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Irani D, Tandon D, Bansal V, Patil A, Balasinor N, Singh D. Correlation between sperm DNA fragmentation and methylation in male partners of couples with idiopathic recurrent pregnancy loss. Syst Biol Reprod Med 2024; 70:164-173. [PMID: 38913941 DOI: 10.1080/19396368.2024.2363209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 05/24/2024] [Indexed: 06/26/2024]
Abstract
With ∼50% recurrent pregnancy loss cases being termed idiopathic (iRPL), understanding of contribution of male factors to iRPL is still lacking. Higher prevalence of sperm DNA fragmentation index (DFI) and lower sperm 5-methylcytosine (5-mC) levels have been previously reported in male partners of iRPL couples and shed light on importance of the male gamete in maintenance of a successful pregnancy. The present study aimed to determine the serum sex steroid hormone levels, sperm DFI and 5-mC and correlation between them in male partners of fertile and iRPL couples. Further, correlation between sperm DFI and 5-mC with semen parameters and paternal age in both groups were determined. 36 male partners of fertile couples and 45 male partners of women experiencing iRPL were enrolled for this study and semen and blood samples were collected. Serum testosterone and estradiol levels were measured by ELISA; sperm DFI and global 5-mC were determined by TUNEL assay and ELISA respectively. Significantly higher serum testosterone levels were noted in the iRPL group (p = 0.028). Incidence of sperm DNA fragmentation was found to be higher in the iRPL study group but with no significance difference. No significant differences in sperm 5-mC values were noted. Upon correlation analysis within both groups, strong significant negative correlation of sperm DFI % and 5-mC % was observed in the control group (p < 0.001) but not the iRPL group (p = 0.249). Hence, we infer that with lower 5-mC levels in sperm genome, there is a higher incidence of sperm DFI in fertile men. However, this trend is not noted in men of iRPL group which could possibly be due to other underlying epigenetic alterations in genomic regions probably unsusceptible to fragmentation. On the other hand, no significant correlations of semen parameters, testosterone, estradiol and paternal age with sperm DFI and 5-mC were noted in both groups.
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Affiliation(s)
- Delna Irani
- Department of Neuroendocrinology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Deepti Tandon
- Department of Clinical Research, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Vandana Bansal
- Department of Obstetrics and Gynaecology, Nowrosjee Wadia Maternity Hospital, Mumbai, India
| | - Anushree Patil
- Department of Clinical Research, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Nafisa Balasinor
- Department of Neuroendocrinology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
| | - Dipty Singh
- Department of Neuroendocrinology, ICMR - National Institute for Research in Reproductive and Child Health, Mumbai, India
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Solanki M, Joseph T, Muthukumar K, Samuel P, Aleyamma TK, Kamath MS. Impact of sperm DNA fragmentation in couples with unexplained recurrent pregnancy loss: A cross-sectional study. J Obstet Gynaecol Res 2024. [PMID: 39096059 DOI: 10.1111/jog.16041] [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: 02/20/2024] [Accepted: 07/17/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE Recurrent pregnancy loss (RPL) has a multifactorial etiology, with a majority of cases remaining unexplained. To account for these unexplained cases, possible male factors are being explored. Conventional semen analysis lacks a qualitative assessment of sperms and information regarding sperm DNA integrity. Sperm DNA fragmentation (SDF) has diagnostic value in unexplained RPL, and it may account for a number of unexplained cases. Hence, we planned a study to explore and evaluate the impact of sperm DNA fragmentation in couples with unexplained recurrent pregnancy losses. STUDY DESIGN Analytical cross-sectional study was conducted at a tertiary-level referral facility in India between August 2021 and July 2023. Participants (n = 70) were divided into two groups-male partners of couples with unexplained RPL (following spontaneous conceptions) (n = 35) and men with at least one previous live birth (spontaneous or following fertility treatments for female factor infertility such as ovulation induction or intrauterine insemination) as controls (n = 35). Neither of the two groups of couples recruited for this study had undergone ART as fertility treatment. Primary outcome assessed was mean DNA fragmentation index (DFI). Secondary outcomes included differences in semen parameters such as sperm concentration, progressive sperm motility and morphology, proportion of men with high (≥30%) and low DFI in the two groups, and the association between various semen parameters and DFI. RESULTS Univariate logistic regression revealed that sperm DNA fragmentation was higher in men with unexplained RPL (30.0; IQR (interquartile range) 19.0, 46.0) as compared to controls (22.0; IQR 14.0, 30.0) although it was not statistically significant (OR, odds ratio, 1.02; 95% CI 1.0-1.1, p = 0.08). A higher proportion of men with unexplained RPL had DFI ≥30% compared to controls (54.2% vs. 25.7%; OR 3.43 (95% CI 1.2-9.4); p = 0.02). No statistically significant differences were observed in semen volume, sperm concentration, progressive motility, and morphology between the two groups. Sperm DNA fragmentation index also showed a weak but significant inverse relationship with sperm morphology (r = -0.336, p = 0.004). CONCLUSION The current study did not show any significant difference in the mean sperm DNA fragmentation levels in male partners of couples with unexplained RPL compared to controls. However, a higher proportion of men with DFI ≥30% were observed in unexplained RPL population when compared to controls.
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Affiliation(s)
- Megha Solanki
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India
| | - Treasa Joseph
- Department of Reproductive Medicine and Surgery, Christian Medical College and Hospital, Vellore, India
| | - K Muthukumar
- Department of Reproductive Medicine and Surgery, Christian Medical College and Hospital, Vellore, India
| | - Prasanna Samuel
- Department of Biostatistics, Christian Medical College, Vellore, India
| | - T K Aleyamma
- Department of Reproductive Medicine and Surgery, Christian Medical College and Hospital, Vellore, India
| | - Mohan S Kamath
- Department of Reproductive Medicine and Surgery, Christian Medical College, Vellore, India
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Wang L, Yang S, Ma X, Yang L, Ma J, Zhao X, Zhang Q. Bibliometric and visual analysis on oxidative stress in gynecological and reproductive diseases: A systematic review. Medicine (Baltimore) 2024; 103:e37815. [PMID: 38608064 PMCID: PMC11018168 DOI: 10.1097/md.0000000000037815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND The imbalance between the generation and elimination of reactive oxygen species (ROS) is defined as oxidative stress (OS). Elevated levels of OS are implicated in various diseases, especially in gynecological and reproductive disorders. The abundance of recent literature makes it challenging to assimilate all available information. This bibliometric analysis seeks to depict the research landscape of OS in gynecological and reproductive diseases and to identify future hotspots and trends. METHODS The Web of Science Core Collection served as the source for articles related to OS in gynecological and reproductive diseases. CtieSpace and VOSviewer software were utilized to analyzed countries/regions, institutions, journals, authors, and keywords of all eligible articles. RESULTS A total of 1423 articles were included. There was a gradual increase in the number of publications in this field. The USA maintained the highest number of publications, with 372 articles. Cleveland Clinic was the leading institution in terms of publication volume, contributing 67 articles. In total, 6925 authors were identified. Agarwal A as the most frequently co-cited author, received 812 citations across 43 publications. The predominant clusters included "placenta," "polycystic ovary syndrome," "male infertility," and "oocyte quality." Notably, "oocyte quality'" was identified as a current key research topic. CONCLUSION There was an uptrend in the number of articles addressing OS in gynecological and reproductive diseases. However, international collaboration and exchange were limited. The topic of male infertility had remained a consistent area of interest, and research on oocyte quality is poised to become a potential focal point in the future.
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Affiliation(s)
- Ling Wang
- Department of TCM Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Sichen Yang
- The Third School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaona Ma
- The Third Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Liuqing Yang
- Department of TCM Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Jing Ma
- Department of TCM Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaoxuan Zhao
- Department of TCM Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
| | - Qin Zhang
- Department of TCM Gynecology, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China
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Rasmussen JMK, Dalgaard MIR, Alipour H, Dardmeh F, Christiansen OB. Seminal Oxidative Stress and Sperm DNA Fragmentation in Men from Couples with Infertility or Unexplained Recurrent Pregnancy Loss. J Clin Med 2024; 13:833. [PMID: 38337527 PMCID: PMC10856715 DOI: 10.3390/jcm13030833] [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: 12/16/2023] [Revised: 01/24/2024] [Accepted: 01/28/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: This case-control study examined whether men from couples with unexplained recurrent pregnancy loss (RPL) or infertility exhibited higher seminal oxidative stress (OS) and sperm DNA fragmentation (SDF) compared to fertile controls. (2) Methods: The study included 30 participants from each group: unexplained RPL, unexplained infertility, and proven fertility. Data were collected at Aalborg University Hospital tertiary RPL and fertility treatment clinics (Aalborg, Denmark), excluding couples with mixed conditions for homogeneity. Semen samples were analyzed using computer-aided sperm analysis (CASA) for concentration, motility, and morphology. SDF was assessed via a CASA-based sperm chromatin dispersion test. OS was measured as static oxidation-reduction potential (sORP). (3) Results: The results showed no significant OS differences between groups. The RPL group had significantly lower SDF levels than the control group. A significant positive correlation between SDF and OS was observed in the infertility group. Overall, this study did not find significant differences in OS levels between men from couples with unexplained RPL or infertility and fertile controls, while SDF levels were lower in the RPL group compared to controls. (4) Conclusion: In conclusion, despite the existing literature suggesting that OS and SDF are negative prognostic factors, our findings suggest they may not be reliable diagnostic markers for RPL and infertility.
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Affiliation(s)
| | - Maya Isabella Riise Dalgaard
- Department of Obstetrics and Gynecology, Aalborg University Hospital, 9000 Aalborg, Denmark; (J.M.K.R.); (M.I.R.D.)
| | - Hiva Alipour
- Regenerative Medicine, Department of Health Science and Technology, Aalborg University, 9260 Gistrup, Denmark;
| | - Fereshteh Dardmeh
- Regenerative Medicine, Department of Health Science and Technology, Aalborg University, 9260 Gistrup, Denmark;
| | - Ole Bjarne Christiansen
- Department of Obstetrics and Gynecology, Aalborg University Hospital, 9000 Aalborg, Denmark; (J.M.K.R.); (M.I.R.D.)
- Department of Clinical Medicine, Aalborg University, 9260 Gistrup, Denmark
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Pelzman DL, Sandlow JI. Sperm morphology: Evaluating its clinical relevance in contemporary fertility practice. Reprod Med Biol 2024; 23:e12594. [PMID: 38915912 PMCID: PMC11194684 DOI: 10.1002/rmb2.12594] [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: 04/22/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
Background The World Health Organization (WHO) recommends reporting sperm morphology in a standard semen analysis. However, the clinical utility and prognostic value of morphology is often debated. Methods We reviewed and summarized studies that assessed both the benefits and limitations of sperm morphology in the context of natural fertility, assisted reproductive technologies, and recurrent pregnancy loss. We additionally describe possible environmental and anatomical etiologies of teratozoospermia. Results Sperm morphology evaluation has continuously evolved since the release of the first WHO manual in 1980. Initially, several large studies reported significant inverse associations between fertility outcomes and teratozoospermia. Most recent studies, however, fail to show an association between sperm morphology and natural or assisted fertility outcomes. Conclusion Sperm morphology analysis may have limited diagnostic and prognostic value. Providers should be aware of these limitations when counseling or managing infertile patients.
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Affiliation(s)
- Daniel L. Pelzman
- Department of UrologyMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jay I. Sandlow
- Department of UrologyMedical College of WisconsinMilwaukeeWisconsinUSA
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Inversetti A, Bossi A, Cristodoro M, Larcher A, Busnelli A, Grande G, Salonia A, Di Simone N. Recurrent pregnancy loss: a male crucial factor-A systematic review and meta-analysis. Andrology 2023. [PMID: 37881014 DOI: 10.1111/andr.13540] [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: 04/06/2023] [Revised: 08/12/2023] [Accepted: 09/27/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Recurrent pregnancy loss (RPL), defined as two or more failed clinical pregnancies, affects 1%-3% of couples trying to conceive. Nowadays up to 50% of cases remain idiopathic. In this context, paternal factors evaluation is still very limited. The aim is to address the topic of the male factor in RPL with a broad approach, analyzing collectively data on sperm DNA fragmentation (SDF) and semen parameters. We systematically searched in Pubmed/MEDLINE and Google Scholar from inception to February 2023. A protocol has been registered on PROSPERO (ID number CRD42022278616). PRISMA guidelines were followed. METHODS Pooled results from 20 studies revealed a higher DNA fragmentation rate in the RPL group compared to controls (mean difference [MD] 9.21, 95% CI 5.58-12.85, p < 0.00001, I2 98%). Age, body mass index (BMI), smoking, and alcohol intake were not associated with DNA fragmentation. Subgroup analysis by different SDF assays (TUNEL and COMET at a neutral pH vs. indirect assessment with other assays) and ethnicity did not highlight different results (p = 0.25 and 0.44). RESULTS Results pooled from 25 studies showed a significant difference comparing RPL and control groups regarding ejaculation volume (MD -0.24, 95% CI -0.43; -0.06, p 0.01, I2 66%), total sperm number (MD -10.03, 95% CI -14.65; -5.41, p < 0.0001, I2 76%), total sperm motility (MD -11.20, 95% CI -16.15; -6.25, p < 0.0001, I2 96%), progressive sperm motility (MD -7.34, 95% CI -10.87; -3.80, p < 0.0001, I2 97%), and normal sperm morphology (MD -5.99, 95% CI -9.08; -2.90, p 0.0001, I2 98%). A sub-analysis revealed that Asian and Africans, but not white-European RPL men had lower progressive sperm motility compared to controls. CONCLUSION In conclusion, current review and meta-analysis findings suggested that SDF and some specific semen parameters were associated with RPL in a multi-ethnic evaluation. This effort opens future direction on a growing awareness of, first, how the male factor plays a key role and, second, how appropriate would be to establish a direct dialogue between the gynecologist and the urologist. PATIENT SUMMARY We performed a systematic review and meta-analysis on the male component of RPL. We found that sperm DNA fragmentation and some specific sperm parameters are significantly associated with RPL.
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Affiliation(s)
- Annalisa Inversetti
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Arianna Bossi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | | | - Alessandro Larcher
- Department of Urology and Division of Experimental Oncology, URI Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Busnelli
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Giuseppe Grande
- Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padova, Padova, Italy
| | - Andrea Salonia
- Department of Urology and Division of Experimental Oncology, URI Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicoletta Di Simone
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Rozzano, Italy
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Gao J, Yan Z, Yan L, Zhu X, Jiang H, Qiao J. The effect of sperm DNA fragmentation on the incidence and origin of whole and segmental chromosomal aneuploidies in human embryos. Reproduction 2023; 166:117-124. [PMID: 37252832 PMCID: PMC10326632 DOI: 10.1530/rep-23-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/30/2023] [Indexed: 06/01/2023]
Abstract
In brief Whether sperm DNA fragmentation (SDF) affects embryo development and clinical outcomes is still controversial, which limits the utility of SDF testing in assisted reproductive technology management. This study demonstrates that high SDF is associated with the incidence of segmental chromosomal aneuploidy and increased paternal whole chromosomal aneuploidies. Abstract We aimed to investigate the correlation of sperm DNA fragmentation (SDF) with the incidence and paternal origin of whole and segmental chromosomal aneuploidies of embryos at the blastocyst stage. A retrospective cohort study was conducted with a total of 174 couples (women aged 35 years or younger) who underwent 238 cycles (including 748 blastocysts) of preimplantation genetic testing for monogenic diseases (PGT-M). All subjects were divided into two groups based on the sperm DNA fragmentation index (DFI) level: low DFI (<27%) and high DFI (≥27%). The rates of euploidy, whole chromosomal aneuploidy, segmental chromosomal aneuploidy, mosaicism, parental origin of aneuploidy, fertilization, cleavage, and blastocyst formation were compared between low- and high-DFI groups. We found no significant differences in fertilization, cleavage, or blastocyst formation between the two groups. Compared to that in the low-DFI group, segmental chromosomal aneuploidy rate was significantly higher in the high-DFI group (11.57% vs 5.83%, P = 0.021; OR: 2.32, 95% CI: 1.10-4.89, P = 0.028). The whole chromosomal embryonic aneuploidy of paternal origin was significantly higher in cycles with high DFI than in cycles with low DFI (46.43% vs 23.33%, P = 0.018; OR: 4.32, 95% CI: 1.06-17.66, P = 0.041). However, the segmental chromosomal aneuploidy of paternal origin was not significantly different between the two groups (71.43% vs 78.05%, P = 0.615; OR: 1.01, 95% CI: 0.16-6.40, P = 0.995). In conclusion, our results suggested that high SDF was associated with the incidence of segmental chromosomal aneuploidy and increased paternal whole chromosomal aneuploidies in embryos.
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Affiliation(s)
- Jiangman Gao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital,Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, China
| | - Zhiqiang Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital,Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, China
| | - Liying Yan
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital,Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, China
| | - Xiaohui Zhu
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital,Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, China
| | - Hui Jiang
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital,Peking University Third Hospital, Beijing, China
| | - Jie Qiao
- Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital,Peking University Third Hospital, Beijing, China
- National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital), Beijing, China
- Key Laboratory of Assisted Reproduction (Peking University), Ministry of Education, Beijing, China
- Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology (Peking University Third Hospital), Beijing, China
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Naglot S, Thapliyal A, Tomar AK, Yadav S. Male Contributory Factors in Recurrent Pregnancy Loss. Reprod Sci 2023; 30:2107-2121. [PMID: 36792841 DOI: 10.1007/s43032-023-01192-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 02/05/2023] [Indexed: 02/17/2023]
Abstract
With 40% of idiopathic cases, recurrent pregnancy loss (RPL) is a problem of great concern for patients and clinicians. In addition to financial burden, it causes a lot of frustration and anxiety in affected couples. The primary objective of this review was to gain knowledge of recent advances in the field of recurrent pregnancy losses and to understand the role of male contributory factors in idiopathic cases. For a long time, researchers and clinicians were seeking an explanation for idiopathic RPL (iRPL) in females only; however, with recent advances in reproductive biology, the role of spermatozoa in early embryonic development has caught the attention of researchers. Clinically, only routine semen parameters and karyotyping are investigated in iRPL male partners, which seem to be insufficient in the present scenario, and thus, more information at the molecular level is required for a comprehensive understanding of iRPL. In concluding remarks, we suggest targeted multi-omics investigations in a large cohort to improve our understanding of the role of male contributory factors in iRPL.
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Affiliation(s)
- Sarla Naglot
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ayushi Thapliyal
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Anil Kumar Tomar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Savita Yadav
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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Davies R, Jayasena CN, Rai R, Minhas S. The Role of Seminal Oxidative Stress in Recurrent Pregnancy Loss. Antioxidants (Basel) 2023; 12:antiox12030723. [PMID: 36978971 PMCID: PMC10045000 DOI: 10.3390/antiox12030723] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/01/2023] [Accepted: 03/07/2023] [Indexed: 03/17/2023] Open
Abstract
Recurrent pregnancy loss is a distressing condition affecting 1–2% of couples. Traditionally investigations have focused on the female, however more recently researchers have started to explore the potential contribution of the male partner. Seminal reactive oxygen species have a physiological function in male reproduction but in excess are suspected to generate structural and functional damage to the sperm. Evidence is mounting to support an association between elevated seminal reaction oxygen species and recurrent pregnancy loss. Studies suggest that the rates of sperm DNA damage are higher in the male partners of women affected by recurrent pregnancy loss compared with unaffected men. However, the available pool of data is conflicting, and interpretation is limited by the recent change in nomenclature and the heterogeneity of study methodologies. Furthermore, investigation into the effects of oxidative stress on the epigenome show promise. The value of antioxidant therapy in the management of recurrent pregnancy loss currently remains unclear.
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Affiliation(s)
- Rhianna Davies
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0NN, UK
| | - Channa N. Jayasena
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London W12 0NN, UK
| | - Raj Rai
- Department of Obstetrics and Gynaecology, St Mary’s Hospital, Imperial College NHS Trust, London W2 1NY, UK
| | - Suks Minhas
- Department of Urology, Charing Cross Hospital, Imperial College NHS Trust, London W6 8RF, UK
- Correspondence:
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Santi D, Spaggiari G, Granata ARM, Simoni M. Real-world evidence analysis of the follicle-stimulating hormone use in male idiopathic infertility. Best Pract Res Clin Obstet Gynaecol 2022; 85:121-133. [PMID: 35618626 DOI: 10.1016/j.bpobgyn.2022.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/11/2022] [Accepted: 04/20/2022] [Indexed: 12/14/2022]
Abstract
Male idiopathic infertility remains a therapeutic challenge in the couple infertility management. In this setting, an empirical treatment with follicle-stimulating hormone (FSH) is allowed, although not recommended. Twenty-one clinical trials and four meta-analyses highlighted an overall increased pregnancy rate in case of FSH administration, but the indiscriminate FSH prescription is still unsupported by clinical evidence in idiopathic infertility. This context could represent an example in which real-world data (RWD) could add useful information. From a nationwide clinical practice survey performed in Italy, emerged the clinicians' attitude to prescribe FSH in the case of impaired semen with a significant improvement of semen parameters, identifying FSH treatment as a therapeutic card in the real-life management. Although more robust data are still needed to optimize FSH treatment in male idiopathic infertility, RWD should be included in the body of evidence considered in healthcare decision-making.
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Affiliation(s)
- Daniele Santi
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Via Giardini 1355, 41126 Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125, Modena, Italy.
| | - Giorgia Spaggiari
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Via Giardini 1355, 41126 Modena, Italy
| | - Antonio R M Granata
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Via Giardini 1355, 41126 Modena, Italy
| | - Manuela Simoni
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Ospedale Civile of Baggiovara, Via Giardini 1355, 41126 Modena, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Campi 287, 41125, Modena, Italy
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Cao C, Bai S, Zhang J, Sun X, Meng A, Chen H. Understanding recurrent pregnancy loss: recent advances on its etiology, clinical diagnosis, and management. MEDICAL REVIEW (BERLIN, GERMANY) 2022; 2:570-589. [PMID: 37724255 PMCID: PMC10471095 DOI: 10.1515/mr-2022-0030] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 11/14/2022] [Indexed: 09/20/2023]
Abstract
Recurrent pregnancy loss (RPL) has become an important reproductive health issue worldwide. RPL affects about 2%-3% of reproductive-aged women, and makes serious threats to women's physical and mental health. However, the etiology of approximately 50% of RPL cases remains unknown (unexplained RPL), which poses a big challenge for clinical management of these patients. RPL has been widely regarded as a complex disease where its etiology has been attributed to numerous factors. Heretofore, various risk factors for RPL have been identified, such as maternal ages, genetic factors, anatomical structural abnormalities, endocrine dysfunction, prethrombotic state, immunological factors, and infection. More importantly, development and applications of next generation sequencing technology have significantly expanded opportunities to discover chromosomal aberrations and single gene variants responsible for RPL, which provides new insight into its pathogenic mechanisms. Furthermore, based upon patients' diagnostic evaluation and etiologic diagnosis, specific therapeutic recommendations have been established. This review will highlight current understanding and recent advances on RPL, with a special focus on the immunological and genetic etiologies, clinical diagnosis and therapeutic management.
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Affiliation(s)
- Chunwei Cao
- Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Province, China
- Guangzhou laboratory, Guangzhou, Guangdong Province, China
- Center for Reproductive Genetics and Reproductive Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Shiyu Bai
- Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
| | - Jing Zhang
- Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Province, China
- Center for Reproductive Genetics and Reproductive Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Xiaoyue Sun
- Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangdong Province, China
- Center for Reproductive Genetics and Reproductive Medicine, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, China
| | - Anming Meng
- Guangzhou laboratory, Guangzhou, Guangdong Province, China
| | - Hui Chen
- Reproductive Medicine Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province, China
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12
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Moretti E, Signorini C, Noto D, Corsaro R, Collodel G. The relevance of sperm morphology in male infertility. FRONTIERS IN REPRODUCTIVE HEALTH 2022; 4:945351. [PMID: 36303645 PMCID: PMC9580829 DOI: 10.3389/frph.2022.945351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
This brief report concerns the role of human sperm morphology assessment in different fields of male infertility: basic research, genetics, assisted reproduction technologies, oxidative stress. One of the best methods in studying sperm morphology is transmission electron microscopy (TEM) that enables defining the concept of sperm pathology and classifying alterations in non-systematic and systematic. Non-systematic sperm defects affect head and tail in variable ratio, whereas the rare systematic defects are characterized by a particular anomaly that marks most sperm of an ejaculate. TEM analysis and fluorescence in situ hybridization represent outstanding methods in the study of sperm morphology and cytogenetic in patients with altered karyotype characterizing their semen quality before intracytoplasmic sperm injection. In recent years, the genetic investigations on systematic sperm defects, made extraordinary progress identifying candidate genes whose mutations induce morphological sperm anomalies. The question if sperm morphology has an impact on assisted fertilization outcome is debated. Nowadays, oxidative stress represents one of the most important causes of altered sperm morphology and function and can be analyzed from two points of view: 1) spermatozoa with cytoplasmic residue produce reactive oxygen species, 2) the pathologies with inflammatory/oxidative stress background cause morphological alterations. Finally, sperm morphology is also considered an important endpoint in in vitro experiments where toxic substances, drugs, antioxidants are tested. We think that the field of sperm morphology is far from being exhausted and needs other research. This parameter can be still considered a valuable indicator of sperm dysfunction both in basic and clinical research.
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13
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Lu JC. High DNA stainability (HDS) should not be recommended as a marker for the detection of sperm DNA damage. Andrologia 2022; 54:e14442. [PMID: 35415912 DOI: 10.1111/and.14442] [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: 12/26/2021] [Revised: 02/06/2022] [Accepted: 03/30/2022] [Indexed: 11/01/2022] Open
Abstract
There was a marker of high DNA stainability (HDS) in the detection of sperm DNA damage, which was defined as the sperm with high green stainability (HIGRN). The sperm with normal double-stranded DNA was stained green by acridine orange (AO). However, the sperm with high green fluorescence or HDS were thought of as immature sperm or the sperm with poor chromatin condensation. Some previous literature reported that the proportion of sperm with HDS increased with age, and had a certain correlation with the poor outcome of assisted reproductive technology. Recently, several articles reported that the marker of HDS decreased linearly with age, which was obviously inconsistent with that reported by the previous literature. In this case, what kind of marker is HDS? Is it worth studying? After extensively reading the literature related to HDS and flow cytometry related books and performing a series of studies related to the detection of sperm DNA damage, we believe that the establishment of HDS in the detection of sperm DNA damage has no theoretical basis and also no support of evidence-based medicine and that using HDS as a marker in the detection of sperm DNA integrity is inappropriate.
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Affiliation(s)
- Jin-Chun Lu
- Center for Reproductive Medicine, Zhongda Hospital, Southeast University, Nanjing, China
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14
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El Fekih S, Gueganic N, Tous C, Ali HB, Ajina M, Douet-Guilbert N, Drapier H, Beauvillard D, Morel F, Perrin A. MACS-annexin V cell sorting of semen samples with high TUNEL values decreases the concentration of cells with abnormal chromosomal content: a pilot study. Asian J Androl 2021; 24:445-450. [PMID: 34975072 PMCID: PMC9491034 DOI: 10.4103/aja202197] [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] [Indexed: 12/03/2022] Open
Abstract
We question whether, in men with an abnormal rate of sperm DNA fragmentation, the magnetic-activated cell sorting (MACS) could select spermatozoa with lower rates of DNA fragmentation as well as spermatozoa with unbalanced chromosome content. Cryopreserved spermatozoa from six males were separated into nonapoptotic and apoptotic populations. We determined the percentages of spermatozoa with (i) externalization of phosphatidylserine (EPS) by annexin V-Fluorescein isothiocyanate (FITC) labeling, (ii) DNA fragmentation by TdT-mediated-dUTP nick-end labeling (TUNEL), and (iii) numerical abnormalities for chromosomes X, Y, 13, 18, and 21 by fluorescence in situ hybridization (FISH), on the whole ejaculate and selected spermatozoa in the same patient. Compared to the nonapoptotic fraction, the apoptotic fraction statistically showed a higher number of spermatozoa with EPS, with DNA fragmentation, and with numerical chromosomal abnormalities. Compared to the whole ejaculate, we found a significant decrease in the percentage of spermatozoa with EPS and decrease tendencies of the DNA fragmentation rate and the sum of disomy levels in the nonapoptotic fraction. Conversely, we observed statistically significant higher rates of these three parameters in the apoptotic fraction. MACS may help to select spermatozoa with lower rates of DNA fragmentation and unbalanced chromosome content in men with abnormal rates of sperm DNA fragmentation.
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Affiliation(s)
- Sahar El Fekih
- University of Brest, Inserm, UMR U1078, Faculty of Medicine and Health Sciences, Brest 29238, France.,Laboratory of Human Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Hospital, Sousse 4031, Tunisia
| | - Nadia Gueganic
- University of Brest, Inserm, UMR U1078, Faculty of Medicine and Health Sciences, Brest 29238, France
| | - Corinne Tous
- Departement of Medical Genetics and Reproductive Biology, Brest University Regional Hospital, Brest 29609, France
| | - Habib Ben Ali
- Laboratory of Human Cytogenetics, Molecular Genetics and Reproductive Biology, Farhat Hached University Hospital, Sousse 4031, Tunisia
| | - Mounir Ajina
- Department of Reproductive Medicine, Farhat Hached Teaching Hospital, Sousse 4031, Tunisia
| | - Nathalie Douet-Guilbert
- University of Brest, Inserm, UMR U1078, Faculty of Medicine and Health Sciences, Brest 29238, France.,Departement of Medical Genetics and Reproductive Biology, Brest University Regional Hospital, Brest 29609, France
| | - Hortense Drapier
- Departement of Medical Genetics and Reproductive Biology, Brest University Regional Hospital, Brest 29609, France
| | - Damien Beauvillard
- Departement of Medical Genetics and Reproductive Biology, Brest University Regional Hospital, Brest 29609, France
| | - Frédéric Morel
- University of Brest, Inserm, UMR U1078, Faculty of Medicine and Health Sciences, Brest 29238, France.,Departement of Medical Genetics and Reproductive Biology, Brest University Regional Hospital, Brest 29609, France
| | - Aurore Perrin
- University of Brest, Inserm, UMR U1078, Faculty of Medicine and Health Sciences, Brest 29238, France.,Departement of Medical Genetics and Reproductive Biology, Brest University Regional Hospital, Brest 29609, France
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15
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Villani MT, Morini D, Spaggiari G, Falbo AI, Melli B, La Sala GB, Romeo M, Simoni M, Aguzzoli L, Santi D. Are sperm parameters able to predict the success of assisted reproductive technology? A retrospective analysis of over 22,000 assisted reproductive technology cycles. Andrology 2021; 10:310-321. [PMID: 34723422 PMCID: PMC9298690 DOI: 10.1111/andr.13123] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/26/2021] [Accepted: 10/27/2021] [Indexed: 12/23/2022]
Abstract
Background An explosive increase in couples attending assisted reproductive technology has been recently observed, despite an overall success rate of about 20%–30%. Considering the assisted reproductive technology‐related economic and psycho‐social costs, the improvement of these percentages is extremely relevant. However, in the identification of predictive markers of assisted reproductive technology success, male parameters are largely underestimated so far. Study design Retrospective, observational study. Objectives To evaluate whether conventional semen parameters could predict assisted reproductive technology success. Materials and methods All couples attending a single third‐level fertility center from 1992 to 2020 were retrospectively enrolled, collecting all semen and assisted reproductive technology parameters of fresh cycles. Fertilization rate was the primary end‐point, representing a parameter immediately dependent on male contribution. Pregnancy and live birth rates were considered in relation to semen variables. Statistical analyses were performed using the parameters obtained according to the World Health Organization manual editions used for semen analysis. Results Note that, 22,013 in vitro fertilization and intracytoplasmic sperm injection cycles were considered. Overall, fertilization rate was significantly lower in patients with abnormal semen parameters compared to normozoospermic men, irrespective of the World Health Organization manual edition. In the in vitro fertilization setting, both progressive motility (p = 0.012) and motility after capacitation (p = 0.002) significantly predicted the fertilization rate (statistical accuracy = 71.1%). Sperm motilities also predicted pregnancy (p < 0.001) and live birth (p = 0.001) rates. In intracytoplasmic sperm injection cycles, sperm morphology predicted fertilization rate (p = 0.001, statistical accuracy = 90.3%). Sperm morphology significantly predicted both pregnancy (p < 0.001) and live birth (p < 0.001) rates and a cut‐off of 5.5% was identified as a threshold to predict clinical pregnancy (area under the curve = 0.811, p < 0.001). Discussion Interestingly, sperm motility plays a role in predicting in vitro fertilization success, while sperm morphology is the relevant parameter in intracytoplasmic sperm injection cycles. These parameters may be considered reliable tools to measure the male role on ART outcomes, potentially impacting the clinical management of infertile couples.
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Affiliation(s)
- Maria Teresa Villani
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Daria Morini
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giorgia Spaggiari
- Department of Medical Specialties, Unit of Endocrinology, Ospedale Civile of Baggiovara, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy
| | - Angela Immacolata Falbo
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Beatrice Melli
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Giovanni Battista La Sala
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Marilina Romeo
- Department of Medical Specialties, Unit of Endocrinology, Ospedale Civile of Baggiovara, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
| | - Manuela Simoni
- Department of Medical Specialties, Unit of Endocrinology, Ospedale Civile of Baggiovara, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
| | - Lorenzo Aguzzoli
- Department of Obstetrics and Gynaecology, Fertility Centre, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Daniele Santi
- Department of Medical Specialties, Unit of Endocrinology, Ospedale Civile of Baggiovara, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.,Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
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16
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Linehan L, Hennessy M, O'Donoghue K. Infertility and subsequent recurrent miscarriage: Current state of the literature and future considerations for practice and research. HRB Open Res 2021. [DOI: 10.12688/hrbopenres.13397.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Recurrent miscarriage (RM) and infertility are independently associated with adverse pregnancy outcomes, in addition to psychological sequelae. Experiencing pregnancy loss alongside infertility is particularly difficult. International guidance regarding RM is conflicting, and applicability to women with infertility is undetermined. The aim of this study was to: (i) establish if women/couples with a history of infertility are recognised in the literature on the investigation and management of RM, and (ii) determine if the specific needs of women/couples experiencing RM and infertility are ascertained and incorporated into clinical management strategies. Methods: We examined the wide-ranging literature to ascertain what gaps existed. Studies were retrieved through searches of PubMed and Google Scholar up to 21 January 2021 using appropriate controlled vocabulary and combinations of key words. No language or study design restrictions were applied. Results: While women/couples experiencing RM after infertility appear in studies evaluating investigations and proposed treatments, high-quality studies are lacking. Furthermore, they are largely excluded from international clinical guidance and qualitative research. Conclusions: The experiences of women/couples with RM and infertility and their specific care needs within maternity and fertility services are underexplored. It is unclear from current RM guidelines how best to manage and support this complex cohort. Women/couples with infertility and RM are underserved in the literature and in clinical guidance. Further robust studies are warranted to examine pregnancy outcomes, investigations and treatments currently used. Qualitative research is also required to identify their medical and psychological needs to better support this vulnerable group.
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17
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Naglot S, Tomar AK, Singh N, Yadav S. Label-free proteomics of spermatozoa identifies candidate protein markers of idiopathic recurrent pregnancy loss. Reprod Biol 2021; 21:100539. [PMID: 34329819 DOI: 10.1016/j.repbio.2021.100539] [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: 03/22/2021] [Revised: 06/29/2021] [Accepted: 07/20/2021] [Indexed: 01/11/2023]
Abstract
Recurrent pregnancy loss (RPL) affects a large number of couples worldwide, increasing their mental and financial burdens. While female factors that contribute to RPL have been studied extensively, the role of male factors is largely unknown, and approximately 40 % RPL cases remain unexplained despite thorough clinical examinations. These cases are clinically termed as idiopathic RPL (iRPL). Several studies have recently found that spermatozoa play an important role, beyond fertilization, in iRPL, specifically in early embryonic development. Consequently, scientists explored spermatozoa to understand iRPL and revealed that both oxidative stress and DNA fragmentation contribute to RPL. In this study, we analyzed sperm samples from male partners of iRPL patients and fertile men who recently fathered a child by LC-MS/MS to identify proteomic markers of iRPL. A total of 1,988 proteins were quantified by a label-free method, and stringent statistical analysis was performed for the selection of candidate biomarkers of iRPL. Out of 1,647 proteins quantified, only 7 proteins qualified the selection criteria, which are lactotransferrin, ATP synthase subunit beta mitochondrial, fatty acid synthase, anterior gradient protein 2 homolog, hemoglobin subunit beta, short-chain specific acyl-CoA dehydrogenase mitochondrial, cytoplasmic dynein 1 heavy chain, and 14-3-3 protein sigma. We then performed gene annotations, pathways, and network analyses to gain more biological insights, identifying an association between oxidative stress and iRPL.
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Affiliation(s)
- Sarla Naglot
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Anil Kumar Tomar
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Neeta Singh
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Savita Yadav
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, 110029, India.
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18
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Li Q, Zhang C, Li C, Lin X, Wang M, Wu L, Li H, Ye P, Qin G. The effectiveness and safety of traditional Chinese herbal medicine for the treatment of male infertility associated with sperm DNA fragmentation: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24918. [PMID: 33655953 PMCID: PMC7939154 DOI: 10.1097/md.0000000000024918] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 11/25/2020] [Accepted: 01/18/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Sperm DNA fragmentation (SDF) may hinder embryonic development and growth, increasing the risk of spontaneous miscarriage, and is considered an important factor affecting male infertility (MI). Traditional Chinese herbal medicine is considered effective in the treatment of MI due to SDF by nourishing kidney essence or promoting blood circulation for removing blood stasis. The objective of this systematic review protocol is to evaluate the effectiveness and safety of traditional Chinese herbal medicine on the treatment of MI associated with SDF. METHODS We searched the PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP Chinese Science, Technology Journal Database, and Wanfang Database until the end of 2020 for English and Chinese published literature. Randomized controlled trials (RCTs) to evaluate the effectiveness and safety of traditional Chinese herbal medicine for the treatment of MI associated with SDF will be included. Study selection and data extraction were performed independently by 2 reviewers, and the quality evaluation and risk assessment were assessed by the Cochrane collaboration's tool, and use the RevMan 5.3 software for meta-analysis. CONCLUSION This study will evaluate the efficacy and safety of traditional Chinese herbal medicine for the treatment of MI due to SDF, which may provide some help for the clinician's decision. PROSPERO REGISTRATION NUMBER CRD42020221053.
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Affiliation(s)
- Qingrui Li
- Beijing University of Chinese Medicine, Beijing
| | - Chao Zhang
- Beijing University of Chinese Medicine, Beijing
| | - Chenxi Li
- Yunnan University of Traditional Chinese Medicine
| | - Xuyao Lin
- Yunnan University of Traditional Chinese Medicine
| | - Mingkai Wang
- Yunnan University of Traditional Chinese Medicine
| | - Lin Wu
- Yunnan University of Traditional Chinese Medicine
| | - Hua Li
- Yunnan University of Traditional Chinese Medicine
| | - Pule Ye
- Yunnan University of Traditional Chinese Medicine
| | - Guozheng Qin
- Hospital of Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan, China
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19
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Pandruvada S, Royfman R, Shah TA, Sindhwani P, Dupree JM, Schon S, Avidor-Reiss T. Lack of trusted diagnostic tools for undetermined male infertility. J Assist Reprod Genet 2021; 38:265-276. [PMID: 33389378 DOI: 10.1007/s10815-020-02037-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/13/2020] [Indexed: 12/15/2022] Open
Abstract
Semen analysis is the cornerstone of evaluating male infertility, but it is imperfect and insufficient to diagnose male infertility. As a result, about 20% of infertile males have undetermined infertility, a term encompassing male infertility with an unknown underlying cause. Undetermined male infertility includes two categories: (i) idiopathic male infertility-infertile males with abnormal semen analyses with an unknown cause for that abnormality and (ii) unexplained male infertility-males with "normal" semen analyses who are unable to impregnate due to unknown causes. The treatment of males with undetermined infertility is limited due to a lack of understanding the frequency of general sperm defects (e.g., number, motility, shape, viability). Furthermore, there is a lack of trusted, quantitative, and predictive diagnostic tests that look inside the sperm to quantify defects such as DNA damage, RNA abnormalities, centriole dysfunction, or reactive oxygen species to discover the underlying cause. To better treat undetermined male infertility, further research is needed on the frequency of sperm defects and reliable diagnostic tools that assess intracellular sperm components must be developed. The purpose of this review is to uniquely create a paradigm of thought regarding categories of male infertility based on intracellular and extracellular features of semen and sperm, explore the prevalence of the various categories of male factor infertility, call attention to the lack of standardization and universal application of advanced sperm testing techniques beyond semen analysis, and clarify the limitations of standard semen analysis. We also call attention to the variability in definitions and consider the benefits towards undetermined male infertility if these gaps in research are filled.
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Affiliation(s)
- Swati Pandruvada
- Department of Biological Sciences, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43607, USA
| | - Rachel Royfman
- Department of Biological Sciences, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43607, USA
| | - Tariq A Shah
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43607, USA
| | - Puneet Sindhwani
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43607, USA
| | - James M Dupree
- Department of Urology and Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, 48019, USA
| | - Samantha Schon
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Tomer Avidor-Reiss
- Department of Biological Sciences, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43607, USA. .,Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, 43607, USA.
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20
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Rodrigo L. Sperm genetic abnormalities and their contribution to embryo aneuploidy & miscarriage. Best Pract Res Clin Endocrinol Metab 2020; 34:101477. [PMID: 33353781 DOI: 10.1016/j.beem.2020.101477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Sperm genetic testing has been proposed for clinical diagnosis of possible causes of male infertility. We reviewed the most remarkable publications of sperm DNA integrity and sperm aneuploidy as they relate to clinical outcomes, and the relationship between both genetic defects, and its association to embryo aneuploidy and recurrent pregnancy loss.
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Affiliation(s)
- Lorena Rodrigo
- PGD Molecular Cytogenetics, Igenomix, Calle Narcís Monturiol Estarriol nº11 Parcela B, Edificio Europark, Parque Tecnológico de Paterna, 46980, Paterna, Valencia, Spain.
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21
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Agarwal A, Majzoub A, Baskaran S, Panner Selvam MK, Cho CL, Henkel R, Finelli R, Leisegang K, Sengupta P, Barbarosie C, Parekh N, Alves MG, Ko E, Arafa M, Tadros N, Ramasamy R, Kavoussi P, Ambar R, Kuchakulla M, Robert KA, Iovine C, Durairajanayagam D, Jindal S, Shah R. Sperm DNA Fragmentation: A New Guideline for Clinicians. World J Mens Health 2020; 38:412-471. [PMID: 32777871 PMCID: PMC7502318 DOI: 10.5534/wjmh.200128] [Citation(s) in RCA: 118] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 07/13/2020] [Accepted: 07/13/2020] [Indexed: 12/13/2022] Open
Abstract
Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative stress) mechanisms are implicated in the etiology of sperm DNA fragmentation (SDF), which affects both natural and assisted reproduction. Several clinical and environmental factors are known to negatively impact sperm DNA integrity. An increasing number of reports emphasizes the direct relationship between sperm DNA damage and male infertility. Currently, several assays are available to assess sperm DNA damage, however, routine assessment of SDF in clinical practice is not recommended by professional organizations. This article provides an overview of SDF types, origin and comparative analysis of various SDF assays while primarily focusing on the clinical indications of SDF testing. Importantly, we report four clinical cases where SDF testing had played a significant role in improving fertility outcome. In light of these clinical case reports and recent scientific evidence, this review provides expert recommendations on SDF testing and examines the advantages and drawbacks of the clinical utility of SDF testing using Strength-Weaknesses-Opportunities-Threats (SWOT) analysis.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
| | - Ahmad Majzoub
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Department of Urology, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Saradha Baskaran
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | | | - Chak Lam Cho
- Department of Surgery, Union Hospital, Hong Kong
- S. H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong
| | - Ralf Henkel
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
- Department of Medical Bioscience, University of the Western Cape, Bellville, South Africa
| | - Renata Finelli
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Kristian Leisegang
- School of Natural Medicine, Faculty of Community and Health Sciences, University of the Western Cape, Bellville, South Africa
| | - Pallav Sengupta
- Department of Physiology, Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jenjarom, Malaysia
| | - Catalina Barbarosie
- Department of Genetics, Faculty of Biology, University of Bucharest, Bucharest, Romania
| | - Neel Parekh
- Department of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Marco G Alves
- Department of Microscopy, Laboratory of Cell Biology & Unit for Multidisciplinary Research in Biomedicine (UMIB), Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Edmund Ko
- Department of Urology, Loma Linda University, Loma Linda, CA, USA
| | - Mohamed Arafa
- Department of Urology, Hamad Medical Corporation, Doha, Qatar
- Andrology Department, Cairo University, Giza, Egypt
| | - Nicholas Tadros
- Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA
| | | | - Parviz Kavoussi
- Austin Fertility & Reproductive Medicine/Westlake IVF, Austin, TX, USA
| | - Rafael Ambar
- Urology Department of Centro Universitario em Saude do ABC, Santo André, Brazil
| | | | - Kathy Amy Robert
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA
| | - Concetta Iovine
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | | | - Sunil Jindal
- Department of Andrology and Reproductive Medicine, Jindal Hospital, Meerut, India
| | - Rupin Shah
- Department of Urology, Lilavati Hospital and Research Centre, Mumbai, India
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Cito G, Picone R, Fucci R, Giachini C, Micelli E, Cocci A, Falcone P, Minervini A, Carini M, Natali A, Coccia ME. Sperm morphology: What implications on the assisted reproductive outcomes? Andrology 2020; 8:1867-1874. [PMID: 32761795 DOI: 10.1111/andr.12883] [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: 06/15/2020] [Revised: 07/15/2020] [Accepted: 07/30/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the impact of sperm morphology (SM) on laboratory and pregnancy outcomes in conventional intracytoplasmic sperm injection (c-ICSI) cycles, using the egg donation model to minimize female confounding variables. MATERIALS AND METHODS We retrospectively collected data of oocyte donation cycles from October 2016 to February 2020. Median seminal parameters, total (1-2-3PN) fertilization rate (FR), 2PN FR, cleavage rate (CR), implantation rate (IR), pregnancy rate (PR), miscarriage rate (MR), and live birth rate (LBR) were collected. The study population was divided into three groups: Group 1 with SM < 4%, Group 2 with SM between 4% and 6%, and Group 3 with SM > 6%. RESULTS Of 741 fresh ICSI cycles and 4507 warmed oocytes were included. Male age was 46.0 (31.0-72.0) years, and recipients' age was 44.0 (29.0-54.0) years. Normal SM was 5.0% (1.0%-15.0%). Male age was negatively correlated with normal SM (P = .002; Rho -0.113). Oocyte survival rate was 83.3% (16.7%-100.0%). Total FR was 75.0% (11.1%-100.0%), 2PN FR was 66.7% (11.1%-100.0%) %, and CR was 100% (0.0%-100%). Comparing samples with SM > 6% and those with SM < 4%, 2PN FR was significantly higher in the first group (P = .04). No significant associations were found among groups in terms of CR. IR was 27.7%, resulting significantly higher when normal SM was > 6% (P < .01). Clinical PR was 36.0%, MR was 23.9%, and LBR was 25.9%. PR and LBR were significantly higher in samples with normal SM > 6%, compared to other groups (P = .02 and P < .01, respectively). CONCLUSIONS Although c-ICSI technique allows the embryologist to select the best quality spermatozoa, male factor plays a key role in achieving successful assisted reproductive outcomes. Normal SM has been shown to have implications not only for laboratory outcomes, in terms of fertilization, but also for clinical findings, as regards implantation, pregnancy, and live birth.
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Affiliation(s)
- Gianmartin Cito
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Rita Picone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Rossella Fucci
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Claudia Giachini
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Elisabetta Micelli
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Cocci
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Patrizia Falcone
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Alessandro Natali
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Maria E Coccia
- Assisted Reproductive Technology Centre, Careggi Hospital, University of Florence, Florence, Italy
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23
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Zhang X, Wang H, Feng T, Yang J, Huang Q, Lu C, Guan Y, Sun R, Chen M, Qian Y. The relationship between semen factors and unexplained recurrent spontaneous abortion. Clin Chim Acta 2020; 510:605-612. [PMID: 32827532 DOI: 10.1016/j.cca.2020.08.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/07/2020] [Accepted: 08/12/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND The male factor may contribute to unexplained recurrent spontaneous abortion (URSA). The relationship between semen factors and URSA is largely unknown. The analysis of metabolomics which is broadly acknowledged as the omics closest to the phenotype is suitable for providing assistance in the semen parameters analysis. METHODS We conducted a study including couples with URSA and controls which was next combined with a meta-analysis, and finally the study included 2352 subjects on semen parameters and URSA. Metabolomics analysis was conducted to detect semen metabolic factors related to URSA in total of 106 samples including seminal plasma and sperm cells. RESULTS The URSA group had significantly lower total sperm count, sperm concentration, motility and normal morphology percentage. Meta-analysis next showed consistent findings. Metabolomics revealed that 4 metabolites and one pathway and 8 metabolites and one pathway were significantly associated with URSA in sperm and seminal plasma, respectively. The combination of ascorbic acid and guanine in seminal plasma and hexadecanedioic acid and pyroglutamic acid in sperm showed ability for URSA prediction. CONCLUSION We provided novel insights into semen indices in relation to URSA. Lower sperm number and quality might increase the risk of URSA, and oxidative stress and hormone metabolism in sperm as well as nucleic acid synthesis and oxidative stress in seminal plasma were related to URSA.
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Affiliation(s)
- Xinyue Zhang
- Reproductive Medical Center of Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
| | - Hui Wang
- Department of Histology and Embryology, School of Basic Medical Sciences, Nanjing Medical University, Nanjing 211166, China
| | - Ting Feng
- Reproductive Medical Center of Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
| | - Jihong Yang
- Reproductive Medical Center of Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
| | - Qianqian Huang
- Reproductive Medical Center of Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
| | - Chaoyi Lu
- Reproductive Medical Center of Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China
| | - Yusheng Guan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Rongli Sun
- Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, 210009, China
| | - Minjian Chen
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
| | - Yun Qian
- Reproductive Medical Center of Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China.
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24
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Mohammadi Z, Tavalaee M, Gharagozloo P, Drevet JR, Nasr-Esfahani MH. Could high DNA stainability (HDS) be a valuable indicator of sperm nuclear integrity? Basic Clin Androl 2020; 30:12. [PMID: 32817794 PMCID: PMC7425160 DOI: 10.1186/s12610-020-00110-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022] Open
Abstract
Background The Sperm Chromatin Structure Assay (SCSA®), in addition to identifying the DNA Fragmentation Index (DFI) also identifies High DNA satiability (HDS), supposed to reflect the nuclear compaction of spermatozoa. However, data on what exactly this parameter reveals, its relevance and usefulness are contradictory. In order to shed light on this situation, spermatozoa of a cohort (N = 397) of infertile men were subjected to the SCSA®, TUNEL (terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling) and CMA3 (Chromomycin A3) tests. In a smaller subcohort (N = 100), aniline blue (AB) and toluidine blue (TB) staining were performed in addition. The objective of this study was thus to answer the question of whether HDS is a relevant and reliable parameter to be taken into account? Results HDS does not appear to be a reliable indicator of nuclear immaturity because it shows a weak correlation with the CMA3, AB and TB stains. The low correlation of HDS with sperm DNA fragmentation (TUNEL and SCSA®) and DNA condensation (CMA3, AB and TB) tests suggests that these two parameters could be decoupled. Unlike DFI and TUNEL, HDS has not been shown to correlate with classic clinical situations of male infertility (asthenozoospermia, teratozoospermia or astheno-teratozoospermia). Conclusion HDS correlates poorly with most tests that focus specifically on the level of maturity of the sperm nucleus. To our knowledge, this study is the first to compare SCSA®, TUNEL, AB, TB and CMA3 assays on identical samples. It shows the potency, consistency and limitations of each test and the care that must be taken in their interpretation.
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Affiliation(s)
- Z Mohammadi
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - M Tavalaee
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran
| | - P Gharagozloo
- CellOxess LLC, 830 Bear Tavern Road, Ewing, NJ 08628 USA
| | - J R Drevet
- GReD Institute, Faculty of Medicine, INSERM-CNRS-Université Clermont Auvergne, Clermont-Ferrand, France
| | - M H Nasr-Esfahani
- Department of Reproductive Biotechnology, Reproductive Biomedicine Research Center, Royan Institute for Biotechnology, ACECR, Isfahan, Iran.,Isfahan Fertility and Infertility Center, Isfahan, Iran
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25
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Turner KA, Rambhatla A, Schon S, Agarwal A, Krawetz SA, Dupree JM, Avidor-Reiss T. Male Infertility is a Women's Health Issue-Research and Clinical Evaluation of Male Infertility Is Needed. Cells 2020; 9:cells9040990. [PMID: 32316195 PMCID: PMC7226946 DOI: 10.3390/cells9040990] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 02/06/2023] Open
Abstract
Infertility is a devastating experience for both partners as they try to conceive. Historically, when a couple could not conceive, the woman has carried the stigma of infertility; however, men and women are just as likely to contribute to the couple’s infertility. With the development of assisted reproductive technology (ART), the treatment burden for male and unexplained infertility has fallen mainly on women. Equalizing this burden requires reviving research on male infertility to both improve treatment options and enable natural conception. Despite many scientific efforts, infertility in men due to sperm dysfunction is mainly diagnosed by a semen analysis. The semen analysis is limited as it only examines general sperm properties such as concentration, motility, and morphology. A diagnosis of male infertility rarely includes an assessment of internal sperm components such as DNA, which is well documented to have an impact on infertility, or other components such as RNA and centrioles, which are beginning to be adopted. Assessment of these components is not typically included in current diagnostic testing because available treatments are limited. Recent research has expanded our understanding of sperm biology and suggests that these components may also contribute to the failure to achieve pregnancy. Understanding the sperm’s internal components, and how they contribute to male infertility, would provide avenues for new therapies that are based on treating men directly for male infertility, which may enable less invasive treatments and even natural conception.
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Affiliation(s)
- Katerina A. Turner
- Department of Biological Sciences, University of Toledo, Toledo, OH 43606, USA;
| | - Amarnath Rambhatla
- Department of Urology, Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI 48202, USA;
| | - Samantha Schon
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology, University of Michigan Medical School, L4000 UH-South, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA;
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA;
| | - Stephen A. Krawetz
- Department of Obstetrics and Gynecology, Center for Molecular Medicine and Genetics, C.S. Mott Center for Human Growth and Development, Wayne State University School of Medicine, Detroit, MI 48201, USA;
| | - James M. Dupree
- Department of Urology and Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48019, USA;
| | - Tomer Avidor-Reiss
- Department of Biological Sciences, University of Toledo, Toledo, OH 43606, USA;
- Department of Urology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH 43614, USA
- Correspondence:
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26
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Chen L, Li D, Ni X, Zhu L, Zhang N, Fang J, Jiang W, Wang J. Effects of the normal sperm morphology rate on the clinical and neonatal outcomes of conventional IVF cycles. Andrologia 2020; 52:e13568. [PMID: 32196721 DOI: 10.1111/and.13568] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/12/2020] [Accepted: 02/17/2020] [Indexed: 12/11/2022] Open
Affiliation(s)
- Linjun Chen
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Dong Li
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Xiaobei Ni
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Lihua Zhu
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Ningyuan Zhang
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Junshun Fang
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Weihua Jiang
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Jie Wang
- Reproductive Medical Center Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School Nanjing China
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27
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Niu X, Ruan Q, Witz CA, Wang W. Comparison of Human Oocyte Activation Between Round-Headed Sperm Injection Followed by Calcium Ionophore Treatment and Normal Sperm Injection in a Patient With Globozoospermia. Front Endocrinol (Lausanne) 2020; 11:183. [PMID: 32318024 PMCID: PMC7154056 DOI: 10.3389/fendo.2020.00183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/13/2020] [Indexed: 11/13/2022] Open
Abstract
Fertilization failure is common in patients with round-headed sperm, a form of globozoospermia. Artificial oocyte activation is able to assist oocyte fertilization after sperm injection in these patients. Comparisons between oocyte fertilization with or without calcium ionophore have been reported in patients with round-headed sperm. However, no comparison has been reported between round-headed sperm injection followed by calcium ionophone activation and normal sperm injection. In this case report, half of oocytes from a patient were injected with her partner's round-headed sperm followed by calcium ionophore activation, and the other half of oocytes were injected with a donor sperm without calcium ionophore activation. The injected oocytes were cultured to examine fertilization, embryo development, and embryonic aneuploidies in the resulting blastocysts. The fertilization rate was lower in round-headed sperm injected oocytes (3/6) than that in donor sperm injected oocytes (5/6), but rates of blastocyst and aneuploidies were similar in the resulting embryos between the two groups. A euploid blastocyst resulted from round-headed sperm injection was transferred, and a healthy baby was delivered. These results indicate that calcium ionophore treatment can assist oocyte activation in patients with round-headed sperm, but its efficiency to activate oocytes is lower than that induced by a normal sperm injection. However, embryo development and chromosome integrity may not be affected by calcium ionophore treatment.
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Affiliation(s)
- Xiangli Niu
- Research Center for Reproductive Medicine, Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Qiuyan Ruan
- Research Center for Reproductive Medicine, Reproductive Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Craig A. Witz
- Houston Fertility Institute, Houston, TX, United States
| | - Weihua Wang
- Prelude-Houston Fertility Laboratory, Houston, TX, United States
- *Correspondence: Weihua Wang,
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28
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Cao W, Pan X, Ye F, Zhou J, Huang Z, Li C, Zhang Y, Fang J, Jiang Y, Lian H, Fu Z, Du Y, Wang L. Association between semen quality among men with different occupational exposures and risk of recurrent spontaneous abortion in island residents. TRADITIONAL MEDICINE AND MODERN MEDICINE 2019. [DOI: 10.1142/s257590001950006x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective: This study aimed to evaluate the semen quality of male adults whose spouses suffer from recurrent spontaneous abortion (RSA) in the island area, and to explore the association between RSA and occupational exposures. Methods: A total of 131 male patients were recruited and divided into two groups: spouse with recurrent spontaneous abortion group (RSA group, [Formula: see text]) and the normal fertility group (control group, [Formula: see text]). Information such as height, weight and occupational exposure history of 131 men were obtained. Semen samples were collected and analyzed. Differences in semen parameters and DNA fragmentation index (DFI) between the two groups were compared. Odds ratios (ORs) and their corresponding 95% confidence intervals were calculated to evaluate the association between occupational exposures and RSA status. Results: Overall, no significant difference was found in sperm concentration, progressive motility and normal morphology rate between RSA and control groups. Only DFI was observed to be significantly higher in the RSA group. Evaluation of the receiver operating characteristic (ROC) curve showed DFI (AUC: 0.623, [Formula: see text]) could discriminate between males from the couples with RSA and without RSA. Conclusion: The analysis of conventional semen parameters could not directly reflect their influence on embryonic development, and test of integrity of the sperm DNA is of paramount importance to fully understand male fertility. It is crucial to conduct studies regarding occupational exposures and pregnancy loss and/or RSA risk, since it will provide population-level data to aid in the identification of important risk factors that warrant further mechanistic investigation, and eventually lead to effective prevention and treatment strategies.
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Affiliation(s)
- Wenli Cao
- Reproductive Medicine Center of Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, P. R. China
| | - Xinyao Pan
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P. R. China
- The Academy of Integrative Medicine of Fudan University, Shanghai, P. R. China
- Shanghai Key Laboratory of Female Reproductive, Endocrine-Related Diseases, Shanghai, P. R. China
| | - Feijun Ye
- Reproductive Medicine Center of Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, P. R. China
| | - Jing Zhou
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P. R. China
- The Academy of Integrative Medicine of Fudan University, Shanghai, P. R. China
- Shanghai Key Laboratory of Female Reproductive, Endocrine-Related Diseases, Shanghai, P. R. China
| | - Zengshu Huang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P. R. China
- The Academy of Integrative Medicine of Fudan University, Shanghai, P. R. China
- Shanghai Key Laboratory of Female Reproductive, Endocrine-Related Diseases, Shanghai, P. R. China
| | - Chuyu Li
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P. R. China
- The Academy of Integrative Medicine of Fudan University, Shanghai, P. R. China
- Shanghai Key Laboratory of Female Reproductive, Endocrine-Related Diseases, Shanghai, P. R. China
| | - Yanpu Zhang
- Reproductive Medicine Center of Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, P. R. China
| | - Jianwei Fang
- Reproductive Medicine Center of Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, P. R. China
| | - Yan Jiang
- Reproductive Medicine Center of Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, P. R. China
| | - Hongyu Lian
- Reproductive Medicine Center of Zhoushan Maternal and Child Health Care Hospital, Zhoushan, Zhejiang, P. R. China
| | - Zhongxing Fu
- Ningguo Bio-Leader Biotechnology Co., Ltd., Anhui, P. R. China
| | - Yan Du
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P. R. China
- The Academy of Integrative Medicine of Fudan University, Shanghai, P. R. China
| | - Ling Wang
- Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, P. R. China
- The Academy of Integrative Medicine of Fudan University, Shanghai, P. R. China
- Shanghai Key Laboratory of Female Reproductive, Endocrine-Related Diseases, Shanghai, P. R. China
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29
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Experimental mild increase in testicular temperature has drastic, but reversible, effect on sperm aneuploidy in men: A pilot study. Reprod Biol 2019; 19:189-194. [DOI: 10.1016/j.repbio.2019.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 06/01/2019] [Accepted: 06/06/2019] [Indexed: 11/19/2022]
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30
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McQueen DB, Zhang J, Robins JC. Sperm DNA fragmentation and recurrent pregnancy loss: a systematic review and meta-analysis. Fertil Steril 2019; 112:54-60.e3. [PMID: 31056315 DOI: 10.1016/j.fertnstert.2019.03.003] [Citation(s) in RCA: 135] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 02/15/2019] [Accepted: 03/04/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the rate of sperm DNA fragmentation in male partners of women with recurrent pregnancy loss and fertile control women. DESIGN Systematic review and meta-analysis. SETTING Not applicable. PATIENT(S) A total of 579 male partners of women with recurrent pregnancy loss and 434 male partners fertile control women. INTERVENTION(S) Prospective studies were identified through a Pubmed search. Recurrent pregnancy loss was defined as two or more previous pregnancy losses. Fertile control women had a history of a live birth or ongoing pregnancy. MAIN OUTCOME MEASURE(S) The primary outcome was the rate of sperm DNA fragmentation. The summary measures were reported as mean difference with 95% confidence interval (CI). RESULT(S) Fifteen prospective studies were included in a qualitative review. Pooled data from 13 studies with sufficient data for meta-analysis suggest that male partners of women with a history of recurrent pregnancy loss have a significantly higher rate of sperm DNA fragmentation compared to the partners of fertile control women: mean difference 11.91, 95% CI 4.97-18.86. CONCLUSION(S) These findings support an association between sperm DNA fragmentation and recurrent pregnancy loss. However, given the significant heterogeneity between studies and lack of prospective pregnancy outcome data, further large prospective studies are needed.
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Affiliation(s)
- Dana B McQueen
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois.
| | - John Zhang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
| | - Jared C Robins
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois
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31
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Abstract
Genetic abnormalities, whether occurring in the conceptus or the parents, can predispose to sporadic or recurrent pregnancy loss (RPL). Abnormalities in the conceptus include aneuploidy, copy number changes, skewed X inactivation, and single gene disorders or mutations. Among parents who suffer RPL, the best studied genetic cause is balanced chromosomal translocations. For evaluation of genetic abnormalities in cases of pregnancy loss, chromosomal microarray is more likely to yield interpretable results than karyotype due to cell culture failure. For parents, karyotype remains the standard since microarray may not detect truly balanced translocations. For those with an identified underlying genetic abnormality, preimplantation genetic testing has been proposed to optimize the live birth rate. This approach shows promise, but currently lacks supporting evidence. In summary, various genetic causes for recurrent pregnancy loss are known, but when such a cause is identified, the implications for management remain unclear.
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Affiliation(s)
- Nathan R. Blue
- University of Utah Health, Dept. of Obstetrics and Gynecology, Maternal-Fetal Medicine. Salt Lake City, Utah
| | - Jessica M. Page
- University of Utah Health, Dept. of Obstetrics and Gynecology, Maternal-Fetal Medicine; Intermountain Healthcare, Salt Lake City, Utah
| | - Robert M. Silver
- University of Utah Health, Dept. of Obstetrics and Gynecology, Maternal-Fetal Medicine. Salt Lake City, Utah
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32
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Tan J, Taskin O, Albert A, Bedaiwy MA. Association between sperm DNA fragmentation and idiopathic recurrent pregnancy loss: a systematic review and meta-analysis. Reprod Biomed Online 2018; 38:951-960. [PMID: 30979611 DOI: 10.1016/j.rbmo.2018.12.029] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 10/18/2018] [Accepted: 12/10/2018] [Indexed: 01/21/2023]
Abstract
Sperm DNA fragmentation (sDF) has emerged as a valuable tool for evaluating male fertility, yet the relationship between DNA fragmentation in the male gamete and idiopathic recurrent pregnancy loss (RPL) remains a topic of ongoing debate. Hence, a meta-analysis was conducted of 12 prospective and 2 retrospective studies involving 530 men with a history of RPL who underwent sDF testing compared with 639 fertile control participants. The main outcome measures were sDF measured by comet assay, TdT (terminal deoxynucleotidyl transferase)-mediated dUDP nick-end labelling (TUNEL), sperm chromatin dispersion (SCD) or sperm chromatin structure assay. Overall, couples with a history of idiopathic RPL demonstrated higher levels of sDF than fertile couples (average mean difference 11.98, P < 0.001). Subgroup analysis demonstrated a similar average mean difference between the RPL and control groups using SCD compared with TUNEL, while mean paternal age and mean sperm motility in the RPL groups tested by meta-regression demonstrated no significant effect on the mean differences in sDF (P > 0.10). These results support the diagnostic value of sDF over standard semen analysis, as well as a possible paternally derived genetic origin of unexplained RPL. Further prospective studies are required to further assess the predictive utility of sDF for assessing couples with unexplained RPL.
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Affiliation(s)
- Justin Tan
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC, Canada
| | - Omur Taskin
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC, Canada
| | - Arianne Albert
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC, Canada
| | - Mohamed A Bedaiwy
- Department of Obstetrics and Gynaecology, University of British Columbia and the Children's and Women's Hospital and Health Centre of British Columbia, Vancouver, BC, Canada.
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33
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Homer HA. Modern management of recurrent miscarriage. Aust N Z J Obstet Gynaecol 2018; 59:36-44. [DOI: 10.1111/ajo.12920] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/23/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Hayden Anthony Homer
- Christopher Chen Oocyte Biology Research Laboratory, UQ Centre for Clinical Research; The University of Queensland; Brisbane Queensland Australia
- Reproductive Endocrinology & Infertility Clinic; Royal Brisbane & Women's Hospital; Brisbane Queensland Australia
- Queensland Fertility Group and Eve Health; Brisbane Queensland Australia
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Colaco S, Sakkas D. Paternal factors contributing to embryo quality. J Assist Reprod Genet 2018; 35:1953-1968. [PMID: 30206748 PMCID: PMC6240539 DOI: 10.1007/s10815-018-1304-4] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/25/2022] Open
Abstract
PURPOSE Advancing maternal and paternal age leads to a decrease in fertility, and hence, many infertile couples opt for assisted reproductive technologies [ART] to achieve biological parenthood. One of the key determinants of achieving a live outcome of ART, embryo quality, depends on both the quality of the oocyte and sperm that have created the embryo. Several studies have explored the effect of oocyte parameters on embryo quality, but the effects of sperm quality on the embryo have not been comprehensively evaluated. METHOD In this review, we assess the effect of various genetic factors of paternal origin on the quality and development of the embryo. RESULTS The effects of sperm aneuploidy, sperm chromatin structure, deoxyribonucleic acid [DNA] fragmentation, role of protamines and histones, sperm epigenetic profile, and Y chromosome microdeletions were explored and found to negatively affect embryo quality. CONCLUSION We propose that careful assessment of spermatozoal parameters is essential to achieve embryo development and a healthy live birth. However, the heterogeneity in test results and the different approaches of assessing a single sperm parameter highlight the need for more research and the development of standardized protocols to assess the role of sperm factors affecting embryo quality.
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Affiliation(s)
- Stacy Colaco
- Molecular and Cellular Biology Laboratory, Indian Council of Medical Research-National Institute for Research in Reproductive Health, JM Street, Parel, Mumbai, 400012, India.
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