1
|
Bar-Chama N, Rabinovitch L, Honig S. Amateur vs Professional Users of the YO Home Sperm Test: An Assessment of Usability. Urology 2024; 190:162-169. [PMID: 38705243 DOI: 10.1016/j.urology.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE To assess the accuracy of the YO home sperm test by real-world/amateur users. METHODS This multisite study investigated whether amateur users could use the FDA-cleared YO Home Sperm Test to obtain accurate motile sperm concentration (MSC) results when compared to trained laboratory technicians. The qualitative MSC results of amateur and professional YO users were compared to each other as well as to the results of an established automated sperm quality analyzer (SQA-V) above and below a 6 m/mL MSC cut-off. RESULTS This was a blinded, prospective study of 316 amateur users and 3 professional laboratory technicians across 3 study sites. Amateur vs Professional YO users demonstrated an accuracy of >97%. Qualitative results of amateurs and professionals vs SQA-V results showed a >95.7% accuracy. CONCLUSION Amateur users with no prior training were able to follow the YO test directions to receive highly accurate qualitative motile sperm concentration (MSC) results. The YO test is user-friendly and can be used as an effective initial home screening tool to gain preliminary insight into the fertility status of the male in a real-world setting. Furthermore, the YO test results correlated with those obtained by the FDA-cleared SQA-V laboratory analyzer, confirming that the YO test delivers accurate MSC results in the hands of amateur users.
Collapse
Affiliation(s)
- Natan Bar-Chama
- Reproductive Medicine Associates of New York, New York, NY; Department of Urology, The Mount Sinai Hospital, New York, NY.
| | | | - Stanton Honig
- Yale School of Medicine, Department of Urology, Yale University, New Haven, CT
| |
Collapse
|
2
|
Wang C, Barratt CLR, Blithe DL. Contraceptive efficacy: Determining the threshold for effective suppression based on sperm concentration, motility, and morphology. Andrology 2024. [PMID: 39031534 DOI: 10.1111/andr.13701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/01/2024] [Accepted: 07/03/2024] [Indexed: 07/22/2024]
Abstract
INTRODCTION Human spermatogenesis is a complex process that transforms spermatogonial stem cells through mitosis and meiosis to spermatozoa. Testosterone is the key regulator of the terminal stages of meiosis, adherence of spermatids to Sertoli cells, and spermiation. Follicle-stimulating hormone (FSH) may be required for early spermatogenesis and is important for maintaining normal spermatogenesis in men. Hormonal contraception suppresses FSH, luteinizing hormone, and intratesticular testosterone concentration, resulting in marked suppression of sperm output. RESULTS Clinical trials using testosterone alone or testosterone plus progestin demonstrate that sustained suppression of sperm concentration to ≤1 million/mL is sufficient to prevent pregnancy in the female partner. New agents that target spermatogenesis could use this as a target for contraceptive efficacy while others that block sperm function or transport may require a lower threshold. When sperm concentrations are suppressed to such low levels, measurement of sperm motility and morphology is technically difficult and unnecessary. With current data from fertile and infertile men, it is not possible to establish a lower limit of sperm motility or percent normal morphology that equates to the prevention of conception. New compounds that decrease sperm motility or alter sperm morphology may need to demonstrate a complete absence of sperm motility or altered morphology in all spermatozoa in the ejaculate. Sperm function tests may be useful depending on the mechanism of action of each new compound. CONCLUSION Monitoring of sperm surrogate markers to ensure effective contraception relies on laboratories experienced in semen analyses. The development of at-home tests to assess sperm parameters has progressed rapidly. Some tests have been assessed in clinical trials and approved by regulatory agencies for at-home use for fertility assessment. However, caution must be exercised in using these tests as many have not been rigorously validated against semen parameters measured in laboratories by trained technologists using standardized tests defined in the World Health Organization Semen Manual.
Collapse
Affiliation(s)
- Christina Wang
- Clinical and Translational Science Institute, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, California, USA
| | - Christopher L R Barratt
- Division of Systems and Cellular Medicine, Medical School, Ninewells Hospital, University of Dundee, Dundee, Scotland
| | - Diana L Blithe
- Contraceptive Development Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| |
Collapse
|
3
|
Sutovsky P, Hamilton LE, Zigo M, Ortiz D’Avila Assumpção ME, Jones A, Tirpak F, Agca Y, Kerns K, Sutovsky M. Biomarker-based human and animal sperm phenotyping: the good, the bad and the ugly†. Biol Reprod 2024; 110:1135-1156. [PMID: 38640912 PMCID: PMC11180624 DOI: 10.1093/biolre/ioae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/28/2024] [Accepted: 04/17/2024] [Indexed: 04/21/2024] Open
Abstract
Conventional, brightfield-microscopic semen analysis provides important baseline information about sperm quality of an individual; however, it falls short of identifying subtle subcellular and molecular defects in cohorts of "bad," defective human and animal spermatozoa with seemingly normal phenotypes. To bridge this gap, it is desirable to increase the precision of andrological evaluation in humans and livestock animals by pursuing advanced biomarker-based imaging methods. This review, spiced up with occasional classic movie references but seriously scholastic at the same time, focuses mainly on the biomarkers of altered male germ cell proteostasis resulting in post-testicular carryovers of proteins associated with ubiquitin-proteasome system. Also addressed are sperm redox homeostasis, epididymal sperm maturation, sperm-seminal plasma interactions, and sperm surface glycosylation. Zinc ion homeostasis-associated biomarkers and sperm-borne components, including the elements of neurodegenerative pathways such as Huntington and Alzheimer disease, are discussed. Such spectrum of biomarkers, imaged by highly specific vital fluorescent molecular probes, lectins, and antibodies, reveals both obvious and subtle defects of sperm chromatin, deoxyribonucleic acid, and accessory structures of the sperm head and tail. Introduction of next-generation image-based flow cytometry into research and clinical andrology will soon enable the incorporation of machine and deep learning algorithms with the end point of developing simple, label-free methods for clinical diagnostics and high-throughput phenotyping of spermatozoa in humans and economically important livestock animals.
Collapse
Affiliation(s)
- Peter Sutovsky
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
- Department of Obstetrics, Gynecology and Women’s Health, University of Missouri, Columbia MO, USA
| | - Lauren E Hamilton
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
| | - Michal Zigo
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
| | - Mayra E Ortiz D’Avila Assumpção
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
- Department of Animal Reproduction, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil
| | - Alexis Jones
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
| | - Filip Tirpak
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
| | - Yuksel Agca
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Karl Kerns
- Department of Animal Science, Iowa State University, Ames, IA, USA
| | - Miriam Sutovsky
- Division of Animal Sciences, University of Missouri, Columbia MO, USA
| |
Collapse
|
4
|
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.
Collapse
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.)
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Ghayda RA, Cannarella R, Calogero AE, Shah R, Rambhatla A, Zohdy W, Kavoussi P, Avidor-Reiss T, Boitrelle F, Mostafa T, Saleh R, Toprak T, Birowo P, Salvio G, Calik G, Kuroda S, Kaiyal RS, Ziouziou I, Crafa A, Phuoc NHV, Russo GI, Durairajanayagam D, Al-Hashimi M, Hamoda TAAAM, Pinggera GM, Adriansjah R, Maldonado Rosas I, Arafa M, Chung E, Atmoko W, Rocco L, Lin H, Huyghe E, Kothari P, Solorzano Vazquez JF, Dimitriadis F, Garrido N, Homa S, Falcone M, Sabbaghian M, Kandil H, Ko E, Martinez M, Nguyen Q, Harraz AM, Serefoglu EC, Karthikeyan VS, Tien DMB, Jindal S, Micic S, Bellavia M, Alali H, Gherabi N, Lewis S, Park HJ, Simopoulou M, Sallam H, Ramirez L, Colpi G, Agarwal A. Artificial Intelligence in Andrology: From Semen Analysis to Image Diagnostics. World J Mens Health 2024; 42:39-61. [PMID: 37382282 PMCID: PMC10782130 DOI: 10.5534/wjmh.230050] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 06/30/2023] Open
Abstract
Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine.
Collapse
Affiliation(s)
- Ramy Abou Ghayda
- Urology Institute, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Aldo E. Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
| | - Amarnath Rambhatla
- Department of Urology, Henry Ford Health System, Vattikuti Urology Institute, Detroit, MI, USA
| | - Wael Zohdy
- Andrology and STDs, Cairo University, Cairo, Egypt
| | - Parviz Kavoussi
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Tomer Avidor-Reiss
- Department of Biological Sciences, University of Toledo, Toledo, OH, USA
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Florence Boitrelle
- Reproductive Biology, Fertility Preservation, Andrology, CECOS, Poissy Hospital, Poissy, France
- Department of Biology, Reproduction, Epigenetics, Environment, and Development, Paris Saclay University, UVSQ, INRAE, BREED, Paris, France
| | - Taymour Mostafa
- Andrology, Sexology & STIs Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Ramadan Saleh
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Tuncay Toprak
- Department of Urology, Fatih Sultan Mehmet Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Ponco Birowo
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Gianmaria Salvio
- Department of Endocrinology, Polytechnic University of Marche, Ancona, Italy
| | - Gokhan Calik
- Department of Urology, Istanbul Medipol University, Istanbul, Turkey
| | - Shinnosuke Kuroda
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Japan
| | - Raneen Sawaid Kaiyal
- Glickman Urological & Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Imad Ziouziou
- Department of Urology, College of Medicine and Pharmacy, Ibn Zohr University, Agadir, Morocco
| | - Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Nguyen Ho Vinh Phuoc
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
- Department of Urology and Andrology, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | | | - Damayanthi Durairajanayagam
- Department of Physiology, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia
| | - Manaf Al-Hashimi
- Department of Urology, Burjeel Hospital, Abu Dhabi, United Arab Emirates (UAE)
- Khalifa University, College of Medicine and Health Science, Abu Dhabi, United Arab Emirates (UAE)
| | - Taha Abo-Almagd Abdel-Meguid Hamoda
- Department of Urology, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Urology, Faculty of Medicine, Minia University, El-Minia, Egypt
| | | | - Ricky Adriansjah
- Department of Urology, Hasan Sadikin General Hospital, Universitas Padjadjaran, Banding, Indonesia
| | | | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medical-Qatar, Doha, Qatar
| | - Eric Chung
- Department of Urology, Princess Alexandra Hospital, University of Queensland, Brisbane QLD, Australia
| | - Widi Atmoko
- Department of Urology, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Lucia Rocco
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania “Luigi Vanvitelli”, Caserta, Italy
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Peking University, Beijing, China
| | - Eric Huyghe
- Department of Urology and Andrology, University Hospital of Toulouse, Toulouse, France
| | - Priyank Kothari
- Department of Urology, B.Y.L. Nair Charitable Hospital, Topiwala National Medical College, Mumbai, India
| | | | - Fotios Dimitriadis
- Department of Urology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nicolas Garrido
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), Valencia, Spain
| | - Sheryl Homa
- Department of Biosciences, University of Kent, Canterbury, United Kingdom
| | - Marco Falcone
- Department of Urology, Molinette Hospital, A.O.U. Città della Salute e della Scienza, University of Turin, Torino, Italy
| | - Marjan Sabbaghian
- Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | | | - Edmund Ko
- Department of Urology, Loma Linda University Health, Loma Linda, CA, USA
| | - Marlon Martinez
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
| | - Quang Nguyen
- Section of Urology, Department of Surgery, University of Santo Tomas Hospital, Manila, Philippines
- Center for Andrology and Sexual Medicine, Viet Duc University Hospital, Hanoi, Vietnam
- Department of Urology, Andrology and Sexual Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Ahmed M. Harraz
- Urology and Nephrology Center, Mansoura University, Mansoura, Egypt
- Department of Surgery, Urology Unit, Farwaniya Hospital, Farwaniya, Kuwait
- Department of Urology, Sabah Al Ahmad Urology Center, Kuwait City, Kuwait
| | - Ege Can Serefoglu
- Department of Urology, Biruni University School of Medicine, Istanbul, Turkey
| | | | - Dung Mai Ba Tien
- Department of Andrology, Binh Dan Hospital, Ho Chi Minh City, Vietnam
| | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Sava Micic
- Department of Andrology, Uromedica Polyclinic, Belgrade, Serbia
| | - Marina Bellavia
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | - Hamed Alali
- King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Nazim Gherabi
- Andrology Committee of the Algerian Association of Urology, Algiers, Algeria
| | - Sheena Lewis
- Examen Lab Ltd., Northern Ireland, United Kingdom
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
- Medical Research Institute of Pusan National University Hospital, Busan, Korea
| | - Mara Simopoulou
- Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Hassan Sallam
- Alexandria University Faculty of Medicine, Alexandria, Egypt
| | - Liliana Ramirez
- IVF Laboratory, CITMER Reproductive Medicine, Mexico City, Mexico
| | - Giovanni Colpi
- Andrology and IVF Center, Next Fertility Procrea, Lugano, Switzerland
| | - Ashok Agarwal
- Global Andrology Forum, Moreland Hills, OH, USA
- Cleveland Clinic, Cleveland, OH, USA
| | | |
Collapse
|
6
|
Si K, Huang B, Jin L. Application of artificial intelligence in gametes and embryos selection. HUM FERTIL 2023; 26:757-777. [PMID: 37705466 DOI: 10.1080/14647273.2023.2256980] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/22/2023] [Indexed: 09/15/2023]
Abstract
Gamete and embryo quality are critical to the success rate of Assisted Reproductive Technology (ART) cycles, but there remains a lack of methods to accurately measure the quality of sperm, oocytes and embryos. The ability of Artificial Intelligence (AI) technology to analyze large amounts of data, especially video and images, is particularly useful in gamete and embryo assessment and selection. The well-trained model has fast calculation speed and high accuracy, which can help embryologists to perform more objective gamete and embryo selection. Various artificial intelligence models have been developed for gamete and embryo assessment, some of which exhibit good performance. In this review, we summarize the latest applications of AI technology in semen analysis, as well as selection for sperm, oocyte and embryo, and discuss the existing problems and development directions of artificial intelligence in this field.
Collapse
Affiliation(s)
- Keyi Si
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Bo Huang
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| | - Lei Jin
- Reproductive Medicine Center, Tongji Hospital, Tongji Medicine College, Huazhong University of Science and Technology, Wuhan, People's Republic of China
| |
Collapse
|
7
|
Zhukov OB, Chernykh VB. Artificial intelligence in reproductive medicine. ANDROLOGY AND GENITAL SURGERY 2023. [DOI: 10.17650/2070-9781-2022-23-4-15-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- O. B. Zhukov
- Рeoples’ Friendship University of Russia (RUDN University); Association of Vascular Urologists and Reproductologists
| | - V. B. Chernykh
- Research Centre for Medical Genetics; N.I. Pirogov Russian National Research Medical University
| |
Collapse
|
8
|
Schardein JN, Fendereski K, Hotaling JM. Evolution of the basic semen analysis and processing sperm. Curr Opin Urol 2023; 33:16-23. [PMID: 36226727 DOI: 10.1097/mou.0000000000001054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The sixth edition of the World Health Organization (WHO) laboratory manual for the examination and processing of human semen was recently published with specific step-by-step instructions for semen evaluation and sperm processing. Point-of-care (POC) testing for semen evaluation and microfluidics for sperm processing are rapidly evolving technologies that could impact how we evaluate and process sperm. Understanding the updated manual in the context of these novel technologies is important. RECENT FINDINGS Proper standardization of semen evaluation and sperm processing will allow for consistent high-quality results among laboratories worldwide. POC testing could improve access to semen evaluations that generate referrals to male infertility specialists for further assessment. Microfluidics can select functional sperm with decreased DNA fragmentation in semen and testicular biopsy samples for assisted reproductive technology (ART). Clinical outcomes, such as pregnancy rates and live birth rates, have not been shown to be consistently improved with these technologies compared to conventional techniques, although high level evidence research in this area is limited. SUMMARY POC testing and microfluidics have the potential to be combined with machine learning technologies to improve fertility care. If these technologies are appropriately optimized, they could change how we evaluate and process sperm, and potentially lead to improved ART outcomes.
Collapse
Affiliation(s)
- Jessica N Schardein
- Department of Surgery, Division of Urology, University of Utah, Salt Lake City, Utah, USA
| | | | | |
Collapse
|
9
|
Medenica S, Zivanovic D, Batkoska L, Marinelli S, Basile G, Perino A, Cucinella G, Gullo G, Zaami S. The Future Is Coming: Artificial Intelligence in the Treatment of Infertility Could Improve Assisted Reproduction Outcomes-The Value of Regulatory Frameworks. Diagnostics (Basel) 2022; 12:diagnostics12122979. [PMID: 36552986 PMCID: PMC9777042 DOI: 10.3390/diagnostics12122979] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Infertility is a global health issue affecting women and men of reproductive age with increasing incidence worldwide, in part due to greater awareness and better diagnosis. Assisted reproduction technologies (ART) are considered the ultimate step in the treatment of infertility. Recently, artificial intelligence (AI) has been progressively used in the many fields of medicine, integrating knowledge and computer science through machine learning algorithms. AI has the potential to improve infertility diagnosis and ART outcomes estimated as pregnancy and/or live birth rate, especially with recurrent ART failure. A broad-ranging review has been conducted, focusing on clinical AI applications up until September 2022, which could be estimated in terms of possible applications, such as ultrasound monitoring of folliculogenesis, endometrial receptivity, embryo selection based on quality and viability, and prediction of post implantation embryo development, in order to eliminate potential contributing risk factors. Oocyte morphology assessment is highly relevant in terms of successful fertilization rate, as well as during oocyte freezing for fertility preservation, and substantially valuable in oocyte donation cycles. AI has great implications in the assessment of male infertility, with computerised semen analysis systems already in use and a broad spectrum of possible AI-based applications in environmental and lifestyle evaluation to predict semen quality. In addition, considerable progress has been made in terms of harnessing AI in cases of idiopathic infertility, to improve the stratification of infertile/fertile couples based on their biological and clinical signatures. With AI as a very powerful tool of the future, our review is meant to summarise current AI applications and investigations in contemporary reproduction medicine, mainly focusing on the nonsurgical aspects of it; in addition, the authors have briefly explored the frames of reference and guiding principles for the definition and implementation of legal, regulatory, and ethical standards for AI in healthcare.
Collapse
Affiliation(s)
- Sanja Medenica
- Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, School of Medicine, University of Montenegro, 81000 Podgorica, Montenegro
| | - Dusan Zivanovic
- Clinic of Endocrinology, Diabetes and Metabolic Disorders, University Clinical Center of Serbia, 11000 Belgrade, Serbia
| | - Ljubica Batkoska
- Medical Faculty, Ss. Cyril and Methodius University of Skopje, 1000 Skopje, North Macedonia
| | | | | | - Antonio Perino
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy
| | - Gaspare Cucinella
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy
| | - Giuseppe Gullo
- Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, IVF UNIT, University of Palermo, 90146 Palermo, Italy
- Correspondence:
| | - Simona Zaami
- Department of Anatomical, Histological, Forensic and Orthopedic Sciences, “Sapienza” University of Rome, 00161 Rome, Italy
| |
Collapse
|
10
|
Assessment of sperm motility in livestock: Perspectives based on sperm swimming conditions in vivo. Anim Reprod Sci 2022; 246:106849. [PMID: 34556397 DOI: 10.1016/j.anireprosci.2021.106849] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 12/14/2022]
Abstract
Evaluation of sperm motility is well-established in farm animals for quickly selecting ejaculates for semen processing into insemination doses and for evaluating the quality of preserved semen. Likewise, sperm motility is a fundamental parameter used by spermatologists in basic and applied science. Motility is commonly assessed using computer-assisted semen analysis (CASA). Recent increases in computational power, as well as utilization of mobile CASA systems and open-source CASA programs, broaden the possibilities for motility evaluation. Despite this technological progress, the potential of computer-generated motility data to assess male fertility remains challenging and may be limited. Relevance for fertility assessment could be improved if measurement conditions would more closely mimic the in vivo situation. Hence, this review is focused on the current trends of automated semen assessment in livestock and explores perspectives for future use with respect to the physiological and physical conditions encountered by sperm in the female reproductive tract. Validation of current CASA systems with more complex, microfluidic-based devices mimicking the female reproductive tract environment could improve the value of sperm kinematic data for assessing the fertilizing capacity of semen samples, not only for application in livestock but also for use in conducting assisted reproduction techniques in other species.
Collapse
|
11
|
Fedorovich AA, Gorshkov AY, Korolev AI, Drapkina OM. Smartphone in medicine — from a reference book to a diagnostic system. Overview of the current state of the issue. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The paper provides a brief overview of the modern possibilities of using a smartphone as a diagnostic device of a wide profile. In some cases, additional specialized attachments are required. In others, the diagnostic algorithm uses only standard cameras, a microphone and various built-in smartphone sensors. The development of the smartphone integration into the healthcare system is modern, relevant and very promising, given the widespread use of smartphones among the global population.
Collapse
Affiliation(s)
- A. A. Fedorovich
- National Medical Research Center for Therapy and Preventive Medicine;
Institute of Biomedical Problems
| | - A. Yu. Gorshkov
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. I. Korolev
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| |
Collapse
|
12
|
Jesse E, Thirumavalavan N, Loeb A. Increase in Direct-to-Consumer Telemedicine in Urology. CURRENT SEXUAL HEALTH REPORTS 2022; 14:119-127. [PMID: 35966236 PMCID: PMC9362147 DOI: 10.1007/s11930-022-00332-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2022] [Indexed: 11/29/2022]
Abstract
Purpose of Review Direct-to-consumer telemedicine has vastly expanded in recent years, and urologic conditions are a common target for these companies. We aim to identify the urologic conditions being treated by direct-to-consumer telemedicine platforms and review the feasibility of adherence to evidence-based practice guidelines via this relatively new healthcare model. Recent Findings Erectile dysfunction, premature ejaculation, testosterone deficiency, and male infertility are being treated with direct-to-consumer telemedicine. Such platforms treating erectile dysfunction perform modestly in practice guideline adherence. Guidelines-based treatment of other urologic conditions via telemedicine is feasible, however, the treatment of these conditions through popular direct-to-consumer telemedicine platforms is largely unstudied. Summary The impact of direct-to-consumer telemedicine on the field of urology is vast and likely to continue to grow. Future studies should inspect direct-to-consumer telemedicine companies’ practice patterns and treatment outcomes to ensure the field’s standards of care are being met. Guidelines specific to the treatment of various urologic conditions via telemedicine are needed.
Collapse
Affiliation(s)
- Erin Jesse
- Urology Institute, University Hospitals Cleveland Medical Center Case Western Reserve University, 11100 Euclid Avenue Lakeside Building Suite, Cleveland, OH 4954 USA
| | - Nannan Thirumavalavan
- Urology Institute, University Hospitals Cleveland Medical Center Case Western Reserve University, 11100 Euclid Avenue Lakeside Building Suite, Cleveland, OH 4954 USA
| | - Aram Loeb
- Urology Institute, University Hospitals Cleveland Medical Center Case Western Reserve University, 11100 Euclid Avenue Lakeside Building Suite, Cleveland, OH 4954 USA
| |
Collapse
|
13
|
Pan X, Gao K, Yang N, Wang Y, Zhang X, Shao L, Zhai P, Qin F, Zhang X, Li J, Wang X, Yang J. A Sperm Quality Detection System Based on Microfluidic Chip and Micro-Imaging System. Front Vet Sci 2022; 9:916861. [PMID: 35847648 PMCID: PMC9280428 DOI: 10.3389/fvets.2022.916861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Sperm quality assessment is the main method to predict the reproductive ability of livestock. The detection of sperm quality of livestock is of great significance to the application of artificial insemination and in vitro fertilization. In order to comprehensively evaluate sperm quality and improve the real-time and portability of sperm quality detection, a portable microscopic imaging system based on microfluidic chip is developed in this paper. The system can realize the comprehensive evaluation of sperm quality by detecting sperm vitality and survival rate. On the hardware side, a microfluidic chip is designed, which can automatically mix samples. A set of optical system with a magnification of 400 times was developed for microscopic observation of sperm. In the aspect of software, aiming at the comprehensive evaluation of sperm quality based on OpenCV, a set of algorithms for identifying sperm motility and survival rate is proposed. The accuracy of the system in detecting sperm survival rate is 94.0%, and the error rate is 0.6%. The evaluation results of sperm motility are consistent with those of computer-aided sperm analysis (CASA). The system's identification time is 9 s. Therefore, the system is absolutely suitable for sperm quality detection.
Collapse
Affiliation(s)
- Xiaoqing Pan
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - Kang Gao
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| | - Ning Yang
- School of Electrical and Information Engineering, Jiangsu University, Zhenjiang, China
| | - Yafei Wang
- School of Agricultural Engineering, Jiangsu University, Zhenjiang, China
| | - Xiaodong Zhang
- School of Agricultural Engineering, Jiangsu University, Zhenjiang, China
| | - Le Shao
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - Pin Zhai
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
- *Correspondence: Pin Zhai
| | - Feng Qin
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - Xia Zhang
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - Jian Li
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
| | - Xinglong Wang
- College of Animal Science and Technology, Yangzhou University, Yangzhou, China
| | - Jie Yang
- Institute of Animal Science, Jiangsu Academy of Agricultural Sciences, Nanjing, China
- Jie Yang
| |
Collapse
|
14
|
Evaluación de la fertilidad masculina en casa. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2022. [DOI: 10.1016/j.gine.2021.100725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
15
|
Extended semen examinations in the sixth edition of the World Health Organization manual on semen analysis: contributing to the understanding of the function of the male reproductive system. Fertil Steril 2022; 117:252-257. [PMID: 34986981 DOI: 10.1016/j.fertnstert.2021.11.034] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 12/26/2022]
Abstract
In the sixth edition of the World Health Organization manual for the examination and processing of human semen, extended examination methods to provide key diagnostics in the investigation of the male reproductive system function are elaborated. These go beyond the basic analysis of semen and may be useful in more specifically guiding the clinical characterization of fertile or infertile men. Among the extended examinations included in the chapter, the use of multiparametric scoring for sperm morphological defects, sperm DNA fragmentation, and the roles for computer-assisted analysis of sperm or semen are arguably those that will be the most widely used and may also cause the most debate.
Collapse
|
16
|
Takeshima T, Karibe J, Saito T, Ishibashi Y, Usui K, Mori K, Kuroda S, Komeya M, Yumura Y. Effect of keishibukuryogan combined with tocopherol nicotinate on sperm parameters in patients with a varicocele. Int J Urol 2021; 29:165-169. [PMID: 34818687 DOI: 10.1111/iju.14746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/07/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the efficacy of keishibukuryogan, a traditional Kampo formula known to be an anti-Oketsu (impaired microcirculation and non-physiological blood congestion) drug, in combination with an anti-oxidant for the treatment of varicoceles. METHODS We retrospectively analyzed 119 patients with palpable and subclinical varicoceles who were treated with 7.5 g/day of keishibukuryogan and 600 mg/day of tocopherol nicotinate. Their motile sperm concentrations at the start of medication and after 3 months were compared. As a subgroup analysis, a comparison test was carried out between patients with a high-grade varicocele and those with a low-grade varicocele. RESULTS The mean age of the study patients was 35.6 years. Among them, 17, 41, 44 and 17 had subclinical, grade 1, grade 2 and grade 3 varicoceles, respectively. Overall, the differences in motile sperm concentration (millions/mL) before and after treatment were not significant (median 0.58, 95% confidence interval -0.12 to 1.56; P = 0.115). The results of the subgroup analysis showed that the motile sperm concentration in patients with a low-grade varicocele significantly increased (median 1.21, 95% confidence interval 0.45-2.47; P = 0.024); however, no significant improvements were seen in patients with a high-grade varicocele. CONCLUSIONS The results of the present study showed that the combination of keishibukuryogan and an anti-oxidant had a limited effect on varicoceles, but they suggest that it is effective for the treatment of low-grade varicoceles.
Collapse
Affiliation(s)
- Teppei Takeshima
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Jurii Karibe
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Tomoki Saito
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yukari Ishibashi
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Kimitsugu Usui
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Kohei Mori
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Shinnosuke Kuroda
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Mitsuru Komeya
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| | - Yasushi Yumura
- Department of Urology, Reproduction Center, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan
| |
Collapse
|
17
|
Park MJ, Lim MY, Park HJ, Park NC. Accuracy comparison study of new smartphone-based semen analyzer versus laboratory sperm quality analyzer. Investig Clin Urol 2021; 62:672-680. [PMID: 34729967 PMCID: PMC8566791 DOI: 10.4111/icu.20210266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/22/2021] [Accepted: 10/20/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to test the clinical efficacy of a portable smartphone-based App assisted semen analysis (SA) system, O'VIEW-M PRO® to clinically accurate in comparison with results of laboratory-based conventional semen analyses including manual microscopic and computer-assisted semen analysis (CASA) for self-evaluation of seminal parameters. Materials and Methods From January to May 2021, a total of 39 semen samples were analyzed for the sperm concentration and motility with new smartphone-based App assisted semen analyzer, O'VIEW-M PRO®, and results compared with those from laboratory-based manual microscopic SA with Makler Counting Chamber and CASA. Results The coefficient factors among the results of the measurement with Makler chamber and laboratory-based CASA comparing to O'VIEW-M PRO® were 0.666 and 0.655 for sperm density, 0.662 and 0.658 for sperm motility, respectively. There were no particular problems with clinical use of the O'VIEW-M PRO®. Device performance in classifying samples is positive (<15×106 sperm/mL) and negative (>15×106 sperm/mL) for sperm concentration criteria, and positive (<40%) and negative (>40%) for sperm motility criteria. The smartphone-based App assisted SA O'VIEW-M PRO® showed a sensitivity of 92.6%, a specificity of 66.7%, and overall accuracy rate of 84.6%. Conclusions This study shows a novel smartphone-based App assisted SA system. O'VIEW-M PRO® can easily obtain semen parameter information through self-diagnosis at home and induce infertile men's treatment and help patients after receiving infertile men's treatment before receiving treatment.
Collapse
Affiliation(s)
- Min Jung Park
- The Korea Institute for Public Sperm Bank, Busan, Korea
| | - Mi Young Lim
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Nam Cheol Park
- The Korea Institute for Public Sperm Bank, Busan, Korea.,Department of Urology, Pusan National University School of Medicine, Busan, Korea.
| |
Collapse
|
18
|
Gonzalez D, Narasimman M, Best JC, Ory J, Ramasamy R. Clinical Update on Home Testing for Male Fertility. World J Mens Health 2021; 39:615-625. [PMID: 33474845 PMCID: PMC8443999 DOI: 10.5534/wjmh.200130] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/02/2020] [Accepted: 10/08/2020] [Indexed: 01/11/2023] Open
Abstract
Male factor infertility accounts for about 50% of the incidence of infertility in couples. In current practice, the men must attend a clinic or hospital facility to provide a semen analysis, which is key to the diagnosis of the male reproductive potential. However, many men are often embarrassed with the process and conventional semen analysis requires complex, labor intensive inspection with a microscope. To mitigate these problems, one of the solutions can be at-home semen analysis. In this review we examine the literature of currently available at home semen analysis test kits, describe their limitations, and compare them to the conventional lab-based methods.
Collapse
Affiliation(s)
- Daniel Gonzalez
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Manish Narasimman
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jordan C Best
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jesse Ory
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Ranjith Ramasamy
- Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.
| |
Collapse
|
19
|
Hudnall MT, Greene LI, Pham MN, Lai JD, Fantus RJ, Keeter MK, Wren J, Bennett NE, Brannigan RE, Halpern JA. Perceptions of Infertility and Semen Analysis Testing Among American Men Without Children. Urology 2021; 158:95-101. [PMID: 34537196 DOI: 10.1016/j.urology.2021.07.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/19/2021] [Accepted: 07/27/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine whether health-conscious men are more likely to be concerned about infertility and self-initiate semen analysis at a laboratory/clinic or through a direct-to-consumer at-home product without a health care provider recommendation. METHODS Cross-sectional survey conducted online via ResearchMatch.org between November 2019 and January 2020. Men age 18 and older without children (n = 634) were included for analysis. Outcomes were likelihood of self-initiating a semen analysis, prevalence of infertility concern. RESULTS Of the 634 participants, 186 expressed concern about infertility but only 29% were likely to discuss these concerns with a health care provider. More men would self-initiate a semen analysis using an at-home product than through a traditional laboratory/clinic (14.2% vs 10.4%, P = .04). Odds of self-initiating a traditional semen analysis were higher for men concerned about low testosterone (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.12-4.74, P = .023) and infertility (OR 3.91, 95% CI 2.14-7.15, P <.001). Self-initiating an at-home semen analysis was associated with concern for low testosterone and infertility as well as middle age (age 40-59: OR 3.02, 95% CI 1.16-7.88, P = .024) and fitness tracker use (OR: 1.95, 95% CI 1.12-3.39, P = .018). CONCLUSION Many men were unlikely to discuss infertility concerns with a health care provider. Middle aged men and those who used fitness trackers were more likely to self-initiate fertility evaluation through at-home semen analysis. Concern about low serum testosterone was pervasive and strongly associated with concern for being infertile and self-initiating a semen analysis of any kind.
Collapse
Affiliation(s)
- Matthew T Hudnall
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Lisa I Greene
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Minh N Pham
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jeremy D Lai
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Richard J Fantus
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Mary Kate Keeter
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - James Wren
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Nelson E Bennett
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Robert E Brannigan
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joshua A Halpern
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL
| |
Collapse
|
20
|
Kanakasabapathy MK, Thirumalaraju P, Kandula H, Doshi F, Sivakumar AD, Kartik D, Gupta R, Pooniwala R, Branda JA, Tsibris AM, Kuritzkes DR, Petrozza JC, Bormann CL, Shafiee H. Adaptive adversarial neural networks for the analysis of lossy and domain-shifted datasets of medical images. Nat Biomed Eng 2021; 5:571-585. [PMID: 34112997 PMCID: PMC8943917 DOI: 10.1038/s41551-021-00733-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 04/15/2021] [Indexed: 01/30/2023]
Abstract
In machine learning for image-based medical diagnostics, supervised convolutional neural networks are typically trained with large and expertly annotated datasets obtained using high-resolution imaging systems. Moreover, the network's performance can degrade substantially when applied to a dataset with a different distribution. Here, we show that adversarial learning can be used to develop high-performing networks trained on unannotated medical images of varying image quality. Specifically, we used low-quality images acquired using inexpensive portable optical systems to train networks for the evaluation of human embryos, the quantification of human sperm morphology and the diagnosis of malarial infections in the blood, and show that the networks performed well across different data distributions. We also show that adversarial learning can be used with unlabelled data from unseen domain-shifted datasets to adapt pretrained supervised networks to new distributions, even when data from the original distribution are not available. Adaptive adversarial networks may expand the use of validated neural-network models for the evaluation of data collected from multiple imaging systems of varying quality without compromising the knowledge stored in the network.
Collapse
Affiliation(s)
- Manoj Kumar Kanakasabapathy
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Prudhvi Thirumalaraju
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Hemanth Kandula
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Fenil Doshi
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anjali Devi Sivakumar
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Deeksha Kartik
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Raghav Gupta
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rohan Pooniwala
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - John A Branda
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Athe M Tsibris
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel R Kuritzkes
- Division of Infectious Diseases, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - John C Petrozza
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Charles L Bormann
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hadi Shafiee
- Division of Engineering in Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
21
|
Onofre J, Geenen L, Cox A, Van Der Auwera I, Willendrup F, Andersen E, Campo R, Dhont N, Ombelet W. Simplified sperm testing devices: a possible tool to overcome lack of accessibility and inconsistency in male factor infertility diagnosis. An opportunity for low- and middle- income countries. Facts Views Vis Obgyn 2021; 13:79-93. [PMID: 33889864 PMCID: PMC8051200 DOI: 10.52054/fvvo.13.1.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background Manual semen assessment (MSA) is a key component in a male’s fertility assessment. Clinicians rely on it to make diagnostic and treatment decisions. When performed manually, this routine laboratory test is prone to variability due to human intervention which can lead to misdiagnosis and consequently over- or under- treatment. For standardisation, continuous training, quality control (QC) programs and pricy Computer-Assisted Sperm Analysis (CASA) systems have been proposed, yet, without resolving intra- and inter-laboratory variability. In response, promising simplified sperm testing devices, able to provide cost-effective point-of-care male infertility diagnosis are prospected as a plausible solution to resolve variability and increase access to sperm testing. Materials and methods A throughout literature research for semen testing, sperm analysis, smart-phone assisted semen analysis, ‘at-home’ semen testing, male infertility, infertility in developing countries, infertility in low- and middle-income countries (LMIC) and quantitative sperm analysis was performed. A total of 14 articles, specific to ‘at-home’ simplified sperm assessment, were included to treat the core subject. Results Continuous training and consistent QC, are sine qua none conditions to achieve accurate and comparable MSA. Compliance does not rule-out variability, nevertheless. Emerging simplified sperm assessment devices are an actual alternative to resolve the lack of standardisation and accessibility to sperm analysis. YO ® , SEEM ® , and ExSeed ® are commercially available, user-friendly smartphone-based devices which can accurately measure volume, sperm concentration (millions/ml) and total motile sperm count. More broadly, by cost-effectiveness, availability, accuracy and convenient application, these devices could effectively select patients for first-line artificial reproduction treatments such as intrauterine insemination. Conclusions Accuracy and cost-effectiveness make smart-phone based sperm testing devices a practical and realistic solution to overcome variability in MSA. Importantly, these tools represent an actual opportunity to standardise and improve male subfertility diagnosis and treatment, especially in LMIC. However, before clinical application is possible, guidelines, further testing with special attention on accuracy in washed sperm, availability, cost-benefit and reliability are required.
Collapse
Affiliation(s)
- J Onofre
- Genk Institute for Fertility Technology, Genk, Belgium.,Department of Obstetrics, Gynaecology and Infertility, Ziekenhuis Oost Limburg, Genk, Belgium
| | - L Geenen
- University of Hasselt, Faculty of Medicine and Life Sciences, Diepenbeek, Belgium
| | - A Cox
- Department of Obstetrics, Gynaecology and Infertility, Ziekenhuis Oost Limburg, Genk, Belgium
| | - I Van Der Auwera
- Department of Obstetrics, Gynaecology and Infertility, Ziekenhuis Oost Limburg, Genk, Belgium
| | | | | | - R Campo
- Genk Institute for Fertility Technology, Genk, Belgium.,Department of Obstetrics, Gynaecology and Infertility, Ziekenhuis Oost Limburg, Genk, Belgium
| | - N Dhont
- Genk Institute for Fertility Technology, Genk, Belgium.,Department of Obstetrics, Gynaecology and Infertility, Ziekenhuis Oost Limburg, Genk, Belgium
| | - W Ombelet
- Genk Institute for Fertility Technology, Genk, Belgium.,Department of Obstetrics, Gynaecology and Infertility, Ziekenhuis Oost Limburg, Genk, Belgium
| |
Collapse
|
22
|
Masterson TA, Patel P. Clinical implications of home-based sperm testing. Fertil Steril 2021; 115:882. [PMID: 33750619 DOI: 10.1016/j.fertnstert.2021.01.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Thomas A Masterson
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
| | - Premal Patel
- Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada.
| |
Collapse
|
23
|
Samplaski MK, Falk O, Honig S, Shin D, Matthews W, Smith JF. Development and validation of a novel mail-in semen analysis system and the correlation between one hour and delayed semen analysis testing. Fertil Steril 2021; 115:922-929. [PMID: 33423785 DOI: 10.1016/j.fertnstert.2020.10.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/07/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop and validate a novel, mail-in semen analysis (SA) system. DESIGN Prospective cohort. SETTING Not applicable. PATIENT(S) Ejaculates from normospermic men. INTERVENTION(S) One-hour SA, then repeat SAs (on same ejaculate) over 52 hours using a novel technique for maintaining sperm viability. MAIN OUTCOME MEASURE(S) World Health Organization SA parameters. RESULT(S) One-hour SA on 104 ejaculates in the validation phase of the study demonstrated normal semen parameters. With up to 52 hours of observation and four subsequent SA measurements/ejaculate, concentration remained stable, motility decreased by 0.39%/h, and normal morphology decreased by 0.1%/h. Measured 1-hour and calculated motility (correlation coefficients 0.87) and morphology (correlation coefficients 0.82) strongly were correlated. CONCLUSION This novel, mail-in, Clinical Laboratory Improvement Amendments-approved SA testing system demonstrates a strong degree of correlation between 1-hour and delayed SA testing. Given the linear motility and morphology decrease and stability of sperm concentration, this test may be used in clinical practice to evaluate semen quality for fertility evaluations. Furthermore, this approach significantly improves the ease, comfort, and efficiency of obtaining a SA, likely breaking down early barriers to accessing successfully a male fertility evaluation.
Collapse
Affiliation(s)
- Mary K Samplaski
- Institute of Urology, University of Southern California, Los Angeles, California
| | - Owen Falk
- Fellow Health Incorporated, San Francisco, California
| | - Stanton Honig
- Department of Urology, Yale School of Medicine, New Haven, Connecticut
| | - David Shin
- Department of Urology, Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | | | - James F Smith
- Departments of Urology, Obstetrics, Gynecology, and Reproductive Sciences, Philip R. Lee Institute for Health Policy, San Francisco, California.
| |
Collapse
|
24
|
Tsao Y, Yang C, Wen Y, Chang T, Matsuura K, Chen Y, Cheng C. Point-of-care semen analysis of patients with infertility via smartphone and colorimetric paper-based diagnostic device. Bioeng Transl Med 2021; 6:e10176. [PMID: 33532582 PMCID: PMC7823130 DOI: 10.1002/btm2.10176] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 12/28/2022] Open
Abstract
Male infertility affects millions of males worldwide and is rising in prevalence due to social and environmental conditions. However, men often feel too embarrassed to receive a semen analysis in the hospital due to social stigmas. To overcome this problem, we developed a 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide test strip to distinguish semen samples with low total motile sperm concentration from those with normal motile sperm concentration. This is a point-of-care colorimetric semen analytical method with a one-step, inexpensive, equipment-free evaluation process, and adequate accuracy validated in a 42-sample clinical trial. In this study, results were evaluated visually and with a smartphone application. Using visual observation methods, the area under the curve (AUC) was 0.71 (95% of confidence interval = 0.55-0.86; p = 0.021), sensitivity was 41%, specificity was 95%, positive predictive value was 90%, negative predictive value (NPV) was 59.4%, and accuracy was 67%. Using a smartphone recording and analytical system, AUC was 0.766 (95% of confidence interval = 0.612-0.92; p = 0.003), sensitivity was 96%, specificity was 65%, PPV was 75%, NPV was 92.9%, and accuracy was 80.9%. This work demonstrated a screening tool that could elevate semen analysis to the level of routine healthcare and provide for private, in-home self-assessment.
Collapse
Affiliation(s)
- Yu‐Ting Tsao
- Institute of Biomedical EngineeringNational Tsing Hua UniversityHsinchuTaiwan
- Department of EducationChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
| | - Chung‐Yao Yang
- Department of Research and DevelopmentHygeia Touch Inc.TaipeiTaiwan
| | - Yun‐Chiao Wen
- Department of EducationChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
- School of Traditional Chinese MedicineChang Gung University College of MedicineTaoyuanTaiwan
| | - Ting‐Chang Chang
- Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
| | - Koji Matsuura
- Department of Biomedical Engineering, Faculty of EngineeringOkayama University of ScienceOkayamaJapan
| | - Yu Chen
- Department of UrologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
| | - Chao‐Min Cheng
- Institute of Biomedical EngineeringNational Tsing Hua UniversityHsinchuTaiwan
| |
Collapse
|
25
|
Ambar RF, Parekh N, Agarwal A. Recent advances and controversies in diagnosing and treating male infertility. Fac Rev 2020; 9:22. [PMID: 33659954 PMCID: PMC7886078 DOI: 10.12703/r/22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Interest in male infertility has increased, as it plays an important role in up to 50% of couples struggling with infertility, which is an estimated 48.5 million couples globally. Despite recent advances, diagnosing and treating male infertility remain a significant clinical challenge owing to complex multifactorial pathways and the diversity of treatment options. This review will assess current controversial topics on male infertility such as the use of home-based semen testing, management of subclinical varicocele, and recent advances in the field of sperm proteomics.
Collapse
Affiliation(s)
- Rafael F Ambar
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
- Urology Department of Faculdade de Medicina do ABC - FMABC/Andrology Group at Ideia Fertil Institute of Human Reproduction, Santo André, SP, Brazil
- Hope Clinic – Fertility Center, Sao Paulo, SP, Brazil
| | - Neel Parekh
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
26
|
Tsai VF, Zhuang B, Pong YH, Hsieh JT, Chang HC. Web- and Artificial Intelligence-Based Image Recognition For Sperm Motility Analysis: Verification Study. JMIR Med Inform 2020; 8:e20031. [PMID: 33211025 PMCID: PMC7714652 DOI: 10.2196/20031] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/11/2020] [Accepted: 10/28/2020] [Indexed: 01/19/2023] Open
Abstract
Background Human sperm quality fluctuates over time. Therefore, it is crucial for couples preparing for natural pregnancy to monitor sperm motility. Objective This study verified the performance of an artificial intelligence–based image recognition and cloud computing sperm motility testing system (Bemaner, Createcare) composed of microscope and microfluidic modules and designed to adapt to different types of smartphones. Methods Sperm videos were captured and uploaded to the cloud with an app. Analysis of sperm motility was performed by an artificial intelligence–based image recognition algorithm then results were displayed. According to the number of motile sperm in the vision field, 47 (deidentified) videos of sperm were scored using 6 grades (0-5) by a male-fertility expert with 10 years of experience. Pearson product-moment correlation was calculated between the grades and the results (concentration of total sperm, concentration of motile sperm, and motility percentage) computed by the system. Results Good correlation was demonstrated between the grades and results computed by the system for concentration of total sperm (r=0.65, P<.001), concentration of motile sperm (r=0.84, P<.001), and motility percentage (r=0.90, P<.001). Conclusions This smartphone-based sperm motility test (Bemaner) accurately measures motility-related parameters and could potentially be applied toward the following fields: male infertility detection, sperm quality test during preparation for pregnancy, and infertility treatment monitoring. With frequent at-home testing, more data can be collected to help make clinical decisions and to conduct epidemiological research.
Collapse
Affiliation(s)
- Vincent Fs Tsai
- Department of Urology, Ten-Chan General Hospital, Taoyuan, Taiwan.,Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Bin Zhuang
- Division of Research and Development, Createcare Technology Corporation, Shenzhen, China
| | - Yuan-Hung Pong
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.,Department of Urology, Ten-Chen General Hospital, Taoyuan, Taiwan
| | - Ju-Ton Hsieh
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| | - Hong-Chiang Chang
- Department of Urology, National Taiwan University Hospital, Taipei, Taiwan
| |
Collapse
|
27
|
Miller D, Vukina J. Recent advances in clinical diagnosis and treatment of male factor infertility. Postgrad Med 2020; 132:28-34. [PMID: 32990123 DOI: 10.1080/00325481.2020.1830589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Infertility is a significant global health issue affecting around 8-12% of couples worldwide with male factor infertility accounting for a substantial proportion of these cases. Despite significant advances within the past few decades, an etiology for male factor infertility cannot be identified in up to 80% of patients and thus, this continues to be an area of active study. This review aims to provide an update on recent advances in the field of male infertility including semen analysis and at-home semen testing, genetics, DNA fragmentation, surgical approaches, and the rise of telemedicine in the era of COVID19.
Collapse
Affiliation(s)
- David Miller
- Department of Urology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania, USA
| | - Josip Vukina
- Department of Urology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania, USA
| |
Collapse
|
28
|
Clavijo R, Ramasamy R, Halpern J, Melnick A, Stewart J, Rosenwaks Z, Brannigan R. "Online" and "at-home" versus traditional models of health care: enhancing access or impeding optimal therapeutics? Fertil Steril 2020; 114:476-482. [PMID: 32912610 PMCID: PMC7476901 DOI: 10.1016/j.fertnstert.2020.07.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Raul Clavijo
- Department of Urology, University of California at Davis, Sacramento, California
| | - Ranjith Ramasamy
- Department of Urology, University of Miami Miller School of Medicine, Miami, Florida
| | - Joshua Halpern
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alexis Melnick
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Joshua Stewart
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Zev Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medicine, New York, New York
| | - Robert Brannigan
- Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
| |
Collapse
|
29
|
Hook KA, Fisher HS. Methodological considerations for examining the relationship between sperm morphology and motility. Mol Reprod Dev 2020; 87:633-649. [PMID: 32415812 PMCID: PMC7329573 DOI: 10.1002/mrd.23346] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 04/10/2020] [Accepted: 04/21/2020] [Indexed: 12/12/2022]
Abstract
Sperm cells of all taxa share a common goal to reach and fertilize an ovum, yet sperm are one of the most diverse cell types in nature. While the structural diversity of these cells is well recognized, the functional significance of variation in sperm design remains elusive. An important function of spermatozoa is a need to migrate toward the ova, often over long distances in a foreign environment, which may include a complex and hostile female reproductive tract. Several comparative and experimental studies have attempted to address the link between sperm morphology and motility, yet the conclusions drawn from these studies are often inconsistent, even within the same taxa. Much of what we know about the functional significance of sperm design in internally fertilizing species has been gleaned from in vitro studies, for which experimental parameters often vary among studies. We propose that discordant results from these studies are in part due to a lack of consistency of methods, conditions that do not replicate those of the female reproductive tract, and the overuse of simple linear measures of sperm shape. Within this review, we provide a toolkit for imaging, quantifying, and analyzing sperm morphology and movement patterns for in vitro studies and discuss emerging approaches. Results from studies linking morphology to motility enhance our understanding of the evolution of adaptive sperm traits and the mechanisms that regulate fertility, thus offering new insights into methods used in assisted reproductive technologies in animal science, conservation and public health.
Collapse
Affiliation(s)
- Kristin A. Hook
- Department of Biology, University of Maryland, College Park, U.S.A
| | - Heidi S. Fisher
- Department of Biology, University of Maryland, College Park, U.S.A
| |
Collapse
|
30
|
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.
Collapse
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.
| |
Collapse
|
31
|
Agarwal A, Henkel R, Huang C, Lee M. Automation of human semen analysis using a novel artificial intelligence optical microscopic technology. Andrologia 2019; 51:e13440. [DOI: 10.1111/and.13440] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/09/2019] [Accepted: 08/30/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- 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
| | | | - Maw‐Sheng Lee
- Lee Women's Hospital Taichung Taiwan
- Institute of Medicine Chung Shan Medical University Taichung Taiwan
| |
Collapse
|
32
|
Reynolds-Wright JJ, Anderson R. Male contraception: where are we going and where have we been? BMJ SEXUAL & REPRODUCTIVE HEALTH 2019; 45:bmjsrh-2019-200395. [PMID: 31537614 PMCID: PMC6892591 DOI: 10.1136/bmjsrh-2019-200395] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 08/13/2019] [Accepted: 08/30/2019] [Indexed: 05/22/2023]
Abstract
Progress in developing new reversible male contraception has been slow. While the hormonal approach has been clearly shown to be capable of providing effective and reversible contraception, there remains no product available. Currently, trials of a self-administered gel combination of testosterone and the progestogen Nestorone® are under way, complementing the largely injectable methods previously investigated. Novel long-acting steroids with both androgenic and progestogenic activity are also in early clinical trials. The non-hormonal approach offers potential advantages, with potential sites of action on spermatogenesis, and sperm maturation in the epididymis or at the vas, but remains in preclinical testing. Surveys indicate the willingness of men, and their partners, to use a new male method, but they continue to lack that opportunity.
Collapse
Affiliation(s)
- John Joseph Reynolds-Wright
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Richard Anderson
- MRC Centre for Reproductive Health, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| |
Collapse
|
33
|
Cheon WH, Park HJ, Park MJ, Lim MY, Park JH, Kang BJ, Park NC. Validation of a smartphone-based, computer-assisted sperm analysis system compared with laboratory-based manual microscopic semen analysis and computer-assisted semen analysis. Investig Clin Urol 2019; 60:380-387. [PMID: 31501801 PMCID: PMC6722405 DOI: 10.4111/icu.2019.60.5.380] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/06/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose This study aimed to evaluate the clinical efficacy of a portable smartphone-based system for computer-assisted semen analysis (CASA) compared with the results of manual microscopic semen analysis (SA) and laboratory-based CASA for self-evaluation of semen parameters by a male partner. Materials and Methods From July 2017 to February 2018, a total of 28 samples were analyzed for concentration and motility with a smartphone-based CASA system and the results compared with those from laboratory-based CASA and manual microscopic SA with a Makler Counting Chamber (SEFI Medical Instruments, Israel). Results Sperm concentration and motility measured with the smartphone-based CASA system were positively correlated with the microscopic-based results. Likewise, sperm motility calculated with smartphone-based CASA was positively correlated with the laboratory-based CASA results. These results suggest that the smartphone-based CASA system can be used for clinical semen diagnosis. Conclusions A portable smartphone-based CASA system can play a role in motivating infertile males to visit clinics, thus resulting in early diagnosis and treatment with cost-effectiveness. The device can be used for easy follow-up on a screening basis by the male partner before visiting a clinic for fertility evaluation or by infertile males after receiving medical management. Additionally, future software advancements and post-marketing consumer surveys will make possible wider applications, including assessment of sperm morphology, in the coming future.
Collapse
Affiliation(s)
- Won Hee Cheon
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Hyun Jun Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Min Jung Park
- The Korea Institute for Public Sperm Bank, Busan, Korea
| | - Mi Young Lim
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Jih Hoon Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Byeong Jin Kang
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| | - Nam Cheol Park
- Department of Urology, Pusan National University School of Medicine, Busan, Korea
| |
Collapse
|
34
|
Chu KY, Nassau DE, Arora H, Lokeshwar SD, Madhusoodanan V, Ramasamy R. Artificial Intelligence in Reproductive Urology. Curr Urol Rep 2019; 20:52. [DOI: 10.1007/s11934-019-0914-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
35
|
Sperm quality in fish: Determinants and affecting factors. Theriogenology 2019; 135:94-108. [PMID: 31203093 DOI: 10.1016/j.theriogenology.2019.06.009] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 06/05/2019] [Indexed: 11/23/2022]
Abstract
Fish sperm quality assessment is helpful for optimizing production and for monitoring the environmental state. Sperm can be monitored relatively easy and, to date, various analyses have been applied and proven to be helpful in this task. Among them, sperm motility parameters such as sperm speed are one of the main performance traits during assisted fish reproduction. Apart from motility the sperm concentration, volume, and seminal plasma pH and osmolality are also frequently evaluated and are the main sperm quality indicators measured in fish sperm. However, other parameters also determine sperm fertilization potential. Recent knowledge reveals several additional parameters of high importance for sperm function. Among them are DNA integration, membrane stability, mitochondria status and enzymatic activity. Measuring all these parameters in fish sperm provides complex knowledge regarding male fertility and helps to improve broodstock maintenance protocols as well as gamete handling and fertilization processes. This review focuses on the presentation of the sperm quality measures for freshwater and marine species of the fish and provides information regarding recent methods of sperm quality evaluation.
Collapse
|
36
|
Home testing for male factor infertility: a review of current options. Fertil Steril 2019; 111:864-870. [DOI: 10.1016/j.fertnstert.2019.01.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 01/21/2019] [Accepted: 01/23/2019] [Indexed: 11/23/2022]
|
37
|
Oehninger S, Ombelet W. Limits of current male fertility testing. Fertil Steril 2019; 111:835-841. [DOI: 10.1016/j.fertnstert.2019.03.005] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/01/2019] [Accepted: 03/04/2019] [Indexed: 12/23/2022]
|
38
|
Esteves SC, Agarwal A, Roque M, Humaidan P. Hot topics in male infertility: an afterword. Panminerva Med 2019; 61:196-199. [PMID: 30990288 DOI: 10.23736/s0031-0808.18.03587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Sandro C Esteves
- Andrology and Human Reproduction Clinic ANDROFERT, Campinas, Brazil - .,Division of Urology, Department of Surgery, University of Campinas (UNICAMP), Campinas, Brazil - .,Faculty of Health, Aarhus University, Aarhus, Denmark -
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Matheus Roque
- Center for Reproductive Medicine ORIGEN, Rio de Janeiro, Brazil
| | - Peter Humaidan
- Faculty of Health, Aarhus University, Aarhus, Denmark.,Fertility Clinic Skive, Skive Regional Hospital, Skive, Denmark
| |
Collapse
|
39
|
Agarwal A, Esteves SC, Humaidan P, Roque M. Male infertility and assisted reproductive technology. Panminerva Med 2019; 61:101-103. [DOI: 10.23736/s0031-0808.18.03586-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
40
|
A semen analysis phone app does not replace laboratory testing. Fertil Steril 2018; 110:1255-1256. [DOI: 10.1016/j.fertnstert.2018.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 10/03/2018] [Indexed: 11/22/2022]
|