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Ambar RF, Gava MM, Ghirelli-Filho M, Yoshida IH, De Paula TS, Glina S. Tissue and sperm handling before assisted reproductive technology (ART): A systematic review. Arab J Urol 2021; 19:238-246. [PMID: 34552775 PMCID: PMC8451624 DOI: 10.1080/2090598x.2021.1954801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Objective : To explore the medical literature on techniques of tissue and sperm handling after surgical retrieval for intracytoplasmic sperm injection (ICSI). Methods : A search was performed in PubMed and Google Scholar databases, according to a modified Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) guideline, considering the studies investigating tissue handling and sperm selection techniques for ICSI. Results : Overall, 42 articles were included in this study, investigating sample handling, methods for sperm selection, and the use of chemical compounds to improve sperm motility and fertilisation rates. Conclusion : The ideal sperm handling method should provide a high sperm count, high vitality and appropriate sperm function, without side-effects. In this review the most common and useful techniques are described and the best combination strategies discussed in clinical scenarios.
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Affiliation(s)
- Rafael Favero Ambar
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil.,Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Marcello M Gava
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil.,Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Milton Ghirelli-Filho
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil.,Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | - Ivan H Yoshida
- Ideia Fertil Institute of Human Reproduction, Santo André, Brazil
| | | | - Sidney Glina
- Urology Department at Centro Universitario Em Saude Do ABC - FMABC, Santo André, Brazil
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Xu F, Guo G, Zhu W, Fan L. Human sperm acrosome function assays are predictive of fertilization rate in vitro: a retrospective cohort study and meta-analysis. Reprod Biol Endocrinol 2018; 16:81. [PMID: 30143014 PMCID: PMC6109296 DOI: 10.1186/s12958-018-0398-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 08/13/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To determine whether acrosome function scoring-including acrosomal enzyme (AE) levels and acrosome reaction (AR) results-can predict fertilization rate in vitro. METHODS We examined the predictive value of acrosomal enzymes (AE) determined by spectrophotometry/N-α-benzoyl-DL-arginine-p-nitroanilide for fertilization rate (FR) in vitro in a retrospective cohort study of 737 infertile couples undergoing IVF therapy. Additionally, a meta-analysis was done for prospective cohort or case-control studies; the following summary measures were reported to expand upon the findings: pooled spearman correlation coefficient (Rs), standardized mean difference (SMD), sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic score (DS), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC). RESULTS Lower AE levels determined by spectrophotometry with a cut-off value of <25μIU/106 spermatozoa were predictive of total fertilization failure (TFF) with moderate SEN (88.23%) and low SPE (16.50%). On meta-analysis, a total of 44 unique articles were selected, but given the multiple techniques described there was a total of 67 total datasets extracted from these 44 articles, comprising 5356 infertile couples undergoing IVF therapy. The AE levels or induced AR% was positively correlated with FR (Rs = 0.38, SMD = 0.79; Rs = 0.40, SMD = 0.86, respectively). Lower AE levels or induced AR% was predictive of lower fertilization rate with moderate accuracy (AUC = 0.78, AUC = 0.84, respectively); this was accompanied by low SEN/moderate SPE (0.57/0.85), moderate SEN/moderate SPE (0.79/0.87), respectively. For AE assay, the diagnostic performance in Asia (Rs = 0.24, SMD = 0.50) was inferior to that in North America (Rs = 0.54, SMD = 0.81) and Europe (Rs = 0.46, SMD = 0.92). Cryopreserved spermatozoa (SMD = 0.20, P = 0.204) were inferior to fresh spermatozoa (SMD = 0.89, P < 0.001). Sperm preparation yielded inferior results as compared to no preparation; spermatozoa after swim up were weak relevant (Rs = 0.27, P = 0.044); and there was no correlation for spermatozoa after a discontinuous gradient (SMD = 1.07, P > 0.05). Lower AE levels determined by fluorometry or substrate assay were used for predicting lower FR with low sensitivity and high specificity; the spectrophotometry assay had an uncertain predictive value. For induced AR assay, the diagnostic performance in the other areas was inferior to that in Africa (Rs = 0.65, SMD = 1.86). No preparation or double preparation yielded inferior results as compared to one preparation (Rs = 0.41); discontinuous gradient (Rs = 0.17, SMD = 0.47) was inferior to swim up (Rs =0.65, SMD = 1.51). Nonphysiological triggers (SMD = 0.81) did not differ from physiological triggers (SMD = 0.95) in general; ZP (Rs = 0.63) or mannose (Rs = 0.59) was superior to other physiological or nonphysiological triggers; and there was no correlation for human follicle fluid, progesterone, cyclic adenosine 3'-5'-phosphate analogue and phorbol ester-BSA-GlcNAc Neoglycoproteins with N-acetylglucosamine residues. Lower induced AR% determined by indirect immunofluorescence, direct immunofluorescence with lection, or triple stain was used for predicting lower FR, with moderate sensitivity/high specificity, moderate sensitivity/high specificity, or high sensitivity/low specificity. CONCLUSIONS Although the correlation between acrosome function scoring and FR was significant, the assays were neither highly sensitive nor specific. Additionally, the diagnostic performance showed regional effects as well as an effect of the sperm preparation or assay method. More studies of multicenter, large-scale, careful design and synthesizing multiple sperm functional assays and oocyte quality assays are still needed in clinical settings to better predict fertilization outcome in IVF.
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Affiliation(s)
- Fang Xu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine Science, Central South University, Changsha, 410078, China
| | - Ganggang Guo
- Business School, Central South University, Changsha, 410078, China
| | - Wenbing Zhu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine Science, Central South University, Changsha, 410078, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China
| | - Liqing Fan
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medicine Science, Central South University, Changsha, 410078, China.
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China.
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Collodel G, Serena C, Federico MG, Pascarelli NA, Geminiani M, Moretti E. Natural Sperm Birefringence Can be Used to Estimate Sperm Viability and Morphology. Syst Biol Reprod Med 2010; 56:465-72. [DOI: 10.3109/19396368.2010.503360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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4
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Jedrzejczak P, Pawelczyk L, Taszarek-Hauke G, Kotwicka M, Warchoł W, Kurpisz M. Predictive value of selected sperm parameters for classical in vitro fertilization procedure of oocyte fertilization. Andrologia 2005; 37:72-82. [PMID: 16026428 DOI: 10.1111/j.1439-0272.2005.00657.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A proportion of fertilized oocytes during classical in vitro fertilization (IVF) procedure was analysed depending on the following factors: number of mature oocytes, seminological criteria such as sperm morphology in raw semen and after its selection in a density gradient (six structural defects of a male gamete were taken into consideration), sperm concentration, motility parameters according to World Health Organization criteria and the functional tests: hypo-osmotic swelling assay and acrosomal reaction induced by calcium ionophore. Evaluation of DNA content in sperm by image cytometry and determination of malonyldialdehydes in seminal plasma were also performed. Seventy-nine semen samples from patients undergoing IVF were assessed. Apart from significant correlations obtained for selected semen parameters and proportion of fertilized eggs, logistic regression analysis showed that the best predictive factors for oocyte fertilization were normal morphology of sperm before and after gradient selection, grade B and C of sperm movement in raw semen, and DNA content after density gradient centrifugation, which all accounted for 76.7% of fertilization predictive value.
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Affiliation(s)
- P Jedrzejczak
- Infertility and Reproductive Endocrinology, University of Medical Sciences, Poznan, Poland
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5
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Henkel R, MAAß G, Bödeker RH, Scheibelhut C, Stalf T, Mehnert C, Schuppe HC, Jung A, Schill WB. Sperm function and assisted reproduction technology. Reprod Med Biol 2005; 4:7-30. [PMID: 29699207 DOI: 10.1111/j.1447-0578.2005.00087.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The evaluation of different functional sperm parameters has become a tool in andrological diagnosis. These assays determine the sperm's capability to fertilize an oocyte. It also appears that sperm functions and semen parameters are interrelated and interdependent. Therefore, the question arose whether a given laboratory test or a battery of tests can predict the outcome in in vitro fertilization (IVF). One-hundred and sixty-one patients who underwent an IVF treatment were selected from a database of 4178 patients who had been examined for male infertility 3 months before or after IVF. Sperm concentration, motility, acrosin activity, acrosome reaction, sperm morphology, maternal age, number of transferred embryos, embryo score, fertilization rate and pregnancy rate were determined. In addition, logistic regression models to describe fertilization rate and pregnancy were developed. All the parameters in the models were dichotomized and intra- and interindividual variability of the parameters were assessed. Although the sperm parameters showed good correlations with IVF when correlated separately, the only essential parameter in the multivariate model was morphology. The enormous intra- and interindividual variability of the values was striking. In conclusion, our data indicate that the andrological status at the end of the respective treatment does not necessarily represent the status at the time of IVF. Despite a relatively low correlation coefficient in the logistic regression model, it appears that among the parameters tested, the most reliable parameter to predict fertilization is normal sperm morphology. (Reprod Med Biol 2005; 4: 7-30).
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Affiliation(s)
- Ralf Henkel
- Department of Urology, Friedrich Schiller University, Jena.,Center for Dermatology and Andrology
| | - Gesa MAAß
- Center for Dermatology and Andrology
| | - Rolf-Hasso Bödeker
- Institute for Medical Informatics, Working Group for Medical Statistics, and
| | | | - Thomas Stalf
- Institute for Reproductive Medicine, Justus Liebig University, Giessen, Germany
| | - Claas Mehnert
- Institute for Reproductive Medicine, Justus Liebig University, Giessen, Germany
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6
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Henkel R, Maa\ G, Bödeker RH, Scheibelhut C, Stalf T, Mehnert C, Schuppe HC, Jung A, Schill WB. Sperm function and assisted reproduction technology. Reprod Med Biol 2005. [DOI: 10.1007/bf03016134] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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7
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Choy CMY, Yeung QSY, Briton-Jones CM, Cheung CK, Lam CWK, Haines CJ. Relationship between semen parameters and mercury concentrations in blood and in seminal fluid from subfertile males in Hong Kong. Fertil Steril 2002; 78:426-8. [PMID: 12137888 DOI: 10.1016/s0015-0282(02)03232-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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8
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Herrera J, Fierro R, Zayas H, Conejo J, Jiménez I, García A, Betancourt M. Acrosome reaction in fertile and subfertile boar sperm. ARCHIVES OF ANDROLOGY 2002; 48:133-9. [PMID: 11868626 DOI: 10.1080/014850102317267445] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The main purpose of sperm evaluation is to predict its fertilizing ability. However, basic sperm test results show a low correlation with fertilizing ability. The purpose of this study was to determine whether there is an association between acrosome reaction (AR) and the incidence of subfertility of normal sperm boar. The production records of 22 farms were analyzed to identify boars with low fertility and/or prolificity, classified as subfertile. Twenty-two subfertile boar semen samples were analyzed and compared with 51 samples of fertile boars. Sperm were capacitated during 4 h at 39 degrees C. viability was determined by bisbenzimide (Hoechst-33258) staining. Acrosome reaction was assessed with fluorescein isothiocyanate conjugated Pisum sativum agglutinin. The percentage of spontaneous acrosome reaction (SAR) was not significantly different in fertile (4.5%) and subfertile boars (4.75%) (p > .05). Nevertheless, the percentage of progesterone-induced acrosome reaction (IAR) was significantly lower in subfertile boars (5.75%) as compared with fertile boars (10%) (p < .01). These results suggest that assessment of IAR in vitro may be a useful parameter to identify subfertility in boars.
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Affiliation(s)
- J Herrera
- Departmento de Ciencias de la Salud, Universidad Autónoma Metropolitana Iztapalapa, México, DF
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9
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Rhemrev JP, Lens JW, McDonnell J, Schoemaker J, Vermeiden JP. The postwash total progressively motile sperm cell count is a reliable predictor of total fertilization failure during in vitro fertilization treatment. Fertil Steril 2001; 76:884-91. [PMID: 11704106 DOI: 10.1016/s0015-0282(01)02826-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To predict the chance of total fertilization failure (TFF) before the day of ovum pickup with known semen and female variables. DESIGN A statistical model was constructed to predict TFF by retrospective analysis (2,366 couples) and subsequently tested on a new IVF population (917 couples). SETTING Academic tertiary referral center. PATIENT(S) Three thousand three hundred eighty-three couples who underwent an IVF-ET treatment. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) The ability to predict the probability of TFF in IVF. RESULT(S) Two variables-postwash total progressively motile sperm cell count (postwash TPMC) and number of follicles-were found to be significant. Taking a probability of 25% as an acceptable risk of TFF, we calculated that a postwash TPMC of <1.1 x 10(6) cells results in a risk of TFF of >25%. Low responders (<4 follicles) needed a postwash TPMC of >2.2 x 10(6) cells to reduce the risk of TFF to <25%. High responders (>15 follicles) needed only 0.35 x 10(6) postwash progressively motile spermatozoa. CONCLUSION(S) When postwash TPMC and number of follicles are known and an unacceptable TFF outcome is expected, one can propose an ICSI procedure a few days before the day of ovum pickup.
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Affiliation(s)
- J P Rhemrev
- IVF Center, Division of Reproductive Endocrinology and Fertility, Research Institute for Endocrinology, Reproduction, and Metabolism, Medical Center Vrije Universiteit, Amsterdam, The Netherlands
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10
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Zeginiadou T, Papadimas J, Mantalenakis S. Acrosome reaction: methods for detection and clinical significance. Andrologia 2000; 32:335-43. [PMID: 11131842 DOI: 10.1046/j.1439-0272.2000.00359.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The present article reviews the methods for detection and the clinical significance of the acrosome reaction. The best method for the detection of the acrosome reaction is electron microscopy, but it is expensive and labour-intensive and therefore cannot be used routinely. The most widely used methods utilize optical microscopy where spermatozoa are stained for the visualization of their acrosomal status. Different dyes are used for this purpose as well as lectins and antibodies labelled with fluorescence. The acrosome reaction following ionophore challenge (ARIC) can separate spermatozoa that undergo spontaneous acrosome reaction from those that are induced, making the result of the inducible acrosome reaction more meaningful. Many different stimuli have been used for the induction of the acrosome reaction with different results. The ARIC test can provide information on the fertilizing capability of a sample. The ARIC test was also used to evaluate patients undergoing in vitro fertilization since a low percentage of induced acrosome reaction was found to be associated with lower rates of fertilization. The cut-off value that could be used to identify infertile patients is under debate. Therapeutic decisions can also be made on the basis of the value of the ARIC test.
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Affiliation(s)
- T Zeginiadou
- Special Unit for Reproductive Endocrinology, First Obstetrics and Gynaecology Clinic, Aristotelian University of Thessaloniki, Greece
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11
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Marnet B, Vieitez G, Milhet P, Richoilley G, Lesourd F, Parinaud J. Computer-assisted assessment of sperm morphology: comparison with conventional techniques. INTERNATIONAL JOURNAL OF ANDROLOGY 2000; 23:22-8. [PMID: 10632758 DOI: 10.1046/j.1365-2605.2000.00199.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The aim of the present study was to compare conventional and computer-assisted morphology assessment of spermatozoa. Sixty-two semen samples from patients undergoing in vitro fertilization (IVF) and 40 samples from patients undergoing an intracytoplasmic sperm injection (ICSI) were studied using both techniques. The percentage of normal spermatozoa found was closely correlated between the techniques (r=0.788, p < 0.0001). The intra-operator variation was low for both techniques but the inter-operator variation was much higher with the conventional than with the computer-assisted method (coefficient of variation = 0.43 vs. 0.08, respectively, for conventional and computer-assisted assessments). The percentage of spermatozoa with normal morphology, as well as sperm motility, was significantly enhanced after PureSperm preparation, whatever the method used for assessment. In the IVF study, fertilization rate was poorly correlated with sperm morphology using both methods. However, combined with motility, morphology assessed with the computer allowed discrimination of two groups of patients with significantly different fertilization rates (30.5 +/- 5.4% vs. 63.1 +/- 5.4%, p < 0.0001). In contrast, the fertilization rate in ICSI was influenced neither by sperm morphology nor by motility. In conclusion, computer-assisted assessment of sperm morphology has a slightly better predictive value for ART than conventional assessment, but above all is much more reproducible, allowing standardization.
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Affiliation(s)
- B Marnet
- Laboratoire de Biologie de la Reproduction, CHU La Grave, 31052 Toulouse Cedex, France
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12
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Moilanen JM, Carpén O, Hovatta O. Flow cytometric analysis of semen preparation, and assessment of acrosome reaction, reactive oxygen species production and leucocyte contamination in subfertile men. Andrologia 1999; 31:269-76. [PMID: 10526635 DOI: 10.1046/j.1439-0272.1999.00286.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Reactive oxygen species (ROS) production, poor acrosome reaction ability, and leucocyte and round cell contamination of semen are associated with diminished male fertility. In addition to the assessment of these variables, the number of abnormal and round cells in semen preparation was studied by flow cytometry. Men with varying degree of fertility despite normal concentrations and motility of spermatozoa were investigated. Group 1 consisted of semen donor candidates (n = 25), group 2 of patients with acceptable fertilization in vitro, but diminished fertility in vivo (n = 56), and group 3 of patients with poor (< 25%) fertilization in vitro (n = 32). The subfertile men in groups 2 and 3 had lower concentrations and poorer rapid progressive motility of spermatozoa than the men in group 1. Using flow cytometry, the number of events in the round cell gate in the Percoll-prepared semen sample was higher in the subfertile men than in the donors, independently of the differences in other semen parameters. However, there were no significant differences between the groups in the number of round cells in native semen by microscopic analysis, or in ROS production or acrosome reaction. In conclusion, flow cytometric assessment of round cells may be a useful method in the investigation of male fertility.
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13
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Sidhu RS, Hallak J, Sharma RK, Thomas AJ, Agarwal A. Relationship between creatine kinase levels and clinical diagnosis of infertility. J Assist Reprod Genet 1998; 15:188-92. [PMID: 9565847 PMCID: PMC3454933 DOI: 10.1023/a:1023096201880] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The creatine kinase level indicates sperm maturity and correlates with the spermatozoal fertilizing potential. The relationship between creatine kinase levels in subfertile men and their clinical diagnosis was examined. METHODS Patients with unexplained infertility (n = 34), varicocele (n = 20), postvasectomy reversal (n = 7), or cancer (n = 22) were included in this prospective clinical study. The control group consisted of healthy normal donors (n = 15). RESULTS The median and interquartile range values of creatine kinase for each group were as follows: normal donors, 0.061 U/10(8) sperm (0.056 to 0.076 U/10(8) sperm); idiopathic male factor, 0.119 U/10(8) sperm (0.061 to 0.190 U/10(8) sperm); varicocele, 0.392 U/10(8) sperm (0.209 to 1.494 U/10(8) sperm); postvasectomy reversal, 0.589 U/10(8) sperm (0.425 to 4.043 U/10(8) sperm); and cancer, 0.068 U/10(8) sperm (0.047 to 0.168 U/10(8) sperm). Sperm creatine kinase levels were significantly higher in patients with varicocele compared to normal donors (P = 0.0001), cancer patients (P = 0.0002), and men with idiopathic infertility (P = 0.0009). Sperm concentration and creatine kinase level were inversely correlated in patients (r = -0.7, P < 0.001) but not in normal donors. CONCLUSIONS Semen quality is poorer in subfertile patients with clinical varicocele and postvasectomy reversal than in cancer patients and patients with idiopathic male infertility. That the creatine kinase levels in cancer patients were similar to those of normal donors suggests that the final phase of spermatogenesis may not be altered in men with cancer; thus semen from these patients should be banked to ensure fertility after cancer treatment.
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Affiliation(s)
- R S Sidhu
- Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA
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14
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Sidhu RS, Sharma RK, Lee JC, Agarwal A. Accuracy of computer-assisted semen analysis in prefreeze and post-thaw specimens with high and low sperm counts and motility. Urology 1998; 51:306-12. [PMID: 9495716 DOI: 10.1016/s0090-4295(97)00628-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We evaluated the accuracy and precision of computer-assisted semen analysis (CASAs) to determine whether variations in the CASA results were related to the type of analyzer or to the type of specimens analyzed. METHODS Semen specimens were analyzed manually and by CASA before freezing and after thawing. Multiple ejaculates (220 semen specimens) from normal healthy donors (n = 8) and 131 semen specimens from 57 patients with cancer were assessed. RESULTS The differences between CASA and manual sperm counts and percent motility were higher in prefreeze and post-thaw specimens at sperm concentrations of less than 20 x 10(6)/mL. The differences between CASA and manual results were significant for cancer patients, compared with normal donors (P <0.01). CONCLUSIONS CASA results are unreliable at sperm counts of less than 20 x 10(6)/mL and post-thaw motility is generally underestimated by CASAs.
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Affiliation(s)
- R S Sidhu
- Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA
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15
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Rufas O, Gilman A, Fisch B, Shalgi R. Spontaneous and follicular fluid-induced acrosome reaction in sperm samples from in vitro fertilizing and nonfertilizing normozoospermic patients. J Assist Reprod Genet 1998; 15:84-9. [PMID: 9513847 PMCID: PMC3455418 DOI: 10.1007/bf02766831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE One of the most challenging and intriguing groups of infertile patients is that of normozoospermic men who have repeatedly not achieved fertilization in vitro. These cases probably present a wide range of gamete disorders manifested at different stages of the fertilization process. The occurrence of spontaneous and follicular fluid (FF)-induced acrosome reactions (ARs) in in vitro fertilizing and nonfertilizing specimens from normozoospermic IVF patients was assessed, and the effect of Percoll and cryopreservation on the incidence of ARs was evaluated. METHODS Semen samples from 62 normozoospermic (15 in vitro nonfertilizing and 47 fertilizing) patients were analyzed. Spermatozoa were double-stained with FITC-conjugated Pissum sativum lectin, to assess their acrosomal status, and propidium iodide, to evaluate their vitality, using flow cytometry analysis. RESULTS A lower average of AR incidence was observed in the nonfertilizing than in the fertilizing group with all treatments. Both groups exhibited an increase in the proportion of ARs following incubation with FF. This rise was most prominent when Percoll-separated fractions were used (15.8 and 25.6% AR in the nonfertilizing and fertilizing groups, respectively). Thawed cryopreserved and fresh fertilizing samples exhibited similar AR rates. CONCLUSIONS That normozoospermic recurrently nonfertilizing compared to fertilizing semen samples have a lower capacity to undergo ARs is suggested.
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Affiliation(s)
- O Rufas
- Department of Embryology and Teratology, Sackler School of Medicine, Tel-Aviv University, Ramat Aviv, Israel
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16
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Sidhu RS, Wang Y, Agarwal A. Creatine kinase level and lipid peroxidation rate in human spermatozoa from patients with cancer. J Assist Reprod Genet 1997; 14:538-42. [PMID: 9401873 PMCID: PMC3454844 DOI: 10.1023/a:1021183528047] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE The present study assessed whether the poor semen quality in patients with cancer results from the inhibition of sperm maturation as indicated by creatine kinase or from increased oxidative stress as assessed by lipid peroxidation of the sperm membrane. METHODS Cryopreserved semen specimens from patients with testicular (n = 10) and nontesticular (n = 12) cancer and normal healthy donors (n = 14) were analyzed for lipid peroxidation and creatine kinase levels. RESULTS The levels of creatine kinase and malonaldehyde did not differ among testicular or nontesticular patients with cancer or normal healthy donors. CONCLUSIONS Poor semen quality in testicular and nontesticular patients with cancer is not related to creatine kinase or lipid peroxidation levels; it may be related to other factors.
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Affiliation(s)
- R S Sidhu
- Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA
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17
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Hershlag A, Paine T, Scholl GM, Rosenfeld DL, Mandel FS, Zhu JZ, Guhring P, Mecerod D, Benoff S. Acrobeads test as a predictor of fertilization in vitro. Am J Reprod Immunol 1997; 37:291-9. [PMID: 9161635 DOI: 10.1111/j.1600-0897.1997.tb00232.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PROBLEM To determine whether the results of the Acrobeads test, which measures the expression of the complement regulator molecule CD46 on the inner acrosomal membrane following the acrosome reaction, accurately identifies semen specimens that will exhibit reduced or failed fertilization following conventional IVF insemination. METHOD The Acrobeads test was performed on semen specimens from 97 consecutive patients preparing to undergo an IVF cycle utilizing a standardized insemination protocol. Motile sperm populations were examined at 6 h and 24 h post-isolation for sperm-bead agglutination. Results of the Acrobeads test were compared to that of TRITC-PSA staining in matched specimens to directly measure the spontaneous loss of acrosome content. The percentages of TRITC-PSA-negative sperm were determined in freshly isolated motile populations and in duplicate aliquots incubated 18 to 20 h under sperm capacitating conditions. The relationship between the results of both analyses estimating spontaneous acrosome reactions and the rate of fertilization of metaphase II oocytes was examined. RESULTS The Acrobeads score did not correlate significantly with the rate of fertilization by insemination at 6 h or at 24 h. The negative predictive value of this test was 21.4%. There was no correlation between the Acrobeads score and the percentage of sperm undergoing a spontaneous acrosome reaction as detected by TRITC-PSA labeling. In contrast, the increment increase in the percentage of spontaneous acrosome reactions as quantified by TRITC-PSA staining was correlated with the fertilization rate. CONCLUSIONS Contrary to previous reports, our prospective, double-blinded study failed to demonstrate that the Acrobeads test can accurately predict fertilization outcome in IVF. Therefore, the routine use of this test to screen patients prior to an IVF cycle in order to select appropriate treatment (i.e., ICSI) cannot be recommended.
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Affiliation(s)
- A Hershlag
- Department of Obstetrics and Gynecology, North Shore University Hospital-New York University School of Medicine, Manhasset 11030, USA
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Piomboni P, Strehler E, Capitani S, Collodel G, De Santo M, Gambera L, Moretti E, Baccetti B, Sterzik K. Submicroscopic mathematical evaluation of spermatozoa in assisted reproduction. 2. In vitro fertilization. (Notulae seminologicae. 7). J Assist Reprod Genet 1996; 13:635-46. [PMID: 8897123 DOI: 10.1007/bf02069642] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
This paper belongs to a series of applications of the Baccetti et al. formula (1) to the submicroscopical mathematical examination of human spermatozoa used for assisted reproduction. The present experiment concerns IVF, a technique requiring careful evaluation of sperm quality to predict the success of the program. Our results demonstrate that the sperm submicroscopic characters introduced in the formula are clearly correlated with the result of IVF. In fact the two numbers concerning sperm quality (percentage of spermatozoa free from structural defects and total number in the ejaculate of spermatozoa free from defects) obtained in successful and unsuccessful IVF groups, showed a large difference. The t distribution in both cases reached a significance of 0.005. The synthetic parameters obtained are therefore a good tool in the prediction of sperm power in in vitro insemination techniques. The most important characteristics seem to be the quality of the acrosomal complex, the status of the chromatin, the shape of mitochondria, the axonemal pattern, and the membrane integrity. All these characteristics are expressed with largely different means in successful and unsuccessful ejaculates (t distribution significant at 0.005). All these data confirm that submicroscopic mathematical diagnosis offers a convincing evaluation of sperm structure and function, involving all organelles, including acrosome function and cell motility. It is also demonstrated that sperm quality is a major factor in the success of IVF and that it is clearly revealed by the integrity of the majority of the sperm organelles.
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Affiliation(s)
- P Piomboni
- Institute of General Biology, CNR, Siena, Italy
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Parinaud J, Richoilley G, Milhet P, Moutaffian H, Vieitez G. Validation of a scoring method predicting the in-vitro fertilizing ability of human spermatozoa. INTERNATIONAL JOURNAL OF ANDROLOGY 1996; 19:18-22. [PMID: 8698533 DOI: 10.1111/j.1365-2605.1996.tb00428.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The fertilizing ability of human spermatozoa depends upon numerous functions such as motility, normal morphology, ability to bind to the zona pellucida and to undergo the acrosome reaction. Hence a lot of tests have been developed to try and predict IVF results. In a previous study we had established a scoring method, based on parameters such as sperm morphology, vitality, motility and the acrosome reaction, which was able to predict up to 83% of in-vitro fertilization results. The present study aimed to validate this score on a separate set of sperm samples. The results confirmed those of the first series. The score allowed prediction of fertilization failures with a 56% sensitivity, a 91% specificity, a 56% positive predictive value and a 91% negative predictive value. Therefore, this score could be used routinely to choose between conventional IVF and ICSI.
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Affiliation(s)
- J Parinaud
- Centre Hospitalier Universitaire La Grave, Toulouse, France
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