1
|
Mehrjerd A, Dehghani T, Jajroudi M, Eslami S, Rezaei H, Ghaebi NK. Ensemble machine learning models for sperm quality evaluation concerning success rate of clinical pregnancy in assisted reproductive techniques. Sci Rep 2024; 14:24283. [PMID: 39414869 PMCID: PMC11484743 DOI: 10.1038/s41598-024-73326-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/16/2024] [Indexed: 10/18/2024] Open
Abstract
This study aimed to investigate the influence of various sperm quality characteristics, including morphology, motility, and count, on the success rates of clinical pregnancy achieved through assisted reproductive technologies (ART) such as in-vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and intrauterine insemination (IUI). The secondary objective was to assess the impact of these sperm parameters on the clinical pregnancy rate that resulted in the detection of a fetal heartbeat during the 11th week of gestation, a crucial milestone in successful ART-derived pregnancies. The researchers employed a retrospective analysis, evaluating data from 734 couples undergoing IVF/ICSI and 1197 couples undergoing IUI across two infertility centers. Exclusion criteria included cases involving donated eggs or sperm, surrogate uteri, and infertile couples with combined male and female factors. Five ensemble machine-learning models were utilized to predict the clinical pregnancy success rates. The Random Forest (RF) model achieved the highest mean accuracy (0.72) and area under the curve (AUC) (0.80), outperforming the other models for both IVF/ICSI and IUI procedures. The Shapley Additive Explanations (SHAP) value analysis revealed that for IUI cycles, all three sperm parameters (morphology, motility, and count) had significant negative impacts on the prediction of clinical pregnancy success. In contrast, for IVF/ICSI cycles, sperm motility had a positive effect, while sperm morphology and count were negative factors. In cycles with 1 to 5 retrieved eggs, sperm motility, and count, they positively affected the clinical pregnancy rate. The study also identified cut-off values for sperm count, with 54 and 35 being the respective thresholds for IVF/ICSI and IUI. Additionally, a significant cut-off point 30 was found for the sperm morphology parameter across all procedures. This study underscores the immense potential of leveraging ensemble machine learning models with traditional sperm quality assessments. This integrated approach can elevate the precision and personalization of clinical decision-making in the field of assisted reproductive technologies, ultimately offering more hope and better outcomes for couples struggling with infertility.
Collapse
Affiliation(s)
- Ameneh Mehrjerd
- Department of Psychiatry and Psychotropic, Faculty of Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Toktam Dehghani
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdie Jajroudi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Pharmaceutical Sciences Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeid Eslami
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
- Pharmaceutical Sciences Research Center, Institute of Pharmaceutical Technology, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medical Informatics, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands.
| | - Hassan Rezaei
- Department of Mathematics, Statistics and Computer Sciences, University of Sistan and Baluchestan, Zahedan, Iran
| | - Nayyereh Khadem Ghaebi
- Department of Obstetrics and Gynecology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
2
|
Meseguer F, Giménez Rodríguez C, Rivera Egea R, Carrión Sisternas L, Remohí JA, Meseguer M. Can Microfluidics Improve Sperm Quality? A Prospective Functional Study. Biomedicines 2024; 12:1131. [PMID: 38791093 PMCID: PMC11118748 DOI: 10.3390/biomedicines12051131] [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: 04/17/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
The same sperm selection techniques in assisted reproduction clinics have remained largely unchanged despite their weaknesses. Recently, microfluidic devices have emerged as a novel methodology that facilitates the sperm selection process with promising results. A prospective case-control study was conducted in two phases: 100 samples were used to compare the microfluidic device with Density Gradient, and another 100 samples were used to compare the device with the Swim-up. In the initial phase, a significant enhancement in progressive motility, total progressive motile sperm count, vitality, morphology, and sperm DNA fragmentation were obtained for the microfluidic group compared to Density Gradient. Nevertheless, no statistically significant differences were observed in sperm concentration and chromatin structure stability. In the subsequent phase, the microfluidic group exhibited significant increases in sperm concentration, total progressive motile sperm count, and vitality compared to Swim-up. However, non-significant differences were seen for progressive motility, morphology, DNA structure stability, and DNA fragmentation. Similar trends were observed when results were stratified into quartiles. In conclusion, in a comparison of microfluidics with standard techniques, an improvement in sperm quality parameters was observed for the microfluidic group. However, this improvement was not significant for all parameters.
Collapse
Affiliation(s)
- Fernando Meseguer
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
| | - Carla Giménez Rodríguez
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| | - Rocío Rivera Egea
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
| | - Laura Carrión Sisternas
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| | - Jose A. Remohí
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| | - Marcos Meseguer
- IVIRMA Global Research Alliance, IVIRMA Valencia, Plaza de la Policía Local 3, 46015 Valencia, Spain; (R.R.E.); (M.M.)
- IVIRMA Global Research Alliance, IVI Foundation, Instituto de Investigación Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain; (C.G.R.); (L.C.S.)
| |
Collapse
|
3
|
Yavuzcan A, Yurtçu E, Keyif B, Osmanlıoğlu Ş. Is There Any Effect of Change in Pre-Wash and Post-Wash Semen Parameters on the Success of Intrauterine Insemination? J Pers Med 2023; 14:43. [PMID: 38248745 PMCID: PMC10820498 DOI: 10.3390/jpm14010043] [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: 10/01/2023] [Revised: 12/15/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
(1) Background: We aimed to investigate the effect of change in pre-wash and post-wash semen parameters on intrauterine insemination (IUI) success in a homogenous study group. (2) Methods: IUI cycles conducted at an infertility clinic were included in this study. Patient records were examined retrospectively. Δ sperm count (per mL) was calculated as [pre-wash sperm count (per mL)-post-wash sperm count (per mL)]. Δ Total progressive motile sperm count (TPMSC) was also calculated as (post-wash TPMSC-pre-wash TPMSC). (3) Results: No statistically significant difference was detected in terms of Δ sperm count (p = 0.38), and Δ TPMSC (p = 0.76) regarding the clinical pregnancy rate (CPR). There was no statistically significant difference between CPR (+) and CPR (-) groups in terms of post-wash sperm count, TPMSC, TPMSC ≥ 10 × 10⁶, TPMSC ≥ 5 × 10⁶ (p = 0.65, p = 0.79, p = 0.49, p = 0.49, respectively). The live birth rate (LBR) showed no statistically significant differences except for a pre-wash TPMSC ≥ 10 × 10⁶ (p = 0.02). Through the performed ROC analysis, no statistically significant cutoff value could be set for the pre-wash TPMSC. (4) Conclusions: There is only a pre-wash TPMSC ≥ 10 × 10⁶ that showed a significant role in the success of IUI, even when considering all other pre-wash and post-wash semen parameters. Δ sperm count and Δ are not useful markers for IUI success.
Collapse
Affiliation(s)
- Ali Yavuzcan
- Department of Obstetrics and Gynecology, Sağlık Bilimleri University, Ankara 06010, Türkiye
- Department of Obstetrics and Gynecology, Düzce University, Düzce 81620, Türkiye; (E.Y.)
| | - Engin Yurtçu
- Department of Obstetrics and Gynecology, Düzce University, Düzce 81620, Türkiye; (E.Y.)
| | - Betül Keyif
- Department of Obstetrics and Gynecology, Düzce University, Düzce 81620, Türkiye; (E.Y.)
| | - Şeyma Osmanlıoğlu
- Department of Obstetrics and Gynecology, Ankara Medipol University, Ankara 06050, Türkiye
| |
Collapse
|
4
|
Lamb DJ, Marinaro JA. Can semen parameters predict pregnancy outcomes? Fertil Steril 2023; 120:709-714. [PMID: 37414207 DOI: 10.1016/j.fertnstert.2023.06.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 06/28/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
Semen analysis is an integral component of the evaluation and management of men with infertility. Although it is important for patient counseling and clinical decision making, a conventional semen analysis cannot reliably predict the chance of pregnancy or differentiate fertile vs. infertile men (except in the most extreme cases). Advanced, nonstandard sperm functional tests may provide additional discriminatory and prognostic power; however, further research is needed to determine how to best incorporate these tests into modern clinical practice. Therefore, the primary applications of a conventional semen analysis should be to judge the severity of infertility, estimate the effects of future therapy, and measure the response to current therapy.
Collapse
Affiliation(s)
- Dolores J Lamb
- Department of Urology, Weill Cornell Medicine, New York, New York
| | | |
Collapse
|
5
|
Jiang Y, Shen Z, Xu J, Zhu J, Wang H, Chen W, Sun Y, Yang Q. The impact of female BMI on sperm DNA damage repair ability of oocytes and early embryonic development potential in intracytoplasmic sperm injection cycles. Front Endocrinol (Lausanne) 2023; 14:1168010. [PMID: 37780615 PMCID: PMC10534975 DOI: 10.3389/fendo.2023.1168010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/06/2023] [Indexed: 10/03/2023] Open
Abstract
Background Obesity adversely influences the quality of oocytes and embryos and can affect DNA repair in embryos, leading to reproductive issues. However, the effects of body mass index (BMI) on DNA repair ability in oocytes during intracytoplasmic sperm injection (ICSI) cycles have not yet been investigated. Therefore, this retrospective study aimed to analyze the influence of sperm DNA damage on embryo development and reproductive outcomes in overweight/obese and normal-weight women in ICSI cycles. Methods A total of 1,141 patients who received the first fresh ICSI cycle treatments were recruited from July 2017 to July 2021. Based on the BMI of the women, all patients were divided into normal weight (18.5≤BMI<25 kg/m2; n=824; 72.22%) and overweight/obese (BMI≥25 kg/m2; n=317; 27.78%) groups. Furthermore, according to the sperm DNA fragmentation index (DFI), these two groups were subdivided into two subgroups: DFI<30% and DFI≥30%. Results In the normal-weight women group, the embryonic development and reproductive outcomes of ICSI cycles were not statistically different between the two subgroups (DFI<30% and DFI≥30%). However, in the overweight/obese women group, couples with a sperm DFI≥30% had a significantly lower fertilization rate (76% vs. 72.7%; p=0.027), cleavage rate (98.7% vs. 97.2%; p=0.006), and high-quality embryo rate (67.8% vs. 62.6%; p=0.006) than couples with a sperm DFI<30%. Conclusion When injected sperm with high DFI into the oocytes of overweight/obese women, resulting in lower fertilization, cleavage, and high-quality embryo rates in ICSI cycles, and the decreased early developmental potential of embryos from overweight/obese patients may be caused by the diminished capacity of oocytes to repair sperm DNA damage.
Collapse
Affiliation(s)
- Yuqing Jiang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhaoyang Shen
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianmin Xu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jing Zhu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huan Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wenhui Chen
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yingpu Sun
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qingling Yang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Key Laboratory of Reproduction and Genetics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Henan Provincial Obstetrical and Gynecological Diseases (Reproductive Medicine) Clinical Research Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
6
|
Miyazaki MA, Guilharducci RL, Intasqui P, Bertolla RP. Mapping the human sperm proteome - novel insights into reproductive research. Expert Rev Proteomics 2023; 20:19-45. [PMID: 37140161 DOI: 10.1080/14789450.2023.2210764] [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: 05/05/2023]
Abstract
INTRODUCTION Spermatozoa are highly specialized cells with unique morphology. In addition, spermatozoa lose a considerable amount of cytoplasm during spermiogenesis, when they also compact their DNA, resulting in a transcriptionally quiescent cell. Throughout the male reproductive tract, sperm will acquire proteins that enable them to interact with the female reproductive tract. After ejaculation, proteins undergo post-translational modifications for sperm to capacitate, hyperactivate and fertilize the oocyte. Many proteins have been identified as predictors of male infertility, and also investigated in diseases that compromise reproductive potential. AREAS COVERED In this review we proposed to summarize the recent findings about the sperm proteome and how they affect sperm structure, function, and fertility. A literature search was performed using PubMed and Google Scholar databases within the past 5 years until August 2022. EXPERT OPINION Sperm function depends on protein abundance, conformation, and PTMs; understanding the sperm proteome may help to identify pathways essential to fertility, even making it possible to unravel the mechanisms involved in idiopathic infertility. In addition, proteomics evaluation offers knowledge regarding alterations that compromise the male reproductive potential.
Collapse
Affiliation(s)
- Mika Alexia Miyazaki
- Department of Surgery, Division of Urology, Human Reproduction Section, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Raquel Lozano Guilharducci
- Department of Surgery, Division of Urology, Human Reproduction Section, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Paula Intasqui
- Department of Surgery, Division of Urology, Human Reproduction Section, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ricardo Pimenta Bertolla
- Department of Surgery, Division of Urology, Human Reproduction Section, Universidade Federal de São Paulo, São Paulo, Brazil
| |
Collapse
|
7
|
Zafar MI, Mills KE, Baird CD, Jiang H, Li H. Effectiveness of Nutritional Therapies in Male Factor Infertility Treatment: A Systematic Review and Network Meta-analysis. Drugs 2023; 83:531-546. [PMID: 36943634 DOI: 10.1007/s40265-023-01853-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Nutritional therapies are effective alternative treatments for male infertility or subfertility. These are cost-effective and easily implementable, unlike other advanced invasive treatments. Even moderate improvements in sperm quality could improve spontaneous pregnancy. OBJECTIVE We aimed to compare the effectiveness of all nutritional therapies in male infertility/subfertility treatment and ranked their efficacy based on type and etiology. We intend to aid clinicians with an evidence-based approach to affordable and safer initial infertility treatment for those who mainly do not wish to have other advanced invasive treatments or could not afford or have access to them. METHODS We included 69 studies with 94 individual study arms identified from bibliographic databases and registries. We included studies in adult men with proven infertility or subfertility that investigated nutritional or dietary supplement therapies compared with control or placebo and at least reported on a sperm parameter. We undertook a network meta-analysis and performed a pairwise meta-analysis on all sperm parameter outcomes and meta-regression. No language or date restriction was imposed. A systematic article search was concluded on August 29, 2022. RESULTS Our network meta-analysis is the first to compare all dietary interventions in a single analysis, sub-grouped by intervention type and type of infertility. L-Carnitine with micronutrients, antioxidants, and several traditional herbal supplements showed statistically and clinically significant improvement in sperm quality. Meta-regression identified that improvement in the sperm count, motility and morphology translated into increased pregnancy rates (p < 0.001; p < 0.001; p < 0.002, respectively). In particular, L-carnitine with micronutrient therapy (risk ratio [RR]: 3.60, 95% CI 1.86, 6.98, p = 0.0002), followed by zinc (RR 5.39, 95% CI 1.26, 23.04, p = 0.02), significantly improved pregnancy rates. Men with oligozoospermia (RR 4.89), followed by oligoasthenozoospermia (RR 4.20) and asthenoteratozoospermia (RR 3.53), showed a significant increase in pregnancy rates. CONCLUSION We ranked nutritional therapies for their ability to improve sperm quality in men with infertility. Nutritional therapies, particularly L-carnitine alone or combined with micronutrients, significantly improved sperm parameters and pregnancy rates even under severe conditions. We believe these affordable solutions may be valuable for people without access to or who do not wish to undergo more invasive and costly fertility treatments.
Collapse
Affiliation(s)
- Mohammad Ishraq Zafar
- Institute of Reproductive Health/Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, 13 Hang Kong Road, Wuhan, 430030, China
- Reproductive Medicine Center, Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, China
| | - Kerry E Mills
- Department of Science and Technology, University of Canberra, Bruce 2617, Canberra, Australia.
- TruDataRx, White River Junction, Vermont, USA.
| | | | - Huahua Jiang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China
| | - Honggang Li
- Institute of Reproductive Health/Center of Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, 13 Hang Kong Road, Wuhan, 430030, China.
- Wuhan Huake Reproductive Hospital, Wuhan, China.
| |
Collapse
|
8
|
Zhu H, Xu S, Wang M, Shang Y, Wei C, Fu J. Effect of hope therapy on fertility stress and pregnancy rate in infertile patients undergoing intrauterine insemination. Am J Transl Res 2022; 14:4363-4371. [PMID: 35836885 PMCID: PMC9274543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the efficacy of hope therapy on fertility stress and pregnancy rate in infertile patients undergoing intrauterine insemination (IUI). METHODS In this retrospective study, 180 infertile patients undergoing IUI during May 2017 and October 2019 were enrolled and grouped into a study group (n=90) receiving hope therapy and control group (n=90) receiving routine infertility care. The two groups were compared in terms of anxiety and depression, scores of Fertility Problem Inventory (FPI), scores of coping style, social support before and after intervention, and post-intervention hormone levels. RESULTS (1) Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) scores showed no significant difference in both groups before intervention (P>0.05). After intervention, the study group exhibited lower scores of HAMA and HAMD than the control group (P<0.05). (2) The two groups showed no significant difference in FPI scale scores before intervention (P>0.05). After intervention, the study group exhibited lower scores of FPI than the control group (P<0.05). (3) The two groups had no significant difference in negative coping and positive coping scores before intervention (P>0.05). After intervention, the study group had lower negative coping scores and higher positive coping scores than the control group (P<0.05). (4) After intervention, the study group showed lower scores of obsessive-compulsive, interpersonal sensibility, depression, and anxiety, and significantly higher proportion of patients with SCL-90 positive factors regarding depression and anxiety than the control group (P<0.05). (5) The study group showed higher serum levels of luteinizing hormone (LH) and follicle stimulating hormone (FSH) than the control group after intervention (P<0.05). (6) The study group had a higher pregnancy rate than the control group at 6 months' follow-up (P<0.05). CONCLUSION Hope therapy for infertile patients undergoing IUI can help improve their adverse mood, improve their fertility attitude, and improve pregnancy rate while decreasing the scores of depression, anxiety, and obsessive-compulsive factors.
Collapse
Affiliation(s)
- Hailing Zhu
- Department of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100, Hainan, China
| | - Siyi Xu
- Department of Urology, The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100, Hainan, China
| | - Meihong Wang
- Department of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100, Hainan, China
| | - Ying Shang
- Department of Urology, The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100, Hainan, China
| | - Chan Wei
- Department of Reproductive Medicine, The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100, Hainan, China
| | - Jinshan Fu
- Department of Urology, The First Affiliated Hospital of Hainan Medical UniversityHaikou 570100, Hainan, China
| |
Collapse
|
9
|
Bonagurio LP, Murakami AE, Cruz FK, Kaneko IN, Gasparino E, Oliveira CAL, Lozano-Poveda CA, Silva CC, Santos TC. Dietary supplementation with canthaxanthin and 25-hydroxycholecalciferol on the incubation performance and fertility of European quail breeders. Poult Sci 2022; 101:101823. [PMID: 35468423 PMCID: PMC9046627 DOI: 10.1016/j.psj.2022.101823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/18/2022] Open
Abstract
This study assessed the effects of combined supplementation with canthaxanthin (Cx) and 25-hydroxycholecalciferol (25-OH-D3) on incubation performance, fertility, and chick quality in European quail breeders. A total of 240 birds were distributed in a completely randomized design with 5 diets and 8 replicates. The animals were fed a basal diet containing 50 µg of vitamin D3 or the basal diet supplemented with 3 ppm Cx and 34.5 µg 25-OH-D3, 6 ppm Cx, and 69 µg 25-OH-D3, 9 ppm Cx and 103.5 µg 25-OH-D3, or 12 ppm Cx and 138 µg 25-OH-D3. Incubation performance was analyzed in 2 periods (32 and 38 wk). Breeders aged 32 wk produced eggs with higher hatchability (P = 0.024), hatchability of fertile eggs (P = 0.026) and lower initial plus mid embryonic mortality (P = 0.021), whereas 38-week-old breeders generated chicks with a higher length at hatching (P < 0.001) and lower final plus pipped embryonic mortality (P = 0.021). In both age groups, Cx + 25-OH-D3 levels had a quadratic effect on egg fertility (P < 0.001), hatchability of total (P < 0.001), and fertile eggs (P < 0.001). The fertility and the number of sperm cells in the perivitelline membrane was analyzed in two periods (26 and 40 wk). A quadratic effect of diet and days after mating on both parameters (P < 0.05) was observed. Eggs from supplementing breeders showed a high fertility (P < 0.001) and sperm cell counts (P < 0.001) for up to 7 and 3 d after mating, respectively, then the control group. Moreover, the supplementation of quail breeder diets with 6 ppm Cx + 69 µg 25-OH-D3 enhances sperm cell longevity in sperm storage tubules, hatchability of total and fertile eggs, fertility, and chick quality, especially in older quail's breeders and reduces embryonic mortality.
Collapse
Affiliation(s)
- L P Bonagurio
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil
| | - A E Murakami
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil
| | - F K Cruz
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil
| | - I N Kaneko
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil
| | - E Gasparino
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil
| | - C A L Oliveira
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil
| | | | - C C Silva
- DSM Nutritional Products, São Paulo, Brazil
| | - T C Santos
- Department of Animal Science, State University of Maringá, Av. Colombo, 5790, Maringá, Paraná 87020-900, Brazil.
| |
Collapse
|
10
|
Jeong M, Kim SK, Kim H, Lee JR, Jee BC, Kim SH. Predictive value of sperm motility before and after preparation for the pregnancy outcomes of intrauterine insemination. Clin Exp Reprod Med 2021; 48:255-261. [PMID: 34488289 PMCID: PMC8421663 DOI: 10.5653/cerm.2021.04469] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/06/2021] [Indexed: 11/06/2022] Open
Abstract
Objective This study aimed to investigate sperm motility and its changes after preparation as predictors of pregnancy in intrauterine insemination (IUI) cycles. Methods In total, 297 IUI cycles from January 2012 to December 2017 at a single tertiary hospital were retrospectively analyzed. Patient and cycle characteristics, and sperm motility characteristics before and after processing were compared according to clinical pregnancy or live birth as outcomes. Results The overall clinical pregnancy rate per cycle was 14.5% (43/297) and the live birth rate was 10.4% (30/289). Patient and cycle characteristics were similar between pregnant and non-pregnant groups. Sperm motility after preparation and the total motile sperm count before and after processing were comparable in terms of pregnancy outcomes. Pre-preparation sperm motility was significantly higher in groups with clinical pregnancy and live birth than in cycles not resulting in pregnancy (71.4%±10.9% vs. 67.2%±11.7%, p=0.020 and 71.6%±12.6% vs. 67.3%±11.7%, p=0.030, respectively). The change in sperm motility after processing was significantly fewer in the non-pregnant cycles, both when the comparison was conducted by subtraction (post-pre) and division (post/pre). These relationships remained significant after adjusting for the female partner’s age, anti-Müllerian hormone level, and number of pre-ovulatory follicles. According to a receiver operating characteristic curve analysis, an initial sperm motility of ≥72.5% was the optimal threshold value for predicting live birth after IUI. Conclusion Initial sperm motility, rather than the motility of processed sperm or the degree of change after preparation, predicted live birth after IUI procedures.
Collapse
Affiliation(s)
- Mina Jeong
- Seoul Rachel Fertility Center, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Seul Ki Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hoon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Jung Ryeol Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Chul Jee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seok Hyun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| |
Collapse
|
11
|
Jeschke L, Santamaria CG, Meyer N, Zenclussen AC, Bartley J, Schumacher A. Early-Pregnancy Dydrogesterone Supplementation Mimicking Luteal-Phase Support in ART Patients Did Not Provoke Major Reproductive Disorders in Pregnant Mice and Their Progeny. Int J Mol Sci 2021; 22:5403. [PMID: 34065597 PMCID: PMC8161261 DOI: 10.3390/ijms22105403] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/17/2021] [Accepted: 05/19/2021] [Indexed: 01/26/2023] Open
Abstract
Progestogens are frequently administered during early pregnancy to patients undergoing assisted reproductive techniques (ART) to overcome progesterone deficits following ART procedures. Orally administered dydrogesterone (DG) shows equal efficacy to other progestogens with a higher level of patient compliance. However, potential harmful effects of DG on critical pregnancy processes and on the health of the progeny are not yet completely ruled out. We treated pregnant mice with DG in the mode, duration, and doses comparable to ART patients. Subsequently, we studied DG effects on embryo implantation, placental and fetal growth, fetal-maternal circulation, fetal survival, and the uterine immune status. After birth of in utero DG-exposed progeny, we assessed their sex ratios, weight gain, and reproductive performance. Early-pregnancy DG administration did not interfere with placental and fetal development, fetal-maternal circulation, or fetal survival, and provoked only minor changes in the uterine immune compartment. DG-exposed offspring grew normally, were fertile, and showed no reproductive abnormalities with the exception of an altered spermiogram in male progeny. Notably, DG shifted the sex ratio in favor of female progeny. Even though our data may be reassuring for the use of DG in ART patients, the detrimental effects on spermatogenesis in mice warrants further investigations and may be a reason for caution for routine DG supplementation in early pregnancy.
Collapse
Affiliation(s)
- Laura Jeschke
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, 39108 Magdeburg, Germany; (L.J.); (C.G.S.); (N.M.); (A.C.Z.)
| | - Clarisa Guillermina Santamaria
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, 39108 Magdeburg, Germany; (L.J.); (C.G.S.); (N.M.); (A.C.Z.)
- UFZ—Helmholtz Centre for Environmental Research Leipzig-Halle, Department of Environmental Immunology, 04318 Leipzig, Germany
| | - Nicole Meyer
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, 39108 Magdeburg, Germany; (L.J.); (C.G.S.); (N.M.); (A.C.Z.)
- UFZ—Helmholtz Centre for Environmental Research Leipzig-Halle, Department of Environmental Immunology, 04318 Leipzig, Germany
| | - Ana Claudia Zenclussen
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, 39108 Magdeburg, Germany; (L.J.); (C.G.S.); (N.M.); (A.C.Z.)
- UFZ—Helmholtz Centre for Environmental Research Leipzig-Halle, Department of Environmental Immunology, 04318 Leipzig, Germany
| | - Julia Bartley
- Reproductive Medicine and Gynecological Endocrinology, University Women’s Clinic, Medical Faculty, Otto-von-Guericke University, 39108 Magdeburg, Germany;
| | - Anne Schumacher
- Experimental Obstetrics and Gynecology, Medical Faculty, Otto-von-Guericke University, 39108 Magdeburg, Germany; (L.J.); (C.G.S.); (N.M.); (A.C.Z.)
- UFZ—Helmholtz Centre for Environmental Research Leipzig-Halle, Department of Environmental Immunology, 04318 Leipzig, Germany
| |
Collapse
|
12
|
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
|
13
|
Muthigi A, Jahandideh S, Bishop LA, Naeemi FK, Shipley SK, O'Brien JE, Shin PR, Devine K, Tanrikut C. Clarifying the relationship between total motile sperm counts and intrauterine insemination pregnancy rates. Fertil Steril 2021; 115:1454-1460. [PMID: 33610321 DOI: 10.1016/j.fertnstert.2021.01.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To study the relationship between postwash total motile sperm count (TMSC) and intrauterine insemination (IUI) outcomes. DESIGN Retrospective review SETTING: Large fertility clinic PATIENT(S): A total of 92,471 insemination cycles from 37,553 patients were included in this study. INTERVENTION(S) All stimulated clomiphene citrate, letrozole, and/or injectable gonadotropin IUI cycles performed at a single institution from 2002 through 2018 were reviewed. Generalized estimating equations (GEE) analysis was used to account for multiple cycles by individual patients and to adjust for female partner age, body mass index, and stimulation protocol. MAIN OUTCOME MEASURE(S) Successful clinical pregnancy was defined as ultrasound confirmation of an intrauterine gestational sac with fetal cardiac activity. RESULT(S) A total of 92,471 insemination cycles were available to evaluate the relationship between postwash TMSC and clinical pregnancy. Pregnancy rates were highest with TMSC of ≥9 × 106 and declined gradually as TMSC decreased. Complete data for the adjusted GEE analysis were available for 62,758 cycles. Adjusted GEE analysis among cycles with TMSC of ≥9 × 106 (n = 46,557) confirmed that TMSC in this range was unrelated to pregnancy. Conversely, TMSC was highly predictive of pregnancy (Wald χ2 = 39.85) in adjusted GEE analysis among cycles with TMSC of <9 × 106 (n = 16,201), with a statistically significant decline. CONCLUSIONS IUI pregnancy is optimized with TMSC of ≥9 × 106, below which the rates gradually decline. Although rare, pregnancies were achieved with TMSC of <0.25 × 106. Since the decline in pregnancy is gradual and continuous, there is no specific threshold above which IUI should be recommended. Rather, these more specific quantitative predictions can be used to provide personalized counseling and guide clinical decision making.
Collapse
Affiliation(s)
- Akhil Muthigi
- MedStar Georgetown University Hospital, Washington, D.C.; Shady Grove Fertility Center, Rockville, Maryland.
| | | | | | | | | | | | - Paul R Shin
- Shady Grove Fertility Center, Rockville, Maryland
| | - Kate Devine
- Shady Grove Fertility Center, Rockville, Maryland
| | | |
Collapse
|
14
|
Delaroche L, Caillou H, Lamazou F, Genauzeau E, Meicler P, Oger P, Dupont C, Humaidan P. Live birth after intrauterine insemination: is there an upper cut-off for the number of motile spermatozoa inseminated? Reprod Biomed Online 2020; 42:S1472-6483(20)30522-8. [PMID: 34756398 DOI: 10.1016/j.rbmo.2020.09.017] [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: 06/09/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
Abstract
RESEARCH QUESTION To date, most studies have investigated the minimum number of spermatozoa available for intrauterine insemination (IUI), with no data on the maximum number of motile spermatozoa inseminated (NMSI) having been published. This study aimed to determine whether an upper cut-off for the NMSI during IUI exists above which the live birth rate (LBR) is negatively affected. DESIGN Retrospective analysis of autologous IUI cycles performed between January 2010 and July 2018 in women <43 years old with a NMSI >1 million. The main outcome was the LBR per IUI cycle as a function of the NMSI. RESULTS A total of 2592 IUI cycles performed in 1017 couples were included. The LBR increased with NMSI up to 30 million without any upper threshold (AUC = 0.5441). The LBR per IUI cycle were 14.5%, 17.9% and 22.7% for NMSI of >1 to ≤10, >10 to ≤20 and >20 to ≤30 million, respectively (P = 0.003). By univariate analysis, the NMSI, female age, number of mature follicles and oestradiol concentrations on day of ovulation triggering, cycle number and infertility aetiology influenced the LBR. Multivariate analysis showed that the LBR was 1.49 and 1.78 times higher when IUI was performed with a NMSI >10 to ≤20 million (odds ratio [OR] 1.49; 95% confidence interval [CI] 1.10-2.02]) and >20 to ≤30 million (OR 1.78; 95% CI 1.08-2.94), respectively, compared with IUI with a NMSI >1 to ≤10 million. CONCLUSIONS The LBR after IUI can be optimized by inseminating a maximum of motile spermatozoa up to 30 million. Thus, in this specific cohort, IUI preparations should not be diluted when more than 10 million motile spermatozoa are obtained.
Collapse
Affiliation(s)
- Lucie Delaroche
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France; Centre de Biologie Médicale, Hôpital Privé de Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France.
| | - Hugo Caillou
- Capionis, 80b Rue Paul Camelle, Bordeaux 33100, France
| | - Frédéric Lamazou
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Emmanuel Genauzeau
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France; Centre de Biologie Médicale, Hôpital Privé de Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Philippe Meicler
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Pierre Oger
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Charlotte Dupont
- Sorbonne Université, Saint Antoine Research Centre, INSERM équipe Lipodystrophies Génétiques et Acquises, Service de Biologie de la Reproduction-CECOS, AP-HP, Hôpital Tenon, Paris F-75020, France
| | - Peter Humaidan
- Fertility Clinic, Skive Regional Hospital, Resenvej 25, 7800 Skive, Denmark and Faculty of Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|