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Bhat GR, Lone FA, Dalal J. Microfluidics-A novel technique for high-quality sperm selection for greater ART outcomes. FASEB Bioadv 2024; 6:406-423. [PMID: 39372125 PMCID: PMC11452445 DOI: 10.1096/fba.2024-00041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 10/08/2024] Open
Abstract
Microfluidics represent a quality sperm selection technique. Human couples fail to conceive and this is so in a significant population of animals worldwide. Defects in male counterpart lead to failure of conception so are outcomes of assisted reproduction affected by quality of sperm. Microfluidics, deals with minute volumes (μL) of liquids run in small-scale microchannel networks in the form of laminar flow streamlines. Microfluidic sperm selection designs have been developed in chip formats, mimicking in vivo situations. Here sperms are selected and analyzed based on motility and sperm behavioral properties. Compared to conventional sperm selection methods, this selection method enables to produce high-quality motile sperm cells possessing non-damaged or least damaged DNA, achieve greater success of insemination in bovines, and achieve enhanced pregnancy rates and live births in assisted reproduction-in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Besides, the concentration of sperm available to oocyte can be controlled by regulating the flow rate in microfluidic chips. The challenges in this technology are commercialization of chips, development of fully functional species-specific microfluidic tools, limited number of studies available in literature, and need of thorough understanding in reproductive physiology of domestic animals. In conclusion, incorporation of microfluidic system in assisted reproduction for sperm selection may promise a great success in IVF and ICSI outcomes. Future prospectives are to make this technology more superior and need to modify chip designs which is cost effective and species specific and ready for commercialization. Comprehensive studies in animal species are needed to be carried out for wider application of microfluidic sperm selection in in vitro procedures.
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Affiliation(s)
- Ghulam Rasool Bhat
- Division of Animal Reproduction, Gynaecology and ObstetricsSher‐e‐Kashmir Institute of Agricultural Sciences and Technology of KashmirSrinagarIndia
| | - Farooz Ahmad Lone
- Division of Animal Reproduction, Gynaecology and ObstetricsSher‐e‐Kashmir Institute of Agricultural Sciences and Technology of KashmirSrinagarIndia
| | - Jasmer Dalal
- Division of Veterinary Gynaecology and ObstetricsLala Lajpat Rai Veterinary and Animal Sciences UniversityHisarIndia
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Dincer MM, Yentur S, Colakerol A, Cil G, Yazar RO, Kandirali E, Semercioz A, Muslumanoglu AY, Temiz MZ. Introducing a New Smartphone Applied Semen Analyzer, SpermCell™: A Cross-Sectional Validation Study with a Comparative Analysis and a Mini Patient Questionnaire on a Large Sample Cohort. Diagnostics (Basel) 2024; 14:689. [PMID: 38611602 PMCID: PMC11011288 DOI: 10.3390/diagnostics14070689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Standard semen analysis methods may exhibit variability between observers and/or human error; therefore, additional methods are needed to overcome these handicaps. We aimed to present a new smartphone-applied semen analyzer, Sperm Cell™, investigate its diagnostic efficacy by comparing it with the standard analysis method, and determine its user-friendly nature. (2) Methods: A cross-sectional study was conducted on a large sample cohort, including 102 men. Three semen analyses were performed for each semen sample. The first employed the standard manual method, whereas the others were smartphone-based analyses performed by technicians and patients. We compared major semen parameters between the three semen analyses. The user-friendly nature of the analyzer was also evaluated with a mini-questionnaire completed by the participants. (3) Results: The determined median sperm count, motile sperm count, and percentage of motile sperms, on standard manual semen analysis, were 50.00 × 106/mL (0-160 × 106/mL), 23.94 × 106/mL (0-108 × 106/mL) and 50.00% (0-73.00%), respectively. Median sperm count and motile sperm count were 50.52 × 106/mL (<1-150 × 106/mL) vs. 55.77 × 106/mL (<1-160 × 106/mL) and 23.34 × 106/mL (0-105 × 106/mL) vs. 23.53 × 106/mL (0-104 × 106/mL) for SpermCell™-based semen analysis performed by a technician and patients themselves, respectively. The percentages of motile sperms were 47.40% (0-67.00%) vs. 47.61% (0-80.20%), respectively. All the parameters were statistically similar between the three semen analysis methods (p > 0.05 for each). The SpermCell™ analysis results were correlated with the standard manual method with up to 0.85 correlation coefficients. Moreover, substantial diagnostic accuracy, sensitivity and specificity were obtained in determining the oligospermia and asthenozoospermia via the device-based analyses performed by technician and patients. The mini-questionnaire results revealed that the analyzer is useful. (4) Conclusions: The novel smartphone-applied semen analyzer is a helpful tool with acceptable diagnostic accuracy in determining the major semen parameters. It can be used as an efficient at-home point-of-care testing method in the initial assessment of couples with infertility concerns.
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Affiliation(s)
- Muhammet Murat Dincer
- Department of Urology, Bagcilar Training and Research Hospital, Istanbul 34200, Turkey (A.C.); (R.O.Y.); (A.Y.M.); (M.Z.T.)
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Fu W, Cui Q, Yang Z, Bu Z, Shi H, Bi B, Yang Q, Xin H, Shi S, Hu L. High sperm DNA fragmentation increased embryo aneuploidy rate in patients undergoing preimplantation genetic testing. Reprod Biomed Online 2023; 47:103366. [PMID: 37812976 DOI: 10.1016/j.rbmo.2023.103366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 10/11/2023]
Abstract
RESEARCH QUESTION Is high sperm DNA fragmentation (SDF) associated with a high embryonic aneuploidy rate in patients undergoing intracytoplasmic sperm injection (ICSI)-preimplantation genetic testing (PGT)? DESIGN This was a retrospective study of 426 couples with normal karyotypes undergoing ICSI-PGT at the authors' centre from March 2017 to March 2021. SDF was assessed using the sperm chromatin structure assay. The population was divided into low and high SDF groups according to cut-off values found by the receiver operating characteristic (ROC) curve. A 1:1 ratio propensity score matching (PSM) method was used to control for potential confounding factors, and a generalized linear mixed model was established to evaluate the relationship between SDF and the embryonic aneuploidy rate. RESULTS The ROC curve indicated a threshold of 30%. In total, 132 couples were included after PSM, and the high SDF group (>30%) had significantly higher SDF (40.74% ± 9.78% versus 15.54% ± 7.86%, P < 0.001) and a higher embryo aneuploidy rate (69.36% versus 53.96%, P < 0.001) compared with the low SDF group (≤30%). The two pronuclear fertilization rate, cleavage rate, rate of high-quality embryos at day 3 rate, blastocyst rate, biochemical pregnancy rate, clinical pregnancy rate, miscarriage rate, live birth rate, caesarean section rate, preterm birth rate, singleton rate and low birthweight rate were similar in both groups (P > 0.05). After PSM, SDF > 30% was significantly correlated with an increased embryo aneuploidy rate after adjusting for all confounding variables (adjusted odds ratio 1.70, 95% CI 1.00-2.88, P = 0.049). CONCLUSIONS SDF > 30% was associated with an increased embryo aneuploidy rate in couples with normal karyotypes undergoing PGT, but did not affect embryonic and clinical outcomes after transfer of euploid embryos.
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Affiliation(s)
- Wanting Fu
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Qiuying Cui
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Ziyao Yang
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Zhiqin Bu
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Hao Shi
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Beibei Bi
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Qingling Yang
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Hang Xin
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Senlin Shi
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Linli Hu
- Centre for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Provincial Obstetrical and Gynaecological Diseases (Reproductive Medicine) Clinical Research Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China; Henan Engineering Laboratory of Preimplantation Genetic Diagnosis and Screening, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
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Huyghe E, Methorst C, Lamazou F, Amar E, Faix A. [The urologist's role in assisted reproductive technology (ART)]. Prog Urol 2023; 33:710-717. [PMID: 38012913 DOI: 10.1016/j.purol.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Following on from the Rapport vers une stratégie nationale de lutte contre l'infertilité (Report on a national strategy to combat infertility) submitted to the French Minister of Health in 2022, whose objective 13 is: to better identify and diagnose male infertility, we wanted to clarify with reproductive specialists what role the urologist should play in the management of the infertile couple. METHODS An expert consensus was reached with the Pedagogical Committee and pilots of the Transversal Specialized Training in Reproductive Medicine and Biology - Andrology, and with the presidents, board and scientific council of the French Federation for Reproductive Study (FFER). RESULTS In the case of infertility in a couple, the fertility of both partners should be assessed from the outset, and in the event of abnormality or failure of ART, the patient should be referred to a uro-andrologist for expert management. The uro-andrologist will set up medical or surgical treatments to improve the prognosis of the man's fertility, in conjunction with the entire ART team. It is also important for the urologist/andrologist to take charge of the man's health before conception, because of the benefits for the patient himself and for his offspring. CONCLUSION This expert consensus has shed light on the role of the uro-andrologist in the ART pathway, on the need for training in Andrology and on the medical demography required.
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Affiliation(s)
- Eric Huyghe
- Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR DEFE, Inserm 1203, université de Toulouse, université de Montpellier, Toulouse, France.
| | - Charlotte Methorst
- Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France
| | | | | | - Antoine Faix
- Clinique Saint-Roch, 560, avenue du Colonel-Pavelet-dit-Villars, 34000 Montpellier, France
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Ellis LB, Molina K, Robbins CR, Freisthler M, Sgargi D, Mandrioli D, Perry MJ. Adult Organophosphate and Carbamate Insecticide Exposure and Sperm Concentration: A Systematic Review and Meta-Analysis of the Epidemiological Evidence. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:116001. [PMID: 37966213 PMCID: PMC10648769 DOI: 10.1289/ehp12678] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 09/27/2023] [Accepted: 10/05/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Evidence of the negative impacts of contemporary use insecticides on sperm concentration has increased over the last few decades; however, meta-analyses on this topic are rare. OBJECTIVES This investigation assessed the qualitative and quantitative strength of epidemiological evidence regarding adult exposure to two classes of contemporary use insecticides-organophosphates (OPs) and N -methyl carbamates (NMCs)-and sperm concentration using robust and reproducible systematic review and meta-analysis methods. METHODS Three scientific databases (PubMed, Scopus, and Web of Science), two U.S. government databases (NIOSHTIC-2 and Science.gov), and five nongovernmental organization websites were searched for relevant primary epidemiological studies published in any language through 11 August 2022. Risk of bias and strength of evidence were evaluated according to Navigation Guide systematic review methodology. Bias-adjusted standardized mean difference effect sizes were calculated and pooled using a three-level, multivariate random-effect meta-analysis model with cluster-robust variance estimation. RESULTS Across 20 studies, 21 study populations, 42 effect sizes, and 1,774 adult men, the pooled bias-adjusted standardized mean difference in sperm concentration between adult men more- and less-exposed to OP and NMC insecticides was - 0.30 (95% CI: - 0.49 , - 0.10 ; P Satt < 0.01 ). Sensitivity and subgroup analyses explored statistical heterogeneity and validated the model robustness. Although the pooled effect estimate was modified by risk of bias, insecticide class, exposure setting, and recruitment setting, it remained negative in direction across all meta-analyses. The body of evidence was rated to be of moderate quality, with sufficient evidence of an association between higher adult OP and NMC insecticide exposure and lower sperm concentration. DISCUSSION This comprehensive investigation found sufficient evidence of an association between higher OP and NMC insecticide exposure and lower sperm concentration in adults. Although additional cohort studies can be beneficial to fill data gaps, the strength of evidence warrants reducing exposure to OP and NMC insecticides now to prevent continued male reproductive harm. https://doi.org/10.1289/EHP12678.
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Affiliation(s)
- Lauren B. Ellis
- Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Karen Molina
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - C. Rebecca Robbins
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Marlaina Freisthler
- Department of Environmental and Occupational Health, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
- Department of Agricultural and Food Sciences, University of Bologna, Bologna, Italy
| | - Melissa J. Perry
- College of Public Health, George Mason University, Fairfax, Virginia, USA
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Sun TC, Li DM, Yu H, Song LL, Jia YJ, Lin L, Zhou SJ. Bilateral varicocele leads to ferroptosis, pyroptosis and necroptosis of human spermatozoa and affects semen quality in infertile men. Front Cell Dev Biol 2023; 11:1091438. [PMID: 36819092 PMCID: PMC9932668 DOI: 10.3389/fcell.2023.1091438] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/19/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose: This study explored the effects of bilateral varicocele on male semen quality in infertile men and the molecular mechanisms involving ferroptosis, pyroptosis and necroptosis signaling pathways. Methods: Totally, 20 healthy males and 26 patients with bilateral varicocele receiving infertility treatment were enrolled. Semen samples were collected. Basic semen parameters, acrosome integrity and membrane integrity, mitochondrial membrane potential (MMP) and apoptosis rate were compared. Levels of reactive oxygen species (ROS), iron, glutathione (GSH), total superoxide dismutase (T-SOD), and, Catalase (CAT), were detected in human seminal plasma. Relative mRNA expression of Ca 2+-independent phospholipases A2 beta (iPLA 2β), P53, Zinc finger E-box binding homeobox 1 (ZEB1) and GSH-dependent peroxidase 4 (GPX4) were evaluated. Relative protein expression was determined for GPX4, receptor interacting serine/threonine kinase 1 (RIPK1) and receptor interacting serine/threonine kinase 3 (RIPK3), as well as pyroptosis markers of Gasdermin E (GSDME) and heat shock protein 90 (HSP 90). Results: The results revealed that the bilateral varicocele group had significantly higher abnormalities (sperm progressive rate and sperm motility) compared to the control group. Meanwhile, compared to control group, GSH, T-SOD, and CAT levels were reduced in the bilateral varicocele group (p < 0.05). However, the level of ROS and iron were significantly increased (p < 0.05). Relative mRNA expression of P53, iPLA 2β, ZEB1, and GPX4 were reduced. In addition, ROS exposure activated ferroptosis-related signal pathways. RIPK1, RIPK3, GSDME and HSP 90 were increased in bilateral varicocele group. ROS exposure affected signaling pathways related to ferroptosis, necrosis and pyroptosis in human spermatozoa. Conclusion: Bilateral varicocele leads to ferroptosis, pyroptosis and necroptosis of human spermatozoa and affects semen quality in infertile men.
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Affiliation(s)
- Tie Cheng Sun
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China,HLA Laboratory, Beijing Red Cross Blood Center, Beijing, China,*Correspondence: Tie Cheng Sun, ; Li Lin, ; Shan Jie Zhou,
| | - Dong Mei Li
- HLA Laboratory, Beijing Red Cross Blood Center, Beijing, China
| | - Hong Yu
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China
| | - Ling Li Song
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China
| | - Yan Jun Jia
- HLA Laboratory, Beijing Red Cross Blood Center, Beijing, China
| | - Li Lin
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China,*Correspondence: Tie Cheng Sun, ; Li Lin, ; Shan Jie Zhou,
| | - Shan Jie Zhou
- Reproductive Medical Center, Department of Obstetrics and Gynecology, Peking University International Hospital, Beijing, China,*Correspondence: Tie Cheng Sun, ; Li Lin, ; Shan Jie Zhou,
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Nurwati I, Murti B, Budihastuti UR, Prakosa T, Laqif A, Melinawati E, Prasetya H, Susanto L, Sukmawati M. Electroacupuncture Effectiveness for Treating Idiopathic Male Infertility. Med Acupunct 2022; 34:405-409. [PMID: 36644422 PMCID: PMC9805838 DOI: 10.1089/acu.2021.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background Male infertility accounts for ∼50% of all infertility cases. The reasons for male infertility may vary, and one of them is related to an idiopathic factor that may impair spermatogenesis. Acupuncture is one of the most well-known and widely accepted alternative treatments and is becoming known as an effective complementary therapy for infertility. Case The case in this article demonstrated the effectiveness of electroacupuncture (EA) for improving male fertility by referring to the total motile sperm count (TMSC), sperm morphology and motility, DNA Fragmentation Index (DFI) of the sperm before and after EA, and pregnancy success in a couple with male infertility. Couples are given therapy with EA twice per week for up to 12 sessions and planned intercourse during the fertile period (ovulation). After planned intercourse, the wife became pregnant; an intrauterine gestational sac (GS) was seen on transvaginal ultrasound and her human chorionic gonadotropin urine test was positive. Results The TMSC parameter, sperm morphology and sperm motility, post-EA DFI was improved, compared to pre-EA. The couple was became pregnant after undergoing EA 12 times to treat male infertility. Conclusions This case illustrated that EA therapy for idiopathic male infertility has an effect toward improvement of the spermiogram test result, DFI, and success in achieving a pregnancy. However, further research is needed because there are many patients with different causes for their infertility.
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Affiliation(s)
- Ida Nurwati
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Doctoral Program in Medical Science, Medical Faculty of Universitas Sebelas Maret, Jawa Tengah, Indonesia
| | - Bhisma Murti
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Public Health Science Study Program, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Doctoral Program in Medical Science, Medical Faculty of Universitas Sebelas Maret, Jawa Tengah, Indonesia
| | - Uki Retno Budihastuti
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
- Public Health Science Study Program, Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Doctoral Program in Medical Science, Medical Faculty of Universitas Sebelas Maret, Jawa Tengah, Indonesia
| | - Teguh Prakosa
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Abdurahman Laqif
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Eriana Melinawati
- Medical Faculty of Universitas Sebelas Maret, Surakarta, Central Java, Indonesia
- Dr. Moewardi General Hospital, Jawa Tengah, Indonesia
| | - Hanung Prasetya
- Acupuncture Department, Surakarta Health Polytechnic, Surakarta, Central Java, Indonesia
| | - Lunardhi Susanto
- School of Pharmacy, Universitas Hang Tuah, Surabaya, Jawa Timur, Indonesia
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Calvert JK, Fendereski K, Ghaed M, Bearelly P, Patel DP, Hotaling JM. The male infertility evaluation still matters in the era of high efficacy assisted reproductive technology. Fertil Steril 2022; 118:34-46. [PMID: 35725120 DOI: 10.1016/j.fertnstert.2022.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/14/2022] [Accepted: 05/04/2022] [Indexed: 11/04/2022]
Abstract
Today's reproductive endocrinology and infertility providers have many tools at their disposal when it comes to achieving pregnancy. In the setting of highly efficacious assisted reproductive technology, it is natural to assume that male factor infertility can be overcome by acquiring sperm and then bypassing the male evaluation. In this review, we go through guideline statements and a stepwise male factor infertility evaluation to propose that a thorough male evaluation remains important to optimize pregnancy and live birth. The foundation of this parallel evaluation is referral to a reproductive urologist for the optimization of the male partner, for advanced diagnostics and interventions, and for the detection of other underlying male pathology. We also discuss what future developments might have an impact on the workup of the infertile male.
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Affiliation(s)
- Joshua K Calvert
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah
| | - Kiarad Fendereski
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah
| | - Mohammadali Ghaed
- Urology Department, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Priyanka Bearelly
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah
| | - Darshan P Patel
- Department of Urology, University of California San Diego Health, San Diego, California
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, Utah.
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9
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Evolution of the World Health Organization semen analysis manual: where are we? Nat Rev Urol 2022; 19:439-446. [PMID: 35523961 DOI: 10.1038/s41585-022-00593-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2022] [Indexed: 12/13/2022]
Abstract
The WHO (World Health Organization) manuals provide state-of-the-art guidance on how a semen analysis should be carried out. The much anticipated sixth edition of the WHO semen analysis manual has been released 10 years after its previous version and includes essential updates, such as new reference standards for semen volume and microscopic sperm characteristics of recent fathers. A well-conducted semen analysis remains an essential foundation of the infertility evaluation process and affects patient referral, diagnosis and treatment. However, a male infertility work-up primarily based on routine semen analysis does not provide men with an optimal fertility pathway; the primary reasons for routine semen analysis inadequacy in this context include its low predictive value for natural and assisted conception success, its inability to detect sperm DNA and epigenetic deficiencies that might negatively affect embryo development, implantation and offspring well-being, and the substantial overlap between semen parameters of fertile and subfertile individuals. Ideally, a full andrological assessment should be carried out by reproductive urologists in all men dealing with couple infertility and should include a detailed history analysis, physical examination, semen analysis, endocrine assessment and other tests as needed. Only through a complete male infertility work-up will relevant underlying medical and infertility conditions be revealed and potentially treated or alleviated. The ultimate goals of a comprehensive andrological assessment are to positively influence overall male health, pregnancy prospects and offspring well-being.
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10
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Multi-model CNN fusion for sperm morphology analysis. Comput Biol Med 2021; 137:104790. [PMID: 34492520 DOI: 10.1016/j.compbiomed.2021.104790] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 12/17/2022]
Abstract
Infertility is a common disorder affecting 20% of couples worldwide. Furthermore, 40% of all cases are related to male infertility. The first step in the determination of male infertility is semen analysis. The morphology, concentration, and motility of sperm are important characteristics evaluated by experts during semen analysis. Most laboratories perform the tests manually. However, manual semen analysis requires much time and is subject to observer variability during the evaluation. Therefore, computer-assisted systems are required. Additionally, to obtain more objective results, a large amount of data is necessary. Deep learning networks, which have become popular in recent years, are used for processing and analysing such quantities of data. Convolutional neural networks (CNNs) are a class of deep learning algorithm that are used extensively for processing and analysing images. In this study, six different CNN models were created for completely automating the morphological classification of sperm images. Additionally, two decision-level fusion techniques namely hard-voting and soft-voting were applied over these CNNs. To evaluate the performance of the proposed approach, three publicly available sperm morphology data sets were used in the experimental tests. For an objective analysis, a cross-validation technique was applied by dividing the data sets into five sub-sets. In addition, various data augmentation scales and mini-batch analysis were employed to obtain the highest classification accuracies. Finally, in the classification, accuracies 90.73%, 85.18% and 71.91% were obtained for the SMIDS, HuSHeM and SCIAN-Morpho data sets, respectively, using the soft-voting based fusion approach over the six created CNN models. The results suggested that the proposed approach could automatically classify as well as achieve high success in three different data sets.
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11
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Kandil H, Agarwal A, Saleh R, Boitrelle F, Arafa M, Vogiatzi P, Henkel R, Zini A, Shah R. Editorial Commentary on Draft of World Health Organization Sixth Edition Laboratory Manual for the Examination and Processing of Human Semen. World J Mens Health 2021; 39:577-580. [PMID: 34169684 PMCID: PMC8443989 DOI: 10.5534/wjmh.210074] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/11/2021] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France.,Paris Saclay University, UVSQ, INRAE, BREED, Jouy-en-Josas, France
| | - Mohamed Arafa
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Andrology, Cairo University, Cairo, Egypt.,Department of Urology, Hamad Medical Corporation, Doha, Qatar
| | - Paraskevi Vogiatzi
- Andromed Health & Reproduction, Fertility Diagnostics Laboratory, Maroussi, Athens, Greece
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.,Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa.,LogixX Pharma, Theale, Berkshire, UK
| | - Armand Zini
- Department of Surgery, McGill University, Montreal, QC, Canada
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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12
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Mary AP, Nandeesha H, Papa D, Chitra T, Ganesh RN, Menon V. Matrix metalloproteinase-9 is elevated and related to interleukin-17 and psychological stress in male infertility: A cross-sectional study. Int J Reprod Biomed 2021; 19:333-338. [PMID: 33997592 PMCID: PMC8106818 DOI: 10.18502/ijrm.v19i4.9059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 06/15/2020] [Accepted: 09/26/2020] [Indexed: 12/27/2022] Open
Abstract
Background Matrix metalloproteinase-9 (MMP-9), interleukin-17 (IL-17) and psychological stress are known to play a role in the pathogenesis of male infertility. Objective To assess the association of MMP-9 with IL-17 and psychological stress in infertile men. Materials and Methods In this cross-sectional study, 39 men with infertility diagnosed based on semen analysis and 39 subjects with normal semen analysis were included in the study. MMP-9 and IL-17 were estimated in both groups by ELISA. Perceived stress scale was used to assess psychological stress in controls and cases. Results In infertile cases, MMP-9 and IL-17 were significantly increased when compared with controls (p = 0.046, p = 0.041 respectively). A significant association of MMP-9 was observed with IL-17 (r = 0.335, p = 0.037) and perceived stress scale (r = 0.329, p = 0.041). Conclusion IL-17 and stress increase MMP- 9 levels in infertile men.
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Affiliation(s)
- Ann Prasad Mary
- Biochemistry Department, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Hanumanthappa Nandeesha
- Biochemistry Department, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Dasari Papa
- Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Thyagaraju Chitra
- Department of Obstetrics and Gynecology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Rajesh Nachiappa Ganesh
- Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
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13
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Pandruvada S, Royfman R, Shah TA, Sindhwani P, Dupree JM, Schon S, Avidor-Reiss T. Lack of trusted diagnostic tools for undetermined male infertility. J Assist Reprod Genet 2021; 38:265-276. [PMID: 33389378 PMCID: PMC7884538 DOI: 10.1007/s10815-020-02037-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/13/2020] [Indexed: 12/15/2022] Open
Abstract
Semen analysis is the cornerstone of evaluating male infertility, but it is imperfect and insufficient to diagnose male infertility. As a result, about 20% of infertile males have undetermined infertility, a term encompassing male infertility with an unknown underlying cause. Undetermined male infertility includes two categories: (i) idiopathic male infertility-infertile males with abnormal semen analyses with an unknown cause for that abnormality and (ii) unexplained male infertility-males with "normal" semen analyses who are unable to impregnate due to unknown causes. The treatment of males with undetermined infertility is limited due to a lack of understanding the frequency of general sperm defects (e.g., number, motility, shape, viability). Furthermore, there is a lack of trusted, quantitative, and predictive diagnostic tests that look inside the sperm to quantify defects such as DNA damage, RNA abnormalities, centriole dysfunction, or reactive oxygen species to discover the underlying cause. To better treat undetermined male infertility, further research is needed on the frequency of sperm defects and reliable diagnostic tools that assess intracellular sperm components must be developed. The purpose of this review is to uniquely create a paradigm of thought regarding categories of male infertility based on intracellular and extracellular features of semen and sperm, explore the prevalence of the various categories of male factor infertility, call attention to the lack of standardization and universal application of advanced sperm testing techniques beyond semen analysis, and clarify the limitations of standard semen analysis. We also call attention to the variability in definitions and consider the benefits towards undetermined male infertility if these gaps in research are filled.
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Affiliation(s)
- Swati Pandruvada
- Department of Biological Sciences, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43607 USA
| | - Rachel Royfman
- Department of Biological Sciences, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43607 USA
| | - Tariq A. Shah
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43607 USA
| | - Puneet Sindhwani
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43607 USA
| | - James M. Dupree
- Department of Urology and Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48019 USA
| | - Samantha Schon
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109 USA
| | - Tomer Avidor-Reiss
- Department of Biological Sciences, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43607 USA
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43607 USA
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14
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Gajbhiye R, Khan S, Kulkarni V, Shah R, Gokral J, Meherji P, Vadigoppula A, Patil A, Bhurke A, Kokate P, Barai R, Surve S, Modi D, Mahale S. Clinical presentations and semen characteristics of men attending the secondary referral infertility clinic at Mumbai, India. J Hum Reprod Sci 2021; 14:356-364. [PMID: 35197680 PMCID: PMC8812386 DOI: 10.4103/jhrs.jhrs_93_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/07/2021] [Accepted: 11/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Limited information is available on the aetiology and semen profiles of male infertility in Indian population. Aim: The aim of this study is to study the clinical and semen characteristics of men attending the infertility clinic and also to understand the impact of World Health Organization (WHO) 2010 reference values on the diagnosis of male infertility. Setting and Design: A retrospective study evaluating the medical case records (January 2005 to December 2015, [n = 1906]) of men attending infertility clinic in Mumbai, India. Materials and Methods: The aetiology was classified based on the andrology evaluation and other investigations. Semen profiles were compared during the years 2005–2010 and 2011–2015 using WHO 1999 and WHO 2010 criteria, respectively. Statistical Analysis: The Chi-square and Mann–Whitney U tests were performed using Open Source Epidemiological software and Social science calculators. Results: The aetiology of male infertility was determined in 62% of the men; while the cause remained undetermined in 38%. Varicocele (25%), urogenital infections (10%), sexual dysfunctions (8%) and vas aplasia (8%) were identified as major aetiologies in our cohort. Men with sexual dysfunctions and vas aplasia were significantly higher during the years 2011–2015 as compared to 2005–2010. Men having normozoospermia (10%) and azoospermia (3%) were increased, whereas those having oligoasthenozoospermia (17%) were reduced in 2011–2015 as compared to 2005–2010. According to WHO 1999 criteria , 12-15% of men showed abnormal semen profiles. The semen parameters of these men became normal on using WHO 2010 reference values. Conclusions: Varicocele is the most common aetiology in infertile men. Idiopathic infertility was seen in a higher proportion among the infertile men.
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15
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De Brucker S, Drakopoulos P, Dhooghe E, De Geeter J, Uvin V, Santos-Ribeiro S, Michielsen D, Tournaye H, De Brucker M. The effect of cigarette smoking on the semen parameters of infertile men. Gynecol Endocrinol 2020; 36:1127-1130. [PMID: 32608274 DOI: 10.1080/09513590.2020.1775195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION 36.9% of men worldwide use tobacco. Previous studies suggest a negative effect of cigarette smoking on semen quality, but the results are contradictory. We have studied the effects of smoking on the semen characteristics such as sperm concentration, semen volume, sperm motility, sperm vitality and sperm morphology in a large group of infertile men. METHODS This retrospective study was conducted on a total of 5146 infertile men with at least one year of idiopathic infertility, who admitted to the Centre for Reproductive medicine (CRG) at the Brussels University Hospital, Belgium between 2010 and 2017. The smokers were classified as mild (1-10 cigarettes/d), moderate (11-20 cigarettes/d) or heavy smokers (> 20 cigarettes/d). Semen analysis was performed for all patients. Statistical analysis was performed using the R software package and t-test or Mann-Whitney U tests were used, group comparisons were performed using ANOVA, ANCOVA or Kruskal-Wallis tests as appropriate. A p-value <0.05 was considered as statistically significant. RESULTS Comparing the semen parameters in the two global groups showed that smoking had a significant decrease in semen volume (p=0.04074) and sperm concentration (p=0.029). ANOVA testing on the different smoking groups versus non-smoking group showed a significant decrease in sperm concentration (p=0.0364). After adjusting for the confounders, age and testosterone, ANCOVA testing showed significant effect on the sperm concentration (p=0.03871) in smokers versus non-smokers. No significant correlation was detected between the other semen characteristics. CONCLUSION We concluded that smoking had a significant and independent effect on the sperm concentration in a semen analysis. Other parameters, like semen volume, sperm motility, sperm vitality and sperm morphology were not influenced by smoking.
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Affiliation(s)
- Simon De Brucker
- Department of Urology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Panagiotis Drakopoulos
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Edouard Dhooghe
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jeroen De Geeter
- Department of Statistics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Valerie Uvin
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Samuel Santos-Ribeiro
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dirk Michielsen
- Department of Urology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Herman Tournaye
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Michaël De Brucker
- Centre for Reproductive Medicine, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Obstetrics and Gynaecology, CHU Tivoli, La Louvière, Belgium
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16
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Nam Y, Kang KM, Sung SR, Park JE, Shin YJ, Song SH, Seo JT, Yoon TK, Shim SH. The association of stromal antigen 3 (STAG3) sequence variations with spermatogenic impairment in the male Korean population. Asian J Androl 2020; 22:106-111. [PMID: 31115363 PMCID: PMC6958972 DOI: 10.4103/aja.aja_28_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The stromal antigen 3 (STAG3) gene, encoding a meiosis-specific cohesin component, is a strong candidate for causing male infertility, but little is known about this gene so far. We identified STAG3 in patients with nonobstructive azoospermia (NOA) and normozoospermia in the Korean population. The coding regions and their intron boundaries of STAG3 were identified in 120 Korean men with spermatogenic impairments and 245 normal controls by using direct sequencing and haplotype analysis. A total of 30 sequence variations were identified in this study. Of the total, seven were exonic variants, 18 were intronic variants, one was in the 5’-UTR, and four were in the 3’-UTR. Pathogenic variations that directly caused NOA were not identified. However, two variants, c.3669+35C>G (rs1727130) and +198A>T (rs1052482), showed significant differences in the frequency between the patient and control groups (P = 0.021, odds ratio [OR]: 1.79, 95% confidence interval [CI]: 1.098–2.918) and were tightly linked in the linkage disequilibrium (LD) block. When pmir-rs1052482A was cotransfected with miR-3162-5p, there was a substantial decrease in luciferase activity, compared with pmir-rs1052482T. This result suggests that rs1052482 was located within a binding site of miR-3162-5p in the STAG3 3’-UTR, and the minor allele, the rs1052482T polymorphism, might offset inhibition by miR-3162-5p. We are the first to identify a total of 30 single-nucleotide variations (SNVs) of STAG3 gene in the Korean population. We found that two SNVs (rs1727130 and rs1052482) located in the 3’-UTR region may be associated with the NOA phenotype. Our findings contribute to understanding male infertility with spermatogenic impairment.
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Affiliation(s)
- Yeojung Nam
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea
| | - Kyung Min Kang
- Genetics Laboratory, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul 06135, Korea
| | - Se Ra Sung
- Genetics Laboratory, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul 06135, Korea
| | - Ji Eun Park
- Genetics Laboratory, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul 06135, Korea
| | - Yun-Jeong Shin
- Genetics Laboratory, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul 06135, Korea
| | - Seung Hun Song
- Department of Urology, CHA Gangnam Medical Center, CHA University, Seoul 06135, Korea
| | - Ju Tae Seo
- Department of Urology, Cheil General Hospital, Seoul 04619, Korea
| | - Tae Ki Yoon
- Department of Obstetrics and Gynecology, CHA Gangnam Medical Center, Seoul 04637, Korea
| | - Sung Han Shim
- Department of Biomedical Science, College of Life Science, CHA University, Seongnam 13488, Korea.,Genetics Laboratory, Fertility Center of CHA Gangnam Medical Center, CHA University, Seoul 06135, Korea
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17
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Keshtmand Z, Akbaribazm M, Bagheri Y, Oliaei R. The ameliorative effects of Lactobacillus coagulans and Lactobacillus casei probiotics on CCl4-induced testicular toxicity based on biochemical, histological and molecular analyses in rat. Andrologia 2020; 53:e13908. [PMID: 33225493 DOI: 10.1111/and.13908] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/09/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022] Open
Abstract
Probiotics are commonly present in foods and role as dietary adjuncts and alternatives to pharmacological products in many medical fields. The aim of this study was to investigate the effects of Lactobacillus coagulans and Lactobacillus casei probiotics on carbon tetrachloride (CCl4 )-induced reproductive injury and sperm toxicity in rats. Thirty-two Wistar rats were divided into four groups as follows: sham, CCl4 (2 ml/kg), L. casei probiotic + 2 ml/kg CCl4 and L. coagulans probiotic + 2 ml/kg CCl4 . On the 36th day after the intervention, serum levels of follicle-stimulating hormone (FSH), luteinising hormone (LH) and total testosterone (T), as well as catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, were measured. Testicular malondialdehyde (MDA) level, the expressions of apoptosis-related genes (Bcl-2 and Bax), Bax/Bcl-2 ratio, histomorphometric indices such as tubular differentiation index (TDI), repopulation index (RI), spermiogenesis index (SPI) and sperm parameters were evaluated. L. casei and L. coagulans probiotics improved the levels of reproductive hormones and antioxidant capacity in rats. Both the probiotics, especially L. casei, increased the rate spermatogenesis which accompanied with significant increments in testicular TDI, RI and SPI. Furthermore, both probiotics down-regulated Bax and up-regulated Bcl-2, following by decreased Bax/Bcl-2 ratio. Our key findings indicated that L. casei and L. coagulans have protective effects against CCl4 -induced testicular toxicity.
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Affiliation(s)
- Zahra Keshtmand
- Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mohsen Akbaribazm
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yasin Bagheri
- Young Researchers and Elite Club, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Reyhaneh Oliaei
- Department of Biology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
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18
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Balawender K, Orkisz S. The impact of selected modifiable lifestyle factors on male fertility in the modern world. Cent European J Urol 2020; 73:563-568. [PMID: 33552585 PMCID: PMC7848840 DOI: 10.5173/ceju.2020.1975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction The modern man during his reproductive period is exposed to the negative influence of widespread lifestyle-related habits. The available studies show a significant decline in the quality of young men's sperm, which results in male and female infertility factors being given equal consideration. The progressive decline of sperm quality has lowered the spermiogram parameters proposed by the World Health Organization. Material and methods We performed a review of the literature on the most common unhealthy habits in the modern world, such as obesity, mobile phone usage, smoking and alcohol intake, and their reported effects on male fertility. Several papers including original, review and meta-analysis were searched using the ScienceDirect and Web of Science databases. Results All the factors under analysis contribute to a significant deterioration of sperm quality, mainly through decreased sperm concentration, vitality, motility and morphology. Conclusions Lifestyle-related factors are a significant cause of male infertility in the world today. Studies have shown that sperm quality is essentially determined by: obesity, nicotine addiction, heavy exposure to electromagnetic compatibility radiation-emitting devices and alcohol consumption. Weight loss and cessation or limitation of unhealthy lifestyle-related factors might represent the best course of action for any couple trying to achieve pregnancy.
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Affiliation(s)
- Krzysztof Balawender
- Morphological Sciences Department of Human Anatomy, Medical Faculty University of Rzeszów, Rzeszów, Poland.,Clinical Department of Urology and Urological Oncology, Municipal Hospital in Rzeszów, Rzeszów, Poland
| | - Stanisław Orkisz
- Morphological Sciences Department of Human Anatomy, Medical Faculty University of Rzeszów, Rzeszów, Poland
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Zhang Y, Cheng J, Ou J, Liu Z, Liu Y, Zang ZJ. Diagnostic performance of discontinuous density gradient centrifugation for estimating human semen quality. Andrology 2020; 9:196-203. [PMID: 32805757 DOI: 10.1111/andr.12892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/13/2020] [Accepted: 08/13/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Semen analysis plays an important role in the diagnosis of male infertility. However, many studies have demonstrated that the current methods of semen analysis are inefficient for assessing male fertility. OBJECTIVE To test whether prior discontinuous density gradient centrifugation (DDCG) improves the performance of semen analysis in diagnosing male infertility. MATERIALS AND METHODS Infertile men and fertile men were recruited from the clinic. Pre- and post-DDGC values for the semen parameters of sperm concentration, total sperm number, percent total motility, percent progressive motility, percent normal sperm morphology, and sperm DNA fragmentation rate were compared. RESULTS A total of 528 men (252 infertile men and 276 fertile men) were enrolled in the present study. After DDGC, sensitivity was significantly increased for sperm concentration, total sperm number, and sperm morphology (P < .01); specificity was significantly increased for progressive motility and sperm morphology (P < .01); and diagnostic accuracy was significantly improved for all of these parameters (area under the curve (AUC): P < .01). Total motility and sperm DNA fragmentation rate exhibited no obvious change in sensitivity, specificity or accuracy after DDGC (all P > .01). For the combination of all these semen parameters, diagnostic accuracy improved significantly after DDGC (AUC: P < .01). In a multiple regression analysis, only sperm morphology and sperm DNA fragmentation rate had P values less than 0.05 before DDGC, whereas all parameters except total sperm number contributed to the equation after DDGC. DISCUSSION DDGC is a mature, standardized procedure for clinical commonly used to optimize spermatozoa. The diagnostic accuracy of semen analysis was significantly improved after DDGC, which indicated that assessing "functional spermatozoa" might be a more suitable method for semen analysis than the WHO 2010 criteria. CONCLUSION Assessing semen parameters after DDGC might improve their diagnostic accuracy for male infertility.
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Affiliation(s)
- Yanan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Juan Cheng
- Department of Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jianping Ou
- Center for Reproduction Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhuojie Liu
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yonghui Liu
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zhi-Jun Zang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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20
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Aghazarian A, Huf W, Pflüger H, Klatte T. The 1999 and 2010 WHO reference values for human semen analysis to predict sperm DNA damage: A comparative study. Reprod Biol 2020; 20:379-383. [PMID: 32527621 DOI: 10.1016/j.repbio.2020.04.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 04/19/2020] [Accepted: 04/24/2020] [Indexed: 12/24/2022]
Abstract
Standard semen parameters are often used to predict male fertility, but whether the 2010 World Health Organization (WHO 2010) thresholds are better predictors than the 1999 thresholds has not been investigated. In this study, we addressed this issue using sperm DNA fragmentation (SDF) as a marker of male fertility in 134 subfertile male individuals. To compare the predictive value of the 1999 thresholds with the 2010 cutoffs, the Youden indices (YIs) of all possible thresholds were calculated using receiver operating characteristic (ROC) curves and compared to each other and to the respective YIs of optimal thresholds. We found that the area under the ROC curves of progressive motility and vitality was the highest among standard semen parameters, and that the YI of both parameters from the 2010 manual was comparable to the respective optimal YIs. In contrast, the threshold of sperm concentration and total sperm number from both WHO recommendations demonstrated low YIs, with substantial differences to the respective optimal YIs. The YIs of normal morphology cutoffs from both WHO manuals were slightly different from each other and from the respective optimal YIs. In conclusion, the 2010 thresholds for progressive motility and vitality are superior to the 1999 thresholds in predicting SDF, whereas the cutoff value of sperm concentration, total sperm number and normal morphology may need further revisions to increase their accuracy.
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Affiliation(s)
- Artin Aghazarian
- Department of Urology, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna, Austria; Department of Laboratory Medicine, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna, Austria.
| | - Wolfgang Huf
- Department of Laboratory Medicine, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna, Austria; Karl Landsteiner Institute for Clinical Risk Management, Vienna, Austria
| | - Heinz Pflüger
- Department of Urology, Krankenhaus Hietzing mit Neurologischem Zentrum Rosenhügel, Vienna, Austria
| | - Tobias Klatte
- Department of Urology, Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, United Kingdom; Department of Surgery, University of Cambridge, Cambridge, United Kingdom
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21
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Baskaran S, Finelli R, Agarwal A, Henkel R. Diagnostic value of routine semen analysis in clinical andrology. Andrologia 2020; 53:e13614. [PMID: 32400107 DOI: 10.1111/and.13614] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/01/2020] [Indexed: 01/11/2023] Open
Abstract
Infertility is a major health issue affecting over 48.5 million couples around the world, with the male factor accounting for about 50% of the cases. The conventional semen analysis recommended by the World Health Organization (WHO) is the cornerstone in the evaluation of male fertility status. It includes macroscopic and microscopic evaluation of the ejaculate, which reflects the production of spermatozoa in the testes, the patency of the duct system and the glandular secretory activity. Evaluation of seminal fructose, sperm vitality and leucocytes (Endtz test) are useful adjuncts to semen analysis that provide information on specific clinical conditions. Though several computer-assisted sperm analysis (CASA) systems have been developed, conventional methods for semen analysis are still widely accepted in clinical practice. This review summarises the conventional techniques used in routine semen analysis and their diagnostic value in clinical andrology.
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Affiliation(s)
- Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
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22
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The current status and future of andrology: A consensus report from the Cairo workshop group. Andrology 2019; 8:27-52. [PMID: 31692249 DOI: 10.1111/andr.12720] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND In attempting to formulate potential WHO guidelines for the diagnosis of male infertility, the Evidence Synthesis Group noted a paucity of high-quality data on which to base key recommendations. As a result, a number of authors suggested that key areas of research/evidence gaps should be identified, so that appropriate funding and policy actions could be undertaken to help address key questions. OBJECTIVES The overall objective of this Consensus workshop was to clarify current knowledge and deficits in clinical laboratory andrology, so that clear paths for future development could be navigated. MATERIALS AND METHODS Following a detailed literature review, each author, prior to the face-to-face meeting, prepared a summary of their topic and submitted a PowerPoint presentation. The topics covered were (a) Diagnostic testing in male fertility and infertility, (b) Male fertility/infertility in the modern world, (c) Clinical management of male infertility, and (d) The overuse of ICSI. At the meeting in Cairo on February 18, 2019, the evidence was presented and discussed and a series of consensus points agreed. RESULTS The paper presents a background and summary of the evidence relating to these four topics and addresses key points of significance. Following discussion of the evidence, a total of 36 consensus points were agreed. DISCUSSION The Discussion section presents areas where there was further debate and key areas that were highlighted during the day. CONCLUSION The consensus points provide clear statements of evidence gaps and/or potential future research areas/topics. Appropriate funding streams addressing these can be prioritized and consequently, in the short and medium term, answers provided. By using this strategic approach, andrology can make the rapid progress necessary to address key scientific, clinical, and societal challenges that face our discipline now and in the near future.
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Dasgupta S. Adherence to WHO 2010 Recommendations in Relation to Semen Analysis Reports in the Laboratories of West Bengal. FERTILITY & REPRODUCTION 2019. [DOI: 10.1142/s266131821950021x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: In 2010, The World Health Organization (WHO) suggested the standards of reporting of semen analysis and the reference values. We tried to determine the adherence to the WHO 2010 standard regarding semen analysis among the laboratories of West Bengal. Methods: An observational study was carried out by collecting the semen analysis reports from different laboratories. Compliance with the WHO 2010 recommendations regarding the reporting of semen analysis and references mentioned was subsequently analyzed. Results: A total of 211 laboratory reports were collected; of which 15 were ART (Assisted Reproductive Technology)-laboratories (7%) and 196 were non-ART-laboratories (93%). More than half of the laboratories did not mention any reference values. Only 7.5% used the phrase “WHO 2010” as the reference. Only 3% of the laboratories reported all the six “important” parameters (volume, pH, sperm concentration, motility, morphology and vitality) and used the WHO 2010 references for all of them. The ART laboratories performed significantly better than their non-ART counterparts in reporting and quoting the WHO 2010 reference values. Conclusion: Even nine years after its introduction, the compliance with the WHO 2010 recommendations on semen analysis was still low among our laboratories. There is need for increased awareness for the laboratory persons in this regard.
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Affiliation(s)
- Sujoy Dasgupta
- Reproductive Medicine, Genome Fertility Centre, 67 Shakespeare Sarani, Kolkata-700017, West Bengal, India
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24
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Al Zoubi MS, Al-Batayneh K, Alsmadi M, Rashed M, Al-Trad B, Al Khateeb W, Aljabali A, Otoum O, Al-Talib M, Batiha O. 4,977-bp human mitochondrial DNA deletion is associated with asthenozoospermic infertility in Jordan. Andrologia 2019; 52:e13379. [PMID: 31746488 DOI: 10.1111/and.13379] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 06/30/2019] [Accepted: 07/04/2019] [Indexed: 12/29/2022] Open
Abstract
Male infertility is commonly associated with sperm abnormalities including asthenozoospermia. The molecular basis of asthenozoospermia was linked to mitochondrial DNA (mtDNA) mutations. The 4,977-bp human mtDNA deletion is one of the most common mutations of spermatozoa and results in loss of about 33% of the mitochondrial genome. In this preliminary study, we aimed to investigate the presence of 4,977-bp mtDNA deletion in asthenozoospermic infertile men in Jordan. Semen specimens of 120 asthenozoospermic infertile men and 80 normozoospermic individuals were collected at the in vitro fertilization unit. MtDNA was extracted after the enrichment of spermatozoa; then, polymerase chain reaction was performed using 4,977-bp mtDNA deletion-specific primers. The deletion of 4,977-bp mtDNA was detected in 79.2% of asthenozoospermic patients compared to 10% in normozoospermic controls. The results showed a significant association between the presence of 4,977-bp mtDNA deletion and the asthenozoospermia and infertility (OR = 34.2000, 95% CI = 14.57-80.26, p-value < .001). In conclusion, our findings underscored a strong association between 4,977-bp mtDNA deletion and asthenozoospermia in the Jordanian population.
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Affiliation(s)
- Mazhar S Al Zoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Khalid Al-Batayneh
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | - Mohammad Alsmadi
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | | | - Bahaa Al-Trad
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | - Wesam Al Khateeb
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | - Alaa Aljabali
- Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Osama Otoum
- Department of Biological Sciences, Faculty of Science, Yarmouk University, Irbid, Jordan
| | - Mohammad Al-Talib
- Department of Statistics, Faculty of Sciences, Yarmouk University, Irbid, Jordan
| | - Osamah Batiha
- Department of Applied Biological Sciences, Faculty of Science and Arts, Jordan University of Science and Technology, Irbid, Jordan
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25
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Douglas C, Parekh N, Kahn LG, Henkel R, Agarwal A. A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men. World J Mens Health 2019; 39:172-185. [PMID: 31749341 PMCID: PMC7994658 DOI: 10.5534/wjmh.190088] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 12/13/2022] Open
Abstract
Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP's potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.
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Affiliation(s)
- Christopher Douglas
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Neel Parekh
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Linda G Kahn
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Pediatrics, New York University School of Medicine, New York City, NY, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.
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26
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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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27
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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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28
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Samuel R, Feng H, Jafek A, Despain D, Jenkins T, Gale B. Microfluidic-based sperm sorting & analysis for treatment of male infertility. Transl Androl Urol 2018; 7:S336-S347. [PMID: 30159240 PMCID: PMC6087839 DOI: 10.21037/tau.2018.05.08] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Accepted: 05/07/2018] [Indexed: 11/06/2022] Open
Abstract
Microfluidics technology has emerged as an enabling technology for different fields of medicine and life sciences. One such field is male infertility where microfluidic technologies are enabling optimization of sperm sample preparation and analysis. In this chapter we review how microfluidic technology has been used for sperm quantification, sperm quality analysis, and sperm manipulation and isolation with subsequent use of the purified sperm population for treatment of male infertility. As we discuss demonstrations of microfluidic sperm sorting/manipulation/analysis, we highlight systems that have demonstrated feasibility towards clinical adoption or have reached commercialization in the male infertility market. We then review microfluidic-based systems that facilitate non-invasive identification and sorting of viable sperm for in vitro fertilization. Finally, we explore commercialization challenges associated with microfluidic sperm sorting systems and provide suggestions and future directions to best overcome them.
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Affiliation(s)
- Raheel Samuel
- Department of Surgery, School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Haidong Feng
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Alex Jafek
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - Dillon Despain
- Department of Mechanical Engineering, Brigham Young University, Provo, Utah, USA
| | - Timothy Jenkins
- Department of Surgery, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Bruce Gale
- Department of Mechanical Engineering, University of Utah, Salt Lake City, Utah, USA
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29
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Kuriya A, Agbo C, Dahan MH. Do pregnancy rates differ with intra-uterine insemination when different combinations of semen analysis parameters are abnormal? J Turk Ger Gynecol Assoc 2018; 19:57-64. [PMID: 29553043 PMCID: PMC5994814 DOI: 10.4274/jtgga.2017.0082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 03/16/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To evaluate the relationship of one or a combination of semen analysis parameter results on insemination outcomes. MATERIAL AND METHODS A retrospective analysis was performed to evaluate the effect on pregnancy rates in relation to one or more abnormal semen analysis parameters based on the 2010 World Health Organization semen analysis guidelines. RESULTS Nine hundred eighty-one couples underwent 2231 intrauterine insemination cycles at the Stanford Fertility and Reproductive Medicine Center. In our study, the pregnancy rates ranged from 11-25% when an individual or combined semen analysis parameters were analyzed. Similar pregnancy rates were found when one, two, and in most cases three parameters were abnormal. When a single parameter was abnormal among volume, concentration, and motility, pregnancy rates were mainly unaffected. There was the exception of total sperm count where pregnancy rates were diminished when counts were below 39 million (p=0.04). CONCLUSIONS Clearly, total sperm in the specimen and not the concentration of sperm per milliliter was the critical factor for predicting pregnancy. Therefore, a reorganization of semen analysis reports should be done emphasizing the total amount of sperm present and de-emphasizing concentration of sperm.
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Affiliation(s)
- Anita Kuriya
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, Canada
| | - Chioma Agbo
- Department of Emergency Medicine, Stanford University School of Medicine, California, USA
| | - Michael H Dahan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, Canada
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30
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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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31
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Agarwal A, Qiu E, Sharma R. Laboratory assessment of oxidative stress in semen. Arab J Urol 2017; 16:77-86. [PMID: 29713538 PMCID: PMC5922001 DOI: 10.1016/j.aju.2017.11.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/17/2017] [Accepted: 11/18/2017] [Indexed: 02/01/2023] Open
Abstract
Objectives To evaluate different laboratory assessments of oxidative stress (OS) in semen and identify a cost-efficient and highly sensitive instrument capable of providing a comprehensive measure of OS in a clinical setting, as early intervention and an accurate diagnostic test are important because they help maintain a balance of free radicals and antioxidants; otherwise, excessive OS could lead to sperm damage and result in male infertility. Materials and methods A systematic literature search was performed through a MedLine database search using the keywords ‘semen’ AND ‘oxygen reduction potential’. We also reviewed the references of retrieved articles to search for other potentially relevant research articles and additional book chapters discussing laboratory assessments for OS, ranging from 1994 to 2017. A total of 29 articles and book chapters involving OS-related laboratory assays were included. We excluded animal studies and articles written in languages other than English. Results Direct laboratory techniques include: chemiluminescence, nitro blue tetrazolium, cytochrome C reduction test, fluorescein probe, electron spin resonance and oxidation–reduction potential (ORP). Indirect laboratory techniques include: measurement of Endtz test, lipid peroxidation, chemokines, antioxidants/micronutrients/vitamins, ascorbate, total antioxidant capacity, or DNA damage. Each of these laboratory techniques has its advantages and disadvantages. Conclusion Traditional OS laboratory assessments have their limitations. Amongst the prevalent laboratory techniques, ORP is novel and better option as it can be easily used in a clinical setting to provide a comprehensive review of OS. However, more studies are needed to evaluate its reproducibility across various laboratory centres.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Emily Qiu
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
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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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Affiliation(s)
- Ralf Henkel
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
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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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Agarwal A, Arafa M, Chandrakumar R, Majzoub A, AlSaid S, Elbardisi H. A multicenter study to evaluate oxidative stress by oxidation-reduction potential, a reliable and reproducible method. Andrology 2017; 5:939-945. [DOI: 10.1111/andr.12395] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/06/2017] [Accepted: 06/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Agarwal
- American Center for Reproductive Medicine; Department of Urology; Cleveland Clinic; Cleveland OH USA
| | - M. Arafa
- Department of Andrology; Cairo University; Cairo Egypt
- Department of Urology; Hamad Medical Corporation; Doha Qatar
| | - R. Chandrakumar
- American Center for Reproductive Medicine; Department of Urology; Cleveland Clinic; Cleveland OH USA
| | - A. Majzoub
- Department of Urology; Hamad Medical Corporation; Doha Qatar
| | - S. AlSaid
- Department of Urology; Hamad Medical Corporation; Doha Qatar
| | - H. Elbardisi
- Department of Urology; Hamad Medical Corporation; Doha Qatar
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36
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Clinical Relevance of Oxidation-Reduction Potential in the Evaluation of Male Infertility. Urology 2017; 104:84-89. [DOI: 10.1016/j.urology.2017.02.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 12/29/2016] [Accepted: 02/09/2017] [Indexed: 12/25/2022]
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37
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Bieniek JM, Drabovich AP, Lo KC. Seminal biomarkers for the evaluation of male infertility. Asian J Androl 2017; 18:426-33. [PMID: 26975492 PMCID: PMC4854096 DOI: 10.4103/1008-682x.175781] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
For men struggling to conceive with their partners, diagnostic tools are limited and often consist of only a standard semen analysis. This baseline test serves as a crude estimation of male fertility, leaving patients and clinicians in need of additional diagnostic biomarkers. Seminal fluid contains the highest concentration of molecules from the male reproductive glands, therefore, this review focuses on current and novel seminal biomarkers in certain male infertility scenarios, including natural fertility, differentiating azoospermia etiologies, and predicting assisted reproductive technique success. Currently available tests include antisperm antibody assays, DNA fragmentation index, sperm fluorescence in situ hybridization, and other historical sperm functional tests. The poor diagnostic ability of current assays has led to continued efforts to find more predictive biomarkers. Emerging research in the fields of genomics, epigenetics, proteomics, transcriptomics, and metabolomics holds promise for the development of novel male infertility biomarkers. Seminal protein-based assays of TEX101, ECM1, and ACRV1 are already available or under final development for clinical use. Additional panels of DNA, RNA, proteins, or metabolites are being explored as we attempt to understand the pathophysiologic processes of male infertility. Future ventures will need to continue data integration and validation for the development of clinically useful infertility biomarkers to aid in male infertility diagnosis, treatment, and counseling.
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Alzoubi A, Mahdi H, Al Bashir S, Halalsheh O, Al Ebbini M, Alzarir M, Al-Ahmar K, Alfaqih M, Al-Hadidi AH. NORMALIZATION OF SERUM VITAMIN D IMPROVES SEMEN MOTILITY PARAMETERS IN PATIENTS WITH IDIOPATHIC MALE INFERTILITY. ACTA ENDOCRINOLOGICA-BUCHAREST 2017; 13:180-187. [PMID: 31149171 DOI: 10.4183/aeb.2017.180] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Context Idiopathic male infertility is evident in half of infertile males. Vitamin D receptors are expressed throughout male reproductive tract, including spermatozoa, promoting motility. Epidemiological studies revealed the positive association between serum vitamin D and semen quality. However, there are no clinical studies examining the differential role of vitamin D in idiopathic male infertility. Objectives 1) To investigate the association between vitamin D deficiency and idiopathic male infertility, and 2) To determine whether vitamin D deficient males would show restoration of semen quality parameters upon supplementation with vitamin D. Design This was a year-long case-control study from November 2015 to November 2016. A therapeutic intervention cohort for 2 months was also performed. Subjects and Methods 117 Jordanian males were enrolled. Following a clinical evaluation by a urologist, baseline serum vitamin D and semen fluid analyses were collected. Participants were stratified into 3 groups: controls (n=30), idiopathic infertility (n=67), and secondary infertility (n=20). Idiopathic infertility patients with low vitamin D (n= 45) were supplemented with oral vitamin D, 5000 IU, once daily for two months. Thereafter, serum vitamin D and semen fluid analyses were reassessed (n= 34; 11 patients were lost to follow up). Results Vitamin D was significantly lower in patients with idiopathic infertility than in both controls and men with secondary infertility. Significant improvement of progressive and total sperm motility was observed after vitamin D treatment. Vitamin D correlated significantly with semen quality in the study population. However, no correlation was found between vitamin D and any of the semen quality parameters in the idiopathic infertility group. Conclusions Vitamin D supplementation improves sperm motility in idiopathic male infertility patients with low vitamin D. Larger and longer clinical trials are warranted to validate the use of vitamin D in these cases.
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Affiliation(s)
- A Alzoubi
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - H Mahdi
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - S Al Bashir
- Jordan University of Science and Technology, College of Medicine, Departments of Pathology, Irbid, Jordan
| | - O Halalsheh
- Jordan University of Science and Technology, College of Medicine, Departments of Urology, Irbid, Jordan
| | - M Al Ebbini
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - M Alzarir
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - K Al-Ahmar
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
| | - M Alfaqih
- Jordan University of Science and Technology, College of Medicine, Departments of Biochemistry, Irbid, Jordan
| | - A H Al-Hadidi
- Jordan University of Science and Technology, College of Medicine, Departments of Pharmacology, Irbid, Jordan
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Decline in semen quality among 30,636 young Chinese men from 2001 to 2015. Fertil Steril 2016; 107:83-88.e2. [PMID: 27793371 DOI: 10.1016/j.fertnstert.2016.09.035] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/16/2016] [Accepted: 09/16/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To provide information of semen quality among young Chinese men in the past 15 years. DESIGN Retrospective cross-sectional study. SETTING Sperm bank. PATIENT(S) A total of 30,636 young adult men who applied to be sperm donors at the Hunan Province Human Sperm Bank of China in 2001-2015 were included in the study. INTERVENTION(S) Physical examination and analysis of blood and semen samples. MAIN OUTCOME MEASURE(S) Semen parameters, such as semen volume, sperm concentration, total sperm count, progressively motile sperm count, sperm progressive motility, sperm morphology, and round cells. RESULT(S) Many of the semen parameters showed a decreasing trend over the 15-year observation period. The sperm concentration and percentage of sperm with normal morphology decreased from 68 × 106/mL to 47 × 106/mL and from 31.8% to 10.8%, respectively. Although sperm progressive motility showed irregular variation, the progressively motile sperm count decreased from 34 × 106 to 21 × 106 over the 15-year period. Furthermore, the rate of qualified donors fell from 55.78% in 2001 to 17.80% in 2015, and the rate for 2015 was approximately threefold lower than the corresponding rates in 2001. CONCLUSION(S) The semen quality among young Chinese men has declined over a period of 15 years, especially in terms of sperm concentration, total sperm count, sperm progressive motility, and normal morphology.
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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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41
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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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Sharma R, Harlev A, Agarwal A, Esteves SC. 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; 70:635-645. [PMID: 27113031 DOI: 10.1016/j.eururo.2016.04.010] [Citation(s) in RCA: 273] [Impact Index Per Article: 34.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/06/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Approximately 37% of men of reproductive age smoke cigarettes, with Europe having the highest tobacco use among all the World Health Organization (WHO) regions. Toxins from tobacco smoking can potentially affect sperm development and function, with a negative effect on semen parameters. Given the high prevalence of smoking and recent changes in the WHO laboratory methods for the examination of human semen, the role of this exposure in face of new WHO methods needs to be clarified. EVIDENCE ACQUISITION We conducted a systematic review, followed by a meta-analysis, to determine whether cigarette smoking affects human semen parameters. PubMed, Saint Joseph's University Discover, and Google Scholar were used to identify relevant studies published after release of the latest WHO methods for laboratory evaluation of human semen. Participants were from fertility/urologic clinics and andrology laboratories. The outcome measures were semen volume, sperm concentration, motility, and morphology, the parameters usually used in clinical settings to assess fertility. EVIDENCE SYNTHESIS Twenty studies with 5865 participants were included in the meta-analysis. Exposure to cigarette smoking was associated with reduced sperm count (mean difference [MD]: -9.72×106/ml; 95% confidence interval [CI], -13.32 to -6.12), motility (MD: -3.48%; 95% CI, -5.53 to -1.44), and morphology (MD: -1.37%; 95% CI, -2.63 to -0.11). Subgroup analyses indicated that effect size was higher in infertile men than in the general population and in moderate/heavy smokers than in mild smokers. The overall effect size on semen volume, sperm count, and motility remained similar when 2010 and earlier WHO manuals were used for semen analysis but was lower with regard to sperm morphology. CONCLUSIONS Our results suggest that cigarette smoking has an overall negative effect on semen parameters. The latest WHO laboratory methods for the examination of human semen had a minimal impact on the magnitude of effect size, thus confirming the observed negative effect of smoking on conventional semen parameters. PATIENT SUMMARY A new systematic review and meta-analysis comprising 5865 men shows that cigarette smoking is associated with reduced sperm count and motility. Deterioration of semen quality is more pronounced in moderate and heavy smokers.
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Affiliation(s)
- 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; American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Sandro C Esteves
- ANDROFERT, Andrology and Human Reproduction Clinic, Referral Center for Male Reproduction, Campinas, SP, Brazil
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43
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Lewis SEM, Kumar K. The paternal genome and the health of the assisted reproductive technology child. Asian J Androl 2016; 17:616-22. [PMID: 25926606 PMCID: PMC4492053 DOI: 10.4103/1008-682x.153301] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
As a number of children born by assisted reproductive technology (ART) are increasing each year across the developed world, the health of such offspring is a matter of public concern. Does the integrity of the paternal genome impact on offspring health? In societal terms, as birth rates fall, and the Western population become unsustainable, do the benefits outweigh the costs of creating and providing for this ART conceived subpopulation? There are little data to date to answer these questions. The long-term health of such children has largely been ignored, and success measured only by early (prebirth) outcomes such as embryo quality or pregnancy. However, there are powerful paradigms such as ageing and smoking that give vital clues as to the potential impact of unhealthy spermatozoa on disease risk, mental and physical health, fertility and mortality of these offspring.
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Affiliation(s)
- Sheena E M Lewis
- Centre for Public Health, Queen's University Belfast, Grosvenor Road, BT12 6BJ,NI, UK
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Centola GM, Blanchard A, Demick J, Li S, Eisenberg ML. Decline in sperm count and motility in young adult men from 2003 to 2013: observations from a U.S. sperm bank. Andrology 2016; 4:270-6. [DOI: 10.1111/andr.12149] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/16/2015] [Accepted: 11/18/2015] [Indexed: 12/22/2022]
Affiliation(s)
- G. M. Centola
- New England Cryogenic Center; Brookline and Marlborough MA USA
| | - A. Blanchard
- New England Cryogenic Center; Brookline and Marlborough MA USA
| | - J. Demick
- New England Cryogenic Center; Brookline and Marlborough MA USA
| | - S. Li
- Department of Urology; Stanford University School of Medicine; Palo Alto CA USA
| | - M. L. Eisenberg
- Department of Urology; Stanford University School of Medicine; Palo Alto CA USA
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45
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Kim SK, Kim YS, Cho IC, Min SK. Semen parameters from 2002 to 2013 in Korea young population: A preliminary report. Korean J Urol 2015; 56:831-6. [PMID: 26682024 PMCID: PMC4681761 DOI: 10.4111/kju.2015.56.12.831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 11/05/2015] [Indexed: 11/26/2022] Open
Abstract
Purpose To analyze the differences of semen parameters in Korean young population for three periods from 2002 to 2013. Materials and Methods A total of 516 semen samples were collected from Korean men presenting for infertility, varicoceles or other infectious problems for three periods from 2002 to 2012: January 2002-December 2003, January 2007-December 2008, and January 2012-December 2013. A standard World Health Organization procedure for semen analysis was performed for assessment of semen concentration, volume, motility, morphology, and pH. Results A total of 160, 162, 194 men constituted the study populations in 2002 to 2003, in 2007 to 2008, and in 2012 to 2013, respectively. The overall sperm parameter results suggested a statistically significant difference between 2002 to 2003 and 2012 to 2013 except pH. However, considering the data from 2007 to 2008, there were no trends in changes in overall semen parameters. Negative correlations were observed in all semen parameters with increasing age in all patients, except for pH. In addition, semen volume, motility, and morphology had higher negative correlation coefficients with age, from 2002 to 2013, serially. Conclusions There were no significant changes in the semen parameters of Korean men from 2002 to 2013. In addition, semen volume, motility, and morphology showed higher negative correlation coefficients with age from 2002 to 2013, serially.
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Affiliation(s)
- Soon Ki Kim
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Yoo Seok Kim
- Department of Urology, National Police Hospital, Seoul, Korea
| | - In-Chang Cho
- Department of Urology, National Police Hospital, Seoul, Korea
| | - Seung Ki Min
- Department of Urology, National Police Hospital, Seoul, Korea
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46
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La Rocca C, Tait S, Guerranti C, Busani L, Ciardo F, Bergamasco B, Perra G, Mancini FR, Marci R, Bordi G, Caserta D, Focardi S, Moscarini M, Mantovani A. Exposure to Endocrine Disruptors and Nuclear Receptors Gene Expression in Infertile and Fertile Men from Italian Areas with Different Environmental Features. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:12426-45. [PMID: 26445054 PMCID: PMC4626977 DOI: 10.3390/ijerph121012426] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 09/23/2015] [Accepted: 09/28/2015] [Indexed: 12/12/2022]
Abstract
Internal levels of selected endocrine disruptors (EDs) (i.e., perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), di-2-ethylhexyl-phthalate (DEHP), mono-(2-ethylhexyl)-phthalate (MEHP), and bisphenol A (BPA)) were analyzed in blood/serum of infertile and fertile men from metropolitan, urban and rural Italian areas. PFOS and PFOA levels were also evaluated in seminal plasma. In peripheral blood mononuclear cells (PBMCs) of same subjects, gene expression levels of a panel of nuclear receptors (NRs), namely estrogen receptor α (ERα) estrogen receptor β (ERβ), androgen receptor (AR), aryl hydrocarbon receptor (AhR), peroxisome proliferator-activated receptor γ (PPARγ) and pregnane X receptor (PXR) were also assessed. Infertile men from the metropolitan area had significantly higher levels of BPA and gene expression of all NRs, except PPARγ, compared to subjects from other areas. Subjects from urban areas had significantly higher levels of MEHP, whereas subjects from rural area had higher levels of PFOA in both blood and seminal plasma. Interestingly, ERα, ERβ, AR, PXR and AhR expression is directly correlated with BPA and inversely correlated with PFOA serum levels. Our study indicates the relevance of the living environment when investigating the exposure to specific EDs. Moreover, the NRs panel in PBMCs demonstrated to be a potential biomarker of effect to assess the EDs impact on reproductive health.
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Affiliation(s)
- Cinzia La Rocca
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Roma 00161, Italy.
| | - Sabrina Tait
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Roma 00161, Italy.
| | - Cristiana Guerranti
- Department of Physical, Earth and Environmental Sciences, University of Siena, Siena 53100, Italy.
- Bioscience Research Center, Orbetello (GR) 58015, Italy.
| | - Luca Busani
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Roma 00161, Italy.
| | - Francesca Ciardo
- Department of Obstetric and Gynecological Sciences and Urological Sciences, University of Roma Sapienza, S. Andrea Hospital, Roma 00189, Italy.
| | - Bruno Bergamasco
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Roma 00161, Italy.
| | - Guido Perra
- Department of Physical, Earth and Environmental Sciences, University of Siena, Siena 53100, Italy.
| | - Francesca Romana Mancini
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Roma 00161, Italy.
| | - Roberto Marci
- Department of Biomedical Sciences and Advanced Therapies, Section of Obstetrics and Gynaecology, University of Ferrara, Ferrara 44124, Italy.
| | - Giulia Bordi
- Department of Obstetric and Gynecological Sciences and Urological Sciences, University of Roma Sapienza, S. Andrea Hospital, Roma 00189, Italy.
| | - Donatella Caserta
- Department of Obstetric and Gynecological Sciences and Urological Sciences, University of Roma Sapienza, S. Andrea Hospital, Roma 00189, Italy.
| | - Silvano Focardi
- Department of Physical, Earth and Environmental Sciences, University of Siena, Siena 53100, Italy.
| | - Massimo Moscarini
- Department of Obstetric and Gynecological Sciences and Urological Sciences, University of Roma Sapienza, S. Andrea Hospital, Roma 00189, Italy.
| | - Alberto Mantovani
- Department of Food Safety and Veterinary Public Health, Istituto Superiore di Sanità, Roma 00161, Italy.
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Caglar Aytac P, Kilicdag EB, Haydardedeoglu B, Simsek E, Cok T, Parlakgumus HA. Can calcium ionophore "use" in patients with diminished ovarian reserve increase fertilization and pregnancy rates? A randomized, controlled study. Fertil Steril 2015; 104:1168-74. [PMID: 26342247 DOI: 10.1016/j.fertnstert.2015.07.1163] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 07/09/2015] [Accepted: 07/27/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine whether calcium ionophore solution can improve the fertilization rate in patients with diminished ovarian reserve whose partners have normal sperm parameters. DESIGN Between January 2014 and August 2014, patients with diminished ovarian reserve were randomized to make artificial oocyte activation with calcium ionophore solution. SETTING University hospital. PATIENT(S) A total of 296 patients who had diminished ovarian reserve and partners with normal sperm parameters were included in the study. INTERVENTION(S) Metaphase 2 oocytes were treated with calcium ionophore solution (GM508 Cult-Active) for 15 minutes just after intracytoplasmic sperm injection. MAIN OUTCOME MEASURE(S) Fertilization rate, implantation rate, clinical pregnancy rate, ongoing pregnancy rate. RESULT(S) Fertilization, implantation, pregnancy, and ongoing pregnancy rates for the calcium ionophore and control groups were 60.7% and 55.4%, 12.8% and 10.7%, 21% and 12.8%, and 10.9% and 6.1%, respectively. CONCLUSION(S) This is the first prospective, randomized, controlled study to analyze the effect of calcium ionophore solution on fertilization rate in patients with diminished ovarian reserve. We did not observe any differences in fertilization, clinical pregnancy, or ongoing pregnancy rates between the groups. We propose that fertilization ratios could not be increased by artificial oocyte activation via application of calcium ionophore solution in patients with diminished ovarian reserve. CLINICAL TRIAL REGISTRATION NUMBER NCT02045914.
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Affiliation(s)
- Pinar Caglar Aytac
- Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Adana, Turkey.
| | - Esra Bulgan Kilicdag
- Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Bulent Haydardedeoglu
- Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Erhan Simsek
- Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Tayfun Cok
- Division of Reproductive Endocrinology and IVF Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Adana, Turkey
| | - Huriye Ayse Parlakgumus
- Division of Perinatology, Department of Obstetrics and Gynecology, Faculty of Medicine, Baskent University, Adana, Turkey
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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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Lee YJ, Cho SY, Paick JS, Kim SW. Usefulness of 2010 world health organization reference values for determining indications for varicocelectomy. Urology 2015; 85:831-5. [PMID: 25817106 DOI: 10.1016/j.urology.2015.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 12/10/2014] [Accepted: 01/13/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To investigate the impact of 2010 World Health Organization (WHO) reference values in patients who underwent microsurgical varicocelectomy. METHODS This retrospective cohort study included 206 men who underwent microsurgical varicocelectomy for a clinical varicocele with at least 1 abnormal semen parameter according to the 1999 WHO criteria. The preoperative semen analysis findings were reclassified according to the 2010 WHO criteria, and an improved seminal result after varicocelectomy was defined as a ≥20% increase in sperm count or motility. RESULTS Semen results of 114 men (55.3%) were reclassified as being above the reference values according to the 2010 WHO criteria. Among those with below reference values, 79.3% and 34.8% showed improved sperm counts and motility, respectively. However, in patients whose semen results converted to normal, 47.4% and 20.2% showed improved sperm counts and motility, respectively. Among those whose semen results were normal on the 2010 criteria, 58.8% showed improved sperm count or motility after microsurgical varicocelectomy. CONCLUSION More than half of the patients whose semen results converted to normal on the 2010 WHO criteria showed improved seminal results after microsurgical varicocelectomy. It is necessary to reconsider the 2010 WHO criteria when determining the surgical indication for microsurgical varicocelectomy.
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Affiliation(s)
- Young Ju Lee
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Sung Yong Cho
- Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Jae-Seung Paick
- Department of Urology, Seoul National University Hospital, Seoul, Korea
| | - Soo Woong Kim
- Department of Urology, Seoul National University Hospital, Seoul, Korea.
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50
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Nangia AK. Semen analysis parameters: stay calm, they are just numbers! Fertil Steril 2014; 103:39-40. [PMID: 25466991 DOI: 10.1016/j.fertnstert.2014.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 10/31/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Ajay K Nangia
- Department of Urology, University of Kansas Medical Center, Kansas City, Kansas
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