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Camargo M, Ibrahim E, Aballa TC, Cardozo KHM, Carvalho VM, Lynne CM, Brackett NL, Bertolla RP. Proteomic insight of seminal plasma in spinal cord injured men submitted to oral probenecid treatment for improved motility. J Spinal Cord Med 2021; 44:966-971. [PMID: 32043922 PMCID: PMC8725690 DOI: 10.1080/10790268.2020.1722937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE To observe the seminal plasma proteomic composition in men with spinal cord injury orally treated with probenecid, in order to observe pathways associated with increased sperm motility. STUDY DESIGN Prospective study. SETTING Miami Project to Cure Paralysis - University of Miami/Miller School of Medicine. PARTICIPANTS Nine men with spinal cord injury, who agreed to participate in the study. INTERVENTION Oral treatment with probenecid - 500 mg per day for one week, then 500 mg twice daily [1000 mg total] per day for three weeks. OUTCOME MEASURES Semen analysis as per WHO 2010 guidelines, and seminal plasma proteomics analysis by LC-MS/MS. RESULTS In total, 783 proteins were identified, of which, 17 were decreased, while 6 were increased after treatment. The results suggest a new pathway that could be treated by the decrease of biglycan after probenecid treatment. CONCLUSION Oral treatment with probenecid is able to alter the seminal plasma proteome, in pathways that explain decreased innate immune response.
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Affiliation(s)
- Mariana Camargo
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo (UNIFESP), Sao Paulo Hospital, Sao Paulo, Brazil
| | - Emad Ibrahim
- Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Teodoro C. Aballa
- Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | | | | | - Charles M. Lynne
- Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Nancy L. Brackett
- Miami Project To Cure Paralysis, Miller School of Medicine, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Ricardo P. Bertolla
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo (UNIFESP), Sao Paulo Hospital, Sao Paulo, Brazil,Hospital São Paulo, São Paulo, Brazil,Correspondence to: Ricardo P. Bertolla Department of Surgery, Division of Urology, Universidade Federal de São Paulo (UNIFESP), Sao Paulo Hospital, R Embau, 231, 04039-060Sao Paulo, Brazil. Supplemental data for this article can be accessed on the publisher's website https://doi.org/10.1080/10790268.2020.1722937
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2
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Naredi N, Agrawal A. From disability to fatherhood: Journey of serving soldiers with spinal cord injury. Med J Armed Forces India 2021; 77:444-451. [PMID: 34594074 DOI: 10.1016/j.mjafi.2021.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/11/2021] [Indexed: 11/19/2022] Open
Abstract
Background Apart from neurological consequences, most distressing sequels of spinal cord injury (SCI) in men are erectile dysfunction, ejaculatory dysfunction and abnormal semen quality. Of these, ejaculatory dysfunction and poor semen parameters pose the biggest challenge to their biological fatherhood. Penile vibratory stimulation (PVS) and electroejaculation are first-line modalities for anejaculation, and surgical sperm retrieval (SSR) is adopted when other treatments fail. Sperms obtained using these techniques can be used for various fertility treatments for couples with spinal cord injured men. The aim of the study was to study the effectiveness of various modalities of sperm retrieval for assisted reproductive treatment in men with SCI. Methods It was a prospective observational study, wherein partners of 12 men with SCI presenting for subfertility underwent assisted reproduction after retrieving sperms via various modalities. The primary outcome was to assess efficacy of PVS in obtaining sperms and of SSR if PVS failed. The secondary outcome was to assess the pregnancy rate in their partners. Results PVS was successful in obtaining ejaculate in 7 of 12 men, and SSR was fruitful in 4 of 5 men. In vitro fertilization cycle for men who underwent PVS resulted in a pregnancy rate of 57.14% and 75% in couples for men who underwent SSR with an overall pregnancy rate of 58.33%. Conclusion With new cases of SCI occurring primarily in young men at the peak of their reproductive health, it is imperative that medical professionals involved with reproductive health should be aware of the various modalities to help them achieve biological paternity.
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Affiliation(s)
- Nikita Naredi
- Senior Advisor (Obst & Gynae) & ART Specialist, ART Centre, Military Hospital, Bhopal, India
| | - Amit Agrawal
- Senior Advisor (Surgery) & Urologist, Command Hospital (Western Command), Chandimandir, Haryana, India
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3
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Chalas C, Jilet L, Wolf JP, Drouineaud V, Abdoul H, Patrat C, Denys P, Giuliano F. Prospective analysis over time of semen parameters in spinal cord-injured patients: Results of a pilot study. Andrology 2021; 10:120-127. [PMID: 34347944 DOI: 10.1111/andr.13089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/20/2021] [Accepted: 08/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Spinal cord injury often results in erectile dysfunction and an ejaculation along with impaired semen parameters. Fertility is a major concern in spinal cord injury adult males and some fear that the delay post-spinal cord injury may negatively affect sperm quality. OBJECTIVES We aimed to (i) assess semen parameters over time in SCI patients according to age at spinal cord injury, time post-spinal cord injury, and the spinal cord injury level and completeness and (ii) measure markers in semen for inflammation and marker of oxidative stress to investigate their impact on sperm parameters. MATERIALS AND METHODS The study is a prospective, longitudinal, pilot study over 18 months. Thirty-five men with spinal cord injury from 18 to 60 years of age were enrolled. Their mean age was 29.4 ± 6.4 years. Semen retrieval was scheduled every 6 months, allowing analysis of four ejaculates, in association with measurement of granulocyte and seminal plasma elastase concentrations to assess markers in semen for inflammation and spermatozoa DNA fragmentation to assess oxidative stress. RESULTS Based on reference limits, a normal total sperm number, decreased motility and vitality of the spermatozoa, and increased morphological abnormalities were found. Mean round cell and granulocyte concentrations were elevated in the semen. Markers in semen for inflammation and marker of oxidative stress were elevated in several semen samples, compared to reference limits. However, neither the presence of markers in semen for inflammation or oxidative stress, the completeness or the level of the spinal cord lesion, the age or the time post-spinal cord injury had a negative impact on the semen quality over time. DISCUSSION There was no significant decline in semen quality in spinal cord injury patients over time within the limitations of this pilot study. Moreover, a chronic genital inflammatory status was not associated with impairment of semen quality. CONCLUSION The present findings are reassuring for men with spinal cord injury and could guide the management of their reproductive ability. According to these preliminary data, not all spinal cord injury patients who are able to ejaculate require systematic freezing of their spermatozoa.
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Affiliation(s)
- Celine Chalas
- Laboratoire d'Histologie-Embryologie-Biologie de la Reproduction-CECOS, Cochin Academic Hospital, AP-HP, Centre Université de Paris, Paris, France
| | - Lea Jilet
- Unité de Recherche Clinique-Centre d'Investigation Clinique, Paris Descartes Necker/Cochin, Hôpital Tarnier, Paris, France
| | - Jean-Philippe Wolf
- Laboratoire d'Histologie-Embryologie-Biologie de la Reproduction-CECOS, Cochin Academic Hospital, AP-HP, Centre Université de Paris, Paris, France.,Institut Cochin, U 1016, Université de Paris, Paris, France
| | - Veronique Drouineaud
- Laboratoire d'Histologie-Embryologie-Biologie de la Reproduction-CECOS, Cochin Academic Hospital, AP-HP, Centre Université de Paris, Paris, France
| | - Hendy Abdoul
- Unité de Recherche Clinique-Centre d'Investigation Clinique, Paris Descartes Necker/Cochin, Hôpital Tarnier, Paris, France
| | - Catherine Patrat
- Laboratoire d'Histologie-Embryologie-Biologie de la Reproduction-CECOS, Cochin Academic Hospital, AP-HP, Centre Université de Paris, Paris, France.,Institut Cochin, U 1016, Université de Paris, Paris, France
| | - Pierre Denys
- Neuro-Uro-Andrology Raymond Poincare Academic Hospital, AP-HP, Garches, France.,Inserm U1179, UFR des sciences de la santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France
| | - Francois Giuliano
- Neuro-Uro-Andrology Raymond Poincare Academic Hospital, AP-HP, Garches, France.,Inserm U1179, UFR des sciences de la santé, University of Versailles Saint-Quentin, Montigny-le-Bretonneux, France
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4
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Cito G, Picone R, Fucci R, Del Popolo G, Cocci A, Gemma L, Lombardi G, Minervini A, Carini M, Natali A, Coccia ME. Reproductive Outcomes in Infertile Men With Spinal Cord Injury (SCI): A Retrospective Case-Control Analysis. Urology 2020; 141:82-88. [DOI: 10.1016/j.urology.2020.03.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 02/17/2020] [Accepted: 03/29/2020] [Indexed: 10/24/2022]
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5
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Van den Berghe F, Paris MCJ, Sarnyai Z, Briggs MB, Millar RP, Ganswindt A, Paris DBBP. Social rank does not affect sperm quality in male African wild dogs (Lycaon pictus). Reprod Fertil Dev 2020; 31:875-887. [PMID: 30694739 DOI: 10.1071/rd18205] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 12/03/2018] [Indexed: 11/23/2022] Open
Abstract
Sperm banking and AI could benefit endangered African wild dog conservation. However, it is unclear whether their dominance hierarchy causes a decrease in reproductive and sperm quality parameters in subordinate males that typically do not breed. In this study, we investigated the effect of social rank on male reproductive parameters, including faecal androgen and glucocorticoid metabolite concentrations, prostate and testes volume, preputial gland size, semen collection success and sperm quality. Samples were obtained from captive males (prebreeding season: n=12 from four packs; breeding season: n=24 from seven packs) that were classified as alpha (dominant), beta or gamma (subordinates) based on the frequency of dominant versus submissive behaviours. In the prebreeding season, semen was successfully collected from all alpha but only half the subordinate males, with urine contamination (associated with lower rank) significantly reducing total and progressive motility, sperm motility index, normal sperm morphology and acrosome integrity. The breeding season was associated with a significant increase in faecal androgens, prostate and testis volume, as well as progressive motility and the total number of spermatozoa ejaculated. However, with the exception of prostate volume (mean±s.e.m: 12.5±4.5, 7.1±1.0 and 7.3±1.0cm3 in alpha, beta and gamma males respectively; P=0.035), all other reproductive and sperm quality parameters did not differ between males of each social rank. In conclusion, reproductive suppression of subordinate males appears to be behaviourally mediated, because males of all social ranks produce semen of similar quality, making them suitable candidates for sperm banking, particularly during the breeding season when sperm quality improves.
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Affiliation(s)
- Femke Van den Berghe
- Gamete and Embryology (GAME) Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, James Cook Drive, Townsville, Qld 4811, Australia; and Institute for Breeding Rare and Endangered African Mammals (IBREAM), 9 Ainslie Place, Edinburgh, EH3 6AT, Scotland
| | - Monique C J Paris
- Institute for Breeding Rare and Endangered African Mammals (IBREAM), 9 Ainslie Place, Edinburgh, EH3 6AT, Scotland; and Wageningen Livestock Research, De Elst 1, 6708 WD Wageningen, Netherlands
| | - Zoltan Sarnyai
- Laboratory of Psychiatric Neuroscience, Australian Institute of Tropical Health and Medicine (AITHM) and College of Public Health, Medical and Veterinary Sciences, James Cook University, Solander Drive, Townsville, Qld 4811, Australia
| | - Michael B Briggs
- African Predator Conservation Research Organisation (APCRO), 848 Rainbow Boulevard #A3, Las Vegas, NV 89107, USA
| | - Robert P Millar
- Institute for Breeding Rare and Endangered African Mammals (IBREAM), 9 Ainslie Place, Edinburgh, EH3 6AT, Scotland; and Centre for Neuroendocrinology, Faculty of Health Sciences, University of Pretoria, Pretoria 0002, South Africa
| | - Andre Ganswindt
- Mammal Research Institute, Faculty of Natural and Agricultural Sciences, University of Pretoria, Hatfield 0028, South Africa; and Endocrine Research Laboratory, Faculty of Veterinary Science, University of Pretoria, Onderstepoort 0110, South Africa
| | - Damien B B P Paris
- Gamete and Embryology (GAME) Laboratory, College of Public Health, Medical and Veterinary Sciences, James Cook University, James Cook Drive, Townsville, Qld 4811, Australia; and Centre for Tropical Environmental and Sustainability Science, James Cook University, James Cook Drive, Townsville, Qld 4811, Australia; and Corresponding author.
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6
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Belardin LB, Antoniassi MP, Camargo M, Intasqui P, Fraietta R, Bertolla RP. Semen levels of matrix metalloproteinase (MMP) and tissue inhibitor of metallorproteinases (TIMP) protein families members in men with high and low sperm DNA fragmentation. Sci Rep 2019; 9:903. [PMID: 30696858 PMCID: PMC6351682 DOI: 10.1038/s41598-018-37122-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/23/2018] [Indexed: 12/20/2022] Open
Abstract
Matrix Metalloproteinases (MMPs) and their regulators – Tissue Inhibitors of Matrix Metalloproteinases (TIMPs) – participate in extracellular matrix remodeling, fibrosis, and semen liquefaction, as well as to inflammatory activity. Seminal plasma has been shown to contain MMPs (MMP-2 and MMP-9) and TIMPs (TIMP-1 and TIMP-2). Also, a link between MMPs gene expression and excessive reactive oxygen species (ROS) has been established. In semen, ROS are associated with altered sperm function and increased DNA fragmentation. In this study, it is hypothesized that seminal MMPs and TIMPs levels are associated with sperm DNA fragmentation due to the fact that MMPs have been associated with semen quality. We also hypothesized that these proteins could predict DNA fragmentation status in sperm. Therefore, this study set out to verify if sperm DNA fragmentation levels relate to seminal levels of members of the MMP and TIMP protein families. The High sperm DNA fragmentation group presented lower seminal plasma levels of MMP-2, MMP-7, TIMP-1, TIMP-2 and TIMP-4 when compared to Low sperm DNA fragmentation group. Also, samples in the high sperm DNA fragmentation group presented higher acrosome integrity and lower mitochondrial activity levels when compared to low sperm DNA fragmentation samples. In the logistic regression analysis, MMP-2, MMP-7, and TIMP-4 classified samples as low and high sperm DNA fragmentation, with an overall model fit of 74.5%. Results from this study may demonstrate a specific inflammatory mechanism in samples with high sperm DNA fragmentation. This, in turn, can lead to the development of new studies regarding this mechanism and, in the future, create an opportunity to treat these patients for sperm DNA fragmentation by treating inflammatory seminal activity.
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Affiliation(s)
| | | | - Mariana Camargo
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Paula Intasqui
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Renato Fraietta
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ricardo Pimenta Bertolla
- Department of Surgery, Division of Urology, Universidade Federal de São Paulo, São Paulo, Brazil. .,Hospital São Paulo, São Paulo, Brazil.
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7
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Belardin L, Camargo M, Intasqui P, Antoniassi M, Fraietta R, Bertolla R. Cysteine‐rich secretory protein 3: inflammation role in adult varicocoele. Andrology 2018; 7:53-61. [DOI: 10.1111/andr.12555] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/03/2018] [Accepted: 09/13/2018] [Indexed: 12/20/2022]
Affiliation(s)
- L. Belardin
- Department of Surgery Division of Urology Universidade Federal de São Paulo São Paulo Brazil
| | - M. Camargo
- Department of Surgery Division of Urology Universidade Federal de São Paulo São Paulo Brazil
| | - P. Intasqui
- Department of Surgery Division of Urology Universidade Federal de São Paulo São Paulo Brazil
| | - M. Antoniassi
- Department of Surgery Division of Urology Universidade Federal de São Paulo São Paulo Brazil
| | - R. Fraietta
- Department of Surgery Division of Urology Universidade Federal de São Paulo São Paulo Brazil
| | - R. Bertolla
- Department of Surgery Division of Urology Universidade Federal de São Paulo São Paulo Brazil
- Hospital São Paulo São Paulo Brazil
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8
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Pourmasumi S, Sabeti P, Rahiminia T, Mangoli E, Tabibnejad N, Talebi AR. The etiologies of sperm DNA abnormalities in male infertility: An assessment and review. Int J Reprod Biomed 2017. [DOI: 10.29252/ijrm.15.6.331] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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9
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Ibrahim E, Brackett NL, Lynne CM. Advances in the management of infertility in men with spinal cord injury. Asian J Androl 2017; 18:382-90. [PMID: 27048781 PMCID: PMC4854086 DOI: 10.4103/1008-682x.178851] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Couples with a spinal cord injured male partner require assisted ejaculation techniques to collect semen that can then be further used in various assisted reproductive technology methods to achieve a pregnancy. The majority of men sustaining a spinal cord injury regardless of the cause or the level of injury cannot ejaculate during sexual intercourse. Only a small minority can ejaculate by masturbation. Penile vibratory stimulation and electroejaculation are the two most common methods used to retrieve sperm. Other techniques such as prostatic massage and the adjunct application of other medications can be used, but the results are inconsistent. Surgical sperm retrieval should be considered as a last resort if all other methods fail. Special attention must be paid to patients with T6 and rostral levels of injury due to the risk of autonomic dysreflexia resulting from stimulation below the level of injury. Bladder preparation should be performed before stimulation if retrograde ejaculation is anticipated. Erectile dysfunction is ubiquitous in the spinal cord injured population but is usually easily managed and does not pose a barrier to semen retrieval in these men. Semen analysis parameters of men with spinal cord injury are unique for this population regardless of the method of retrieval, generally presenting as normal sperm concentration but abnormally low sperm motility and viability. When sperm retrieval is desired in this population, emphasis should be placed on initially trying the simple methods of penile vibratory stimulation or electroejaculation before resorting to more advanced and invasive surgical procedures.
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Affiliation(s)
| | - Nancy L Brackett
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL; Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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10
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Abstract
Young men comprise the overwhelming majority of men with spinal cord injury (SCI), the incidence of which has been growing over the years. Due to advances in physical medicine and rehabilitation, remarkable improvements in survival rates have been reported, leading to life expectancies similar to those of the general population. However, many sexual and reproductive functions may be impaired due to erectile or ejaculatory dysfunction and semen abnormalities, characterised by low-sperm motility or viability in SCI males who have not become parents yet. Nevertheless, fatherhood is still possible through the introduction of specialised medical management, by using various medical, technical and surgical methods for sperm retrieval in combination with assisted reproductive techniques. Erectile dysfunction can be managed by the use of phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be obtained from the vast majority of anejaculatory men by medically assisted ejaculation through the use of penile vibratory stimulation or electroejaculation and via prostate massage or surgical procedures. Despite impaired sperm parameters, reasonable pregnancy rates similar to those in able-bodied subfertile cohorts have been reported. However, future research should focus on the optimisation of semen quality in these men and on improving natural ejaculation.
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Affiliation(s)
- Ermin Čehić
- a Human Reproduction Unit, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
| | - Miro Kasum
- b Department of Obstetrics and Gynaecology , School of Medicine, University Hospital Centre Zagreb, University of Zagreb , Zagreb , Croatia , and
| | - Velimir Šimunić
- c Human Reproduction Unit, Polyclinic IVF , Zagreb , Croatia
| | - Slavko Orešković
- b Department of Obstetrics and Gynaecology , School of Medicine, University Hospital Centre Zagreb, University of Zagreb , Zagreb , Croatia , and
| | - Goran Vujić
- b Department of Obstetrics and Gynaecology , School of Medicine, University Hospital Centre Zagreb, University of Zagreb , Zagreb , Croatia , and
| | - Franjo Grgić
- b Department of Obstetrics and Gynaecology , School of Medicine, University Hospital Centre Zagreb, University of Zagreb , Zagreb , Croatia , and
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11
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Iwahata T, Shin T, Shimomura Y, Suzuki K, Kobayashi T, Miyata A, Kobori Y, Soh S, Okada H. Testicular sperm extraction for patients with spinal cord injury-related anejaculation: A single-center experience. Int J Urol 2016; 23:1024-1027. [PMID: 27766729 DOI: 10.1111/iju.13226] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 09/06/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVES To present a single-center experience with testicular sperm extraction and intracytoplasmic sperm injection for fathering biological children in patients with ejaculatory dysfunction as a result of spinal cord injury. METHODS Testicular sperm extraction was carried out in 52 male patients with ejaculatory dysfunction as a result of spinal cord injury. We investigated sperm retrieval rates and pregnancy rates from medical records. Data on age, testicular volume, hormonal status (luteinizing hormone, follicle stimulating hormone and testosterone), and time since spinal cord injury were obtained and analyzed to detect potential associations with the presence of spermatogenesis. RESULTS Testicular sperm retrieval was achieved in 42 of 52 patients (80.7%). Intracytoplasmic sperm injection was carried out for 37 patients, and pregnancy was achieved in 32 (86.5%). The take-home baby rate was 70.2%. In the group with successful sperm extraction, testicular volume was significantly greater, time from spinal cord injury to extraction was significantly shorter, and serum luteinizing hormone and follicle-stimulating hormone levels were significantly lower. Serum follicle-stimulating hormone levels had the strongest association with feasibility of sperm retrieval by testicular sperm extraction. Furthermore, the sperm retrieval rates of patients injured within the preceding 12 years were significantly better than those injured longer before treatment (P = 0.045). CONCLUSIONS Testicular sperm extraction and intracytoplasmic sperm injection seem to provide favorable results for patients with ejaculatory dysfunction as a result of spinal cord injury. However, early testicular sperm extraction is recommended, because sperm retrieval becomes more difficult with time from spinal cord injury.
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Affiliation(s)
- Toshiyuki Iwahata
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Takeshi Shin
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.,Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Yukihito Shimomura
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Keisuke Suzuki
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Tomohiro Kobayashi
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Akane Miyata
- Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Yoshitomo Kobori
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Shigehiro Soh
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Hiroshi Okada
- Department of Urology, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.,Center for Reproductive Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Antoniassi MP, Intasqui P, Camargo M, Zylbersztejn DS, Carvalho VM, Cardozo KHM, Bertolla RP. Analysis of the functional aspects and seminal plasma proteomic profile of sperm from smokers. BJU Int 2016; 118:814-822. [DOI: 10.1111/bju.13539] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Mariana Pereira Antoniassi
- Department of Surgery; Division of Urology; Human Reproduction Section; Sao Paulo Federal University; Sao Paulo Brazil
| | - Paula Intasqui
- Department of Surgery; Division of Urology; Human Reproduction Section; Sao Paulo Federal University; Sao Paulo Brazil
| | - Mariana Camargo
- Department of Surgery; Division of Urology; Human Reproduction Section; Sao Paulo Federal University; Sao Paulo Brazil
| | - Daniel Suslik Zylbersztejn
- Department of Surgery; Division of Urology; Human Reproduction Section; Sao Paulo Federal University; Sao Paulo Brazil
| | | | | | - Ricardo Pimenta Bertolla
- Department of Surgery; Division of Urology; Human Reproduction Section; Sao Paulo Federal University; Sao Paulo Brazil
- Hospital Sao Paulo; Sao Paulo Brazil
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13
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Intasqui P, Camargo M, Antoniassi MP, Cedenho AP, Carvalho VM, Cardozo KHM, Zylbersztejn DS, Bertolla RP. Association between the seminal plasma proteome and sperm functional traits. Fertil Steril 2016; 105:617-628. [DOI: 10.1016/j.fertnstert.2015.11.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/07/2015] [Accepted: 11/02/2015] [Indexed: 01/11/2023]
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14
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Revenig L, Leung A, Hsiao W. Ejaculatory physiology and pathophysiology: assessment and treatment in male infertility. Transl Androl Urol 2016; 3:41-9. [PMID: 26816751 PMCID: PMC4708301 DOI: 10.3978/j.issn.2223-4683.2014.02.02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Azoospermia is a heterogeneous condition with multiple etiologies and a variety of treatments. In this chapter we present a summary of retrograde ejaculation and anejaculation, both of which are characterized by an absence of antegrade semen propulsion through the male reproductive tract. Each of these affects fertility, but is pathophysiologically distinct disorders with differing evaluation and treatment. Retrograde ejaculation has a myriad of well-characterized causes, from pharmacologic disruption to interference of neural mechanisms by surgical intervention for a variety of diseases. Medication is the mainstay of treatment, although only a minority responds and develops antegrade ejaculation. For the men who are not responders to medical therapy, but still have fertility goals, there are a variety of sperm retrieval techniques to assist their reproductive abilities. Failure of emission is characterized by an absence of the emission phase and no antegrade or retrograde expulsion of ejaculatory products. If fertility is desired, these men must rely on assisted ejaculatory procedures, and treatment choice is guided by etiology and response. Ultimately, retrograde ejaculation and failure of emission are in a spectrum of ejaculatory disorders which impair male fertility.
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Affiliation(s)
- Louis Revenig
- 1 Emory University, Department of Urology, Atlanta, Georgia, USA ; 2 Kaiser Permanente, Oakland Medical Center, Oakland, California, USA
| | - Andrew Leung
- 1 Emory University, Department of Urology, Atlanta, Georgia, USA ; 2 Kaiser Permanente, Oakland Medical Center, Oakland, California, USA
| | - Wayland Hsiao
- 1 Emory University, Department of Urology, Atlanta, Georgia, USA ; 2 Kaiser Permanente, Oakland Medical Center, Oakland, California, USA
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Ibrahim E, Lynne CM, Brackett NL. Male fertility following spinal cord injury: an update. Andrology 2015; 4:13-26. [PMID: 26536656 DOI: 10.1111/andr.12119] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 09/10/2015] [Accepted: 09/14/2015] [Indexed: 12/22/2022]
Abstract
Spinal cord injury (SCI) occurs most often in young men at the peak of their reproductive health. The majority of men with SCI cannot father children naturally. Three major complications contribute to infertility in men with SCI: erectile dysfunction, ejaculatory dysfunction, and abnormal semen quality. Erectile dysfunction can be managed by regimens available to the general population, including oral administration of phosphodiesterase-5 (PDE-5) inhibitors, intracavernosal injections, vacuum devices, and penile prostheses. Semen may be obtained from anejaculatory men with SCI via the medically assisted ejaculation methods of penile vibratory stimulation (PVS) or electroejaculation (EEJ). Sperm retrieval is also possible via prostate massage or surgical sperm retrieval. Most men with SCI have abnormal semen quality characterized by normal sperm concentrations but abnormally low sperm motility and viability. Accessory gland dysfunction has been proposed as the cause of these abnormalities. Leukocytospermia is evident in most SCI patients. Additionally, elevated concentrations of pro-inflammatory cytokines and elevated concentrations of inflammasome components are found in their semen. Neutralization of these constituents has resulted in improved sperm motility. There is a recent and alarming trend in the management of infertility in couples with SCI male partners. Although many men with SCI have sufficient motile sperm in their ejaculates for attempting intrauterine insemination (IUI) or even intravaginal insemination, surgical sperm retrieval is often introduced as the first and only sperm retrieval method for these couples. Surgical sperm retrieval commits the couple to the most advanced, expensive, and invasive method of assisted conception: in vitro fertilization with intracytoplasmic sperm injection (IVF/ICSI). Couples should be informed of all options, including semen retrieval by PVS or EEJ. Intravaginal insemination or IUI should be considered when indicated.
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Affiliation(s)
- E Ibrahim
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA
| | - C M Lynne
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - N L Brackett
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Urology, University of Miami Miller School of Medicine, Miami, FL, USA
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Kanto S, Yamasaki K, Iwamoto T. Progressing management of non-obstructive azoospermia in the era of microdissection testicular sperm extraction. Reprod Med Biol 2014; 13:119-125. [PMID: 29699155 DOI: 10.1007/s12522-014-0178-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/13/2014] [Indexed: 10/25/2022] Open
Abstract
Previously, it was absolutely impossible for azoospermic men to reproduce except in some obstructive azoospermic cases for whom reconstruction of the seminal pathway was successful. However, nowadays, intracytoplasmic sperm injection and microdissection testicular sperm extraction have brought about chances of biological paternity in some non-obstructive azoospermic men. It is almost 15 years since the first trials of testicular sperm retrieval using surgical microscopy for non-obstructive azoospermia were reported. In this manuscript, the progress and outcomes of these novel techniques since then are reviewed, the controversial points are discussed and the latest research to achieve pregnancies in tough non-obstructive azoospermic couples are introduced. Not only the bright side of the renovations, but the underlying concerns are also discussed.
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Affiliation(s)
- Satoru Kanto
- Department of Urology International University of Health and Welfare Shioya Hospital 77 Tomita 329-2145 Yaita Tochigi Japan
| | - Kazumitsu Yamasaki
- Department of Urology International University of Health and Welfare Hospital 537-3 Iguchi Nasushiobara Japan
| | - Teruaki Iwamoto
- International University of Health and Welfare Hospital, Reproduction Center 537-3 Iguchi Nasushiobara Japan
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Bechoua S, Berki-Morin Y, Michel F, Girod S, Sagot P, Fauque P. Outcomes with intracytoplasmic sperm injection of cryopreserved sperm from men with spinal cord injury. Basic Clin Androl 2013; 23:14. [PMID: 25780576 PMCID: PMC4349465 DOI: 10.1186/2051-4190-23-14] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 10/08/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Erectile dysfunction, ejaculatory dysfunction and poor semen quality are the main causes of infertility in men with spinal cord injury (SCI). Different sperm retrieval techniques such as penile vibratory stimulation (PVS), electro-ejaculation (EEJ) or surgical sperm retrieval (SSR) associated or not with sperm cryopreservation can be offered to these patients to preserve their fertility. If fatherhood cannot be achieved naturally, assisted reproductive techniques can be offered to these patients using either fresh or frozen/thawed sperm. The aim of the study was to report in SCI patients from Dijon (Burgundy) and in the literature, intracytoplasmic sperm injection (ICSI) outcomes using frozen sperm obtained either by antegrade ejaculation (PVS or sexual intercourse) or by SSR. METHODS A retrospective analysis was performed in Dijon, Burgundy over a 17 year period (1995-2011) on a cohort of 19 SCI men (6 quadriplegics and 13 paraplegics, mean age: 25.2 ± 5.6 years) who underwent a sperm cryopreservation followed or not by intracytoplasmic sperm injection (ICSI). Patients were divided into two groups according to the sperm retrieval method used (antegrade ejaculation group (n=10): penile vibratory stimulation (PVS) for 9 patients and sexual intercourse for 1 patient and surgical sperm retrieval (SSR) group: n=9). The sperm parameters in both groups were analyzed. Pregnancy outcomes in the 8 couples who underwent ICSI were evaluated. RESULTS The fertilization rates were 57 and 55%, the embryo's cleavage rates were 90 and 93% in the antegrade ejaculation and SSR groups respectively. Among the 8 couples who underwent ICSI, 5 couples achieved pregnancy. The pregnancy rates per couple were 50% and 75% in the antegrade and SSR groups respectively. CONCLUSIONS Although some studies don't recommend freezing sperm in SCI patients, the pregnancy rates presented in this study are encouraging and warrant the use of frozen/thawed sperm in very specific situations.
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Affiliation(s)
- Shaliha Bechoua
- Hôpital de Dijon, Laboratoire de Biologie de la Reproduction, Université de Bourgogne, 21079 Dijon, France
| | - Yasmine Berki-Morin
- Hôpital de Dijon, Laboratoire de Biologie de la Reproduction, Université de Bourgogne, 21079 Dijon, France
| | - Frédéric Michel
- Hôpital de Dijon, Service de Chirurgie Urologique-Andrologie, Université de Bourgogne, 21079 Dijon, France
| | - Sophie Girod
- Hôpital de Dijon, Université de Bourgogne, Service de Gynécologie-Obstétrique, Médecine Fœtale et Stérilité Conjugale, 21079 Dijon, France
| | - Paul Sagot
- Hôpital de Dijon, Université de Bourgogne, Service de Gynécologie-Obstétrique, Médecine Fœtale et Stérilité Conjugale, 21079 Dijon, France
| | - Patricia Fauque
- Hôpital de Dijon, Laboratoire de Biologie de la Reproduction, Université de Bourgogne, 21079 Dijon, France
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Chéhensse C, Bahrami S, Denys P, Clément P, Bernabé J, Giuliano F. The spinal control of ejaculation revisited: a systematic review and meta-analysis of anejaculation in spinal cord injured patients. Hum Reprod Update 2013; 19:507-26. [DOI: 10.1093/humupd/dmt029] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Talebi AR, Khalili MA, Vahidi S, Ghasemzadeh J, Tabibnejad N. Sperm chromatin condensation, DNA integrity, and apoptosis in men with spinal cord injury. J Spinal Cord Med 2013; 36:140-6. [PMID: 23809529 PMCID: PMC3595962 DOI: 10.1179/2045772312y.0000000055] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES To evaluate the effect of cord injury on (1) sperm parameters and (2) DNA chromatin status. DESIGN Case-control study. SETTING Data were collected from men referred to Research and Clinical Center for Infertility, Yazd, Iran. PARTICIPANTS Thirty infertile men with the presence of any level of spinal cord injury (SCI) were compared with 30 healthy donors with definite fertility and normal sperm parameters. INTERVENTIONS Not applicable. OUTCOME MEASURES Sperm chromatin integrity was assessed using aniline blue (AB), chromomycin A3 (CMA3), toluidine blue (TB), and acridine orange (AO) assays. The rate of apoptotic spermatozoa was evaluated with terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling (TUNEL) staining. RESULTS Sperm concentration, motility, and morphology in men with SCI were significantly decreased compared with control group (P < 0.05). In addition, with regard to cytochemical staining and TUNEL test, the rate of reacted spermatozoa was increased significantly in SCI group when compared with the controls (P < 0.05). The majority of AB, TB, AO, and CMA3-reacted spermatozoa were higher than the "cut-off" value in men with SCI, as were the number of apoptotic spermatozoa stained with TUNEL. CONCLUSION Results showed that SCI disturbs sperm parameters, nuclear maturity, and DNA integrity of spermatozoa. Therefore, the production of spermatozoa with less condensed chromatin and more apoptotic rate increases after cord injury and this may be one possible cause of infertility following SCI.
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Affiliation(s)
| | | | | | | | - Nasim Tabibnejad
- Correspondence to: Nasim Tabibnejad, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Bouali Avenue, Safaeiyeh, Yazd, 8916877391, Iran.
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Kathiresan AS, Ibrahim E, Aballa TC, Attia GR, Ory SJ, Hoffman DI, Maxson WS, Barrionuevo MJ, Lynne CM, Brackett NL. Comparison of in vitro fertilization/intracytoplasmic sperm injection outcomes in male factor infertility patients with and without spinal cord injuries. Fertil Steril 2011; 96:562-6. [DOI: 10.1016/j.fertnstert.2011.06.078] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 06/20/2011] [Accepted: 06/27/2011] [Indexed: 11/28/2022]
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Pregnancy outcomes by intravaginal and intrauterine insemination in 82 couples with male factor infertility due to spinal cord injuries. Fertil Steril 2011; 96:328-31. [DOI: 10.1016/j.fertnstert.2011.05.019] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Revised: 05/03/2011] [Accepted: 05/05/2011] [Indexed: 11/20/2022]
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O'Kelly F, Manecksha RP, Cullen IM, McDermott TE, Flynn R, Grainger R. Electroejaculatory stimulation and its implications for male infertility in spinal cord injury: a short history through four decades of sperm retrieval (1975-2010). Urology 2011; 77:1349-52. [PMID: 21624595 DOI: 10.1016/j.urology.2011.01.053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 01/06/2011] [Accepted: 01/27/2011] [Indexed: 11/28/2022]
Affiliation(s)
- Fardod O'Kelly
- Department of Urology, Adelaide and Meath Hospitals, National Children's Hospital, Dublin, Ireland.
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Perrin J, Saïas-Magnan J, Thiry-Escudié I, Gamerre M, Serment G, Grillo JM, Guillemain C, Karsenty G. Le blessé médullaire : quel sperme et quelle prise en charge en Assistance médicale à la procréation ? ACTA ACUST UNITED AC 2010; 38:532-5. [DOI: 10.1016/j.gyobfe.2010.07.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 07/05/2010] [Indexed: 11/30/2022]
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Marcelli F, Leroy M, Robin G, Saint-Pol P, Rigot JM, Mitchell V. Prise en charge de l’infécondité dans les troubles de l’éjaculation: avis conjoints de l’andrologue, du biologiste et du gynécologue. Basic Clin Androl 2009. [DOI: 10.1007/s12610-009-0049-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Résumé
Quatre-vingts pour cent des hommes qui présentent des troubles de l’éjaculation sont en âge de procréer, mais seul 5 à 10 % en sont spontanément capables. Du sperme antérograde et/ou rétrograde peut être recueilli par éjaculation assistée en association à des traitements pharmacologiques (chlorhydrate de minodrine-vibroéjaculation). En cas d’échecs de recueil de sperme et d’azoospermie, l’extraction chirurgicale des spermatozoïdes épididymaires ou testiculaires permet d’obtenir des spermatozoïdes, en quantité généralement moins importante que les techniques d’éjaculation assistée, mais non infectés et dépourvus de plasma séminal (souvent délétère dans les troubles de l’éjaculation). Même en cas d’éjaculation antérograde, il est impératif de recueillir les urines systématiquement à la recherche d’une éjaculation rétrograde, fréquente dans les troubles de l’éjaculation. Au laboratoire, l’analyse du sperme et de l’urine s’effectue par les méthodes de routine standardisées. La plupart des hommes présentant des troubles de l’éjaculation ont un sperme de mauvaise qualité (asthénospermie, nécrospermie, leucospermie). Les étiologies de la dégradation des paramètres du sperme sont multifactorielles, d’origine centrale et périphérique (testiculaire et extratesticulaire). Optimiser la qualité du sperme et des spermatozoïdes reste un challenge d’actualité dans les troubles de l’éjaculation. Si la cryopréservation doit être systématique, l’utilisation du sperme frais optimisé a généralement la préférence. Réussir à obtenir du sperme offre au couple une chance de grossesse naturelle (rarement) grâce à une éjaculation coïtale, par auto-insémination, par insémination intra-utérine, par fécondation in vitro conventionnelle (FIVc) ou injection intracytoplasmique de spermatozoïdes (ICSI) dans l’ovocyte. Dans les troubles de l’éjaculation, la prise en charge de la fécondité de l’homme doit être la plus rapide possible. Elle s’effectue conjointement à celle de la femme par une équipe coordonnant l’andrologue, le biologiste et le gynécologue.
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