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Zhang EC, Yin XY, Peng ZY, Lai ZZ, Hu L, Peng YQ, Zhang H, Ming R, Lin G, Li WN. Novel insights into necrozoospermia from a single-center study: reference ranges, possible etiology, and impact on male fertility. Asian J Androl 2024:00129336-990000000-00194. [PMID: 38831691 DOI: 10.4103/aja202422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/08/2024] [Indexed: 06/05/2024] Open
Abstract
ABSTARCT Necrozoospermia is a poorly documented condition with a low incidence, and its definition and clinical significance are unclear. Herein, we provide a reference range for necrozoospermia and discuss its possible etiology and impact on male fertility and assisted reproductive outcomes. We extracted relevant information from 650 Chinese male partners of infertile couples and statistically analyzed sperm vitality. Necrozoospermia was present in 3.4% (22/650) of our study population, and the lower cut-off value for sperm vitality was 75.3%. We compared two methods for assessing sperm vitality (eosin-nigrosin head staining and hypo-osmotic swelling test [HOST]), for which the percentage in the eosin-nigrosin group (mean ± standard deviation [s.d.]: 77.5% ± 10.5%) was significantly higher than that in the HOST group (mean ± s.d.: 58.1% ± 6.7% [5-10 min after incubation] and 55.6% ± 8.2% [25-30 min after incubation]; both P < 0.001). The incidence of necrozoospermia increased with age (odds ratio [OR] = 1.116, 95% confidence interval [CI]: 1.048-1.189, P = 0.001), while the percentage of normal sperm morphology and DNA fragmentation index (DFI) were significantly associated with necrozoospermia, with ORs of 0.691 (95% CI: 0.511-0.935, P = 0.017) and 1.281 (95% CI: 1.180-1.390, P < 0.001), respectively. In the following 6 months, we recruited 166 patients in the nonnecrozoospermia group and 87 patients in the necrozoospermia group to compare intracytoplasmic sperm injection (ICSI) and pregnancy outcomes between the two groups. The necrozoospermia group had a significantly lower normal fertilization rate (74.7% vs 78.2%, P = 0.041; OR = 0.822; 95% CI: 0.682-0.992) than that in the nonnecrozoospermia group. This study presents substantial information on necrozoospermia to establish comprehensive and applicable reference values for sperm vitality for spontaneous conception and artificially assisted reproductive management.
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Affiliation(s)
- Er-Chen Zhang
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China
| | - Xin-Yu Yin
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China
| | - Zi-Yan Peng
- Laboratory of Zebrafish Genetics, College of Life Sciences, Hunan Normal University, Changsha 410006, China
| | - Zhi-Zhou Lai
- Hunan Guangxiu Hospital, School of Medicine, Hunan Normal University, Changsha 410001, China
| | - Liang Hu
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha 410008, China
| | - Yang-Qin Peng
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- Hunan International Scientific and Technological Cooperation Base of Development and Carcinogenesis, Changsha 410008, China
| | - Huan Zhang
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China
| | - Rui Ming
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China
| | - Ge Lin
- NHC Key Laboratory of Human Stem Cell and Reproductive Engineering, School of Basic Medical Sciences, Central South University, Changsha 410008, China
| | - Wei-Na Li
- Clinical Research Center for Reproduction and Genetics in Hunan Province, Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha 410008, China
- Hunan Guangxiu Hi-tech Life Technology Co., Ltd., Changsha 410013, China
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Zhang L, Li Y, Huang Y, Li Z. Successful birth after ICSI with testicular immotile spermatozoa from a patient with total MMAF in the ejaculates: a case report. ZYGOTE 2021; 30:1-7. [PMID: 34583791 DOI: 10.1017/s096719942100068x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
There has been no report on the outcome of vitrified blastocyst transfer from a vitrified oocyte injected with immotile testicular spermatozoa with only multiple morphological abnormalities of the sperm flagella (MMAF). A couple diagnosed with MMAF returned to the clinic to attempt pregnancy using their vitrified oocytes. Testicular spermatozoa were injected intracytoplasmically, and the following intracytoplasmic sperm injection results were observed. In the second cycle, surplus vitrified oocytes and testicular retrieved sperm were used, but no pregnancy ensued. In the third cycle, a surplus vitrified blastocyst was transferred, and a healthy female child was delivered, with a birth weight of 3050 g and a birth length of 53 cm. In this report we describe a successful pregnancy achieved in a patient presenting MMAF. The successful pregnancy was obtained from vitrified oocytes microinjected with testicular retrieved sperm in a vitrified blastocyst transfer.
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Affiliation(s)
- Liuguang Zhang
- Center for Reproductive Medicine, Haikou Mary Hospital, 7 Lantian Road, Haikou570203, China
| | - Yuhu Li
- Center for Reproductive Medicine, Haikou Mary Hospital, 7 Lantian Road, Haikou570203, China
| | - Yuqun Huang
- Dong Guan Guang Ji Hospital, Dong Guan, 523690, China
| | - Zongqiang Li
- College of Animal Science and Technology, Guang Xi University, NanNing 530004, Guang Xi, China
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Palermo GD, O'Neill CL, Chow S, Cheung S, Parrella A, Pereira N, Rosenwaks Z. Intracytoplasmic sperm injection: state of the art in humans. Reproduction 2017; 154:F93-F110. [PMID: 29158352 PMCID: PMC5719728 DOI: 10.1530/rep-17-0374] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 11/09/2017] [Accepted: 11/20/2017] [Indexed: 12/31/2022]
Abstract
Among infertile couples, 25% involve both male and female factors, while male factor alone accounts for another 25% due to oligo-, astheno-, teratozoospermia, a combination of the three, or even a complete absence of sperm cells in the ejaculate and can lead to a poor prognosis even with the help of assisted reproductive technology (ART). Intracytoplasmic sperm injection (ICSI) has been with us now for a quarter of a century and in spite of the controversy generated since its inception, it remains in the forefront of the techniques utilized in ART. The development of ICSI in 1992 has drastically decreased the impact of male factor, resulting in millions of pregnancies worldwide for couples who, without ICSI, would have had little chance of having their own biological child. This review focuses on the state of the art of ICSI regarding utility of bioassays that evaluate male factor infertility beyond the standard semen analysis and describes the current application and advances in regard to ICSI, particularly the genetic and epigenetic characteristics of spermatozoa and their impact on reproductive outcome.
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Affiliation(s)
- G D Palermo
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - C L O'Neill
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - S Chow
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - S Cheung
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - A Parrella
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - N Pereira
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
| | - Z Rosenwaks
- The Ronald O. Perelman and Claudia Cohen Center for Reproductive MedicineWeill Cornell Medicine, New York, New York, USA
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Milachich T, Shterev A. Are there optimal numbers of oocytes, spermatozoa and embryos in assisted reproduction? JBRA Assist Reprod 2016; 20:142-9. [PMID: 27584608 PMCID: PMC5264380 DOI: 10.5935/1518-0557.20160032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The aim of this overview is to discuss the current information about the search for the optimum yield of gametes in assisted reproduction, as one of the major pillars of IVF success. The first topic is focused on the number of male gametes and the possible impact of some genetic traits on these parameters. The number of spermatozoa did not seem to be crucial when there is no severe male factor of infertility. Genetic testing prior to using those sperm cells is very important. Different methods were applied in order to elect the "best" spermatozoa according to specific indications. The next problem discussed is the importance of the number of oocytes collected. Several studies have agreed that "15 oocytes is the perfect number," as the number of mature oocytes is more important. However, if elective single embryo transfer is performed, the optimal number of oocytes will enable a proper embryo selection. The third problem discussed concerns fertility preservation. Many educational programs promote and encourage procreation at maternal ages between 20-35 years, since assisted reproduction is unable to fully overcome the effects of female aging and fertility loss after that age. It is also strongly recommended to ensure a reasonable number of cryopreserved mature oocytes, preferably in younger ages (<35), for which an average of two stimulation cycles are likely required. For embryo cryopreservation, the "freeze all" strategy suggests the vitrification of good embryos, therefore quality is prior to number and patient recruitment for this strategy should be performed cautiously.
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Rubino P, Viganò P, Luddi A, Piomboni P. The ICSI procedure from past to future: a systematic review of the more controversial aspects. Hum Reprod Update 2015; 22:194-227. [DOI: 10.1093/humupd/dmv050] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Accepted: 10/19/2015] [Indexed: 12/26/2022] Open
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Konc J, Kanyó K, Cseh S. The effect of condition/state of testicular spermatozoa injected to the outcome of TESE-ICSI-ET cycles. Eur J Obstet Gynecol Reprod Biol 2008; 141:39-43. [PMID: 18687516 DOI: 10.1016/j.ejogrb.2008.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2006] [Revised: 04/24/2008] [Accepted: 06/26/2008] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The effect of state/condition of spermatozoa (fresh/motile, fresh/immotile, frozen/motile and frozen/immotile) to fertilization, embryo formation/development, implantation and pregnancy/delivery and abortion rates were studied. STUDY DESIGN The data of a total of 167 TESE-ICSI-ET cycles with fresh and cryopreserved, motile and immotile testicular spermatozoa collected with testicular biopsy from patients suffering from non-obstructive azoospermia were analyzed retrospectively. Analysis of variance (ANOVA) was used to distinguish the group effects in fertilization, embryo formation, and implantation ratio. The group effect was evaluated by using non-parametric statistics and the independent grouping variable was also the "semen state/condition". "Semen state/condition" groups were created according to fresh or frozen, and motile or non-motile (immotile) characteristics. For comparing the four groups, Kruskal-Wallis ANOVA and Median-test was applied. The analysis was carried out using Statistica for Windows (StatSoft, Inc., Chicago, USA). RESULTS Independently of state/condition of testicular spermatozoa injected into oocytes, no differences were found in fertilization and implantation/pregnancy rates. No difference was obtained in embryo development of oocytes injected with fresh/immotile or frozen/motile spermatozoa. However, difference was found in embryo development of oocytes injected with fresh/motile or frozen/immotile testicular spermatozoa (87% vs. 73%; P<0.04). Comparing embryo development of oocytes injected with fresh vs. frozen spermatozoa difference was also found (83% vs. 74%; P<0.01). No difference was found in the abortion rates between the groups. Differences were observed in the implantation rates, however, these differences could not be verified statistically. CONCLUSION The presented data show that condition of injected testicular spermatozoa has influence to embryo development and even frozen/immotile testicular spermatozoa is able to induce/support fertilization and early embryo development.
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Affiliation(s)
- Janos Konc
- Infertility and IVF Center of Buda, Saint Janos Hospital, Budapest, Hungary
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Successful twin birth following blastocyst culture of embryos derived from the immotile ejaculated spermatozoa from a patient with primary ciliary dyskinesia: a case report. J Assist Reprod Genet 2008; 25:437-43. [PMID: 18855132 DOI: 10.1007/s10815-008-9254-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2008] [Accepted: 09/17/2008] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To describe the ultrastructure of spermatozoa from a patient with complete asthenozoospermia that resulted in live births following blastocyst culture. MATERIALS AND METHODS Analyses of spermatozoa from a 36 year old patient were performed using light and electron microscopy. The hypo-osmotic swelling test was used to select spermatozoa for intracytoplasmic sperm injection. Embryos were cultured to the blastocyst stage. RESULTS 100% of the spermatozoa had dynein arm deficiency with secondary defects varying from 3-17%. Six oocytes were injected; five fertilized normally and one was digynic. All five zygotes formed good quality blastocysts. Three blastocysts were cryopreserved and two blastocysts were transferred. Twin females were born at 37 weeks. CONCLUSIONS The hypo-osmotic swelling test can be used to select viable immotile ejaculated spermatozoa from a patient with dynein arm deficiency and can produce excellent fertilization rates and blastocyst development resulting in live births.
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Birth after intracytoplasmic sperm injection with use of testicular sperm from men with Kartagener or immotile cilia syndrome. Fertil Steril 2007; 88:497.e9-11. [DOI: 10.1016/j.fertnstert.2006.11.113] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2006] [Revised: 11/20/2006] [Accepted: 11/21/2006] [Indexed: 11/20/2022]
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Mitchell V, Rives N, Albert M, Peers MC, Selva J, Clavier B, Escudier E, Escalier D. Outcome of ICSI with ejaculated spermatozoa in a series of men with distinct ultrastructural flagellar abnormalities. Hum Reprod 2006; 21:2065-74. [PMID: 16644911 DOI: 10.1093/humrep/del130] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Severe sperm motility impairment results in human infertility, which can be overcome by ICSI. Whether some particular, possibly genetic, flagellar abnormalities can influence embryonic development is a matter of debate. METHODS Analysis of ultrastructural flagellar abnormalities and ICSI outcomes with ejaculated spermatozoa in a series of 21 infertile patients with asthenozoospermic or dyskinetic spermatozoa due to a primary and specific flagellar abnormality was carried out. RESULTS Patients were sorted into six categories according to flagellar ultrastructural defects. Oocyte fertilization occurred in the 21 couples with a mean 2PN fertilization rate reaching 61.85%. No difference was observed in the kinetics of in vitro development or in the morphological quality of the embryos between the different types of flagellar abnormalities. Pregnancy occurred in 12 couples (57.1%) and delivery in nine couples (42.86%). Both the implantation rate and the clinical pregnancy rate per cycle were lower in type III abnormalities and in patients with an initial sperm motility less than 5%. CONCLUSIONS The rate of ICSI success may be influenced by the type of flagellar abnormality. ICSI provides a suitable solution for patients with sperm flagellar defects but raises the question of the consequences of a specific (and primary flagellar) abnormality on oocyte fertilization, on embryo and fetal development as well as on live birth.
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Affiliation(s)
- Valérie Mitchell
- Laboratoire de Spermiologie, CHRU-Faculté de Médecine, Lille cedex, France.
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Yanagimachi R. Intracytoplasmic injection of spermatozoa and spermatogenic cells: its biology and applications in humans and animals. Reprod Biomed Online 2005; 10:247-88. [PMID: 15823233 DOI: 10.1016/s1472-6483(10)60947-9] [Citation(s) in RCA: 108] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Intracytoplasmic sperm injection (ICSI) has become the method of choice to overcome male infertility when all other forms of assisted fertilization have failed. Animals in which ICSI has produced normal offspring include many species. Success rate with normal spermatozoa is well above 50% in the mouse but ICSI success rates in other animals have been low, ranging from 0.3 to 16.5%. Mouse ICSI revealed that spermatozoa that cannot participate in normal fertilization can produce normal offspring by ICSI, provided their nuclei are genomically intact. Human ICSI using infertile spermatozoa has been highly successful perhaps because of the intrinsic instability of human sperm plasma membrane. The health of children born after ICSI and other assisted fertilization techniques is of major concern. Careful analyses suggest that higher incidences of congenital malformations and/or low birth weights after assisted fertilization are largely attributable to parental genetic background and increased incidence of multiple births, rather than to the techniques of assisted fertilization. Since the physiological and nutritional environments of developing embryos may cause persisting alteration in DNA methylation, extreme caution must be exercised in handling gametes and embryos in vitro. In the mouse, round spermatid injection (ROSI) has been routinely successful but its use in humans is controversial. Whether human ROSI and assisted fertilization involving younger spermatogenic cells are medically safe must be the subject of further investigations.
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Affiliation(s)
- Ryuzo Yanagimachi
- Institute for Biogenesis Research, University of Hawaii Medical School, Honolulu, Hawaii 96822, USA.
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Saremi A, Esfandiari N, Salehi N, Saremi MR. The first successful pregnancy following injection of testicular round spermatid in Iran. ARCHIVES OF ANDROLOGY 2002; 48:315-9. [PMID: 12137593 DOI: 10.1080/01485010290031637] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The authors report the healthy delivery of the first successful round spermatid injection in Iran. The male was a 40-year-old with nonobstructive azoospermia whose previous testicular biopsy revealed only round spermatids. The wife was a 29-year-old healthy woman.
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Affiliation(s)
- A Saremi
- Infertility Department, Sarem Medical Center, Tehran, Iran
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Abstract
Infertile men with severe spermatogenic defects and low or no sperm counts have a significantly higher rate of genetic abnormalities than fertile men. The fact that intracytoplasmic sperm injection can potentially bypass natural selection barriers to genetic disease transmission has brought a sobering but important impetus to recent research in the area of genetic infertility. Recent studies have focused on examining the prevalence of certain genetic defects in infertile men, analyzing the molecular basis of infertility in genetic disorders, and detecting new causes of genetic infertility. Several novel research findings deserve mention for their potential impact on genetic infertility. It has been demonstrated that elongated and round spermatids can be successfully injected into human oocytes and viable births obtained. Likewise, significant advances have been made in the arena of interspecies germ cell transplantation. Of some concern is the finding of a relationship between faulty DNA repair and infertility in men with severe testis failure. This review summarizes the recent genetic advances in these areas of male genetic infertility.
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Affiliation(s)
- D M Nudell
- Department of Urology, University of California, San Francisco, 533 Parnassus Ave., Room U575, San Francisco, CA 94143, USA
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Abstract
Men with non-obstructive azoospermia exhibit different histopathologic syndromes in the testicle biopsy, varying from aplasia, Sertoli cell only syndrome, maturation arrest and hypoplasia. The genetic basis of these syndromes is discussed. We present the diagnostic testicle biopsies performed on 160 consecutive non-obstructive azoospermic patients, and these results were correlated with the findings after multiple bilateral treatment testicle biopsy. Each syndrome had to be reevaluated as for the presence of at least one focus of spermatogenesis up to the primary spermatocyte, round spermatid, elongating spermatid, elongated spermatid, or spermatozoa stages. The clinical outcome using donor sperm-IVF, spermatid or sperm intracytoplasmic injection is thereafter presented. A new prognosis based on the findings of this large clinical series coupled to results obtained with Y chromosome molecular screening is offered. Alternative treatments to donor sperm for men without spermatids are discussed.
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Affiliation(s)
- M Sousa
- Laboratory of Cell Biology, Institute of Biomedical Sciences Abel Salazar, University of Porto, Lg. Prof. Abel Salazar 2, 4099-003, Porto, Portugal.
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TREATMENT OF INFERTILITY DUE TO ANEJACULATION IN THE MALE WITH ELECTROEJACULATION AND INTRACYTOPLASMIC SPERM INJECTION. J Urol 2000. [DOI: 10.1097/00005392-200006000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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SCHATTE EDWARDC, OREJUELA FRANCISCOJ, LIPSHULTZ LARRYI, KIM EDWARDD, LAMB DOLORESJ. TREATMENT OF INFERTILITY DUE TO ANEJACULATION IN THE MALE WITH ELECTROEJACULATION AND INTRACYTOPLASMIC SPERM INJECTION. J Urol 2000. [DOI: 10.1016/s0022-5347(05)67527-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- EDWARD C. SCHATTE
- From the Scott Department of Urology and Department of Cell Biology, Baylor College of Medicine, Houston, Texas
| | - FRANCISCO J. OREJUELA
- From the Scott Department of Urology and Department of Cell Biology, Baylor College of Medicine, Houston, Texas
| | - LARRY I. LIPSHULTZ
- From the Scott Department of Urology and Department of Cell Biology, Baylor College of Medicine, Houston, Texas
| | - EDWARD D. KIM
- From the Scott Department of Urology and Department of Cell Biology, Baylor College of Medicine, Houston, Texas
| | - DOLORES J. LAMB
- From the Scott Department of Urology and Department of Cell Biology, Baylor College of Medicine, Houston, Texas
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Shibahara H, Hamada Y, Hasegawa A, Wakimoto E, Toji H, Shigeta M, Koyama K. Relationship between the sperm motility index assessed by the sperm quality analyzer and the outcome of intracytoplasmic sperm injection. J Assist Reprod Genet 1999; 16:540-5. [PMID: 10575583 PMCID: PMC3455380 DOI: 10.1023/a:1020501305235] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Intracytoplasmic sperm injection (ICSI) has been validated as a useful treatment in severe male-factor patients who could not achieve fertilization and live births by conventional in vitro fertilization treatment. To examine the impact of male factors on ICSI outcome, clinical laboratory data were retrospectively analyzed. METHODS One hundred two cycles of ICSI treatment indicated by severe male-factor infertility were entered into this study. Sperm parameters including sperm motility, sperm concentration, and sperm motility index assessed by the Sperm Quality Analyzer were evaluated. RESULTS Five hundred seventy-six metaphase II oocytes retrieved were manipulated. The normal fertilization (2 PN) rate per oocyte was 64.9 +/- 26.0% (mean +/- SD). Of the 99 transfers, 31 clinical pregnancies were obtained, yielding an average pregnancy rate of 31.3% per transfer. The mean sperm motility, sperm concentration, and sperm motility index were 20.3 +/- 16.1% (range, 0 to 50%), 18.2 +/- 25.1 x 10(6)/ml (range, < 1 to 150 x 10(6)/ml), and 31.2 +/- 45.0 (range, 0 to 220), respectively. Sperm concentration did not have a significant impact on fertilization rate by ICSI. In four cases, ICSI was performed using totally immotile sperm and the fertilization rate was 43.5%, which was significantly lower than that of some of the other sperm motility groups, and no pregnancy could be achieved. In 14 cases in which the sperm motility index assessed by the Sperm Quality Analyzer was 0, the fertilization rate (50.0%) was significantly lower than in most of the other sperm motility index groups. CONCLUSIONS These findings suggest that in severe male-factor cases with totally immotile sperm or a sperm motility index of 0, the selection of good-quality sperm should be verified before injection.
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Affiliation(s)
- H Shibahara
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Japan
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