Introduction to methods for collecting human gametes in assisted reproduction

Germline Gene Editing: The Gender Issues

Human germline gene editing constitutes an extremely promising technology; at the same time, however, it raises remarkable ethical, legal, and social issues. Although many of these issues have been largely explored by the academic literature, there are gender issues embedded in the process that have not received the attention they deserve. This paper examines ways in which this new tool necessarily affects males and females differently-both in rewards and perils. The authors conclude that there is an urgent need to include these gender issues in the current debate, before giving a green light to this new technology.

Perurethral transvesical route for oocytes retrieval: an old technique for a new indication in oncofertility

We aimed to evaluate the safety and efficiency of the peruretheral transvesical oocyte retrieval in oncofertility. We conducted a retrospective comparative study in our assisted reproductive technologies center.

STUDY GROUP

28 pubertal young women affected by malignancies, referred for fertility preservation and refusing transvaginal (TV) procedure.

CONTROL GROUP

28 infertile patients, aged less than 25 years, who have undergone in vitro fertilization with TV oocyte retrieval. The ovarian stimulation was significantly longer on the study group. There was no difference between the two groups regarding mean number of collected metaphase II oocytes. One patient of the study group had a transient dysuria. These preliminary data suggest that, in oncofertility, peruretheral transvesical oocyte retrieval is an alternative when the TV route is refused or not feasible.

Detection of damage in mammalian sperm cells

Ejaculated semen is washed for in vitro fertilization or diluted and processed to allow optimal and long-term low temperature liquid- and cryo-preservation. However, sperm are vulnerable to the washing, dilution, temperature and osmotic changes involved in sperm storage. In this review, a number of techniques are considered for detecting damaged spermatozoa. Staining protocols have been developed to detect the membrane and organelle integrity of mammalian sperm cells. Plasma membrane integrity is usually assessed after staining cells with membrane-impermeable dyes or alternatively with acetylated membrane (AM) permeable probes that are selectively de-esterified and become membrane impermeable and thus entrapped into viable cells only (AM ester loading). Organelle-specific dyes are commonly used to detect functionality of mitochondria or the acrosome. A distortion in the lateral and bilayer organization of lipids as well as the peroxidation of fatty acid moieties can be quantified and localized in living sperm. The relation of a disordering in the sperm membrane's lipid architecture and sperm deterioration versus capacitation is discussed. Finally, the integrity of sperm DNA can be measured at three different levels by assessing the degree of DNA-protamine condensation, the incidence of breaks and nicks in the DNA and the frequency of fragmentation of the nuclei into sub-haploid apoptotic bodies. The relevance of detecting DNA aberrations and especially the putative link to the incidence of apoptosis is critically considered.

Percutaneous epididymal sperm aspiration: a diagnostic tool for the prediction of complete spermatogenesis

The classification of azoospermia into obstructive or non-obstructive is largely based on medical history, physical examination and biochemical markers in serum and semen. However, the most accurate parameter for diagnosis is the testicular histology. The predictive value of the percutaneous epididymal sperm aspiration (PESA), FSH, LH, testosterone, inhibin-B and testicular volume was investigated for their accuracy to predict a complete spermatogenesis (Johnsen score > or =8) in order to replace the testicular histology. The specificity and sensitivity of FSH, inhibin-B, LH, testosterone, testicular volume, and the presence of sperm in a PESA procedure was evaluated in 147 azoospermic males attending the centre for infertility diagnosis. A positive PESA outcome presented the highest sensitivity and specificity to predict a Johnsen score > or =8 (93 and 94% respectively) compared with FSH (90 and 19%), inhibin-B (88 and 57%) and testicular volume (95 and 45%). Differences in clinical presentation were observed between patients with positive sperm retrieval with PESA, depending on the aetiology of obstruction. In conclusion, the presence of spermatozoa in the epididymis (PESA+) correlates with a Johnsen score > or =8 and is the most accurate parameter to predict complete spermatogenesis compared with clinical or biochemical parameters. Between obstructive azoospermic patients, the clinical parameters observed varied according to the aetiology.