1
|
Crafa A, Russo M, Cannarella R, Gül M, Compagnone M, Mongioì LM, Cannarella V, Condorelli RA, La Vignera S, Calogero AE. Predictability of varicocele repair success: preliminary results of a machine learning-based approach. Asian J Androl 2024:00129336-990000000-00218. [PMID: 39118538 DOI: 10.4103/aja202438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/07/2024] [Indexed: 08/10/2024] Open
Abstract
Varicocele is a prevalent condition in the infertile male population. However, to date, which patients may benefit most from varicocele repair is still a matter of debate. The purpose of this study was to evaluate whether certain preintervention sperm parameters are predictive of successful varicocele repair, defined as an improvement in total motile sperm count (TMSC). We performed a retrospective study on 111 patients with varicocele who had undergone varicocele repair, collected from the Department of Endocrinology, Metabolic Diseases and Nutrition, University of Catania (Catania, Italy), and the Unit of Urology at the Selcuk University School of Medicine (Konya, Türkiye). The predictive analysis was conducted through the use of the Brain Project, an innovative tool that allows a complete and totally unbiased search of mathematical expressions that relate the object of study to the various parameters available. Varicocele repair was considered successful when TMSC increased by at least 50% of the preintervention value. For patients with preintervention TMSC below 5 × 106, improvement was considered clinically relevant when the increase exceeded 50% and the absolute TMSC value was >5 × 106. From the preintervention TMSC alone, we found a model that predicts patients who appear to benefit little from varicocele repair with a sensitivity of 50.0% and a specificity of 81.8%. Varicocele grade and serum follicle-stimulating hormone (FSH) levels did not play a predictive role, but it should be noted that all patients enrolled in this study were selected with intermediate- or high-grade varicocele and normal FSH levels. In conclusion, preintervention TMSC is predictive of the success of varicocele repair in terms of TMSC improvement in patients with intermediate- or high-grade varicoceles and normal FSH levels.
Collapse
Affiliation(s)
- Andrea Crafa
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| | - Marco Russo
- Department of Physics and Astronomy, University of Catania, Catania 95123, Italy
- INFN-Section of Catania, Catania 95123, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA
| | - Murat Gül
- Department of Urology, Selcuk University School of Medicine, Konya 42750, Türkiye
| | - Michele Compagnone
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| | - Laura M Mongioì
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| | - Vittorio Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| | - Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Catania 95123, Italy
| |
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
|
Karavani G, Akroof B, Lau S, Lo KC, Grober ED, Mehra VM, Kattan MS, Lajkosz K, Jarvi K. Intra-individual changes in sperm parameters and total motile count with time among infertile men. Andrology 2024. [PMID: 38685862 DOI: 10.1111/andr.13638] [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: 08/24/2023] [Revised: 02/01/2024] [Accepted: 03/07/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Paternal age association with sperm parameters has been previously studied, demonstrating a decrease in semen volume, sperm motility, and sperm morphology, but not in sperm concentration. However, scarce data exists on the individual intra-personal changes in semen parameters with time. STUDY DESIGN Retrospective cohort study. OBJECTIVE To evaluate the changes in semen parameters and total motile count of infertile men over time. MATERIALS AND METHODS In this retrospective cohort study, infertile men without known risk factors for sperm quality deterioration and at least two semen analyses done > 3 months apart, between 2005 and 2021, were evaluated. Allocation to groups was according to time between first and last semen analyses - 3-12 months, 1-3 years, 3-5 years, and > 5 years. Basic characteristics and first and last semen analyses were compared. The primary outcome was the change in sperm parameters and the secondary outcome was the occurrence of a total motile count < 5 million in men with an initial total motile count > 10 million. RESULTS A total of 2018 men were included in the study. The median age at first semen analyses was 36.2 (interquartile range: 32.8-40.1) years and the median time between semen analyses was 323 days (range 90-5810 days). The overall trend demonstrated an increase in concentration in the 3-12 months and the 1-3 years groups, whereas volume, motility, and morphology remained similar in these time groups. Semen analyses done more than 5 years apart showed decreased volume (p < 0.05), motility (p < 0.05) morphology (p < 0.05), and steady sperm concentration. Significant declines in TMCs were found over time (p < 0.001), with 18% and 22% of infertile men with an initial total motile count > 10 million dropping to < 5 million after 3 and 5 years, respectively. The factors independently predictive of total motile count < 5 M in the last semen analyses in men with an initial total motile count of > 10 M in a multivariate logistic regression model were baseline volume (odds ratio 0.80, p = 0.03), baseline total motile count (odds ratio 0.98, p = 0.01) and time between semen analyses - 3-5 years (odds ratio 3.79, p < 0.001) and > 5 years (odds ratio 3.49, p = 0.04) DISCUSSION: Our study demonstrates, at the individual level, that while improvement in sperm concentration is observed in the first year and between 1 and 3 years, possibly due to fertility treatments, fertility-related counseling, and lifestyle changes, semen parameters decline with time over 3 years in individuals. Of significance, close to 22% of men with an initial total motile count > 10 million (a range where spontaneous pregnancy is attainable) declined to < 5 million (a range usually indicating a need for in-vitro fertilization/intracytoplasmic sperm injection) over 5 years. This data could contribute to individualized family planning for infertile men regarding the mode and timing of conception and the need for sperm banking, in order to minimize the need for future fertility treatments.
Collapse
Affiliation(s)
- Gilad Karavani
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Bader Akroof
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Susan Lau
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Kirk C Lo
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Ethan D Grober
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Vrati M Mehra
- Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mohamed S Kattan
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| | - Katherine Lajkosz
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Canada
| | - Keith Jarvi
- Department of Surgery, Division of Urology, Mount Sinai Hospital, University of Toronto, Toronto, Canada
| |
Collapse
|
4
|
Sudhakaran G, Kesavan D, Kandaswamy K, Guru A, Arockiaraj J. Unravelling the epigenetic impact: Oxidative stress and its role in male infertility-associated sperm dysfunction. Reprod Toxicol 2024; 124:108531. [PMID: 38176575 DOI: 10.1016/j.reprotox.2023.108531] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
Male infertility is a multifactorial condition influenced by epigenetic regulation, oxidative stress, and mitochondrial dysfunction. Oxidative stress-induced damage leads to epigenetic modifications, disrupting gene expression crucial for spermatogenesis and fertilization. Paternal exposure to oxidative stress induces transgenerational epigenetic alterations, potentially impacting male fertility in offspring. Mitochondrial dysfunction impairs sperm function, while leukocytospermia exacerbates oxidative stress-related sperm dysfunction. Therefore, this review focuses on understanding these mechanisms as vital for developing preventive strategies, including targeting oxidative stress-induced epigenetic changes and implementing lifestyle modifications to prevent male infertility. This study investigates how oxidative stress affects the epigenome and sperm production, function, and fertilization. Unravelling the molecular pathways provides valuable insights that can advance our scientific understanding. Additionally, these findings have clinical implications and can help to address the significant global health issue of male infertility.
Collapse
Affiliation(s)
- Gokul Sudhakaran
- Toxicology and Pharmacology Laboratory, Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology, Chengalpattu District, Kattankulathur 603203, Tamil Nadu, India
| | - D Kesavan
- Toxicology and Pharmacology Laboratory, Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology, Chengalpattu District, Kattankulathur 603203, Tamil Nadu, India
| | - Karthikeyan Kandaswamy
- Department of Cariology, Saveetha Dental College and Hospitals, SIMATS, Chennai 600077, Tamil Nadu, India
| | - Ajay Guru
- Department of Cariology, Saveetha Dental College and Hospitals, SIMATS, Chennai 600077, Tamil Nadu, India.
| | - Jesu Arockiaraj
- Toxicology and Pharmacology Laboratory, Department of Biotechnology, Faculty of Science and Humanities, SRM Institute of Science and Technology, Chengalpattu District, Kattankulathur 603203, Tamil Nadu, India.
| |
Collapse
|
5
|
Cheng YS, Chen HY, Lin YC, Lin YS, Yeh YC, Yeh YH, Cheng YH, Lin YM, Weng HY, Lin TY, Lin SC. The MAEL expression in mitochondria of human spermatozoa and the association with asthenozoospermia. Andrology 2023; 11:1286-1294. [PMID: 36779514 DOI: 10.1111/andr.13408] [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: 10/07/2022] [Revised: 01/19/2023] [Accepted: 02/05/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE The maelstrom spermatogenic transposon silencer (MAEL) function in postmeiotic germ cells remains unclear, and its protein localization in human testis and spermatozoa awaits determination. This study aims to clarify the MAEL expression in human spermatogenesis and to explore its role in sperm function. MATERIALS AND METHODS Twenty-seven asthenozoospermic men, 40 normozoospermic controls, and three obstructive azoospermic men were enrolled. The transcripts of MAEL in the seminiferous epithelium and MAEL downstream targets were identified by bioinformatics analysis. MAEL protein expression in human testis and ejaculated sperms were examined by immunohistochemical and immunogold staining, respectively. The roles of MAEL in mitochondria function were investigated by siRNA knockdown in human H358 cells. The association between MAEL protein levels and clinical sperm features was evaluated. RESULTS Abundant MAEL was expressed in spermatid and spermatozoa of the human testis. Remarkably, MAEL was located in the mitochondria of ejaculated sperm, and bioinformatics analysis identified GPX4 and UBL4B as MAEL's downstream targets. Knockdown of MAEL sabotaged mitochondria function and reduced adenosine triphosphate (ATP) production in H358 cells. MAEL, GPX4, and UBL4B expression levels were significantly decreased in asthenozoospermic sperms than in controls. The MAEL protein levels were positively correlated with GPX4 and UBL4B in human sperm. Total motile sperm count (TMSC) was positively correlated with protein levels of MAEL, GPX4, and UBL4B in ejaculated sperms. CONCLUSIONS We highlight prominent MAEL expression in the intratesticular spermatid and the mitochondria of ejaculated spermatozoa. MAEL directly binds to GPX4 and UBL4B, and loss of MAEL induces mitochondrial dysfunction. MAEL-mitochondrial function-motility relationship might advance our understanding of the causes of asthenozoospermia.
Collapse
Affiliation(s)
- Yu-Sheng Cheng
- Department of Urology, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hsing-Yi Chen
- Department of Urology, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Chiao Lin
- Department of Urology, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Syuan Lin
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chun Yeh
- International Center for Wound Repair and Regeneration, National Cheng Kung University, Tainan, Taiwan
- Department of Physiology and Pharmacology, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsuan Yeh
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yung-Hsuan Cheng
- Department of Urology, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yung-Ming Lin
- Department of Urology, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Han-Yu Weng
- Department of Urology, National Cheng Kung University Hospital, College of, Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Tsung-Yen Lin
- Department of Surgery, Division of Urology, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan
| | - Shih-Chieh Lin
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
6
|
Effect of pre-IVF incubation in maturation medium on oocyte maturity, fertilization, embryonic development, and clinical outcomes following embryo transfer. REPRODUCTIVE AND DEVELOPMENTAL MEDICINE 2022. [DOI: 10.1097/rd9.0000000000000029] [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] Open
|
7
|
Tenorio Lira Neto F, Marques RA, Filho ADFC, Fonte JEFD, Lima SVC, Silva RO. Prediction of semen analysis parameters improvement after varicocelectomy using 1 H NMR-based metabonomics assays. Andrology 2022; 10:1581-1592. [PMID: 36018886 DOI: 10.1111/andr.13281] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 08/09/2022] [Accepted: 08/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Varicocele is the most common correctable cause of male infertility, however, predicting varicocelectomy outcomes is difficult. "Omics" techniques have been increasingly used to develop new diagnostic and prognostics tools for several male infertility causes, and could be applied to study varicocele. OBJECTIVES To create metabolomics models capable of segregating men who improved semen analysis (SA) parameters or achieved natural pregnancy after microsurgical varicocelectomy (MV) from those who did not, using Hydrogen-1 nuclear magnetic resonance (1 H NMR) spectra of seminal plasma of pre-operative samples. MATERIAL AND METHODS We recruited 29 infertile men with palpable varicocele. 1 H NMR spectra of seminal plasma were obtained from pre-operative samples and used to create metabonomics models. Improvement was defined as an increase in the total motile progressive sperm count (TMC) of the post-operative SA when compared to the baseline, and pregnancy was assessed during 24 months after MV. RESULTS Using Linear Discriminant Analysis (LDA), we created a model that discriminated the men who improved SA from those who did not with accuracy of 93.1%. Another model segregated men who achieved natural pregnancy from men who did not. We identified 7 metabolites that were important for group segregation: caprylate, isoleucine, N-acetyltyrosine, carnitine, N-acetylcarnitine, creatine and threonine. DISCUSSION We described the use of metabonomics model to predict with high accuracy the outcomes of MV in infertile men with varicocele. The most important metabolites for groups segregation are involved in energy metabolism and oxidative stress response, highlighting the pivotal role of these mechanisms in the pathophysiology of varicocele. CONCLUSIONS 1 H NMR spectroscopy of seminal plasma can be used in conjunction with multivariate statistical tools to create metabonomics models useful segregate men with varicocele based on the reproductive outcomes of MV. These models may help counseling infertile men with varicocele regarding their prognosis after surgery. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Filipe Tenorio Lira Neto
- Andros Recife, Recife, Brazil. Department of Urology, Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Brazil. Departamento de Cirurgia, Universidade Federal de Pernambuco, Recife, Brazil
| | | | | | | | | | | |
Collapse
|
8
|
Is seminal quality worsening? A 20-year experience in Córdoba, Argentina. J Assist Reprod Genet 2022; 39:1125-1134. [PMID: 35296953 PMCID: PMC9107558 DOI: 10.1007/s10815-022-02458-4] [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: 12/16/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To assess the possible variations in semen quality during the last 20 years in Córdoba, Argentina, and to identify possible causal lifestyle or genitourinary factors. METHODS Retrospective study of 23,130 patients attending an andrology laboratory. The 20-year period (2001-2020) was divided into four quinquenniums. Seminal parameters (sperm concentration, motility, morphology, viability, and membrane functional integrity) were classified as normal or abnormal according to WHO, and results were expressed as percentage of patients abnormal for each parameter per quinquennium. In addition, the percentage of patients per quinquennium exposed to the different risk factors (daily alcohol and/or tobacco consumption; occupational exposure to heat or toxics; history of parotitis or varicocele; and high body mass index, BMI) was reported. RESULTS Patients included in our study did not show impairment in seminal quality over time. Beyond a transient decrease in normozoospermia in the second and third quinquennium, possibly explained by a parallel increase in teratozoospermia, other important parameters of the spermogram did not change. In fact, abnormalities in sperm concentration (oligozoospermia), total sperm count, viability and response to hypoosmotic test showed a decreasing trend over time. On the other hand, parotitis, varicocele, morbid obesity and regular exposition to heat/toxics were the factors more frequently associated with semen abnormalities; the last two increased their frequency over the study period. CONCLUSION The population included in this study did not show a clear impairment in semen quality during the last 20 years. The decreasing patterns found were associated with high BMI and exposure to heat/toxics.
Collapse
|
9
|
Helmi ZR, Hameed BH. CYP24A1 Gene Expression in Spermatozoa of Human and Other Oxidation Level Controlling Enzymes as Biomarkers of Infertility. J Obstet Gynaecol India 2022; 72:290-294. [PMID: 35928074 PMCID: PMC9343504 DOI: 10.1007/s13224-021-01608-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 12/01/2021] [Indexed: 10/19/2022] Open
Abstract
Background Physiologically, the spermatozoa are exposed to reactive oxygen species (ROS), and those ROS can strongly affect sperm's function through sperm capacitation. However, producing a high level of ROS reduces the sperm anti-oxidation system that may cause infertility, especially in cases with normal sperm count. Purpose To investigate the expression of the CYP24A1 gene in human spermatozoa and other oxidation-related biomarkers, including vitamin E, ROS, and catalase as added tools to predict male infertility. Method The study included 50 infertile men and 50 young volunteers from the general Iraqi population. Blood samples were drawn from all included men, and semen samples were collected by masturbation. All the samples of semen were investigated for CYP24A1 expression, and routine semen analysis was performed. In addition, the serum was separated and used to assess other biochemical parameters, namely catalase, reactive oxygen species, and vitamin E, which were measured by ELISA. Results Serum ROS levels were higher in patients than control groups, while the serum catalase and vitamin E levels were significantly lower in patients than controls. CYP24A1 gene expression is significantly higher in infertile men with sperm count higher than 70 million and reaches twofold times the control. Conclusion CYP24A1 gene expression is significantly higher in infertile men and can be used as a marker of infertility, especially in infertile males with normal sperm count. At the same time, the serum catalase and vitamin E levels were significantly lower, which can be added as tools to predict male infertility..
Collapse
|
10
|
Feferkorn I, Azani L, Kadour-Peero E, Hizkiyahu R, Shrem G, Salmon-Divon M, Dahan MH. An evaluation of changes over time in the semen parameters data used for the World Health Organization semen analysis reference ranges. Andrology 2021; 10:660-668. [PMID: 34964554 DOI: 10.1111/andr.13150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Previous meta-analyses concluded that there is a decline in sperm parameters over time. This conclusion might be incorrect due to inherent biases or focusing only on a single parameter - sperm concentration. OBJECTIVE To study trends in sperm parameters over the past twenty years using data from the trials that defined the reference ranges of the World Health Organization manual. MATERIALS AND METHODS Retrospective evaluation of the data used to define the World Health Organization reference ranges. The data from 11 studies, including 3589 participants between 1996-2016, were divided into three period groups based on the decade of study. Differences in semen parameters' distribution were presented in boxplot. P-values were calculated by the Kruskal Wallis rank-sum test followed by Dunn post-hoc test. Analyses were conducted using the R programming language. RESULTS A small decrease was noted in mean sperm concentrations (88.1 million/ml, 87.6 million/ml and 77.2 million/ml for the first second and third decades respectively) (p<0.01). However, the 5th percentile of sperm concentration for the third decade was higher than the first or second decades (18 million/ml vs. 14.9 million/ml and 15 million/ml respectively). No significant differences were noted in progressive motility over the years (p = 0.32). The percent of morphologically normal sperm decreased between the first (24.2%) and the second (12.6%) periods of the study (p<0.001) and then increased in the third decade (14.2%) (p<0.01). While TMC declined between the second and third decades (189 million and 153.9 million respectively, p<0.001), at levels unlikely to decrease fertility. However, the 5th percentile of the TMC remained stable at 24.9, 20.8 and 20.6 million, for the first, second and third decades respectively (p = 0.36). DISCUSSION AND CONCLUSION AND RELEVANCE Trends in sperm parameters over the last three decades do not seem to be clinically significant. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Ido Feferkorn
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
| | - Liat Azani
- Department of Molecular Biology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel
| | - Einav Kadour-Peero
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
| | - Ranit Hizkiyahu
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
| | - Guy Shrem
- IVF unit, Department of Obstetrics and Gynecology, Kaplan Medical Center, 1 Derech Pasternak, Rehovot, Israel
| | - Mali Salmon-Divon
- Department of Molecular Biology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel.,Adelson School of Medicine, Ariel University, 65 Ramat HaGolan St, Ariel, Israel
| | - Michael H Dahan
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
| |
Collapse
|
11
|
Vogiatzi P, Pouliakis A, Sakellariou M, Athanasiou A, Athanasiou A, Colaghis A, Finelli R, Loutradis D, Henkel R, Agarwal A. Male Age and Progressive Sperm Motility Are Critical Factors Affecting Embryological and Clinical Outcomes in Oocyte Donor ICSI Cycles. Reprod Sci 2021; 29:883-895. [PMID: 34782988 DOI: 10.1007/s43032-021-00801-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/05/2021] [Indexed: 11/28/2022]
Abstract
This retrospective cohort study aimed to explore whether paternal age and semen quality parameters affect the embryological and clinical outcomes of ICSI with oocyte donation. A total of 339 oocyte donation (OD)-ICSI cycles were categorized into four groups according to the semen parameter profiles of the male counterparts: normozoospermia (NS, n = 184), oligozoospermia (OS, n = 41), asthenozoospermia (AS, n = 50), and oligoasthenozoospermia (OAS, n = 64). The effect of age, total sperm count, and progressive motility was separately analyzed for reproductive outcomes and compared between the study groups: fertilization, blastulation, and top-quality embryo rate, biochemical and clinical pregnancy, live birth, and miscarriage. A negative correlation between male age and fertilization rate was observed (rs = - 0.23, p < 0.0001), while male age was a significant factor for biochemical pregnancy (p = 0.0002), clinical pregnancy (p = 0.0017), and live birth (p = 0.0038). Reduced total sperm count and lowered progressive motility led to poorer fertilization rates (rs = 0.19 and 0.35, respectively, p < 0.0001) and affected embryo quality (rs = 0.13, p = 0.02, and rs = 0.22, p < 0.0001, respectively). OD-ICSI cycles with asthenozoospermia had significantly lowered success rates in biochemical pregnancy, clinical pregnancy, and live birth (p < 0.05). Our study demonstrated that both advanced male age and reduced progressive motility of spermatozoa exert a significant negative influence on the outcome of assisted reproduction, even in controlled procedures with gamete selection and optimization such as in OD-ICSI. Improvement in treatment strategies and male fertility evaluation requires incorporation of such evidence to obtain better prognosis towards personalized management.
Collapse
Affiliation(s)
- Paraskevi Vogiatzi
- IVF Athens Reproduction Center, 5 Kifissias Avenue, 151 23, Maroussi, Greece. .,Andromed Health & Reproduction, Fertility Diagnostics Laboratory, 3 Mesogion Str, 15126, Maroussi, Greece.
| | - Abraham Pouliakis
- Second Department of Pathology, "Attikon" University Hospital, National and Kapodistrian University of Athens, 1 Rimini Street, 12462, Athens, Greece
| | - Maria Sakellariou
- IVF Athens Reproduction Center, 5 Kifissias Avenue, 151 23, Maroussi, Greece
| | | | | | - Alexandros Colaghis
- IVF Athens Reproduction Center, 5 Kifissias Avenue, 151 23, Maroussi, Greece
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH, 44195, USA
| | - Dimitrios Loutradis
- First Department of Obstetrics and Gynecology, "Alexandra" Maternity Hospital, National and Kapodistrian University of Athens, 80 Vassilissis Sophias Avenue, 115 28, Athens, Greece
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH, 44195, USA.,Department of Metabolism, Digestion and Reproduction, Imperial College London, London, SW7 2BX, UK.,Department of Medical Bioscience, University of the Western Cape, Robert Sobukwe Road, Bellville, 7535, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, 10681 Carnegie Avenue, Cleveland, OH, 44195, USA
| |
Collapse
|
12
|
Feferkorn I, Shrem G, Azani L, Son WY, Nehushtan T, Salmon-Divon M, Dahan MH. Hope for male fecundity: clinically insignificant changes in semen parameters over 10 years at a single clinic while assessing an infertility population. J Assist Reprod Genet 2021; 38:2995-3002. [PMID: 34386934 PMCID: PMC8609088 DOI: 10.1007/s10815-021-02298-8] [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: 06/13/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE What is the trend in sperm parameters in a group of men attending a single reproductive center, over a 10-year period? METHODS A retrospective study was conducted on 12,188 semen samples obtained from unique individuals who attended a university reproductive clinic from 2009 to 2018, inclusively. Semen analysis was done using computer-assisted sperm analysis and verified by an andrologist. Analysis was done after dividing the dataset into two groups: above WHO 2010 lower reference limits (ARL) (N = 6325) and below the reference limits (BRL) (N = 5521). RESULTS Volume increased slightly (ARL, p = 0.049) before returning to baseline or was stable (BRL, p = 0.59). Sperm concentration and total count of the BRL and ARL group declined initially and then recovered slightly (p < 0.0001, in all cases). Although these changes were statistically significant, this was due to the large study population; clinically, these changes were quite mild and would not have been significant for fertility. Sperm total motility and progressive motility of both the BRL group and the ARL group increased slightly from 2009 until 2015 and then decreased back to baseline (p < 0.0001). This change offset the decrease in count seen in those years. A spurious change was observed with sperm morphology that declined after the first 2 years and remained stable thereafter (p < 0.0001, in both groups). However, this change was attributed to a contemporaneous change in the method of analyzing strict morphology which happened when the change occurred. CONCLUSION While statistically significant changes were found, clinically, these changes were quite mild and would not have been significant for fertility.
Collapse
Affiliation(s)
- Ido Feferkorn
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada.
| | - Guy Shrem
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
- IVF Unit, Department of Obstetrics and Gynecology, Kaplan Medical Center, 1 Derech Pasternak, Rehovot, Israel
| | - Liat Azani
- Department of Molecular Biology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel
| | - Weon-Young Son
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
| | - Tamar Nehushtan
- Department of Molecular Biology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel
| | - Mali Salmon-Divon
- Department of Molecular Biology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel
- Adelson School of Medicine, Ariel University, 65 Ramat HaGolan St, Ariel, Israel
| | - Michael Haim Dahan
- Division of Reproductive Endocrinology and Infertility, McGill University Health Care Center, 888 Boul. de Maisonneuve E #200, Montréal, QC, H2L 4S8, Canada
| |
Collapse
|
13
|
Sperm Selection and Embryo Development: A Comparison of the Density Gradient Centrifugation and Microfluidic Chip Sperm Preparation Methods in Patients with Astheno-Teratozoospermia. Life (Basel) 2021; 11:life11090933. [PMID: 34575082 PMCID: PMC8466221 DOI: 10.3390/life11090933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/02/2021] [Accepted: 09/04/2021] [Indexed: 11/28/2022] Open
Abstract
In recent years, microfluidic chip-based sperm sorting has emerged as an alternative tool to centrifugation-based conventional techniques for in vitro fertilization. This prospective study aims to compare the effects of density gradient centrifugation and microfluidic chip sperm preparation methods on embryo development in patient populations with astheno-teratozoospermia. In the study, the semen samples of the patients were divided into two groups for preparation with either the microfluidic or density gradient methods. Selected spermatozoa were then used to fertilize mature sibling oocytes and the semen parameters and embryo development on days 3 and 5 were assessed. While the density gradient group was associated with a higher sperm concentration, motility (progressive and total) was significantly higher in the microfluidic chip group. No significant differences were observed in the fertilization rates or grade 1 (G1) and grade 2 (G2) proportions of the third-day embryos. Furthermore, while the proportions of the poor, fair and good blastocysts on day 5 did not differ significantly, excellent blastocysts (indicating high-quality embryos) were observed in a significantly higher proportion of the microfluidic chip group. When compared to the classical density gradient method, the microfluidic chip sperm preparation yielded sperm with higher motility and higher quality blastocysts at day 5; in patients with astheno-teratozoospermia.
Collapse
|
14
|
Diagnostics and Management of Male Infertility in Primary Ciliary Dyskinesia. Diagnostics (Basel) 2021; 11:diagnostics11091550. [PMID: 34573892 PMCID: PMC8467018 DOI: 10.3390/diagnostics11091550] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 11/21/2022] Open
Abstract
Primary ciliary dyskinesia (PCD), a disease caused by the malfunction of motile cilia, manifests mainly with chronic recurrent respiratory infections. In men, PCD is also often associated with infertility due to immotile sperm. Since causative mutations for PCD were identified in over 50 genes, the role of these genes in sperm development should be investigated in order to understand the effect of PCD mutations on male fertility. Previous studies showed that different dynein arm heavy chains are present in respiratory cilia and sperm flagellum, which may partially explain the variable effects of mutations on airways and fertility. Furthermore, recent studies showed that male reproductive tract motile cilia may play an important part in sperm maturation and transport. In some PCD patients, extremely low sperm counts were reported, which may be due to motile cilia dysfunction in the reproductive tract rather than problems with sperm development. However, the exact roles of PCD genes in male fertility require additional studies, as do the treatment options. In this review, we discuss the diagnostic and treatment options for men with PCD based on the current knowledge.
Collapse
|
15
|
Keihani S, Verrilli LE, Zhang C, Presson AP, Hanson HA, Pastuszak AW, Johnstone EB, Hotaling JM. Semen parameter thresholds and time-to-conception in subfertile couples: how high is high enough? Hum Reprod 2021; 36:2121-2133. [PMID: 34097024 DOI: 10.1093/humrep/deab133] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 04/25/2021] [Indexed: 12/12/2022] Open
Abstract
STUDY QUESTION What thresholds for total sperm count, sperm concentration, progressive motility, and total progressive motile sperm count (TPMC) are associated with earlier time-to-conception in couples undergoing fertility evaluation? SUMMARY ANSWER Values well above the World Health Organization (WHO) references for total sperm count, concentration, and progressive motility, and values up to 100 million for TPMC were consistently associated with earlier time-to-conception and higher conception rates. WHAT IS KNOWN ALREADY Although individual semen parameters are generally not able to distinguish between fertile and infertile men, they can provide clinically useful information on time-to-pregnancy for counseling patients seeking fertility treatment. Compared to the conventional semen parameters, TPMC might be a better index for evaluating the severity of male infertility. STUDY DESIGN, SIZE, DURATION We used data from a longitudinal cohort study on subfertile men from 2002 to 2017 and included 6061 men with initial semen analysis (SA) in the study. PARTICIPANTS/MATERIALS, SETTING, METHODS Men from subfertile couples who underwent a SA within the study period were included, and 5-year follow-up data were collected to capture conception data. Couples were further categorized into two subgroups: natural conception (n = 5126), after separating those who achieved conception using ART or IUI; natural conception without major female factor (n = 3753), after separating those with severe female factor infertility diagnoses. TPMC was calculated by multiplying the semen volume (ml) by sperm concentration (million/ml) and the percentage of progressively motile sperm (%). Cox proportional hazard models were used to report hazard ratios (HRs) with 95% CIs before and after adjusting for male age, the number of previous children before the first SA, and income. Using the regression tree method, we calculated thresholds for total sperm count, sperm concentration, progressive motility, and TPMC to best differentiate those who were more likely to conceive within 5 years after first SA from those less likely to conceive. We also plotted continuous values of semen parameters in predicting 5-year conception rates and time-to-conception. MAIN RESULTS AND THE ROLE OF CHANCE Overall, the median time to conception was 22 months (95% CI: 21-23). A total of 3957 (65%) couples were known to have achieved conception within 5 years of the first SA. These patients were younger and had higher values of sperm concentration, progressive motility, and TPMC. In the overall cohort, a TPMC of 50 million best differentiated men who were more likely to father a child within 5 years. Partners of men with TPMC ≥50 million had a 45% greater chance of conception within 5 years in the adjusted model (HR: 1.45; 95% CI: 1.34-1.58) and achieved pregnancy earlier compared to those men with TPMC < 50 million (median 19 months (95% CI: 18-20) versus 36 months (95% CI: 32-41)). Similar results were observed in the natural conception cohort. For the natural conception cohort without major female factor, the TPMC cut-off was 20 million. In the visual assessment of the graphs for the continuous semen parameter values, 5-year conception rates and time-to-conception consistently plateaued at higher values of sperm concentration, total sperm count, progressive motility, and TPMC compared to the WHO reference levels and our calculated thresholds. For TPMC, values up to 100-150 million were still associated with a better conception rate and time-to-conception in the visual assessment of the curves. LIMITATIONS, REASONS FOR CAUTION There was limited information on female partners and potential for inaccuracies in capturing less severe female infertility diagnoses. Also we lacked details on assisted pregnancies achieved outside of our healthcare network (with possible miscoding as 'natural conception' in our cohort). We only used the initial SA and sperm morphology, another potentially important parameter, was not included in the analyses. We had no information on continuity of pregnancy attempts/intention, which could affect the time-to-conception data. Finally, most couples had been attempting conception for >12 months prior to initiating fertility treatment, so it is likely that we are underestimating time to conception. Importantly, our data might lack the generalizability to other populations. WIDER IMPLICATIONS OF THE FINDINGS Our results suggest that a TPMC threshold of 50 million sperm provided the best predictive power to estimate earlier time-to-conception in couples evaluated for male factor infertility. Higher values of sperm count, concentration and progressive motility beyond the WHO references were still associated with better conception rates and time-to-conception. This provides an opportunity to optimize semen parameters in those with semen values that are low but not abnormal according to the WHO reference values. These data can be used to better inform patients regarding their chances of conception per year when SA results are used for patient counseling. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Sorena Keihani
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Lauren E Verrilli
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Chong Zhang
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Angela P Presson
- Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
| | - Heidi A Hanson
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA.,Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Alexander W Pastuszak
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Erica B Johnstone
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - James M Hotaling
- Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
16
|
Effect of Microfluidic Sperm Separation vs. Standard Sperm Washing Processes on Laboratory Outcomes and Clinical Pregnancy Rates in an Unselected Patient Population. REPRODUCTIVE MEDICINE 2021. [DOI: 10.3390/reprodmed2030013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A prospective, multicenter, randomized, sibling oocyte study was conducted with 86 couples to evaluate if a microfluidic sperm separation device improved ICSI sperm selection and subsequent cycle outcomes of fertilization, blastocyst utilization, ploidy, and clinical pregnancy rate when applied to a general patient population. Patients with at least 10 metaphase II oocytes were enrolled in the study and sibling oocyte groups were split in half. One half of the oocytes underwent ICSI with the control processed sperm and the other half were injected with sperm sorted by the ZyMōt microfluidic sperm separation device. Fertilization rate was recorded and resulting blastocysts were biopsied and evaluated for ploidy status with NGS. Euploid, non-mosaic embryos were randomly selected for single embryo transfer. A total of 787 oocytes were evaluated in the ZyMōt group and 777 in the control group. No statistical differences were observed between ZyMōt and control processing methods in any of the study outcomes evaluated. It is possible that the selection of normal, progressive sperm for ICSI, and the repair capacity of oocytes are sufficient to promote normal embryonic development in the general infertility population.
Collapse
|
17
|
Kendall Rauchfuss LM, Kim T, Bleess JL, Ziegelmann MJ, Shenoy CC. Testicular sperm extraction vs. ejaculated sperm use for nonazoospermic male factor infertility. Fertil Steril 2021; 116:963-970. [PMID: 34233843 DOI: 10.1016/j.fertnstert.2021.05.087] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To study the potential benefit of testicular sperm compared with ejaculated sperm for men with oligospermia. DESIGN After exemption from institutional review board approval, we performed a retrospective cohort study using the Mayo Clinic Assisted Reproductive Technology database. SETTING Single academic center. PATIENT(S) Couples with nonazoospermic male factor infertility (total motile sperm <25 million per ejaculate) undergoing intracytoplasmic sperm injection with sperm obtained by testicular sperm extraction (TESE) or ejaculated sperm between 2016 and 2019. INTERVENTION(S) In vitro fertilization, Intracytoplasmic sperm injection, TESE. MAIN OUTCOME MEASURE(S) The primary outcome was live birth rate. The secondary outcomes were fertilization rate, blastulation rate, pregnancy rate, and miscarriage rate. RESULT(S) Subjects in the two groups were similar in age, body mass index, and ovarian reserve. Baseline sperm parameters were similar in the two groups: total motile sperm (5.4 in the ejaculate sperm group vs. 3.6 million motile per ejaculate), except that baseline motility was higher in the group that used ejaculated sperm (40% vs. 29%). The total number of mature oocytes retrieved was similar in the two groups, but the use of TESE was associated with a 20% decrease in fertilization (60.0% vs. 80.6%) and half the number of blastocyst embryos (two vs. four) compared with ejaculated sperm. Compared with ejaculated sperm, use of TESE did not improve the miscarriage rate (11% vs. 9%) or the live birth rate (50.0% vs. 31.3%). CONCLUSION(S) Patients with male factor infertility and oligozoospermia did not have improved ICSI outcomes with the use of TESE samples compared with ejaculated sperm.
Collapse
Affiliation(s)
| | - Tana Kim
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - Jessica L Bleess
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | | | - Chandra C Shenoy
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| |
Collapse
|
18
|
Oocyte ability to repair sperm DNA fragmentation: the impact of maternal age on intracytoplasmic sperm injection outcomes. Fertil Steril 2021; 116:123-129. [DOI: 10.1016/j.fertnstert.2020.10.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 12/13/2022]
|
19
|
Majzoub A, Arafa M, El Ansari W, Mahdi M, Agarwal A, Al-Said S, Elbardisi H. Correlation of oxidation reduction potential and total motile sperm count: its utility in the evaluation of male fertility potential. Asian J Androl 2021; 22:317-322. [PMID: 31339113 PMCID: PMC7275803 DOI: 10.4103/aja.aja_75_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Oxidative stress (OS) is detrimental to sperm functions, and the oxidation reduction potential (ORP) is a good measure of OS as it considers the balance between oxidants and reductants. Total motile sperm count (TMSC) is viewed as the single most important semen analysis parameter that can predict male infertility severity, and its correlation with ORP has never been undertaken. The objectives of this study were to assess the correlation between ORP and TMSC, to identify the ORP cutoff value based on the TMSC result, and to compare this cutoff value with previously reported ORP cutoff values in literature. One thousand one hundred and sixty-eight infertile patients and 100 fertile controls were enrolled. Demographic and semen data of the participants were retrieved and analyzed. Wilcoxon's rank-sum test compared variables between infertile men and fertile controls; Spearman's correlation assessed the static ORP (sORP)-TMSC relationship for the whole sample and among each group individually. Using a 20×106 TMSC threshold, receiver operator characteristic (ROC) analysis determined the sORP cutoff associated with the highest predictive values. TMSC was significantly negatively correlated with sORP across all participants (r = 0.86, P < 0.001), among infertile patients (r = 0.729, P < 0.001), and among fertile controls (r = 0.53, P < 0.001). A 20-million TMSC threshold determined an sORP cutoff value of 2.34 mV/106 sperm/ml to be associated with 82.9% sensitivity, 82.8% specificity, 91.5% positive predictive value (PPV), 68.5% negative predictive value (NPV), and 82.9% overall accuracy. Compared with previously reported cutoff values in searched literature, the 2.34 mV/106 sperm/ml cutoff value identified in our study yielded the highest overall diagnostic accuracy in the evaluation of infertile men.
Collapse
Affiliation(s)
- Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha 00974, Qatar.,Department of Urology, Weill Cornell Medicine-Qatar, Doha 00974, Qatar
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha 00974, Qatar.,Department of Urology, Weill Cornell Medicine-Qatar, Doha 00974, Qatar.,Department of Andrology, Cairo University, Cairo 12613, Egypt
| | - Walid El Ansari
- Department of Surgery, Hamad Medical Corporation, Doha 00974, Qatar.,College of Medicine, Qatar University, Doha 00974, Qatar.,School of Health and Education, University of Skövde, Skövde 54128, Sweden
| | - Mohammed Mahdi
- Department of Urology, Hamad Medical Corporation, Doha 00974, Qatar
| | - Ashok Agarwal
- Department of Urology, Glickman Urology and Kidney Institute, Cleveland Clinic Foundation, OH 44195, USA
| | - Sami Al-Said
- Department of Urology, Hamad Medical Corporation, Doha 00974, Qatar.,Department of Urology, Weill Cornell Medicine-Qatar, Doha 00974, Qatar
| | - Haitham Elbardisi
- Department of Urology, Hamad Medical Corporation, Doha 00974, Qatar.,Department of Urology, Weill Cornell Medicine-Qatar, Doha 00974, Qatar
| |
Collapse
|
20
|
Satwik R, Kochhar M. Unexplained infertility categorization based on female laparoscopy and total motile sperm count, and its impact on cumulative live-births after one in-vitro fertilization cycle. A retrospective cohort study involving 721 cycles. Reprod Med Biol 2021; 20:190-198. [PMID: 33850452 PMCID: PMC8022093 DOI: 10.1002/rmb2.12368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 12/18/2020] [Accepted: 01/10/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To determine how subcategorizing unexplained infertility based on female laparoscopy and total-motile-sperm-count assessment would impact cumulative live-births after one in-vitro fertilization (IVF) cycle. METHODS Seven hundred twenty one IVF cycles from Jan 2014-April 2019 performed at a single-center were retrospectively analyzed. Couples with unexplained infertility having normal uterine and endometrial morphology were subcategorized into three cohorts, UI (1): those with no tuboperitoneal pathology on laparoscopy and total-motile-sperm-count (TMSC) ≧20 million: n = 103; UI (2): tuboperitoneal pathology on laparoscopy or TMSC <20 million, n = 86; and UI(3): tuboperitoneal status not known: n = 114. Controls were severe male factor, bilateral tubal block, and grade 3/4 endometriosis: n = 418. Primary Outcome was cumulative-live-birth-per-initiated-IVF cycle (CLBR). Odds ratio for live-births were adjusted for confounding factors. RESULTS The CLBR in UI1 cohort was significantly lower than controls (29.1% vs 39; OR = 0.62; 95%CI = 0.39-0.98; P = .04); but similar in UI2 and UI3 vs. controls. (37.2% vs 39.95%; OR = 0.89, 95%CI = 0.55-1.44; P = .89) and (38.6% vs 39.95%; OR = 0.98, 95%CI = 0.64-1.55; P = .98). After adjusting for age, infertility duration, past live-births, and AMH, the adjusted odds for CLBR in UI1 was 0.48 (95%CI = 0.28-0.82; P = .007). CONCLUSIONS Unexplained infertility when defined after a normal laparoscopy and TMSC significantly lowered cumulative-live-births-per-initiated-IVF cycle when compared with traditional diagnosis of tubal, endometriosis, or male factor infertility. In UI subcategory with abnormal laparoscopy or TMSC, CLBR remained unaffected. This information could be useful for counseling couples prior to IVF. Large-scale prospective studies are needed to confirm this observation.
Collapse
Affiliation(s)
- Ruma Satwik
- Centre of IVF and Human ReproductionInstitute of Obstetrics and GynaecologySir Ganga Ram HospitalNew DelhiIndia
| | - Mohinder Kochhar
- Centre of IVF and Human ReproductionInstitute of Obstetrics and GynaecologySir Ganga Ram HospitalNew DelhiIndia
| |
Collapse
|
21
|
Aghajanova L, Kao CN, Cedars M, Tran N. Assessing the impact of semen quality on embryo development in an egg donation model. F S Rep 2021; 2:22-29. [PMID: 34223269 PMCID: PMC8244319 DOI: 10.1016/j.xfre.2020.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/22/2020] [Accepted: 10/29/2020] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To investigate if any of the World Health Organization semen parameters and/or male age are associated with embryo development. DESIGN Retrospective chart review between January 2008 and May 2015. SETTING Academic fertility practice. PATIENTS Anonymous egg donors aged ≤30 years. INTERVENTIONS Chart review. MAIN OUTCOME MEASURES Sperm parameters were evaluated on a continuum and were dichotomized to determine if low values (strict morphology < 4%, concentration < 15 × 106, low motility < 40%) or older age (>50 years) are associated with embryo morphology. Repeated linear regression measures to determine the associations and multivariate testing to determine independent effects for each predictor were performed. RESULTS Three hundred eighty-four donors with 574 egg donation cycles were identified, and 205 subjects with 275 cycles were included in the final analysis. The mean donor age was 25.31 ± 2.81 years, with a mean antral follicle count of 28.09 ± 10.5. The mean male age was 43.25 ± 6.65 years. The mean World Health Organization semen parameters at fertilization were 55.8 × 106 ± 44.3 × 106/mL concentration, 44.8% ± 20.2% motility, and 6.9% ± 5.3% strict morphology. Neither male age nor sperm morphology was associated with embryo morphology. A low total motile count was significantly associated with a higher cell number in day-3 embryos and a 1.56-times higher chance of poor day-3 cell symmetry. There was no statistically significant difference in blastocyst formation, clinical pregnancy, or live-birth rates. CONCLUSIONS Although statistically significant, the effect of the low total motile count on day-3 cell number and cell symmetry are likely clinically insignificant. Male age, race, or poor sperm morphology were not associated with a poor cycle outcome or impaired embryo development. The use of intracytoplasmic sperm injection likely alleviates the negative effect of diminished semen quality on treatment outcome.
Collapse
Affiliation(s)
- Lusine Aghajanova
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Stanford School of Medicine, Sunnyvale, California
| | - Chia-Ning Kao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Marcelle Cedars
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| | - Nam Tran
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California
| |
Collapse
|
22
|
Maranhão KDS, Mariz MEGDSM, Araújo EADD, Souza GRD, Taveira KVM, Morais DB. Factors related to infertility in Brazil and their relationship with success rates after assisted reproduction treatment: an integrative review. JBRA Assist Reprod 2021; 25:136-149. [PMID: 32759095 PMCID: PMC7863087 DOI: 10.5935/1518-0557.20200051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This integrative review evaluated the most commonly diagnosed causes of infertility in men and women in Brazil, as well as the medically assisted reproduction technologies regularly employed in these cases. We searched in four electronic databases (PubMed, including Medline; Scopus; Web of Science and LILACS), and two grey literature (Google Scholar and OpenGrey), guided by the focused question: "What are the main factors responsible for male and female infertility in Brazil, and what are its relationships with success rates after assisted reproduction treatment?". We included interventional or observational studies, without limitation by language or year of publication. Our searches in the electronic indexers recovered 1,119 articles, and after analyzing the inclusion and exclusion criteria, 27 articles composed the body of analysis for this review. We grouped the studies into four themes: factors responsible for male and female infertility, assisted reproductive technologies (ART) used in the infertility treatment, assisted reproduction procedures, and clinical predictors of success rates in ART. Despite the scarcity of studies analyzing the association between infertility and assisted reproductive technologies in Brazil, it was possible to infer that the most prevalent infertility cause in women was endometriosis, while in men it was azoospermia. The most widely assisted reproductive technology applied in the country is the intracytoplasmic injection of spermatozoa (ICSI), ensuring better success rates in the treatment of infertility for men and women.
Collapse
|
23
|
Pantos K, Sfakianoudis K, Maziotis E, Rapani A, Karantzali E, Gounari-Papaioannou A, Vaxevanoglou T, Koutsilieris M, Simopoulou M. Abnormal fertilization in ICSI and its association with abnormal semen parameters: a retrospective observational study on 1855 cases. Asian J Androl 2021; 23:376-385. [PMID: 33510051 PMCID: PMC8269831 DOI: 10.4103/aja.aja_84_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Intracytoplasmic sperm injection (ICSI) efficiently addresses male factor infertility. However, the occurrence of abnormal fertilization, mainly characterized by abnormal pronuclei (PN) patterns, merits investigation. To investigate abnormal fertilization patterns following ICSI and identify their respective associations with abnormal parameters in semen analysis (SA), a retrospective observational study including 1855 cycles was performed. Male infertility diagnosis relied on the 2010 WHO criteria. The population was divided into groups based on their SA results. The presence of 2PNs and extrusion of the second polar body (PB) indicated normal fertilization. A Kruskal–Wallis test along with a Wilcoxon post hoc evaluation and Bonferroni correction was employed for comparison among the groups. For the pregnancy rate, logistic regression was employed. No correlation was established between the SA abnormalities and the 1PN or 3PN formation rates. The highest and lowest 0PN rates were reported for the oligoasthenoteratozoospermic and normal groups, respectively. The lowest cleavage formation rates were identified in the oligoasthenozoospermic and oligoasthenoteratozoospermic groups. The aforementioned groups along with the oligoteratozoospermic group similarly presented the lowest blastocyst formation rates. For the clinical pregnancy rate, no statistically significant difference was observed. In conclusion, the incidence of two or more abnormal SA parameters – with the common denominator being oligozoospermia – may jeopardize normal fertilization, cleavage, and blastocyst rates. Once the developmental milestone of achieving blastocyst stage status was achieved, only oligoasthenozoospermia and oligoasthenoteratozoospermia were associated with lower rates. Interestingly, following adjustment for the number of blastocysts, no statistically significant differences were observed.
Collapse
Affiliation(s)
- Konstantinos Pantos
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16 Papanikoli, Chalandri, Athens 11527, Greece
| | - Konstantinos Sfakianoudis
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16 Papanikoli, Chalandri, Athens 11527, Greece
| | - Evangelos Maziotis
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
| | - Anna Rapani
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
| | - Eleni Karantzali
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
| | - Artemis Gounari-Papaioannou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
| | - Terpsithea Vaxevanoglou
- Centre for Human Reproduction, Genesis Athens Clinic, 14-16 Papanikoli, Chalandri, Athens 11527, Greece
| | - Michael Koutsilieris
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
| | - Mara Simopoulou
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, 75 Mikras Asias, Athens 11527, Greece
| |
Collapse
|
24
|
Tsao Y, Yang C, Wen Y, Chang T, Matsuura K, Chen Y, Cheng C. Point-of-care semen analysis of patients with infertility via smartphone and colorimetric paper-based diagnostic device. Bioeng Transl Med 2021; 6:e10176. [PMID: 33532582 PMCID: PMC7823130 DOI: 10.1002/btm2.10176] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 12/28/2022] Open
Abstract
Male infertility affects millions of males worldwide and is rising in prevalence due to social and environmental conditions. However, men often feel too embarrassed to receive a semen analysis in the hospital due to social stigmas. To overcome this problem, we developed a 3-(4,5-Dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide test strip to distinguish semen samples with low total motile sperm concentration from those with normal motile sperm concentration. This is a point-of-care colorimetric semen analytical method with a one-step, inexpensive, equipment-free evaluation process, and adequate accuracy validated in a 42-sample clinical trial. In this study, results were evaluated visually and with a smartphone application. Using visual observation methods, the area under the curve (AUC) was 0.71 (95% of confidence interval = 0.55-0.86; p = 0.021), sensitivity was 41%, specificity was 95%, positive predictive value was 90%, negative predictive value (NPV) was 59.4%, and accuracy was 67%. Using a smartphone recording and analytical system, AUC was 0.766 (95% of confidence interval = 0.612-0.92; p = 0.003), sensitivity was 96%, specificity was 65%, PPV was 75%, NPV was 92.9%, and accuracy was 80.9%. This work demonstrated a screening tool that could elevate semen analysis to the level of routine healthcare and provide for private, in-home self-assessment.
Collapse
Affiliation(s)
- Yu‐Ting Tsao
- Institute of Biomedical EngineeringNational Tsing Hua UniversityHsinchuTaiwan
- Department of EducationChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
| | - Chung‐Yao Yang
- Department of Research and DevelopmentHygeia Touch Inc.TaipeiTaiwan
| | - Yun‐Chiao Wen
- Department of EducationChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
- School of Traditional Chinese MedicineChang Gung University College of MedicineTaoyuanTaiwan
| | - Ting‐Chang Chang
- Department of Obstetrics and GynecologyChang Gung Memorial Hospital Linkou BranchTaoyuanTaiwan
| | - Koji Matsuura
- Department of Biomedical Engineering, Faculty of EngineeringOkayama University of ScienceOkayamaJapan
| | - Yu Chen
- Department of UrologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
| | - Chao‐Min Cheng
- Institute of Biomedical EngineeringNational Tsing Hua UniversityHsinchuTaiwan
| |
Collapse
|
25
|
Tsampoukas G, Dellis A, Katsouri A, Brown D, Deliveliotis K, Moussa M, Buchholz N, Papatsoris A. Role of total motile sperm count in the evaluation of young men with bilateral subclinical varicocele and asthenospermia. ACTA ACUST UNITED AC 2020; 92. [PMID: 33348969 DOI: 10.4081/aiua.2020.4.366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/24/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION In comparison to its clinical analogue, the subclinical varicocele represents a questionable entity and specific guidelines for the optimal management are lacking. In our previous study of patients with subclinical varicocele, we showed that bilateral condition is associated with risk of dyspermia. In the present study, we evaluated the risk of deterioration of semen quality in men with bilateral disease and impaired motility according to WHO criteria. MATERIALS AND METHODS Men with bilateral subclinical varicocele, not desiring fatherhood at the time of presentation, were included in study. During initial evaluation, the number of Total Motile Sperm Count (TMSC) was calculated and the patients' age, total testicular volume (TTV), maximum venous size and mean resistive index (RI) of the intratesticular arteries were recorded. We classified the participants in five classes according to the TMSC reading: class A-: TMSC < 5 x 106, class A: TMSC between 5-10 x 106, class B: TMSC between 10-15 x 106, class C: TMSC between 15-20 x 106, and class D: TMSC > 20 x 106 per ejaculate. The participants were seen after 6 months for a repeat spermiogram and physical examination. If clinical varicocele was diagnosed or a new abnormality in the spermiogram was noted, the participants were excluded from the study. The remaining patients were allocated to two groups according to the repeat TMSC reading: patients sub-classified into a lower class (group 1), and patients remaining at the same class (group 2). A comparative analysis was performed between two groups. RESULTS Nineteen men were included. Nine patients were subclassified (group 1). Three patients moved to A- class (< 5 x 106). Ten patients remained in the same class having no deterioration (group 2). Comparing the two groups, no statistically significant difference was recognized for age, TTV, maximum venous size on both sides, and mean RI (p > 0.05). However, the initial reading for TMSC was 14.57 x 106 in group 1, and 22.84 x 106 in group 2, respectively. This difference was statistically significant (p < 0.05). Additionally, in a paired analysis there was a significant difference in TMSC after 6 months (p < 0.05), too. Summary Conclusions: Young men with bilateral varicocele and asthenospermia seem to be at risk of deterioration in their semen quality after a follow-up of 6 months. The measurement of TMSC can unmask patients at risk, whereas men with the lowest readings seem to be at highest risk for deterioration. The possibility of a worsening sperm quality should be considered in the appropriate clinical context.
Collapse
Affiliation(s)
- Georgios Tsampoukas
- U-merge Ltd. (Urology for emerging countries), London, UK; Department of Urology, Princess Alexandra Hospital, Harlow, UK; Department of Urology, Agios Andreas Hospital, Patras.
| | - Athanasios Dellis
- U-merge Ltd. (Urology for emerging countries), London; Department of Urology, Aretaieion Academic Hospital, Athens.
| | | | - Dominic Brown
- Department of Urology, Princess Alexandra Hospital, Harlow.
| | | | - Mohamad Moussa
- Al Zahraa Hospital, University Medical Center, Lebanese University, Beirut.
| | - Noor Buchholz
- U-merge Ltd. (Urology for emerging countries), London.
| | - Athanasios Papatsoris
- U-merge Ltd. (Urology for emerging countries), London; 2nd Department of Urology, University Hospital of Athens, Athens.
| |
Collapse
|
26
|
Pazir Y, Erdem S, Cilesiz NC, Kadioglu A. Determination of the time for improvement in semen parameters after varicocelectomy. Andrologia 2020; 53:e13895. [PMID: 33141946 DOI: 10.1111/and.13895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 11/29/2022] Open
Abstract
This retrospective study aimed to determine the time for improvement in semen parameters after varicocelectomy. A total of 175 patients over 18 years of age, who underwent microscopic inguinal varicocelectomy in a tertiary centre between 2005 and 2016 and had post-operative follow-up data of at least 12 months, were included in the study. Serial semen analyses in the pre-operative period and at the post-operative third, sixth, ninth and 12th months were retrospectively documented. With respect to their pre-operative total motile sperm counts, the patients were classified into three subgroups as <5 million, 5-9 million and >9 million. In the overall cohort and the group with a total motile sperm count of >9 million, the semen parameters continued to improve up to the post-operative 12th month. No further significant improvement was observed after the post-operative third and sixth months for the patients with pre-operative total motile sperm counts of <5 million and 5-9 million respectively. For the candidates of varicocelectomy, the decision of treatment strategies, such as assisted reproductive technologies and waiting for spontaneous pregnancy can be based on the prediction of the time for improvement in semen parameters.
Collapse
Affiliation(s)
- Yasar Pazir
- Department of Urology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Selcuk Erdem
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nusret C Cilesiz
- Department of Urology, Gaziosmanpaşa Taksim Education Hospital, Istanbul, Turkey
| | - Ates Kadioglu
- Department of Urology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
27
|
Al Rashid K, Taylor A, Lumsden MA, Goulding N, Lawlor DA, Nelson SM. Association of the serum metabolomic profile by nuclear magnetic resonance spectroscopy with sperm parameters: a cross-sectional study of 325 men. F&S SCIENCE 2020; 1:142-160. [PMID: 35559925 DOI: 10.1016/j.xfss.2020.10.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 10/08/2020] [Accepted: 10/08/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine whether 155 circulating metabolic measures relevant to lifestyle and metabolic health are associated with sperm parameters, as measured by concentration, motility, and total motile sperm count (TMSC). STUDY DESIGN Cross sectional. SETTING University hospital. PATIENT(S) Three hundred twenty-five men prospectively recruited between April 1, 2017 and March 31, 2019. INTERVENTION(S) Detailed demographic, lifestyle, fertility, medical history, and semen analysis with quantification of nonfasting serum lipids, lipoprotein subclasses, and low-molecular weight metabolites (including amino acids, glycolysis, and inflammatory markers) by nuclear magnetic resonance (NMR) spectroscopy. MAIN OUTCOME MEASURE(S) Association of serum metabolic profiles with sperm parameters. RESULT(S) The age of the participants was mean 37.2 years, with a median sperm concentration of 35 million/mL and median motility of 53%. Of these men, 76% had a TMSC >15 million, 10% had 5-15 million, and 14% had <5 million. In both univariate and confounder adjusted analyses, an extensive range of lipids and lipoproteins, glycolysis-related metabolites, amino acids, ketone bodies, creatinine, or albumin showed no strong statistically significant association with sperm concentration, motility, or the odds of having a reduced or low TMSC. Higher levels of glycolysis metabolites and ketone bodies were associated with an increased odds of TMSC <15 million compared with ≥15 million (odds ratios of ∼1.2-1.3), and several lipids/lipoprotein concentrations appeared to protect against very low TMSC (<5 million compared with ≥5 million) with odds ratios of ∼0.8 or greater. CONCLUSION(S) Several metabolites exhibited potentially clinically relevant strength of association with the odds of a low TMSC and warrant replication.
Collapse
Affiliation(s)
- Karema Al Rashid
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Amy Taylor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Mary Ann Lumsden
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom
| | - Neil Goulding
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom
| | - Scott M Nelson
- School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom; National Institute for Health Research Bristol Biomedical Research Centre, Bristol, United Kingdom.
| |
Collapse
|
28
|
Cicek OSY, Kaya G, Alyuruk B, Doger E, Girisen T, Filiz S. The association of seminal oxidation reduction potential with sperm parameters in patients with unexplained and male factor ınfertility. Int Braz J Urol 2020; 47:112-119. [PMID: 33047916 PMCID: PMC7712687 DOI: 10.1590/s1677-5538.ibju.2019.0751] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 05/07/2020] [Indexed: 01/28/2023] Open
Abstract
Purpose: Understanding the effects of high oxidation reduction potential (ORP) levels on sperm parameters will help to identify patients with unexplained and male factor infertility who may have seminal oxidative stress and determine if ORP testing is needed. This study aimed to evaluate the association between seminal ORP and conventional sperm parameters. Materials and Methods: A total of 58 patients who provided a semen sample for simultaneous evaluation of sperm parameters and ORP between January and September 2019 were enrolled in this retrospective study. To identify normal and high ORP levels, a static ORP (sORP) cut-off value of 1.36mV/106sperm/mL was used. Sperm parameters were compared between infertile men with normal sORP (control group, n=23) and high sORP values (study group, n=35). Results: Men with sORP values >1.36mV/106sperm/mL had significantly lower total sperm count (TSC) (p <0.001), sperm concentration (p <0.001) and total motile sperm count (TMSC) (p <0.001). In addition, progressive motility (p=0.04) and fast forward progressive motility (p <0.001) were significantly lower in the study group. A negative correlation was found between sORP and TSC (r=-0.820, p <0.001), sperm concentration (r=-0.822, p <0.001), TMSC (r=-0.808, p <0.001) and progressive motility (r=-0.378, p=0.004). Non-progressive motility positively correlated with sORP (r=0.344, p=0.010). Conclusions: This study has shown that TSC, sperm concentration, progressive motility and TMSC are associated with seminal oxidative stress, indicated by a sORP cut-off of 1.36mV/106sperm/mL. Presence of oligozoospermia, reduced progressive motilty or low TMSC in sperm analysis should raise the suspicion of oxidative stress and warrants seminal ROS testing.
Collapse
Affiliation(s)
- Ozge Senem Yucel Cicek
- Department of Obstetrics and Gynecology, Kocaeli University, Faculty of Medicine, Izmit, Kocaeli, Turkey.,Kocaeli University Assisted Reproductive Technologies Clinic; İIzmit, Kocaeli, Turkey
| | - Gozde Kaya
- Kocaeli University Assisted Reproductive Technologies Clinic; İIzmit, Kocaeli, Turkey
| | - Begum Alyuruk
- Kocaeli University Assisted Reproductive Technologies Clinic; İIzmit, Kocaeli, Turkey
| | - Emek Doger
- Department of Obstetrics and Gynecology, Kocaeli University, Faculty of Medicine, Izmit, Kocaeli, Turkey.,Kocaeli University Assisted Reproductive Technologies Clinic; İIzmit, Kocaeli, Turkey
| | - Tugba Girisen
- Kocaeli University Assisted Reproductive Technologies Clinic; İIzmit, Kocaeli, Turkey
| | - Serdar Filiz
- Kocaeli University Assisted Reproductive Technologies Clinic; İIzmit, Kocaeli, Turkey.,Department of Histology and Embryology, Kocaeli University, İzmit, Kocaeli, Turkey
| |
Collapse
|
29
|
Jang WS, Kim KH, Lim KT, Lee J, Heo JE, Kwon H, Kang H, Lee JH, Choe SA, Kim DK. External validation of the post-varicocele repair semen analysis nomogram to predict total motile sperm count: A multicenter study. Andrologia 2020; 52:e13809. [PMID: 32882055 DOI: 10.1111/and.13809] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/17/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022] Open
Abstract
Total motile sperm count is an important parameter for predicting the probability of natural pregnancy. We have externally validated the Samplaski's post-varicocele repair semen analysis nomogram to confirm the predictive accuracy of total motile sperm count. A total of 300 patients who had undergone varicocelectomy between July 2016 and July 2019 from 4 treatment centres were included in this validation cohort study. The predictive performance of the externally validated nomogram was revealed by applying the Pearson correlation coefficient (R = 0.328; 95% confidence interval (CI) 0.220-0.435; p < .001). Compared to Samplaski's nomogram result (R = 0.581; 95% CI 0.186-0.729), our study also revealed a statistically significant rate. However, it had a relatively lower correlation coefficient rate. Notably, the predicted total motile sperm count was lower than the observed post-varicocelectomy total motile sperm count. The calibration plot revealed that the discrepancy between the predicted and observed total motile sperm count was plausible. However, it had low explanatory power in this nomogram model. This validation study demonstrates that the post-varicocele repair Samplaski's nomogram predicts a relatively lower total motile sperm count than the observed count.
Collapse
Affiliation(s)
- Won Sik Jang
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Hong Kim
- Department of Urology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Kyoung Taek Lim
- Department of Urology, Maria Fertility Hospital, Seoul, Korea
| | - Jongsoo Lee
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Ji Eun Heo
- Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojeong Kwon
- Andrology Laboratory, CHA Fertility Center Seoul Station, Seoul, Korea
| | - Hyoeun Kang
- Andrology Laboratory, CHA Fertility Center Seoul Station, Seoul, Korea
| | - Jae Ho Lee
- Department of Biomedical Science, College of Life Science, CHA Fertility Center Seoul Station, CHA University, Seoul, Korea
| | - Seung-Ah Choe
- Department of Obstetrics and Gynecology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, Korea
| | - Dae Keun Kim
- Department of Urology, CHA Fertility Center Seoul Station, CHA University School of Medicine, Seoul, Korea
| |
Collapse
|
30
|
Hanson BM, Kim JG, Osman EK, Tiegs AW, Lathi RB, Cheng PJ, Scott RT, Franasiak JM. Impact of paternal age on embryology and pregnancy outcomes in the setting of a euploid single-embryo transfer with ejaculated sperm: retrospective cohort study. F S Rep 2020; 1:99-105. [PMID: 34223225 PMCID: PMC8244285 DOI: 10.1016/j.xfre.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/24/2023] Open
Abstract
Objective To evaluate the impact of paternal age on embryology and pregnancy outcomes in the setting of a euploid single-embryo transfer. Design Retrospective cohort study. Setting Not applicable. Patient(s) Couples undergoing a first in vitro fertilization cycle with fresh ejaculated sperm who used intracytoplasmic sperm injection for fertilization followed by preimplantation genetic testing for aneuploidy and single-embryo transfer of a euploid embryo between January 2012 and December 2018. Intervention(s) Not applicable. Main Outcome Measure(s) Embryology outcomes assessed were fertilization rate, blastulation rate, and euploid rate. Pregnancy outcomes assessed included positive human chorionic gonadotropin rate, delivery rate, biochemical loss rate, and clinical loss rate. Results A total of 4,058 patients were assessed. After adjusting for female age, increased paternal age in the setting of fresh ejaculated sperm use was associated with decreased blastulation and decreased euploid rate using 40 years as an age cutoff. Conclusion(s) In this study, advancing paternal age appears to have a detrimental impact on rates of blastocyst formation and euploid status. However, if a euploid embryo is achieved, older paternal age does not appear to affect negatively pregnancy outcomes.
Collapse
Affiliation(s)
- Brent M Hanson
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.,Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Julia G Kim
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.,Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Emily K Osman
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.,Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ashley W Tiegs
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.,Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Ruth B Lathi
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Stanford Fertility & Reproductive Health Center, Sunnyvale, California
| | - Philip J Cheng
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey
| | - Richard T Scott
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.,Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jason M Franasiak
- Department of Reproductive Endocrinology & Infertility, IVI-Reproductive Medicine Associates of New Jersey, Basking Ridge, New Jersey.,Division of Reproductive Endocrinology & Infertility, Department of Obstetrics & Gynecology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
31
|
Cai H, Gordts S, Sun J, Meng B, Shi J. Reproductive outcomes with donor sperm in couples with severe male-factor infertility after intracytoplasmic sperm injection failures. J Assist Reprod Genet 2020; 37:1883-1893. [PMID: 32440933 PMCID: PMC7468038 DOI: 10.1007/s10815-020-01828-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 05/13/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To evaluate reproductive outcomes of artificial insemination and IVF with donor sperm (AID or IVF-D) for male-factor couples with a history of unsuccessful ICSI attempt. METHODS This retrospective cohort includes couples with severe male-factor infertility who failed ICSI treatment, and subsequently underwent semen donation treatment. We report the following outcomes: (1) live birth rates in AID and IVF-D treatment for couples with severe male infertility factors and prior ICSI failures; (2) paternal impact on embryo development of the same oocyte cohort; (3) prognostic factors in obtaining a live birth with donor semen. RESULTS Of 92 women with failed ICSI cycles (26 with multiple attempts), 45 couples underwent AID treatment. Live birth rate per cycle of AID was 18.9%. Fifty-three patients underwent IVF-D including 6 couples who previously did not conceive with AID. Embryological outcomes including fertilization, viable cleavage embryos, and blastocyst formation rates were significantly lower in ICSI cycles with partner sperm compared with IVF-D (P < 0.01). Logistic regression analysis showed that female age and the severity of spermatogenetic disorder are prognostic factors in obtaining a live birth with donated sperm. CONCLUSION Couples with severe male infertility factor (azoospermia or extreme oligoasthenospermia) and a history of unsuccessful ICSI cycles benefit from treating with donor sperm. ICSI fertilization, embryo viability, and progression of the embryo to the blastocyst stage are significantly deteriorated by semen parameters. The prognostic factors identified may help couples plan their treatment and prepare for their parenthood journey.
Collapse
Affiliation(s)
- He Cai
- Assisted Reproduction Center, Northwest Women's and Children's Hospital Affiliated to Xi'an Jiaotong University, 73#, Houzaimen North Street, Xi'an, People's Republic of China
| | - Stephan Gordts
- Leuven Institute for Fertility & Embryology, Schipvaartstraat 4, 3000, Leuven, Belgium
| | - Jianhua Sun
- Assisted Reproduction Center, Northwest Women's and Children's Hospital Affiliated to Xi'an Jiaotong University, 73#, Houzaimen North Street, Xi'an, People's Republic of China
| | - Bin Meng
- Assisted Reproduction Center, Northwest Women's and Children's Hospital Affiliated to Xi'an Jiaotong University, 73#, Houzaimen North Street, Xi'an, People's Republic of China
| | - Juanzi Shi
- Assisted Reproduction Center, Northwest Women's and Children's Hospital Affiliated to Xi'an Jiaotong University, 73#, Houzaimen North Street, Xi'an, People's Republic of China.
| |
Collapse
|
32
|
Braga DPDAF, Zanetti BF, Setti AS, Iaconelli A, Borges E. Immature oocyte incidence: Contributing factors and effects on mature sibling oocytes in intracytoplasmic sperm injection cycles. JBRA Assist Reprod 2020; 24:70-76. [PMID: 31589389 PMCID: PMC6993156 DOI: 10.5935/1518-0557.20190056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective The aim of this study was to investigate which factors contribute to the incidence of immature oocytes (germinal vesicle -GV- and metaphase I -MI-) and how they impact the intracytoplasmic sperm injection (ICSI) outcomes of sibling mature oocytes. Methods Data from 3,920 cycles performed from June/2010 to August/2016 in a private university-affiliated IVF center were evaluated for the influence of controlled ovarian stimulation protocol (COS) on immature oocytes incidence and its effects on ICSI outcomes. Results MI (p=0.004) and GV (p=0.029) number were negatively correlated with gonadotropin dose. Patients stimulated by rFSH had increased GV/oocyte rate in both GnRH agonists (p<0.001) and antagonist (p=0.042) protocols, in comparison to rFSH associated with rLH protocol. MI and GV/oocyte rates were negatively correlated to fertilization (p<0.001), high-quality embryo on da p<0.001; GV/oocyte p=0.033) and pregnancy (MI/oocyte p=0.002; GV/oocyte p=0.013) rates. Cycles above a 10.5% MI/oocyte cut-off were correlated to higher response to ovarian stimulation, poor embryo development and almost two times lower pregnancy rate. Immature oocyte incidence is affected by COS and impacts on ICSI outcomes. Conclusion Our evidence suggests that oocytes derived from a cohort with high incidence of maturation fail may have detrimental clinical outcomes.
Collapse
Affiliation(s)
- Daniela Paes de Almeida Ferreira Braga
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Bianca Ferrarini Zanetti
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| | - Edson Borges
- Fertility Medical Group, São Paulo, SP - Brazil.,Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP - Brazil
| |
Collapse
|
33
|
Xu C, Cai J, Liu L, Ren J. Prosaposin in seminal plasma on the day of oocyte retrieval is associated with normal fertilization and embryo development in in vitro fertilization cycles. PeerJ 2019; 7:e8177. [PMID: 31844578 PMCID: PMC6911340 DOI: 10.7717/peerj.8177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/07/2019] [Indexed: 11/20/2022] Open
Abstract
The prospective study including 166 participants aims to evaluate the association between seminal prosaposin and the outcomes of in vitro fertilization (IVF) cycles in humans. The generalized linear model (GLM) was used to analyze the associations between seminal prosaposin concentrations and normal fertilization rates and good embryos proportion. The generalized estimating equation (GEE) was used to evaluate the association between embryo parameters and the prosaposin concentrations. Each model was adjusted for age of the couples, female basal FSH, AFC and BMI, starting dose and oocyte yield of IVF cycles and smoker. GLM models suggested that prosaposin was significantly associated with fertilization rate (P = 0.005) and good embryo proportion (P = 0.038) while none of the semen parameters (sperm concentration, motility, progressive motility, normal morphology rate, postwash sperm concentration and motility) was significantly associated with the parameters in the cohort. Using GEE, it was also shown that prosaposin was positively associated with the occurrence of early cleavage and negatively associated with uneven cleavage pattern on day 3. In both the overall population and the normozoospermia patients, the prosaposin was significantly associated with pregnancy with adjustment with covariates. In conclusion, our data suggested that seminal prosaposin concentration could provide more information regarding normal fertilization and embryo development in IVF than traditional semen parameters.
Collapse
Affiliation(s)
- Chun Xu
- Reproductive Medicine Centre, Chinese PLA 174th Hospital, Xiamen, Fujian, China
| | - Jiali Cai
- Reproductive Medicine Centre, Chinese PLA 174th Hospital, Xiamen, Fujian, China.,Medical College, Xiamen University, Xiamen, Fujian, China
| | - Lanlan Liu
- Reproductive Medicine Centre, Chinese PLA 174th Hospital, Xiamen, Fujian, China.,Medical College, Xiamen University, Xiamen, Fujian, China
| | - Jianzhi Ren
- Reproductive Medicine Centre, Chinese PLA 174th Hospital, Xiamen, Fujian, China
| |
Collapse
|
34
|
Setti AS, Braga DPAF, Iaconelli Junior A, Borges Junior E. Increasing paternal age and ejaculatory abstinence length negatively influence the intracytoplasmic sperm injection outcomes from egg‐sharing donation cycles. Andrology 2019; 8:594-601. [DOI: 10.1111/andr.12737] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 11/19/2019] [Accepted: 11/19/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Amanda S. Setti
- Fertility Medical Group São Paulo/SP Brazil
- Sapientiae Institute São Paulo/SP Brazil
| | | | | | - Edson Borges Junior
- Fertility Medical Group São Paulo/SP Brazil
- Sapientiae Institute São Paulo/SP Brazil
| |
Collapse
|
35
|
Wei SY, Chao HH, Huang HP, Hsu CF, Li SH, Hsu L. A collective tracking method for preliminary sperm analysis. Biomed Eng Online 2019; 18:112. [PMID: 31775764 PMCID: PMC6882231 DOI: 10.1186/s12938-019-0732-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 11/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Total motile sperm count (TMSC) and curvilinear velocity (VCL) are two important parameters in preliminary semen analysis for male infertility. Traditionally, both parameters are evaluated manually by embryologists or automatically using an expensive computer-assisted sperm analysis (CASA) instrument. The latter applies a point-tracking method using an image processing technique to detect, recognize and classify each of the target objects, individually, which is complicated. However, as semen is dense, manual counting is exhausting while CASA suffers from severe overlapping and heavy computation. Methods We proposed a simple frame-differencing method that tracks motile sperms collectively and treats their overlapping with a statistical occupation probability without heavy computation. The proposed method leads to an overall image of all of the differential footprint trajectories (DFTs) of all motile sperms and thus the overall area of the DFTs in a real-time manner. Accordingly, a theoretical DFT model was also developed to formulate the overall DFT area of a group of moving beads as a function of time as well as the total number and average speed of the beads. Then, using the least square fitting method, we obtained the optimal values of the TMSC and the average VCL that yielded the best fit for the theoretical DFT area to the measured DFT area. Results The proposed method was used to evaluate the TMSC and the VCL of 20 semen samples. The maximum TMSC evaluated using the method is more than 980 sperms per video frame. The Pearson correlation coefficient (PCC) between the two series of TMSC obtained using the method and the CASA instrument is 0.946. The PCC between the two series of VCL obtained using the method and CASA is 0.771. As a consequence, the proposed method is as accurate as the CASA method in TMSC and VCL evaluations. Conclusion In comparison with the individual point-tracking techniques, the collective DFT tracking method is relatively simple in computation without complicated image processing. Therefore, incorporating the proposed method into a cell phone equipped with a microscopic lens can facilitate the design of a simple sperm analyzer for clinical or household use without advance dilution.
Collapse
Affiliation(s)
- Sung-Yang Wei
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Hsuan-Hao Chao
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Han-Ping Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Chang Francis Hsu
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Sheng-Hsiang Li
- Department of Medical Research, Mackay Memorial Hospital, Tamsui District, New Taipei City, 25160, Taiwan. .,Mackay Junior College of Medicine, Nursing, and Management, Taipei, 11260, Taiwan.
| | - Long Hsu
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan.
| |
Collapse
|
36
|
Douglas C, Parekh N, Kahn LG, Henkel R, Agarwal A. A Novel Approach to Improving the Reliability of Manual Semen Analysis: A Paradigm Shift in the Workup of Infertile Men. World J Mens Health 2019; 39:172-185. [PMID: 31749341 PMCID: PMC7994658 DOI: 10.5534/wjmh.190088] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/08/2019] [Accepted: 10/28/2019] [Indexed: 12/13/2022] Open
Abstract
Conventional semen analysis (SA) is an essential component of the male infertility workup, but requires laboratories to rigorously train and monitor technicians as well as regularly perform quality assurance assessments. Without such measures there is room for error and, consequently, unreliable results. Furthermore, clinicians often rely heavily on SA results when making diagnostic and treatment decisions, however conventional SA is only a surrogate marker of male fecundity and does not guarantee fertility. Considering these challenges, the last several decades have seen the development of many advances in SA methodology, including tests for sperm DNA fragmentation, acrosome reaction, and capacitation. While these new diagnostic tests have improved the scope of information available to clinicians, they are expensive, time-consuming, and require specialized training. The latest advance in laboratory diagnostics is the measurement of seminal oxidation-reduction potential (ORP). The measurement of ORP in an easy, reproducible manner using a new tool called the Male Infertility Oxidative Stress System (MiOXSYS) has demonstrated ORP's potential as a feasible adjunct test to conventional SA. Additionally, the measurement of ORP by this device has been shown to be predictive of both poor semen quality and male infertility. Assessing ORP is a novel approach to both validating manual SA results and identifying patients who may benefit from treatment of male oxidative stress infertility.
Collapse
Affiliation(s)
- Christopher Douglas
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Neel Parekh
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Linda G Kahn
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Pediatrics, New York University School of Medicine, New York City, NY, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, OH, USA.
| |
Collapse
|
37
|
Krzastek SC, Smith RP. EDITORIAL COMMENT. Urology 2019; 132:116. [PMID: 31581986 DOI: 10.1016/j.urology.2019.06.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Sarah C Krzastek
- University of Virginia, Department of Urology, Charlottesville, VA
| | - Ryan P Smith
- University of Virginia, Department of Urology, Charlottesville, VA
| |
Collapse
|
38
|
Tiegs AW, Landis J, Garrido N, Scott RT, Hotaling JM. Total Motile Sperm Count Trend Over Time: Evaluation of Semen Analyses From 119,972 Men From Subfertile Couples. Urology 2019; 132:109-116. [DOI: 10.1016/j.urology.2019.06.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 06/05/2019] [Accepted: 06/20/2019] [Indexed: 10/26/2022]
|
39
|
Darbandi S, Darbandi M, Khorshid HRK, Sadeghi MR, Heidari M, Cheshmi G, Akhondi MM. The effect of paternal age on semen quality and fertilization outcome in men with normal sperm DNA compaction, reactive oxygen species, and total antioxidant capacity levels. Turk J Urol 2019; 45:164-170. [PMID: 30817269 PMCID: PMC6469725 DOI: 10.5152/tud.2019.74944] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 11/28/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Studies showed a decrease of the semen analysis parameters and an increase in the average age of first-time fathers over the past several decades. The aim of the present study was to assess the influence of paternal age on semen quality and fertilization outcomes in men with normal sperm DNA fragmentation and chromatin maturation index (DFI and CMI), reactive oxygen species (ROS), and total antioxidant capacity (TAC) levels. MATERIAL AND METHODS The study was performed on 70 men with their wife's age ≤38 years and normal sperm DFI, CMI, ROS, and TAC levels. None of the couples had a history of genital inflammation, chronic diseases, endocrine abnormality, chromosomal aberrations, Y chromosome microdeletion, azoospermia, and leukocytospermia. These men were separated into 2 groups according to their age (group A: age <45 years and group B: age ≥45 years). Semen analysis and fertilization outcome after using the intracytoplasmic sperm injection were assessed in both groups. RESULT Sperm concentration showed a significant reduction in group B (p=0.04). Although semen volume, sperm normal morphology, and progressive motility were decreased in group B, the reduction was not significant when compared with group A (p=0.09, p=0.47, and p=0.77, respectively). In addition, the differences of embryo quality with grades A, B, and C and 8-cell embryo formation were not statistically significant between the 2 groups. CONCLUSION These results demonstrated that in men with normal sperm DFI, CMI, ROS, and TAC levels, there were no significant changes in semen parameters and fertilization outcomes with an increasing age.
Collapse
Affiliation(s)
- Sara Darbandi
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mahsa Darbandi
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | | | - Mohammad Reza Sadeghi
- Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Mahnaz Heidari
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | - Ghazaleh Cheshmi
- Reproductive Biotechnology Research Center, Avicenna Research Institute, ACECR, Tehran, Iran
| | | |
Collapse
|
40
|
Zanetti BF, Braga DPDAF, Setti AS, Iaconelli A, Borges E. Predictive factors for biochemical pregnancy in intracytoplasmic sperm injection cycles. Reprod Biol 2019; 19:55-60. [PMID: 30745201 DOI: 10.1016/j.repbio.2019.01.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/21/2019] [Accepted: 01/22/2019] [Indexed: 11/29/2022]
Abstract
The aim of this study was to investigate which factors contribute to the incidence of biochemical pregnancy (BP) in intracytoplasmic sperm injection (ICSI) cycles. This cohort study included cycles performed from June 2010 to September 2016 in a private, university-affiliated IVF centre. Cycles were split into four groups, depending on the pregnancy outcomes: Clinical Pregnancy (CP, n = 903), Biochemical Pregnancy (BP, n = 55), Miscarriage (MI, n = 142) and Negative Pregnancy (NP, n = 2034). The effects of ovarian stimulation, laboratory data and seminal parameters on pregnancy outcomes were evaluated using adjusted general linear models. Discriminant analyses were conducted to construct a model for pregnancy prediction and to establish cut-offs for BP. The total sperm count (p = 0.035), total and progressive sperm motility (p = 0.001 and p = 0.023, respectively), total motile sperm count (TMSC, p = 0.029) and the endometrial thickness (p < 0.001) were lower among BP group cycles. Lower rates of high-quality cleavage-stage embryos were observed in the BP group compared to CP and MI groups (p < 0.001). In discriminant analyses, cut-offs for BP prediction were established for the following factors: endometrial thickness < 11 mm, sperm motility < 55.5% and total dose of follicle-stimulating hormone (FSH)> 2400 IU. The incidence of biochemical pregnancy was four times higher when the aforementioned factors did not meet the defined cut-offs. The combination of suboptimal endometrial development and poor seminal and embryo quality contribute to an increased incidence of biochemical pregnancy in ICSI cycles.
Collapse
Affiliation(s)
| | - Daniela Paes de Almeida Ferreira Braga
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, 4545, São Paulo, SP, 01401-002, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | - Amanda Souza Setti
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, 4545, São Paulo, SP, 01401-002, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | - Assumpto Iaconelli
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, 4545, São Paulo, SP, 01401-002, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil
| | - Edson Borges
- Fertility Medical Group, Av. Brigadeiro Luis Antonio, 4545, São Paulo, SP, 01401-002, Brazil; Instituto Sapientiae, Centro de Estudos e Pesquisa em Reprodução Humana Assistida, Rua Vieira Maciel, 62, São Paulo, SP, 04503-040, Brazil.
| |
Collapse
|
41
|
Bolat MS, Kocamanoglu F, Gulsen M, Sengul M, Asci R. The impact of age on fertility rate in patients who underwent microsurgical varicocelectomy. Andrologia 2019; 51:e13234. [DOI: 10.1111/and.13234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/01/2018] [Accepted: 12/08/2018] [Indexed: 01/03/2023] Open
Affiliation(s)
| | | | - Murat Gulsen
- Department of Urology Ondokuz Mayıs University Samsun Turkey
| | - Mesut Sengul
- Department of Urology Ondokuz Mayıs University Samsun Turkey
| | - Ramazan Asci
- Department of Urology Ondokuz Mayıs University Samsun Turkey
| |
Collapse
|
42
|
Bartolacci A, Pagliardini L, Makieva S, Salonia A, Papaleo E, Viganò P. Abnormal sperm concentration and motility as well as advanced paternal age compromise early embryonic development but not pregnancy outcomes: a retrospective study of 1266 ICSI cycles. J Assist Reprod Genet 2018; 35:1897-1903. [PMID: 29995229 PMCID: PMC6150884 DOI: 10.1007/s10815-018-1256-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/29/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To investigate the effect of sperm concentration, motility and advanced paternal age on reproductive outcomes. METHODS A retrospective analysis of 1266 intracytoplasmic sperm injection (ICSI) cycles between 2013 and 2017. The cohort was divided into four groups according to semen concentration based on the WHO criteria (2010): group A (conc. <1 M/ml), group B (1 ≤ conc. <5 M/ml), group C (5 ≤ conc. < 15 M/ml) and the control group D (conc. ≥15 M/ml). The primary outcome investigated was the blastulation rate. Secondary outcomes were fertilization rate, top quality blastocyst formation rate and ongoing pregnancy rate. RESULTS After adjustment for maternal age and number of oocytes recovered, a significant difference was observed between group A and group D on the rate of fertilized oocytes [66.7 (40.0-80.0) vs 75.0 (57.1-90.2), adjusted p < 0.001] and the blastocyst formation rate [50.0 (33.3-66.3) vs 55.6 (40.0-75.0), adjusted p < 0.05]. However, the male factor did not affect the top quality blastocyst formation rate nor the ongoing pregnancy rate. Considering the age of the male partner as confounding factor, at the increase of each year of age, a reduction of 0.3% on the fertilization rate was observed but no other outcome was impacted. A negative correlation was also observed between sperm motility and fertilization rate in the group with a motility <5%. CONCLUSION Male factor infertility and advanced paternal age may compromise fertilization and blastulation rates but not top quality blastocyst formation rate or the establishment of pregnancy in ICSI cycles.
Collapse
Affiliation(s)
| | - Luca Pagliardini
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy
| | - Sofia Makieva
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Enrico Papaleo
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Via Olgettina 58, 20132, Milan, Italy.
| |
Collapse
|
43
|
Masterson TA, Greer AB, Ramasamy R. Time to improvement in semen parameters after microsurgical varicocelectomy in men with severe oligospermia. Can Urol Assoc J 2018; 13:E66-E69. [PMID: 30169150 DOI: 10.5489/cuaj.5408] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION We aimed to determine the time and predictive factors of semen quality improvement in men with severe oligospermia after microsurgical varicocelectomy. METHODS Men with total motile sperm count (TMSC) <5 million on two semen analyses were identified from May 2015 to August 2017. Postoperative semen analysis was collected at 3-6 months and >6 months. We evaluated preoperative factors for successful semen quality upgrading based on assisted reproductive technology (ART) eligibility: in vitro fertilization [IVF] (<5 million), intrauterine insemination (IUI) (5-9 million), and natural pregnancy (>9 million). We compared men with TMSC <5 million to those with TMSC 5-9 million. Data are reported as means and standard error of the mean (SEM). Pregnancy data was collected by phone interview at >6 months postoperatively RESULTS: A total of 33 men were included. TMSC improved from 1.5±0.2 to 7.3±1.8 million at 3-6 months (p<0.05) and 12.2±3.6 million at >6 months (p<0.05). There was no statistical difference in TMSC between 3-6 months and >6 months. Sixteen (48.5%) men upgraded semen quality into the range of natural pregnancy. Preoperative TMSC from 2-5 million was predictive of upgrading semen quality. Twenty-four couples were contacted by phone; 20 were attempting pregnancy in the postoperative period and five (25%) of them had achieved natural pregnancy. CONCLUSIONS Men with TMSC <5 million can expect the largest improvement in TMSC from 3-6 months postoperatively with minimal improvement thereafter. Preoperative TMSC >2 million was most predictive of semen quality upgrading.
Collapse
|
44
|
Hamano I, Hatakeyama S, Nakamura R, Fukuhara R, Noro D, Tanaka T, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Koie T, Yokoyama Y, Ohyama C. Differences in semen characteristics between patients with testicular cancer and other malignancies using various cut-off values. Int J Urol 2018; 25:817-824. [DOI: 10.1111/iju.13732] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/04/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Itsuto Hamano
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Shingo Hatakeyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Rika Nakamura
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Rie Fukuhara
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Daisuke Noro
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Toshikazu Tanaka
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Tohru Yoneyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Hayato Yamamoto
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Takahiro Yoneyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Yasuhiro Hashimoto
- Department of Advanced Transplant and Regenerative Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Aomori Japan
| | - Takuya Koie
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Chikara Ohyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
- Department of Advanced Transplant and Regenerative Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Aomori Japan
| |
Collapse
|
45
|
Zanetti BF, Braga DPAF, Provenza RR, Figueira RCS, Iaconelli A, Borges E. Sperm morphological normality under high magnification is correlated to male infertility and predicts embryo development. Andrology 2018; 6:420-427. [PMID: 29457367 DOI: 10.1111/andr.12473] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/15/2018] [Accepted: 01/16/2018] [Indexed: 01/23/2023]
Abstract
Human sperm morphology has been described as an essential parameter for the diagnosis of male infertility and a prognostic indicator of natural or assisted pregnancies. Nevertheless, standard morphological assessment remains a subjective analysis and its impact on intracytoplasmic sperm injection (ICSI) is also of limited value. The objective of this prospective cohort study was to investigate whether motile sperm organelle morphology examination (MSOME) can improve semen analysis by better defining male infertility and providing a better prognosis for ICSI up to a year later. Data were obtained from 483 patients undergoing conventional semen analysis from June 2015 to June 2017 in a private university-affiliated in vitro fertilization (IVF) center. The correlation of MSOME with seminal parameters was evaluated. One hundred and thirty patients underwent ICSI up to a year later, and the correlation between MSOME and ICSI outcomes was established. Except for volume, all seminal parameters were positively correlated with MSOME I+II. MSOME was also distinct between World Health Organization (WHO) classification groups, with normozoospermic and oligoasthenoteratozoospermic presenting the higher and the lower proportion of MSOME I+II, respectively. MSOME I+II was prognostic for fertilization rate, high-quality cleavage-stage embryos rate, and blastocyst rate. The normality cutoff value based on blastocyst rate was MSOME I+II≥ 5.5%. MSOME could be a useful tool for the diagnosis of infertility severity as it is correlated with sperm morphology, motility, and concentration. Men who had higher MSOME I+II had better ICSI outcomes. The future use of MSOME as a routine method for semen analysis may be a reliable form of assessing male infertility.
Collapse
Affiliation(s)
- B F Zanetti
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - D P A F Braga
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | | | | | - A Iaconelli
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| | - E Borges
- Fertility Medical Group, São Paulo, SP, Brazil
- Instituto Sapientiae - Centro de Estudos e Pesquisa em Reprodução Humana Assistida, São Paulo, SP, Brazil
| |
Collapse
|
46
|
Agarwal A, Bui AD. Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility. Investig Clin Urol 2017; 58:385-399. [PMID: 29124237 PMCID: PMC5671957 DOI: 10.4111/icu.2017.58.6.385] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/15/2017] [Indexed: 01/08/2023] Open
Abstract
Male infertility affects men worldwide. Oxidative stress (OS), characterized by an overabundance of reactive oxygen species (ROS) or a deficiency of antioxidants, is one of the major causes of male infertility. OS causes damage at the molecular level, which impairs lipids, proteins, and DNA. The cyclic cascade of redox reactions weakens sperm function which leads to poor semen parameters and eventual sterility. There is a need for advanced diagnostic tests that can quickly and accurately detect OS. Most commonly used assays can only measure single constituents of OS. However, the MiOXSYS System introduces a new strategy to detect OS by measuring the oxidation-reduction potential (ORP)--a direct evaluation of the redox balance between ROS and antioxidants. The MiOXSYS System has shown promise as a diagnostic tool in the evaluation of male infertility. This review explores the concept of ORP, details the principle of the MiOXSYS System, and summarizes the findings in clinical studies that support ORP measurement in semen.
Collapse
Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Albert Danh Bui
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA.,Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
| |
Collapse
|
47
|
Sperm preparation after freezing improves motile sperm count, motility, and viability in frozen-thawed sperm compared with sperm preparation before freezing-thawing process. J Assist Reprod Genet 2017; 35:237-245. [PMID: 28990130 DOI: 10.1007/s10815-017-1050-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/15/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The aim of this study is to evaluate which cryopreservation protocol, freezing before or after swim-up, optimizes cryopreservation outcomes in terms of motile sperm count, motility, morphology, and viability, and also to establish whether sperm viability could be assessed based on sperm motility. METHODS Fifty-three fresh and 53 swim-up prepared samples were considered for the first experiment. In parallel, total motility evaluation by CASA system (computer-assisted sperm analyzer) and hypoosmotic swelling test (HOS-test) was performed in each sample to compare the viability results of both methods. In the second experiment, 21 normozoospermic semen samples and 20 semen samples from male factor patients were included. After fresh ejaculate evaluation, the semen sample of each patient was divided into two aliquots, one of them was frozen before swim-up and the other was frozen after swim-up. Motility, sperm count, morphology, and viability were evaluated after thawing. RESULTS A linear regression model allows prediction of HOS-test viability results based on total motility: HOS = 1.38 + 0.97 · TM (R 2 = 99.10, residual mean squares = 9.51). Freezing before sperm selection leads to higher total and progressive motility, total motile sperm count, and viability rates than when sperm selection is performed before freezing (P < 0.005 in all cases). In fact, sperm selection prior to freezing reaches critical values when subfertile patients are considered. CONCLUSIONS To conclude, total motility evaluation can predict HOS-test viability results, resulting in a more objective and less time-consuming method to assess viability. In addition, sperm freezing prior to swim-up selection must be considered in order to achieve better outcomes after thawing, especially in patients presenting poor sperm baseline.
Collapse
|
48
|
Keihani S, Craig JR, Zhang C, Presson AP, Myers JB, Brant WO, Aston KI, Emery BR, Jenkins TG, Carrell DT, Hotaling JM. Impacts of Abstinence Time on Semen Parameters in a Large Population-based Cohort of Subfertile Men. Urology 2017; 108:90-95. [DOI: 10.1016/j.urology.2017.06.045] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 06/29/2017] [Accepted: 06/30/2017] [Indexed: 12/28/2022]
|
49
|
Palomar Rios A, Molina Botella I. Sperm parameters that play a major role in the assessment of semen quality after cryopreservation. J Assist Reprod Genet 2017. [PMID: 28624858 DOI: 10.1007/s10815-017-0973-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- A Palomar Rios
- Hospital Universitari i Politècnic La Fe, Assisted Reproduction Unit, 46026, Valencia, Spain.
| | - I Molina Botella
- Hospital Universitari i Politècnic La Fe, Assisted Reproduction Unit, 46026, Valencia, Spain
| |
Collapse
|
50
|
Chapuis A, Gala A, Ferrières-Hoa A, Mullet T, Bringer-Deutsch S, Vintejoux E, Torre A, Hamamah S. Sperm quality and paternal age: effect on blastocyst formation and pregnancy rates. Basic Clin Androl 2017; 27:2. [PMID: 28127436 PMCID: PMC5251225 DOI: 10.1186/s12610-016-0045-4] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/06/2016] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Several studies suggest a decrease in sperm quality in men in the last decades. Therefore, the aim of this work was to assess the influence of male factors (sperm quality and paternal age) on the outcomes of conventional in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). METHODS This retrospective study included all couples who underwent IVF or ICSI at Montpellier University Hospital, France, between 1 January 2010 and 31 December 2015. Exclusion criteria were cycles using surgically retrieved sperm or frozen sperm, with pre-implantation genetic diagnosis or using frozen oocytes. The primary outcomes were the blastulation rate (number of blastocysts obtained at day 5 or day 6/number of embryos in prolonged culture at day 3) and the clinical pregnancy rate. The secondary outcomes were the fertilization and early miscarriage rates. RESULTS In total, 859 IVF and 1632 ICSI cycles were included in this study. The fertilization rate after ICSI was affected by oligospermia. Moreover, in ICSI, severe oligospermia (lower than 0.2 million/ml) led to a reduction of the blastulation rate. Reduced rapid progressive motility affected particularly IVF, with a decrease of the fertilization rate and number of embryos at day 2 when progressive motility was lower than 32%. Paternal age also had a negative effect. Although it was difficult to eliminate the bias linked to the woman's age, pregnancy rate was reduced in IVF and ICSI when the father was older than 51 and the mother older than 37 years. CONCLUSIONS These results allow adjusting our strategies of fertilization technique and embryo transfer. In the case of severe oligospermia, transfer should be carried out at the cleaved embryo stage (day 2-3) due to the very low blastulation rate. When the man is older than 51 years, couples should be aware of the reduced success rate, especially if the woman is older than 37 years. Finally, promising research avenues should be explored, such as the quantification of free sperm DNA, to optimize the selection of male gametes.
Collapse
Affiliation(s)
- Aurélie Chapuis
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
| | - Anna Gala
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
| | - Alice Ferrières-Hoa
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
| | - Tiffany Mullet
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
- Montpellier University, UFR of Medicine, Montpellier, France
| | | | - Emmanuelle Vintejoux
- Gynaecology and Obstetric Department, CHU Montpellier, Montpellier, F-34295 France
| | - Antoine Torre
- Gynaecology and Obstetric Department, CHU Montpellier, Montpellier, F-34295 France
| | - Samir Hamamah
- ART/PGD Division, CHU Montpellier, Montpellier, F-34295 France
- INSERM U1203, Montpellier, F-34295 France
- Montpellier University, UFR of Medicine, Montpellier, France
| |
Collapse
|