessment of human sperm DNA damage II: the effect of sperm concentration adjustment during processing. J Assist Reprod Genet 2019; 36:799-807. [PMID: 30805848 DOI: 10.1007/s10815-019-01423-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/14/2019] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To evaluate the effect of sperm concentration adjustment in human ejaculates on the sperm DNA quality and longevity. METHODS Semen samples were obtained from 30 donors with a normal spermiogram. Following centrifugation, the sperm pellet was resuspended in PBS, and the sperm concentration adjusted to 200, 100, 50, 25, 12, and 6 × 106/mL. Each set of samples was incubated at 37 °C for 24 h, and the sperm DNA damage was assessed using the chromatin-dispersion test following 0 h, 2 h, 6 h, and 24 h of incubation. RESULTS Sperm DNA fragmentation (SDF) did not differ between the selected experimental conditions at T0; however, Kaplan-Meier estimates for survival showed significant differences with respect to the dilution and time (all P values were smaller than .001). DNA fragmentation in semen samples adjusted to 200 × 106/mL was approximately 3.3 times higher when compared to samples containing 25 × 106/mL and 3.9 higher in comparison with samples adjusted to 12 × 106/mL following 2 h of in vitro incubation. Although there was evidence of individual variation in SDF during the incubation period, the general finding was that lower sperm concentrations resulted in a slower rate of DNA fragmentation. CONCLUSIONS Incubation of spermatozoa for ART purposes should be done following a concentration adjustment below 25 × 106/mL in order to avoid a higher susceptibility of the sperm DNA molecule towards fragmentation.
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Balasubramanian A, Thirumavalavan N, Scovell JM, Lo J, Ji B, Godfrey EL, Pastuszak AW, Lipshultz LI. An Infertile Couple's Long and Expensive Path to Varicocele Repair. Urology 2019; 124:131-135. [PMID: 30359710 PMCID: PMC6387868 DOI: 10.1016/j.urology.2018.10.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 08/30/2018] [Accepted: 10/09/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To characterize the pathways to care that infertile couples requiring varicocele repair (VR) pursue prior to presenting to a male fertility clinic. METHODS An IRB-approved single center retrospective review of patients undergoing VR after presentation to an academic male fertility clinic was performed. Patients whose charts included partner histories were assessed for duration of attempting conception, prior workup, and assisted reproductive technology (ART) use. RESULTS A total of 405 couples were included. At presentation, mean age was 34.4 (SD ± 6.5) years for men and 31.1 (SD ± 4.3) years for women (P < .0001). A couple's first visit to a physician was a gynecologist in 59% (198/334) of couples, a reproductive endocrinologist (REI) in 25% (83/334) of cases, with 14% (47/334) presenting without a previous female workup and were self-referred, and 2% (6/334) seeing both a gynecologist and REI prior to presentation. On average, couples attempted pregnancy for 22.3 (SD ± 21.1, range 0-120) months prior to presentation. Eighteen percent of couples underwent ART prior to presentation. Couples who had undergone ART had lower pre-VR total motile sperm counts compared to couples not pursuing ART prior to presentation (P = 0.031). The majority (70.4%) of females had no abnormality in their workup, making varicocele the only correctable factor for infertility in the couple. CONCLUSIONS Our findings show a significant delay in referral of infertile men requiring VR. Eighteen percent of couples underwent costly ART prior to an inexpensive male workup. In an era of medical cost containment, early referral to a male infertility specialist is imperative.
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Affiliation(s)
- Adithya Balasubramanian
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Nannan Thirumavalavan
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX.
| | - Jason M Scovell
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Jonathan Lo
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Byung Ji
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Elizabeth L Godfrey
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Alexander W Pastuszak
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
| | - Larry I Lipshultz
- Center for Reproductive Medicine, Scott Department of Urology, Baylor College of Medicine, Houston, TX
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Inconsistent Adoption of World Health Organization V (2010) Semen Analysis Reference Ranges in the United States Eight Years After Publication. Urology 2019; 126:96-101. [PMID: 30605693 DOI: 10.1016/j.urology.2018.09.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 08/24/2018] [Accepted: 09/08/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine the percentage of laboratories in the United States that have adopted the World Health Organization 2010 (WHO 5) semen analysis (SA) reference values 6years after their publication. METHODS Laboratories were identified via 3 approaches: using the Clinical Laboratory Improvement Amendments (CLIA) website, the CDC's 2015 Assisted Reproductive Technology Fertility Clinical Success Rate Report, and automated web searches. Laboratories were contacted by phone or email to obtain de-identified SA reports and reference ranges. RESULTS We contacted 617 laboratories in 46 states, of which 208 (26.7%) laboratories in 45 states were included in our analysis. 132 (63.5%) laboratories used WHO 5 criteria, 57 (27.4%) used WHO 4 criteria, and 19 (9.1%) used other criteria. WHO 5 criteria adoption rates varied by geographic region, ranging from 87.5% (35/40) in the Midwest to 50.0% (33/66) in the West. There was a greater adoption rate of WHO 5 reference values in academic affiliated (23/26, 88.5%) compared to non-academic affiliated laboratories (110/182, 60.4%) (P = .028). CONCLUSION While the majority of laboratories have adopted WHO 5 criteria following its release 6years ago, a large percentage (36.5%) use what is now considered outdated criteria. This variability could result in the characterization of a male's semen values as being "within reference range" at one center and "outside of reference range" at another. This inconsistency in classification may result in confusion for the both patient and physician and potentially shift the burden of infertility evaluation and treatment to the female partner.
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Jensen CFS, Khan O, Nagras ZG, Sønksen J, Fode M, Østergren PB, Shah T, Ohl DA. Male infertility problems of patients with strict sperm morphology between 5–14% may be missed with the current WHO guidelines. Scand J Urol 2019; 52:427-431. [DOI: 10.1080/21681805.2018.1548503] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Christian Fuglesang S. Jensen
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Omar Khan
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
| | - Zainab G. Nagras
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Jens Sønksen
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Mikkel Fode
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Peter B. Østergren
- Department of Urology, Herlev and Gentofte Hospital, University of Copenhagen, Herlev, Denmark
| | - Tariq Shah
- Department of Urology, University of Toledo, Toledo, OH, USA
| | - Dana A. Ohl
- Department of Urology, University of Michigan, Ann Arbor, MI, USA
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Punjabi U, Van Mulders H, Goovaerts I, Peeters K, Clasen K, Janssens P, Zemtsova O, De Neubourg D. Sperm DNA fragmentation in the total and vital fractions before and after density gradient centrifugation: Significance in male fertility diagnosis. Clin Biochem 2018; 62:47-54. [DOI: 10.1016/j.clinbiochem.2018.05.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/19/2018] [Indexed: 01/29/2023]
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Sperm lipidic profiles differ significantly between ejaculates resulting in pregnancy or not following intracytoplasmic sperm injection. J Assist Reprod Genet 2018; 35:1973-1985. [PMID: 30105539 DOI: 10.1007/s10815-018-1284-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/02/2018] [Indexed: 12/17/2022] Open
Abstract
Although assisted reproduction techniques involve the use of semen samples, there is little scientific methodology applied when selecting sperm. To select the most appropriate spermatozoa, first we need to define the optimal molecular characteristics. Sperm lipids may contribute to sperm function, thus our aim was to compare the lipidic profiles of sperm samples used in intracytoplasmic sperm injection cycles that ultimately led to a pregnancy with those that did not.Spermatozoa from infertile patients after intracytoplasmic sperm injection (group non-pregnant, n = 16; vs. group pregnant, n = 22) were analyzed for lipid composition using ultra-high performance liquid chromatography coupled to mass spectrometry, by means two platforms for measuring fatty acyls, bile-acids, lysoglycerophospholipids, glycerolipids, cholesteryl-esters, sphingolipids, and glycerophospholipids. Lipid levels were compared using a univariate test and multivariate analyses after logarithmic transformation.We detected 151 different lipids in the sperm samples, 10 of which were significantly increased in sperm samples from the NP group, ranging from 1.10- to 1.30-fold change. These were primarily ceramides, sphingomyelins and three glycerophospholipids, a lysophosphatidylcholine, and two plasmalogen species. Additionally, 2-Monoacylglycerophosphocholine were also found in higher levels in non-pregnant group.Our results describe the composition of sperm lipids linked to optimal sperm function, opening new possibilities for the development of male fertility diagnostic tools and culture media formulations to improve sperm quality and enhance reproductive results. Given that lipids compose the majority of the sperm plasma membrane, this information is also useful in designing new sperm selection tools that will allow for the selection of the best spermatozoa.
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Chang X, Zhou L, Chen X, Xu B, Cheng Y, Sun S, Fang M, Xiang Y. Impact of Imatinib on the Fertility of Male Patients with Chronic Myelogenous Leukaemia in the Chronic Phase. Target Oncol 2018; 12:827-832. [PMID: 28791527 DOI: 10.1007/s11523-017-0521-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Imatinib is a first-line tyrosine kinase inhibitor for treating chronic myelogenous leukaemia (CML) and has greatly improved the prognosis of this disease. An increasing number of CML patients of reproductive age are diagnosed each year, and the impact of imatinib on fertility is a major concern. Providing useful advice to these patients regarding the choice of their therapeutic treatment is very important. OBJECTIVE This study examined the impact of imatinib on the fertility of male patients with CML in the chronic phase. PATIENTS AND METHODS We performed a study of 48 adult male CML patients in the chronic phase (CML-CP), 50 healthy control subjects, and 10 male patients with infertility. Imatinib levels in semen and plasma were measured using high-performance liquid chromatography/mass spectrometry. We examined the effects of imatinib on sperm parameters and the male reproductive system using a computer-assisted sperm assay and ultrasound, respectively. We analysed sex hormone levels in the sera of CML-CP patients using an enzyme-linked immunosorbent assay. RESULTS Imatinib levels in semen were comparable to plasma levels in CML-CP patients. CML-CP patients treated with imatinib exhibited reduced sperm density, counts, survival rates, and activity. Ultrasound demonstrated that the shape and size of the testis and epididymis in CML-CP patients undergoing imatinib treatment were normal. However, 19 of these patients exhibited a hydrocele in their tunica vaginalis, with a large dark area of effusion (0.7-2.9 cm in width). Sex hormone levels in the sera of the CML-CP patients were normal. CONCLUSIONS These results suggest that imatinib crosses the blood-testis barrier and reduces sperm density, sperm count, survival rates, and activity in CML-CP patients. However, imatinib did not affect the structure of reproductive organs or sex hormone levels.
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Affiliation(s)
- Xiaohui Chang
- Department of Hematology, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China
| | - Lin Zhou
- Department of Scientific Research, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China
| | - Xiaoxia Chen
- Department of Pharmacy, The Liaoning University of Traditional Chinese Medicine, Liaoning, China
| | - Baoli Xu
- Department of Pharmacy, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China
| | - Yubin Cheng
- Department of Hematology, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China
| | - Shujun Sun
- Department of Hematology, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China
| | - Meiyun Fang
- Department of Hematology, The First Affiliated Hospital, Dalian Medical University, Liaoning, China.
| | - Yang Xiang
- Department of Hematology, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China.
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Liu SY, Zhang CJ, Peng HY, Sun H, Lin KQ, Huang XQ, Huang K, Chu JY, Yang ZQ. Strong association of SLC1A1 and DPF3 gene variants with idiopathic male infertility in Han Chinese. Asian J Androl 2018; 19:486-492. [PMID: 27232852 PMCID: PMC5507099 DOI: 10.4103/1008-682x.178850] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Male infertility is a multifactorial syndrome encompassing a wide variety of disorders. In recent years, several genome-wide single-nucleotide polymorphism (SNP) association studies (GWAS) have been performed on azoospermia and/or oligozoospermia in different populations including two GWAS on nonobstructive azoospermia in China; however, the association of SNPs with idiopathic male infertility, especially asthenozoospermia and oligozoospermia, and their correlation with semen parameters are still not clear. To investigate genetic variants associated with idiopathic male infertility (asthenozoospermia, oligozoospermia, and oligoasthenozoospermia) in Chinese Han people, 20 candidate SNPs were selected from GWAS results and genotyped using the Sequenom MassARRAY assay. A total of 136 subfertile men and 456 healthy fertile men were recruited. rs6476866 in SLC1A1 (P = 1.919E-4, OR = 0.5905, 95% CI: 0.447–0.78) and rs10129954 in DPF3 (P = 0.0023, OR = 2.199, 95% CI: 1.311–3.689) were strongly associated with idiopathic male infertility. In addition, positive associations were observed between asthenozoospermia and rs215702 in LSM5 (P = 0.0016, OR = 1.479, 95% CI: 1.075–2.033) and between oligoasthenozoospermia and rs2477686 in PEX10 (P = 0.0011, OR = 2.935, 95% CI: 1.492–5.775). In addition, six SNPs (rs215702 in LSM5, rs6476866 in SLC1A1, rs10129954 in DPF3, rs1801133 in MTHFR, rs2477686 in PEX10, and rs10841496 in PED3A) were significantly correlated with semen quality alterations. Our results suggest that idiopathic male infertility in different ethnic groups may share the same mechanism or pathway. Cohort expansion and further mechanistic studies on the role of genetic factors that influence spermatogenesis and sperm progressive motility are suggested.
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Affiliation(s)
- Shu-Yuan Liu
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
| | - Chang-Jun Zhang
- Reproductive Medical Research Centre, People's Hospital of Shiyan, Shiyan 442000, China
| | - Hai-Ying Peng
- Reproductive Medical Research Centre, People's Hospital of Shiyan, Shiyan 442000, China
| | - Hao Sun
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
| | - Ke-Qin Lin
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
| | - Xiao-Qin Huang
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
| | - Kai Huang
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
| | - Jia-You Chu
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
| | - Zhao-Qing Yang
- Department of Medical Genetics, Institute of Medical Biology, Chinese Academy of Medical Sciences and Peking Union Medical College, Kunming 650118, China
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Bae J, Kim S, Chen Z, Eisenberg ML, Buck Louis GM. Human semen quality and the secondary sex ratio. Asian J Androl 2018; 19:374-381. [PMID: 26975484 PMCID: PMC5427797 DOI: 10.4103/1008-682x.173445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this study was to evaluate the association between semen quality and the secondary sex ratio (SSR), defined as the ratio of male to female live births. Our study cohort comprised 227 male partners who were enrolled prior to conception in Michigan and Texas between 2005 and 2009, and prospectively followed through delivery of a singleton birth. The male partners provided a baseline and a follow-up semen sample a month apart. Semen analysis was conducted to assess 27 parameters including five general characteristics, six sperm head measures, 14 morphology measures, and two sperm chromatin stability assay measures. Modified Poisson regression models with a robust error variance were used to estimate the relative risk (RR) and 95% confidence interval (95% CI) of a male birth for each semen parameter, after adjusting for potential confounders. Of the 27 semen parameters, only the percentage of bicephalic sperm was significantly associated with the SSR (2ndvs 1st quartile, RR, 0.65, 95% CI, 0.45–0.95, P = 0.03; 4thvs 1st quartile, RR, 0.61, 95% CI, 0.38–1.00, P < 0.05 before rounding to two decimal places), suggestive of a higher percentage of bicephalic sperm being associated with an excess of female births. Given the exploratory design of the present study, this preconception cohort study suggests no clear signal that human semen quality is associated with offspring sex determination.
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Affiliation(s)
- Jisuk Bae
- Department of Preventive Medicine, Catholic University of Daegu School of Medicine, Daegu 42472, Korea.,Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852, USA
| | - Sungduk Kim
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852, USA
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852, USA
| | - Michael L Eisenberg
- Department of Urology, Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305-5118, USA
| | - Germaine M Buck Louis
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, MD 20852, USA
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Zanetti BF, Braga DPAF, Provenza RR, Figueira RCS, Iaconelli A, Borges E. Sperm morphological normality under high magnification is correlated to male infertility and predicts embryo development. Andrology 2018; 6:420-427. [PMID: 29457367 DOI: 10.1111/andr.12473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/23/2023]
Abstract
Human sperm morphology has been described as an essential parameter for the diagnosis of male infertility and a prognostic indicator of natural or assisted pregnancies. Nevertheless, standard morphological assessment remains a subjective analysis and its impact on intracytoplasmic sperm injection (ICSI) is also of limited value. The objective of this prospective cohort study was to investigate whether motile sperm organelle morphology examination (MSOME) can improve semen analysis by better defining male infertility and providing a better prognosis for ICSI up to a year later. Data were obtained from 483 patients undergoing conventional semen analysis from June 2015 to June 2017 in a private university-affiliated in vitro fertilization (IVF) center. The correlation of MSOME with seminal parameters was evaluated. One hundred and thirty patients underwent ICSI up to a year later, and the correlation between MSOME and ICSI outcomes was established. Except for volume, all seminal parameters were positively correlated with MSOME I+II. MSOME was also distinct between World Health Organization (WHO) classification groups, with normozoospermic and oligoasthenoteratozoospermic presenting the higher and the lower proportion of MSOME I+II, respectively. MSOME I+II was prognostic for fertilization rate, high-quality cleavage-stage embryos rate, and blastocyst rate. The normality cutoff value based on blastocyst rate was MSOME I+II≥ 5.5%. MSOME could be a useful tool for the diagnosis of infertility severity as it is correlated with sperm morphology, motility, and concentration. Men who had higher MSOME I+II had better ICSI outcomes. The future use of MSOME as a routine method for semen analysis may be a reliable form of assessing male infertility.
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Affiliation(s)
- B F Zanetti
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - D P A F Braga
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | | | | | - A Iaconelli
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - E Borges
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
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Mahmud N, Sharmin E, Mamun MA, Shamayeen Z, Rivadeneira N, Rochat R, Mehta A. Decline in semen parameters from 2000 to 2016 among Bangladeshi men attending a tertiary care hospital. Indian J Urol 2018; 34:28-33. [PMID: 29343909 PMCID: PMC5769245 DOI: 10.4103/iju.iju_30_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction: The objective of this study was to analyze longitudinal changes in sperm parameters of Bangladeshi men. We hypothesized that semen parameters declined for this population. Methods: We retrospectively analyzed semen data from men aged 18-64 years who sought care for general sperm quality or updates on fertility status at an infertility clinic in Dhaka, Bangladesh, from January 2000 to June 2016 (n = 13,953). Samples with incomplete data were excluded (n = 143). The WHO normal criteria and semen analysis procedures were used to evaluate parameters of the remaining 13,810 specimens. Samples with missing values on sperm concentration (n = 6187) were excluded from concentration analyses. Age and duration of abstinence at testing were recorded and adjusted for. Data were imported into SAS® 9.4 statistical software. Temporal significance was investigated using one-way ANOVA for motility parameters and Chi-square test for raw concentration. Logistic regression analyzed the effects of confounders on azoospermia and raw concentration, while median regression modeling adjusted confounders for concentration, total motility, and rapid linear (RL) motility. Results: Age distribution was significantly correlated with annual parameter changes (concentration, total motility, and RL motility [P < 0.0001]). Adjusted total motility and RL motility declined by 20% from their maximum values to end of the study (P < 0.0001). Raw concentration lacked clear trends and was unaffected by adjustment. Azoospermia increased by 18% between the 2000–2010 and 2011–2016 participants (odds ratio = 0.16 [0.14–0.16]). Conclusion: In agreement with the hypothesis, Bangladeshi males attending this clinic have experienced decline in semen parameters (total motility and RL motility) and increased frequency of azoospermia.
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Affiliation(s)
- Nusrat Mahmud
- Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Eshita Sharmin
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Md Arif Mamun
- Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | | | - Natalie Rivadeneira
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Roger Rochat
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Akanksha Mehta
- Department of Urology, School of Medicine, Emory University, Atlanta, GA, USA
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Zedan H, Ismail S, Gomaa A, Saleh R, Henkel R, Agarwal A. Evaluation of reference values of standard semen parameters in fertile Egyptian men. Andrologia 2018; 50:e12942. [PMID: 29336040 DOI: 10.1111/and.12942] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2017] [Indexed: 11/28/2022] Open
Abstract
The reference values of human semen, published in the WHO's latest edition in 2010, were lower than those previously reported. The objective of this study was to evaluate reference values of standard semen parameters in fertile Egyptian men. This cross-sectional study included 240 fertile men. Men were considered fertile when their wives had recent spontaneous pregnancies with time to pregnancy (TTP) ≤12 months. The mean age of fertile men was 33.8 ± 0.5 years (range 20-55 years). The 5th percentiles (95% confidence interval) of macroscopic semen parameters were 1.5 ml for volume and 7.2 for pH. The 5th percentiles of microscopic parameters were 15 million/ml for sperm concentration, 30 million per ejaculate for total sperm count, 50% for total motility, 40% for progressive motility, 62% for vitality, 4% for normal sperm forms and 0.1 million/ml for seminal leucocyte counts. In conclusion, fertile Egyptian men had higher reference values of sperm total motility, progressive motility and vitality, and lower reference values for total sperm counts as compared to those determined by the latest edition of the WHO laboratory manual in 2010. Other semen parameters were identical to those defined by the WHO 2010 manual.
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Affiliation(s)
- H Zedan
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assuit, Egypt
| | - S Ismail
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assuit, Egypt
| | - A Gomaa
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assiut University, Assuit, Egypt
| | - R Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - R Henkel
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - A Agarwal
- Department of Urology, American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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65
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Netherton JK, Hetherington L, Ogle RA, Velkov T, Baker MA. Proteomic analysis of good- and poor-quality human sperm demonstrates that several proteins are routinely aberrantly regulated. Biol Reprod 2017; 99:395-408. [DOI: 10.1093/biolre/iox166] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/06/2017] [Indexed: 01/10/2023] Open
Affiliation(s)
- Jacob K Netherton
- Department of Environmental and Life Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Louise Hetherington
- Department of Environmental and Life Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Rachel A Ogle
- Department of Environmental and Life Science, University of Newcastle, Callaghan, New South Wales, Australia
| | - Tony Velkov
- Facility for Drug Development and Innovation, Drug Delivery, Disposition and Dynamics, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Mark A Baker
- Department of Environmental and Life Science, University of Newcastle, Callaghan, New South Wales, Australia
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66
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Patel AS, Leong JY, Ramasamy R. Prediction of male infertility by the World Health Organization laboratory manual for assessment of semen analysis: A systematic review. Arab J Urol 2017; 16:96-102. [PMID: 29713540 PMCID: PMC5922004 DOI: 10.1016/j.aju.2017.10.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 10/18/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022] Open
Abstract
Objective To discuss the role, reliability and limitations of the semen analysis in the evaluation of fertility with reference to the World Health Organization (WHO) fifth edition guidelines, with semen analysis reference values published in 2010. We also discuss the limitations of using a single threshold value to distinguish ‘abnormal’ and ‘normal’ parameters. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to search the MEDLINE, EMBASE, and the Cochrane electronic database for articles discussing the effectiveness of semen analysis. Results Limitations affecting the reliability of semen analysis as a predictor of fertility were found. These include: the lack of consideration of the female factor, the vaguely defined threshold values, and the intra-individual variation in semen parameters. Conclusions Impaired semen parameters alone cannot be used to predict fertility as these men still have a chance of being fertile, except when a man has azoospermia, necrospermia or globozoospermia.
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Affiliation(s)
- Amir S Patel
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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67
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Agarwal A, Bui AD. Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility. Investig Clin Urol 2017; 58:385-399. [PMID: 29124237 PMCID: PMC5671957 DOI: 10.4111/icu.2017.58.6.385] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/15/2017] [Indexed: 01/08/2023] Open
Abstract
Male infertility affects men worldwide. Oxidative stress (OS), characterized by an overabundance of reactive oxygen species (ROS) or a deficiency of antioxidants, is one of the major causes of male infertility. OS causes damage at the molecular level, which impairs lipids, proteins, and DNA. The cyclic cascade of redox reactions weakens sperm function which leads to poor semen parameters and eventual sterility. There is a need for advanced diagnostic tests that can quickly and accurately detect OS. Most commonly used assays can only measure single constituents of OS. However, the MiOXSYS System introduces a new strategy to detect OS by measuring the oxidation-reduction potential (ORP)--a direct evaluation of the redox balance between ROS and antioxidants. The MiOXSYS System has shown promise as a diagnostic tool in the evaluation of male infertility. This review explores the concept of ORP, details the principle of the MiOXSYS System, and summarizes the findings in clinical studies that support ORP measurement in semen.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Albert Danh Bui
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA.,Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
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68
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Azad N, Nazarian H, Ghaffari Novin M, Masteri Farahani R, Piryaei A, Heidari MH. Phospholipase C zeta parameters in sperm from polymorphic teratozoospermic men. Ann Anat 2017; 215:63-70. [PMID: 28954206 DOI: 10.1016/j.aanat.2017.09.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/01/2017] [Accepted: 09/08/2017] [Indexed: 01/16/2023]
Abstract
Teratozoospermia is a disorder associated with high abnormal sperm morphology which affects fertility in males. In recent years, it has been described that biomarker-based sperm quality evaluation can alleviate male infertility treatment. Phospholipase C zeta (PLCζ) is a sperm-specific factor which appears to be a predicting biomarker for fertilization potential of males. Following fertilization, PLCζ enters into oocyte cytoplasm and induces oocyte activation, a fundamental stage in initiation of embryo development. Currently, PLCζ parameters, including localization patterns, the proportion of PLCζ-expressing sperm and the expression level, are not defined in polymorphic teratozoospermic men. This study aimed to evaluate PLCζ parameters in polymorphic teratozoospermic men, and compare these parameters with fertile normozoospermic men. Semen samples from thirteen normozoospermic fertile men and twenty-three polymorphic teratozoospermic men were included in this study and evaluated using western blotting and immunofluorescence analyses. Our data indicated significantly lower expression of PLCζ in polymorphic teratozoospermic men, as compared with control men; however, there was no significant difference in localization patterns and the proportion of PLCζ-expressing sperm between polymorphic teratozoospermic patients and control men. Collectively, findings from the present study demonstrated that polymorphic teratozoospermic men did not show abnormal localization patterns or the absence of PLCζ, as compared to the control men; nonetheless, lower expression of PLCζ, considering its role in oocyte activation, might be one of the possible causes of infertility in these patients.
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Affiliation(s)
- Nahid Azad
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Nazarian
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; IVF Center, Taleghani Educational Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marefat Ghaffari Novin
- Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Reza Masteri Farahani
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Piryaei
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Urogenital Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hassan Heidari
- Department of Biology and Anatomical Sciences, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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69
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Agarwal A, Cho CL, Esteves SC, Majzoub A. Sperm DNA fragmentation testing is on the right track. Transl Androl Urol 2017; 6:S389-S391. [PMID: 29082951 PMCID: PMC5643657 DOI: 10.21037/tau.2017.04.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Sandro C Esteves
- Androfert, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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70
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Esteves SC, Majzoub A, Agarwal A. Further evidence supports the clinical utility of sperm DNA fragmentation testing in male infertility workup and assisted reproductive technology. Transl Androl Urol 2017; 6:S428-S436. [PMID: 29082932 PMCID: PMC5643628 DOI: 10.21037/tau.2017.06.20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.,Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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71
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
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72
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Esteves SC, Agarwal A, Cho CL, Majzoub A. A Strengths-Weaknesses-Opportunities-Threats (SWOT) analysis on the clinical utility of sperm DNA fragmentation testing in specific male infertility scenarios. Transl Androl Urol 2017; 6:S734-S760. [PMID: 29082207 PMCID: PMC5643602 DOI: 10.21037/tau.2017.08.20] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Sperm DNA fragmentation (SDF) is recognized as a leading cause of male infertility because it can impair the paternal genome through distinct pathophysiological mechanisms. Current evidence supports SDF as a major factor in the pathophysiology of several conditions, including varicocele, unexplained infertility, assisted reproductive technology failure, and environmental lifestyle factors, although the mechanisms involved have not been fully described yet. Measurement of the levels of DNA fragmentation in semen provides valuable information on the integrity of paternal chromatin and may guide therapeutic strategies. A recently published clinical practice guideline (CPG) highlighted how to use the information provided by SDF testing in daily practice, which triggered a series of commentaries by leading infertility experts. These commentaries contained an abundance of information and conflicting views about the clinical utility of SDF testing, which underline the complex nature of SDF. Methods A search of papers published in response to the CPG entitled “Clinical utility of sperm DNA fragmentation testing: practice recommendations based on clinical scenarios” was performed within the Translational Andrology and Urology (TAU) website (http://tau.amegroups.com/). The start and end dates for the search were May 2017 and August 2017, respectively. Each commentary meeting our inclusion criteria was rated as “supportive without reservation”, “supportive with reservation”, “not supportive” or “neutral”. We recorded whether articles discussed either SDF characteristics as a laboratory test method or clinical scenarios, or both. Subsequently, we extracted the particulars from each commentary and utilized the ‘Strengths-Weaknesses-Opportunities-Threats’ (SWOT) analysis to understand the perceived advantages and drawbacks of SDF as a specialized sperm function method in clinical practice. Results Fifty-eight fertility experts from six continents and twenty-two countries contributed commentaries. Overall, participants (87.9%; n=51) were supportive of the recommendations provided by the CPG on the utility of SDF testing based on clinical scenarios. The majority of participants made explicit remarks about both the clinical scenarios and SDF assays’ characteristics. Among ‘not supportive’ and ‘supportive with reservation’ participants, 75% (n=30/40) and 77.5% (n=31/40) expressed concerns related to technical limitations of SDF testing methods and clinical utility of the test in one or more clinical scenarios discussed in the CPG, respectively. The SWOT analysis revealed that the CPG provides a reasonable evidence-based proposal for integration of SDF testing in the routine daily practice. It also uncovered gaps of knowledge and threats limiting the widespread application of SDF in everyday practice, thus allowing the identification of opportunities to further refine SDF testing and its clinical utility. Conclusions The understanding of the role of SDF in male infertility requires an in-depth analysis of the multifactorial pathophysiological processes and the theories involved. The SWOT analysis allowed an objective evaluation of CPG on the clinical utility of SDF testing based on clinical scenarios and its accompanying commentaries written by global experts in all possible angles. Implementation of SDF testing in the clinic may not only increase the outcome of ART but more importantly improve the health of both fathers to be and resulting offspring.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil.,Division of Urology, Department of Surgery, Universtity of Campinas (UNICAMP), SP, Brazil.,Faculty of Health, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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73
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Agarwal A, Cho CL, Majzoub A, Esteves SC. The missing piece in management of infertile couple-clinical andrology. Transl Androl Urol 2017; 6:S481-S483. [PMID: 29082966 PMCID: PMC5643711 DOI: 10.21037/tau.2017.05.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
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74
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Esteves SC, Majzoub A, Agarwal A. Expanding our understanding of clinical laboratory testing in male infertility patients. Transl Androl Urol 2017; 6:S440-S442. [PMID: 29082926 PMCID: PMC5643612 DOI: 10.21037/tau.2017.05.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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75
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Cho CL, Agarwal A, Majzoub A, Esteves SC. It is high time for clinical application of sperm DNA fragmentation testing. Transl Androl Urol 2017; 6:S577-S579. [PMID: 29082964 PMCID: PMC5643680 DOI: 10.21037/tau.2017.06.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- Chak-Lam Cho
- Division of Urology, Department of Surgery, Kwong Wah Hospital, Hong Kong, China
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
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76
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Esteves SC, Agarwal A, Majzoub A. Unraveling the utility and limitations of clinical practice guidelines. Transl Androl Urol 2017; 6:S506-S508. [PMID: 29082955 PMCID: PMC5643648 DOI: 10.21037/tau.2017.03.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
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77
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Esteves SC, Majzoub A, Agarwal A. Technical aspects of sperm DNA fragmentation testing, methods to select sperm with low DNA fragmentation, and usefulness of redox potential measurement in male infertility. Transl Androl Urol 2017; 6:S636-S639. [PMID: 29082972 PMCID: PMC5643696 DOI: 10.21037/tau.2017.05.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction.,Division of Urology, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
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78
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Alshahrani S, Aldossari K, Al-Zahrani J, Gabr AH, Henkel R, Ahmad G. Interpretation of semen analysis using WHO 1999 and WHO 2010 reference values: Abnormal becoming normal. Andrologia 2017; 50. [DOI: 10.1111/and.12838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 01/21/2023] Open
Affiliation(s)
- S. Alshahrani
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
| | - K. Aldossari
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
| | - J. Al-Zahrani
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
| | - A. H. Gabr
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
- Faculty of Medicine; Minia University; Minya Egypt
| | - R. Henkel
- Department of Medical Bioscience; University of the Western Cape; Bellville South Africa
| | - G. Ahmad
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
- Department of Physiology; University of Health Sciences; Lahore Pakistan
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79
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Khandwala YS, Zhang CA, Li S, Behr B, Guo D, Eisenberg ML. Racial Variation in Semen Quality at Fertility Evaluation. Urology 2017; 106:96-102. [DOI: 10.1016/j.urology.2017.03.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 02/23/2017] [Accepted: 03/15/2017] [Indexed: 10/19/2022]
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80
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Esteves SC. Editorial - A missing vas deferens: practical implications for urologists performing vasectomies and managing infertile men. Int Braz J Urol 2017; 42:872-875. [PMID: 27716455 PMCID: PMC5066881 DOI: 10.1590/s1677-5538.ibju.2016.05.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology & Human Reproduction Clinic, Campinas, SP, Brasil
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81
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Sabeti P, Amidi F, Kalantar SM, Sedighi Gilani MA, Pourmasumi S, Najafi A, Talebi AR. Evaluation of intracellular anion superoxide level, heat shock protein A2 and protamine positive spermatozoa percentages in teratoasthenozoospermia. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.5.279] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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82
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Kosteria I, Anagnostopoulos AK, Kanaka-Gantenbein C, Chrousos GP, Tsangaris GT. The Use of Proteomics in Assisted Reproduction. In Vivo 2017; 31:267-283. [PMID: 28438852 PMCID: PMC5461434 DOI: 10.21873/invivo.11056] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 02/06/2023]
Abstract
Despite the explosive increase in the use of Assisted Reproductive Technologies (ART) over the last 30 years, their success rates remain suboptimal. Proteomics is a rapidly-evolving technology-driven science that has already been widely applied in the exploration of human reproduction and fertility, providing useful insights into its physiology and leading to the identification of numerous proteins that may be potential biomarkers and/or treatment targets of a successful ART pregnancy. Here we present a brief overview of the techniques used in proteomic analyses and attempt a comprehensive presentation of recent data from mass spectrometry-based proteomic studies in humans, regarding all components of ARTs, including the male and female gamete, the derived zygote and embryo, the endometrium and, finally, the ART offspring both pre- and postnatally.
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Affiliation(s)
- Ioanna Kosteria
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | | | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
| | - George P Chrousos
- Division of Endocrinology, Diabetes and Metabolism, First Department of Pediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece
- Proteomics Research Unit, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - George T Tsangaris
- Proteomics Research Unit, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
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83
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Boissière A, Gala A, Ferrières-Hoa A, Mullet T, Baillet S, Petiton A, Torre A, Hamamah S. Cell-free and intracellular nucleic acids: new non-invasive biomarkers to explore male infertility. Basic Clin Androl 2017; 27:7. [PMID: 28439417 PMCID: PMC5399401 DOI: 10.1186/s12610-017-0052-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/09/2017] [Indexed: 02/06/2023] Open
Abstract
Male infertility is a devastating problem that affects many couples worldwide. However, the molecular mechanisms and causes of idiopathic male infertility remain unclear. Circulating cell-free nucleic acids have an important role in human physiology and emerging evidence suggests that they play a role in male infertility. This review summarizes recent results on cell-free and intracellular nucleic acids in male infertility and discusses their potential use as biomarkers of male infertility in the clinical practice.
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Affiliation(s)
- Anne Boissière
- Unité INSERM U1203, Hôpital Saint Eloi, CHRU Montpellier, 80, avenue Fliche, 34295 Montpellier, France
| | - Anna Gala
- Unité INSERM U1203, Hôpital Saint Eloi, CHRU Montpellier, 80, avenue Fliche, 34295 Montpellier, France.,Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - Alice Ferrières-Hoa
- Unité INSERM U1203, Hôpital Saint Eloi, CHRU Montpellier, 80, avenue Fliche, 34295 Montpellier, France.,Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - Tiffany Mullet
- Unité INSERM U1203, Hôpital Saint Eloi, CHRU Montpellier, 80, avenue Fliche, 34295 Montpellier, France.,Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - Solenne Baillet
- Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - Amaël Petiton
- Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - Antoine Torre
- Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
| | - Samir Hamamah
- Unité INSERM U1203, Hôpital Saint Eloi, CHRU Montpellier, 80, avenue Fliche, 34295 Montpellier, France.,Département de biologie de la reproduction, Hôpital Arnaud de Villeneuve, CHRU Montpellier, 371, avenue du Doyen-Gaston-Giraud, 34295 Montpellier, France
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84
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Ilgin S, Kilic G, Baysal M, Kilic V, Korkut B, Ucarcan S, Atli O. Citalopram Induces Reproductive Toxicity in Male Rats. Birth Defects Res 2017; 109:475-485. [PMID: 28398617 DOI: 10.1002/bdr2.1010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Citalopram hydrobromide (CTL) has been shown to cause sexual dysfunction; however, its reproductive toxicity potential has not been sufficiently elucidated in men. Therefore, we aimed to clarify the toxic effects of CTL on the reproductive system of male rats. METHODS For this purpose, CTL was administered at 5, 10, and 20 mg/kg/day to rats orally for 28 days. Sperm concentration, motility, and morphology were investigated using a computer-assisted sperm analysis system, and sperm DNA damage was detected using a Comet assay. The testes were histopathologically examined. Serum follicle-stimulating hormone, luteinizing hormone, and testosterone levels were measured and the oxidative status of testes was investigated. RESULTS Our results showed that sperm concentration was reduced, and abnormal sperm morphology and sperm DNA damage were increased in CTL-administered groups. Additionally, histopathological changes were observed in the testes of CTL-administered rats. Luteinizing hormone levels were increased in CTL-administered groups, while testosterone levels were increased in the 5 and 10 mg/kg CTL-administered groups. Decreased glutathione signaled enhanced oxidative stress in the 10 and 20 mg/kg CTL-administered groups. CONCLUSION Thus, we concluded that CT induced testicular damage in male rats; this testicular damage was accompanied by oxidative stress and hormonal changes, which are considered as the important causes of reproductive disorders. Birth Defects Research 109:475-485, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Sinem Ilgin
- Anadolu University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Eskisehir, Turkey
| | - Gozde Kilic
- Anadolu University, Faculty of Science, Department of Biology, Eskisehir, Turkey
| | - Merve Baysal
- Anadolu University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Eskisehir, Turkey
| | - Volkan Kilic
- Anadolu University, Faculty of Science, Department of Biology, Eskisehir, Turkey
| | - Busra Korkut
- Anadolu University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Eskisehir, Turkey
| | - Seyda Ucarcan
- Anadolu University, Faculty of Science, Department of Biology, Eskisehir, Turkey
| | - Ozlem Atli
- Anadolu University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Eskisehir, Turkey
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85
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Aminzadeh Z, Jamalan M, Chupani L, Lenjannezhadian H, Ghaffari MA, Aberomand M, Zeinali M. In vitroreprotoxicity of carboxyl-functionalised single- and multi-walled carbon nanotubes on human spermatozoa. Andrologia 2016; 49. [DOI: 10.1111/and.12741] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2016] [Indexed: 12/24/2022] Open
Affiliation(s)
- Z. Aminzadeh
- Department of Clinical Biochemistry; Cellular and Molecular Research Center; Ahvaz Jundishapur University of Medical Sciences; Ahvaz Iran
| | - M. Jamalan
- Abadan School of Medical Sciences; Abadan Iran
| | - L. Chupani
- Faculty of Fisheries and Protection of Waters; South Bohemian Research Center of Aquaculture and Biodiversity of Hydrocenoses; Research Institute of Fish Culture and Hydrobiology; University of South Bohemia in Ceske Budejovice; Vodňany Czech Republic
| | - H. Lenjannezhadian
- Biotechnology Research Center; Research Institute of Petroleum Industry (RIPI); Tehran Iran
| | - M. A. Ghaffari
- Department of Clinical Biochemistry; Cellular and Molecular Research Center; Ahvaz Jundishapur University of Medical Sciences; Ahvaz Iran
| | - M. Aberomand
- Department of Clinical Biochemistry; Cellular and Molecular Research Center; Ahvaz Jundishapur University of Medical Sciences; Ahvaz Iran
| | - M. Zeinali
- Biotechnology Research Center; Research Institute of Petroleum Industry (RIPI); Tehran Iran
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86
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Agarwal A, Sharma R, Harlev A, Esteves SC. Effect of varicocele on semen characteristics according to the new 2010 World Health Organization criteria: a systematic review and meta-analysis. Asian J Androl 2016; 18:163-70. [PMID: 26780872 PMCID: PMC4770480 DOI: 10.4103/1008-682x.172638] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
This study investigated the effects of varicocele on semen parameters in infertile men based on the new 2010 World Health Organization laboratory manual for the examination of human semen. Semen analysis results (volume, sperm count, motility, and morphology) were the primary outcomes. An electronic search to collect the data was conducted using the Medline/PubMed, SJU discover, and Google Scholar databases. We searched articles published from 2010 to August 2015, i.e., after the publication of the 2010 WHO manual. We included only those studies that reported the actual semen parameters of adult infertile men diagnosed with clinical varicocele and contained a control group of either fertile men or normozoospermic men who were not diagnosed with varicocele. Ten studies were included in the meta-analysis, involving 1232 men. Varicocele was associated with reduced sperm count (mean difference: −44.48 × 106 ml−1; 95% CI: −61.45, −27.51 × 106 ml−1; P < 0.001), motility (mean difference: −26.67%; 95% CI: −34.27, −19.08; P < 0.001), and morphology (mean difference: −19.68%; 95% CI: −29.28, −10.07; P < 0.001) but not semen volume (mean difference: −0.23 ml; 95% CI: −0.64, 0.17). Subgroup analyses indicated that the magnitude of effect was influenced by control subtype but not WHO laboratory manual edition used for semen assessment. We conclude that varicocele is a significant risk factor that negatively affects semen quality, but the observed pooled effect size on semen parameters does not seem to be affected by the WHO laboratory manual edition. Given most of the studies published after 2010 still utilized the 1999 manual for semen analysis, further research is required to fully understand the clinical implication of the 2010 WHO laboratory manual on the association between varicocele and semen parameters.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, X-11, Cleveland, OH 44195, USA
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87
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Puga Molina LC, Pinto NA, Torres Rodríguez P, Romarowski A, Vicens Sanchez A, Visconti PE, Darszon A, Treviño CL, Buffone MG. Essential Role of CFTR in PKA-Dependent Phosphorylation, Alkalinization, and Hyperpolarization During Human Sperm Capacitation. J Cell Physiol 2016; 232:1404-1414. [PMID: 27714810 DOI: 10.1002/jcp.25634] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/05/2016] [Indexed: 12/17/2022]
Abstract
Mammalian sperm require to spend a limited period of time in the female reproductive tract to become competent to fertilize in a process called capacitation. It is well established that HCO3- is essential for capacitation because it activates the atypical soluble adenylate cyclase ADCY10 leading to cAMP production, and promotes alkalinization of cytoplasm, and membrane hyperpolarization. However, how HCO3- is transported into the sperm is not well understood. There is evidence that CFTR activity is involved in the human sperm capacitation but how this channel is integrated in the complex signaling cascades associated with this process remains largely unknown. In the present work, we have analyzed the extent to which CFTR regulates different events in human sperm capacitation. We observed that inhibition of CFTR affects HCO3- -entrance dependent events resulting in lower PKA activity. CFTR inhibition also affected cAMP/PKA-downstream events such as the increase in tyrosine phosphorylation, hyperactivated motility, and acrosome reaction. In addition, we demonstrated for the first time, that CFTR and PKA activity are essential for the regulation of intracellular pH, and membrane potential in human sperm. Addition of permeable cAMP partially recovered all the PKA-dependent events altered in the presence of inh-172 which is consistent with a role of CFTR upstream of PKA activation. J. Cell. Physiol. 232: 1404-1414, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Lis C Puga Molina
- Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Nicolás A Pinto
- Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Paulina Torres Rodríguez
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México (UNAM), Cuernavaca, Morelos, México
| | - Ana Romarowski
- Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
| | - Alberto Vicens Sanchez
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México (UNAM), Cuernavaca, Morelos, México
| | - Pablo E Visconti
- Department of Veterinary and Animal Science, Paige Labs, University of Massachusetts, Amherst, Massachusetts
| | - Alberto Darszon
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México (UNAM), Cuernavaca, Morelos, México
| | - Claudia L Treviño
- Departamento de Genética del Desarrollo y Fisiología Molecular, Instituto de Biotecnología, Universidad Nacional Autónoma de México (UNAM), Cuernavaca, Morelos, México
| | - Mariano G Buffone
- Instituto de Biología y Medicina Experimental (IBYME), Consejo Nacional de Investigaciones Científicas y Tecnológicas (CONICET), Buenos Aires, Argentina
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88
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Hetherington L, Schneider EK, Scott C, DeKretser D, Muller CH, Hondermarck H, Velkov T, Baker MA. Deficiency in Outer Dense Fiber 1 Is a Marker and Potential Driver of Idiopathic Male Infertility. Mol Cell Proteomics 2016; 15:3685-3693. [PMID: 27770032 DOI: 10.1074/mcp.m116.060343] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 10/10/2016] [Indexed: 11/06/2022] Open
Abstract
Globally, ∼1 in 15 men of reproductive age are infertile, yet the precise mechanisms underlying their gamete failure are unknown. Although a semen analysis is performed to determine fertilizing potential, the diagnostic suitability of this analysis has been questioned in several reports, as many men, classified as infertile according to their semen analysis, subsequently turn out to be fertile. Herein, we have used a quantitative (phospho)-proteomic analysis, using enrichment on titanium dioxide followed by ion-trap mass spectrometry (LC-MS/MS), to compare the semen of infertile versus fertile males. One protein, namely outer dense fiber 1 (ODF1), was dramatically reduced in infertile males. Using specific antibodies, we then screened the gametes of a cohort of suspected infertile men and demonstrated a reduction in the amount of ODF1 compared with fertile controls. Stress treatment of sperm deficient in ODF1 caused the head to decapitate, suggesting why these gametes fail to initiate fertilization. Interestingly, electron micrographs of ODF1-deficient spermatozoa revealed an abnormal connecting piece, indicating several developmental defects with both the implantation plate and the thin laminated fibers. In some cases, the implantation plate appeared to be reduced in size or was overburdened by granular material near the connecting piece. Hence, a strong reduction ODF1 is a marker of idiopathic male infertility and a potential driver of this condition.
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Affiliation(s)
- Louise Hetherington
- From the ‡Discipline of Biological Sciences, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute,University of Newcastle, Callaghan, NSW 2308, Australia
| | - Elena K Schneider
- §Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Vic, 3052, Australia
| | | | - David DeKretser
- ¶Department of Anatomy and Developmental Biology, Monash University, Vic, 3800, Australia; Department of Urology 356510, University of Washington, Seattle WA 98195-6510, USA
| | | | | | - Tony Velkov
- §Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Vic, 3052, Australia
| | - Mark A Baker
- From the ‡Discipline of Biological Sciences, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute,University of Newcastle, Callaghan, NSW 2308, Australia;
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89
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Esteves SC. Novel concepts in male factor infertility: clinical and laboratory perspectives. J Assist Reprod Genet 2016; 33:1319-1335. [PMID: 27423664 PMCID: PMC5065546 DOI: 10.1007/s10815-016-0763-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 06/22/2016] [Indexed: 12/22/2022] Open
Abstract
In recent years, the management of male factor infertility has undergone important changes with the introduction of novel concepts, advanced testing, and therapeutic interventions. This review highlights some of these changes and discusses their impact to routine clinical practice. First, we discuss the recent changes in the World Health Organization (WHO) laboratory methods and reference values for the examination of human semen. Second, we examine the role of sperm chromatin integrity tests in light of increasing evidence of the detrimental effect of sperm DNA fragmentation on reproductive outcomes. Third, we summarize the main findings of varicocele-related infertility and the outcomes of microsurgical varicocele repair to different case scenarios. Lastly, we critically discuss the current management of men with nonobstructive azoospermia seeking fertility and the new opportunities that emerged to help these men achieve biological fatherhood.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Av. Dr. Heitor Penteado, 1464, Campinas, SP, 13075-460, Brazil.
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90
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Kellesarian SV, Yunker M, Malmstrom H, Almas K, Romanos GE, Javed F. Male Infertility and Dental Health Status: A Systematic Review. Am J Mens Health 2016; 12:1976-1984. [PMID: 27339766 DOI: 10.1177/1557988316655529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
A limited number of studies have reported an association between male factor infertility (MFI) and dental health status (DHS). The aim of the present study was to assess the association between DHS and MFI through a systematic review of indexed literature. To address the focused question-"Is there a relationship between DHS and MFI?"-indexed databases were searched up to March 2016 using various key words "infertility," "periodontal disease," "periodontitis," "dental infection," "caries," and "odontogenic infection." Letters to the editor, case reports, commentaries, historic reviews, and experimental studies were excluded. In total seven studies were included in the present systematic review and processed for data extraction. All the studies reported a positive association between MFI and DHS. The number of study participants ranged between 18 and 360 individuals. Results from six studies showed a positive association between chronic periodontitis and MFI. Three studies reported a positive relationship between MFI and odontogenic infections associated to necrotic pulp, chronic apical osteitis, and radicular cysts. One study reported a relationship between caries index and MFI. From the literature reviewed, there seems to be a positive association between MFI and DHS; however, further longitudinal studies and randomized control trials assessing confounders are needed to establish real correlation. Dentists and general practitioners should be aware that oral diseases can influence the systemic health. Andrological examination should include comprehensive oral evaluation, and physicians detecting oral diseases should refer the patient to a dentist for further evaluation.
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Affiliation(s)
| | | | | | | | - Georgios E Romanos
- 3 University of Frankfurt, Frankfurt, Germany.,4 Stony Brook University, Stony Brook, NY, USA
| | - Fawad Javed
- 1 University of Rochester, Rochester, NY, USA
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91
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Esteves SC, Agarwal A, Sharma R, Harlev A. Reply to Eugenio Ventimiglia, Montorsi Francesco, and Andrea Salonia's Letter to the Editor re: Reecha Sharma, Avi Harlev, Ashok Agarwal, Sandro C. Esteves. Cigarette Smoking and Semen Quality: A New Meta-analysis Examining the Effect of the 2010 World Health Organization Laboratory Methods for the Examination of Human Semen. Eur Urol 2016;70:635-45. Eur Urol 2016; 71:e21-e22. [PMID: 27289568 DOI: 10.1016/j.eururo.2016.05.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Accepted: 05/27/2016] [Indexed: 12/22/2022]
Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Reecha Sharma
- Department of Health Services, Saint Joseph's University, Philadelphia, PA, USA
| | - Avi Harlev
- Fertility and IVF Unit, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel
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92
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Borges E, Setti AS, Braga DPAF, Figueira RCS, Iaconelli A. Total motile sperm count has a superior predictive value over the WHO 2010 cut-off values for the outcomes of intracytoplasmic sperm injection cycles. Andrology 2016; 4:880-6. [PMID: 27152971 DOI: 10.1111/andr.12199] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 03/08/2016] [Accepted: 03/21/2016] [Indexed: 11/30/2022]
Abstract
The objective of this study was to compare (i) the intracytoplasmic sperm injection outcomes among groups with different total motile sperm count ranges, (ii) the intracytoplasmic sperm injection outcomes between groups with normal and abnormal total motile sperm count, and (iii) the predictive values of WHO 2010 cut-off values and pre-wash total motile sperm count for the intracytoplasmic sperm injection outcomes, in couples with male infertility. This study included data from 518 patients undergoing their first intracytoplasmic sperm injection cycle as a result of male infertility. Couples were divided into five groups according to their total motile sperm count: Group I, total motile sperm count <1 × 10(6) ; group II, total motile sperm count 1-5 × 10(6) ; group III, total motile sperm count 5-10 × 10(6) ; group IV, total motile sperm count 10-20 × 10(6) ; and group V, total motile sperm count >20 × 10(6) (which was considered a normal total motile sperm count value). Then, couples were grouped into an abnormal and normal total motile sperm count group. The groups were compared regarding intracytoplasmic sperm injection outcomes. The predictive values of WHO 2010 cut-off values and total motile sperm count for the intracytoplasmic sperm injection outcomes were also investigated. The fertilization rate was lower in total motile sperm count group I compared to total motile sperm count group V (72.5 ± 17.6 vs. 84.9 ± 14.4, p = 0.011). The normal total motile sperm count group had a higher fertilization rate (84.9 ± 14.4 vs. 81.1 ± 15.8, p = 0.016) and lower miscarriage rate (17.9% vs. 29.5%, p = 0.041) compared to the abnormal total motile sperm count group. The total motile sperm count was the only parameter that demonstrated a predictive value for the formation of high-quality embryos on D2 (OR: 1.18, p = 0.013), formation of high-quality embryos on D3 (OR: 1.12, p = 0.037), formation of blastocysts on D5 (OR: 1.16, p = 0.011), blastocyst expansion grade on D5 (OR: 1.27, p = 0.042), and the odds of miscarriage (OR: 0.52, p < 0.045). The total motile sperm count has a greater predictive value than the WHO 2010 cut-off values for laboratory results and pregnancy outcomes in couples undergoing intracytoplasmic sperm injection as a result of male infertility.
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Affiliation(s)
- E Borges
- Fertility Medical Group, São Paulo, SP, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - A S Setti
- Fertility Medical Group, São Paulo, SP, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - D P A F Braga
- Fertility Medical Group, São Paulo, SP, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | | | - A Iaconelli
- Fertility Medical Group, São Paulo, SP, Brazil.,Sapientiae Institute - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
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93
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Sikka SC, Hellstrom WJG. Current updates on laboratory techniques for the diagnosis of male reproductive failure. Asian J Androl 2016; 18:392-401. [PMID: 27056346 PMCID: PMC4854088 DOI: 10.4103/1008-682x.179161] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Revised: 03/14/2016] [Accepted: 03/15/2016] [Indexed: 01/22/2023] Open
Abstract
The incidence of male reproductive failure leading to infertility, whether due to delayed parenthood, environmental issues, genetic factors, drugs, etc., is increasing throughout the world. The diagnosis and prognosis of male subfertility have become a challenge. While the basic semen assessment has been performed for many years, a number of studies question the value of the traditional semen characteristics. This is partly due to inadequate methods and standardization, limited knowledge of technical requirements for quality assurance, and an incomplete understanding of what clinical information a semen assessment can provide. Laboratories currently performing semen and endocrine assessment show great variability. The World Health Organization (WHO) manual for the evaluation of semen has been the core of andrology and fertility evaluation that has helped in further development of this field over many years. These include the physical appearance of the ejaculate, assessments of sperm count, motility, vitality, morphology, and functional aspects of the sperm and semen sample. These tests also include male endocrine profile, biochemical evaluation of the semen, detection of antisperm antibodies in serum, the use of computer-aided sperm analysis (CASA), sperm DNA integrity, and its damage due to oxidative stress. Assisted reproductive techniques (e.g., IVF, ICSI) have shown great success but are too expensive. Further development in this field with newer techniques and extensive training/instructions can improve accuracy and reduce variability, thus maintaining the quality and standards of such an evaluation. There is an urgent need to have standardized training centers and increased awareness in this area of men's health for reproductive success.
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Affiliation(s)
- Suresh C Sikka
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Wayne JG Hellstrom
- Department of Urology, Tulane University School of Medicine, New Orleans, Louisiana, USA
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94
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Bahadur G, Almossawi O, Zeirideen Zaid R, Ilahibuccus A, Al-Habib A, Muneer A, Okolo S. Semen characteristics in consecutive ejaculates with short abstinence in subfertile males. Reprod Biomed Online 2016; 32:323-8. [DOI: 10.1016/j.rbmo.2015.11.021] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 11/13/2015] [Accepted: 11/25/2015] [Indexed: 11/29/2022]
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95
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Hajder M, Hajder E, Husic A. The Effects of Total Motile Sperm Count on Spontaneous Pregnancy Rate and Pregnancy After IUI Treatment in Couples with Male Factor and Unexplained Infertility. Med Arch 2016; 70:39-43. [PMID: 26980930 PMCID: PMC4779344 DOI: 10.5455/medarh.2016.70.39-43] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/05/2015] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Male infertility factor is defined if the total number of motile spermatozoa (TMSC) < 20 × 10(6)/ejaculated, and unexplained infertility if spermiogram is normal with normal female factor. THE AIM of this study was to determine the predictive value of TMSC for spontaneous pregnancy (ST) and pregnancy after treatment with intrauterine insemination (IUI) in couples with male factor and unexplained infertility. WHAT IS KNOWN ALREADY According to the WHO qualification system abnormal spermiogram can be diagnosed as oligozoospermia (O), asthenozoospermia (A), teratozoospermia (T) or combination (O+A+T) and azoospermia (A). Although this classification indicates the accuracy of findings its relevance for prognosis in infertile couple and the choice of treatment is questionable. MATERIALS AND METHODS The study included 98 couples with male infertility factor (bad spermiogram) and couples with normospermia and normal female factor (unexplained infertility). Testing group is randomized at: group (A) with TMSC> 3,10(6) / ejaculate and a spontaneous pregnancy, group (B) with TMSCl <3 x 10(6) / ejaculate and pregnancy after IUI, plus couples who have not achieved SP with TMSC> 3 x 10(6) / ejaculate and couples who have not achieved pregnancy. MAIN RESULTS From a total of 98 pairs of men's and unexplained infertility, 42 of them (42.8%) achieved spontaneous pregnancy, while 56 (57.2%) pairs did not achieve spontaneous pregnancy. TMSC was significantly higher (42.4 ± 28.4 vs. 26.2 ± 24, p <0.05) in the group A compared to group B. Couples with TMSC 1-5 × 10(6) ejaculate had significantly lower (9.8% vs. 22.2%, p <0.0001) rate of spontaneous pregnancy in comparison to couples after IUI treatment. Couples with unexplained infertility had significantly higher (56.8% vs. 29.9%, p <0.01) spontaneous pregnancy rate compared to couples after IUI treatment. Infertile couples had significant pregnancy rate with TMSC 5-10 x 10(6) / ejaculate (OR = 1.45, 95% CI:1.26-1.78, <0.01); with TMSC 10-20 x 10(6) / ejaculate (OR = 1.36, 95% CI: 1:12 to 1:46, <0.0001) with TMSC> 20 x 10(6) / ejaculate (RR = 1.7, 95% CI: 1.56-1.82, <0.001) after treatment with IUI compared to spontaneous pregnancy. CONCLUSION / INTERPRETATION Based on these results we can conclude that couples with the TMSC> 5 x 10(6) / ejaculate are indicated for treatment with IUI. TMSC can be used as the method of choice for diagnosis and treatment of male infertility.
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Affiliation(s)
- Mithad Hajder
- Department of Endocrinology, Internal Clinic, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina
| | - Elmira Hajder
- PZU Institute of Human Reproduction, Obstetrics and Perinatal Medicine, “Dr. Hajder” Tuzla, Bosnia and Herzegovina
| | - Amela Husic
- PZU Institute of Human Reproduction, Obstetrics and Perinatal Medicine, “Dr. Hajder” Tuzla, Bosnia and Herzegovina
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96
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Sakkas D, Ramalingam M, Garrido N, Barratt CLR. Sperm selection in natural conception: what can we learn from Mother Nature to improve assisted reproduction outcomes? Hum Reprod Update 2015; 21:711-26. [PMID: 26386468 PMCID: PMC4594619 DOI: 10.1093/humupd/dmv042] [Citation(s) in RCA: 141] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 08/12/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In natural conception only a few sperm cells reach the ampulla or the site of fertilization. This population is a selected group of cells since only motile cells can pass through cervical mucus and gain initial entry into the female reproductive tract. In animals, some studies indicate that the sperm selected by the reproductive tract and recovered from the uterus and the oviducts have higher fertilization rates but this is not a universal finding. Some species show less discrimination in sperm selection and abnormal sperm do arrive at the oviduct. In contrast, assisted reproductive technologies (ART) utilize a more random sperm population. In this review we contrast the journey of the spermatozoon in vivo and in vitro and discuss this in the context of developing new sperm preparation and selection techniques for ART. METHODS A review of the literature examining characteristics of the spermatozoa selected in vivo is compared with recent developments in in vitro selection and preparation methods. Contrasts and similarities are presented. RESULTS AND CONCLUSIONS New technologies are being developed to aid in the diagnosis, preparation and selection of spermatozoa in ART. To date progress has been frustrating and these methods have provided variable benefits in improving outcomes after ART. It is more likely that examining the mechanisms enforced by nature will provide valuable information in regard to sperm selection and preparation techniques in vitro. Identifying the properties of those spermatozoa which do reach the oviduct will also be important for the development of more effective tests of semen quality. In this review we examine the value of sperm selection to see how much guidance for ART can be gleaned from the natural selection processes in vivo.
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Affiliation(s)
- Denny Sakkas
- Boston IVF, 130 Second Ave, Waltham, MA 02451, USA
| | - Mythili Ramalingam
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD19SY, UK
| | | | - Christopher L R Barratt
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD19SY, UK
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97
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Aston KI, Uren PJ, Jenkins TG, Horsager A, Cairns BR, Smith AD, Carrell DT. Aberrant sperm DNA methylation predicts male fertility status and embryo quality. Fertil Steril 2015; 104:1388-97.e1-5. [PMID: 26361204 DOI: 10.1016/j.fertnstert.2015.08.019] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 07/29/2015] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To evaluate whether male fertility status and/or embryo quality during in vitro fertilization (IVF) therapy can be predicted based on genomewide sperm deoxyribonucleic acid (DNA) methylation patterns. DESIGN Retrospective cohort study. SETTING University-based fertility center. PATIENT(S) Participants were 127 men undergoing IVF treatment (where any major female factor cause of infertility had been ruled out), and 54 normozoospermic, fertile men. The IVF patients were stratified into 2 groups: patients who had generally good embryogenesis and a positive pregnancy (n = 55), and patients with generally poor embryogenesis (n = 72; 42 positive and 30 negative pregnancies) after IVF. INTERVENTION(S) Genomewide sperm DNA methylation analysis was performed to measure methylation at >485,000 sites across the genome. MAIN OUTCOME MEASURE(S) A comparison was made of DNA methylation patterns of IVF patients vs. normozoospermic, fertile men. RESULT(S) Predictive models proved to be highly accurate in classifying male fertility status (fertile or infertile), with 82% sensitivity, and 99% positive predictive value. Hierarchic clustering identified clusters enriched for IVF patient samples and for poor-quality-embryo samples. Models built to identify samples within these groups, from neat samples, achieved positive predictive value ≥ 94% while identifying >one fifth of all IVF patient and poor-quality-embryo samples in each case. Using density gradient prepared samples, the same approach recovered 46% of poor-quality-embryo samples with no false positives. CONCLUSION(S) Sperm DNA methylation patterns differ significantly and consistently for infertile vs. fertile, normozoospermic men. In addition, DNA methylation patterns may be predictive of embryo quality during IVF.
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Affiliation(s)
- Kenneth I Aston
- Department of Surgery, University of Utah Andrology and IVF Laboratories, University of Utah School of Medicine, Salt Lake City, Utah
| | - Philip J Uren
- Molecular and Computational Biology, University of Southern California, Los Angeles, California
| | - Timothy G Jenkins
- Department of Surgery, University of Utah Andrology and IVF Laboratories, University of Utah School of Medicine, Salt Lake City, Utah
| | | | - Bradley R Cairns
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, Utah; Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Andrew D Smith
- Molecular and Computational Biology, University of Southern California, Los Angeles, California
| | - Douglas T Carrell
- Department of Surgery, University of Utah Andrology and IVF Laboratories, University of Utah School of Medicine, Salt Lake City, Utah; Department of Obstetrics and Gynecology and Department of Human Genetics, University of Utah School of Medicine, Salt Lake City, Utah.
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98
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Gosálvez J, López-Fernández C, Fernández JL, Esteves SC, Johnston SD. Unpacking the mysteries of sperm DNA fragmentation. ACTA ACUST UNITED AC 2015. [DOI: 10.1177/2058915815594454] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Although it has been thirty years since publication of one of the most influential papers on the value of assessing sperm DNA damage, andrologists have yet to reach a general consensus about how to apply this seminal parameter to improve or predict reproductive outcomes. Studies that have attempted to establish a causal relationship between sperm DNA damage and pregnancy success have often resulted in conflicting findings, eroding the practitioner’s confidence to incorporate this phenomenon into their appraisal of fertility. In this review we have identified and answered ten important unresolved questions commonly asked by andrologists with respect to the relationship between sperm DNA damage and fertility. We answer questions ranging from a basic comprehension of biological mechanisms and external factors that contribute to increased levels of sperm DNA damage in the ejaculate to what type of DNA lesions we might be expect to occur and what are some of the consequences of DNA damage on early embryonic development. We also address some of the fundamental technical issues associated with the most appropriate measurement of sperm DNA damage and the need to attenuate the confounding impacts of iatrogenic damage. We conclude by asking whether it is possible to reduce elevated levels of sperm DNA damage therapeutically.
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Affiliation(s)
- J Gosálvez
- Genetics Unit, Department of Biology, Autonomous University of Madrid, Madrid, Spain
| | - C López-Fernández
- Genetics Unit, Department of Biology, Autonomous University of Madrid, Madrid, Spain
| | - JL Fernández
- Laboratory of Molecular Genetics and Radiobiology, Oncology Center of Galicia, A Coruña, Galicia, Spain
| | - SC Esteves
- Androfert, Andrology and Human Reproduction Clinic, Campinas, São Paulo, Brazil
| | - SD Johnston
- School of Agriculture and Food Science, The University of Queensland, Gatton, Queensland, Australia
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99
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Esteves SC, Chan P. A systematic review of recent clinical practice guidelines and best practice statements for the evaluation of the infertile male. Int Urol Nephrol 2015; 47:1441-56. [PMID: 26238943 DOI: 10.1007/s11255-015-1059-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 07/08/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE We systematically identified and reviewed the methods and consistency of recommendations of recently developed clinical practice guidelines (CPG) and best practice statements (BPS) on the evaluation of the infertile male. METHODS MEDLINE and related engines as well as guidelines' Web sites were searched for CPG and BPS written in English on the general evaluation of male infertility published between January 2008 and April 2015. RESULTS Four guidelines were identified, all of which reported to have been recently updated. Systematic review was not consistently used in the BPS despite being reported in the CPG. Only one of them reported having a patient representative in its development team. The CPG issued by the European Association of Urology (EAU) graded some recommendations and related that to levels (but not quality) of evidence. Overall, the BPS issued respectively by the American Urological Association and American Society for Reproductive Medicine concurred with each other, but both differed from the EAU guidelines with regard to methods of collection, extraction and interpretation of data. None of the guidelines incorporated health economics. Important specific limitations of conventional semen analysis results were ignored by all guidelines. Besides variation in the methodological quality, implementation strategies were not reported in two out of four guidelines. CONCLUSIONS While the various panels of experts who contributed to the development of the CPG and BPS reviewed should be commended on their tremendous efforts aiming to establish a clinical standard in both the evaluation and management of male infertility, we recognized inconsistencies in the methodology of their synthesis and in the contents of their final recommendations. These discrepancies pose a barrier in the general implementation of these guidelines and may limit their utility in standardizing clinical practice or improving health-related outcomes. Continuous efforts are needed to generate high-quality evidence to allow further development of these important guidelines for the evaluation and management of males suffering from infertility.
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Affiliation(s)
- Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Campinas, SP, 13075-460, Brazil,
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100
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Petropanagos A, Campo-Engelstein L. Tough Talk: Discussing Fertility Preservation with Adolescents and Young Adults with Cancer. J Adolesc Young Adult Oncol 2015; 4:96-9. [PMID: 26812662 DOI: 10.1089/jayao.2014.0047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Angel Petropanagos
- 1 Novel Tech Ethics, Faculty of Medicine, Dalhousie University , Halifax, Canada
| | - Lisa Campo-Engelstein
- 2 Alden March Bioethics Institute and Department of Obstetrics and Gynecology, Albany Medical College , Albany, New York
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