Successful pregnancies after using immotile spermatozoa from ejaculate, epididymis and testis

Laser-Guided Sperm Selection: Optimizing the Reproductive Success Rate in Assisted Reproductive Technology

Assisted reproductive technologies (ART) enable these patient's spermatozoa to fertilize the oocyte and create viable and healthy offspring, but the effectiveness of the various procedures still has room to increase. In the field of assisted reproductive technology, the need to improve fertility results has led to the development of novel sperm selection strategies. Laser-assisted selection of immotile sperm (LAISS) appears to be a promising strategy, harnessing the power of modern optical instruments to better the selection process and, ultimately, maximize the probability of successful fertilization. This technology takes advantage of sperm cells' distinctive features, such as shape, form, and motility patterns, that can be sensitively changed by laser forces. Using precision laser manipulation, spermatozoa with desirable features can be precisely targeted, improving the overall quality and viability of the sperm population. The existence of an elevated percentage of DNA-damaged sperm in a patient's ejaculation may be one of the key factors decreasing ART outcomes. As a result, one of the most difficult tasks in reproductive medicine is ensuring the best quality of spermatozoa utilized in ART, particularly with regard to genetic integrity. The most recent approaches for preparing and selecting human spermatozoa by LAISS techniques are covered here, with an emphasis on those that have been shown to improve.

Genomic fragmentation and extrachromosomal telomeric repeats impact assessment of telomere length in human spermatozoa: quantitative experiments and systematic review

STUDY QUESTION

Can differences in DNA isolation alter assessment of sperm telomere length (spTL) and do they account for conflicting results in the literature on spTL and male fertility?

SUMMARY ANSWER

DNA isolation methods preferentially include or exclude short, extrachromosomal (EC) telomere-specific sequences that alter spTL measurements, and are responsible for a proportion of the disparity observed between investigations.

WHAT IS KNOWN ALREADY

The relationship between spTL and male fertility has become an active area of research. The results across investigations, however, have been discordant, generating a need to critically evaluate the existing body of knowledge to guide future investigations.

STUDY DESIGN, SIZE, DURATION

Quantitative experiments determined the effect of DNA isolation on the integrity of sperm DNA and measures of spTL, while a systematic analysis of the current literature evaluated the effect of DNA isolation and study design on experimental outcomes.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Two DNA isolation methods were compared: Genomic Tips which isolate 'High Molecular Weight' (HMW) DNA exclusively, and QIAamp® DNA Mini which isolates 'Total' genomic DNA irrespective of size. DNA quality was assessed via field inversion gel electrophoresis (FIGE) and spTL was measured via terminal restriction fragment analysis. In addition, major databases in medicine, health and the life sciences were subject to a targeted search, and results were independently screened according to defined exclusion/inclusion criterion. Findings from primary articles were analyzed for concordance and study designs were compared across six moderator variables (sample size, participant age, fertility status, semen fraction, telomere population and type of analysis).

MAIN RESULTS AND THE ROLE OF CHANCE

HMW DNA spTL was significantly longer than spTL measured from total DNA (P < 0.01), indicating that Total DNA contained short, EC telomeric repeats that shifted downstream assessment towards shorter spTL. HMW DNA spTL reflected the length of intact, chromosomal telomeres. Major findings on spTL showed the greatest concordance amongst studies that implemented HMW DNA isolation prior to spTL assessment. Studies that utilized Total DNA varied in concordance, but outcomes were similar if (i) a comparative analysis was applied or (ii) a sample size threshold of 81 was achieved for correlative analysis.

LIMITATIONS, REASONS FOR CAUTION

Chromosomal and EC telomeric DNA were distinguished based on outcomes of HMW DNA isolation and size. Further experiments are required to determine the nature and function of these two types of telomeric sequences.

WIDER IMPLICATIONS OF THE FINDINGS

This study reveals a dramatic impact of upstream DNA processing and study design on measurements of spTL, which accounts for conflicting results in the literature. Future assessments of spTL should incorporate independent detection of chromosomal and EC telomeric DNA and specific experimental planning.

STUDY FUNDING/COMPETING INTERESTS

This study was funded by CReATe Fertility Centre, Toronto, Ontario, Canada. The authors have declared no conflict of interest.

REGISTRATION NUMBER

N/A.

Healthy live birth using theophylline in a case of retrograde ejaculation and absolute asthenozoospermia

OBJECTIVE

To analyze whether the use of ready-to-use theophylline is a feasible option in a case of retrograde ejaculation and absolute asthenozoospermia.

DESIGN

Case report.

SETTING

In vitro fertilization unit of a public hospital.

PATIENT(S)

Thirty-one-year-old nulliparous woman, and 39-year-old male with retrograde ejaculation and absolute asthenozoospermia.

INTERVENTION(S)

Retrieval of postejaculatory urine, restoration of motility using a methylxanthine, intracytoplasmic sperm injection, single-embryo transfer.

MAIN OUTCOME MEASURE(S)

Sperm motility, fertilization, embryo quality, live birth.

RESULT(S)

Successful fertilization and a single-embryo transfer resulted in a healthy live birth.

CONCLUSION(S)

Theophylline turned out to be a safe, efficient agent for stimulating immotile spermatozoa in patients with retrograde ejaculation.

Fresh MESA improved embryo fertilization, cleavage, blastula formation and implantation rates after failed TESA in couples with obstructive azoospermia

PURPOSE

To determine whether our use of fresh MESA cycles improved outcomes in patients with obstructive azoospermia who had failed IVF with TESA.

METHODS

A prospective observational trial of couples undergoing IVF for obstructive azoospermia was performed at an academic IVF center.

RESULTS

When TESA resulted in poor embryo cleavage, implantation and ongoing pregnancy rates, subsequent fresh MESA cycles in these same couples, demonstrated dramatic improvement in cleavage, blastulation, implantation and live birth rates.

CONCLUSIONS

In patients undergoing IVF-TESA-ICSI with obstructive azoospermia resulting in poor cleavage rates, blastulation rates and cycle failure, a repeat cycle with MESA may result in marked improvement in outcome.

Intracytoplasmic sperm injection: An assisted reproductive technique and its outcome to overcome infertility

This review focuses on the outcome, merits and demerits of intracytoplasmic sperm injection (ICSI) for treatment of male factor infertility. Spermatozoa of infertile men are surgically retrieved from the epididymis or testis. Fertilisation and pregnancy rates after ICSI are found to be around 66% and 48%, respectively, with surgically retrieved spermatozoa. Major contributing factors to failed fertilisation after ICSI are the number of metaphase II oocytes retrieved and availability of viable spermatozoa for injection. Children born after ICSI have an increased risk of major congenital deformity as compared with children born naturally. Both paternal and maternal risk factors seem to pose an increased risk of congenital malformations in the offspring born after ICSI. The ICSI technique per se is not an independent risk factor. Qualitative differences in development and social interaction between ICSI and natural children appears to be related to developmental processes of the entire family unit. Parents of ICSI children have a good relationship with their children.

Effects of different concentrations of aflatoxin B on ram epididymal and ejaculatory sperm viability and motility in vitro

The present study was carried to observe the effect of aflatoxin on ovine sperm in vitro. Ram epididymal and ejaculatory sperm cells were added into media containing different concentrations of aflatoxin B1. When ram epididymal sperm were put in different concentrations of aflatoxin, one-hour post incubation in control group, 81.25% of sperm cells were alive of which, 82.88% were motile. Significantly (p < 0.05) higher than medium with 31.25 ppb and higher concentration. The lowest motility (15.93%) was observed in 62.5 ppb aflatoxin. Sperm viability did not significantly changed after 2nd and 3rd h incubation but significantly decreased in 4th and 5th h post incubation. However, motility was not altered in the 2nd, 3rd, 4th and 5th h post incubation. In ejaculatory sperm, one hour post-incubation, in control group, 83.24% of sperm were alive of which 93.98% were motile, significantly (p < 0.05) higher than motility in medium with 7.81 ppb and higher concentrations of aflatoxin but not different with 1.96 ppb aflatoxin. In 62.5 ppb aflatoxin, the lowest motility was observed (18.9%). Sperm motility patterns for both epididymal and ejaculatory sperm cells were different after incubation in different concentrations of aflatoxin. The results of the present experiment showed that aflatoxin could decrease sperm motility obtained from ejaculation or epididymis.

Cryopreservation of spermatozoa in alginic acid capsules

OBJECTIVE

To develop a method of freezing small amounts of spermatozoa in polymerized alginic acid drops, which can be liquified after thawing for recovery of the spermatozoa.

DESIGN

Prospective clinical study.

SETTING

Medical School, RWTH Aachen, Aachen Germany.

PATIENT(S)

None.

INTERVENTION(S)

Validation of the encapsulation method with bovine sperm; cryopreservation of human spermatozoa in alginic capsules.

MAIN OUTCOME MEASURE(S)

We optimized the cryopreservation method by testing different parameters influencing the freezing procedure, such as concentration of alginic acid, size of drops, time of polymerization, and culture media.

RESULT(S)

The final protocol was as follows: encapsulation by 7.3 mg/mL alginic acid forming 10-muL drops polymerized for 30 seconds and liquefied for 2.5 minutes in sodium citrate. Cryopreservation of human spermatozoa by this protocol resulted in a decreased motility of 18.3% compared with standard protocols but a 19.9% higher vitality of the immotile spermatozoa.

CONCLUSION(S)

No difference in viability of spermatozoa after both sperm-freezing procedures could be observed. Further investigation will be undertaken to reduce the amount of immotile but viable sperm after microencapsulation in alginic acid.