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Delaroche L, Caillou H, Lamazou F, Genauzeau E, Meicler P, Oger P, Dupont C, Humaidan P. Live birth after intrauterine insemination: is there an upper cut-off for the number of motile spermatozoa inseminated? Reprod Biomed Online 2020; 42:S1472-6483(20)30522-8. [PMID: 34756398 DOI: 10.1016/j.rbmo.2020.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 10/23/2022]
Abstract
RESEARCH QUESTION To date, most studies have investigated the minimum number of spermatozoa available for intrauterine insemination (IUI), with no data on the maximum number of motile spermatozoa inseminated (NMSI) having been published. This study aimed to determine whether an upper cut-off for the NMSI during IUI exists above which the live birth rate (LBR) is negatively affected. DESIGN Retrospective analysis of autologous IUI cycles performed between January 2010 and July 2018 in women <43 years old with a NMSI >1 million. The main outcome was the LBR per IUI cycle as a function of the NMSI. RESULTS A total of 2592 IUI cycles performed in 1017 couples were included. The LBR increased with NMSI up to 30 million without any upper threshold (AUC = 0.5441). The LBR per IUI cycle were 14.5%, 17.9% and 22.7% for NMSI of >1 to ≤10, >10 to ≤20 and >20 to ≤30 million, respectively (P = 0.003). By univariate analysis, the NMSI, female age, number of mature follicles and oestradiol concentrations on day of ovulation triggering, cycle number and infertility aetiology influenced the LBR. Multivariate analysis showed that the LBR was 1.49 and 1.78 times higher when IUI was performed with a NMSI >10 to ≤20 million (odds ratio [OR] 1.49; 95% confidence interval [CI] 1.10-2.02]) and >20 to ≤30 million (OR 1.78; 95% CI 1.08-2.94), respectively, compared with IUI with a NMSI >1 to ≤10 million. CONCLUSIONS The LBR after IUI can be optimized by inseminating a maximum of motile spermatozoa up to 30 million. Thus, in this specific cohort, IUI preparations should not be diluted when more than 10 million motile spermatozoa are obtained.
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Affiliation(s)
- Lucie Delaroche
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France; Centre de Biologie Médicale, Hôpital Privé de Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France.
| | - Hugo Caillou
- Capionis, 80b Rue Paul Camelle, Bordeaux 33100, France
| | - Frédéric Lamazou
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Emmanuel Genauzeau
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France; Centre de Biologie Médicale, Hôpital Privé de Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Philippe Meicler
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Pierre Oger
- Ramsay Générale de Santé, Hôpital Privé de Parly 2, Institut Fertilité Maternité Parly 2, 21 Rue Moxouris, Le Chesnay 78150, France
| | - Charlotte Dupont
- Sorbonne Université, Saint Antoine Research Centre, INSERM équipe Lipodystrophies Génétiques et Acquises, Service de Biologie de la Reproduction-CECOS, AP-HP, Hôpital Tenon, Paris F-75020, France
| | - Peter Humaidan
- Fertility Clinic, Skive Regional Hospital, Resenvej 25, 7800 Skive, Denmark and Faculty of Health, Aarhus University, Aarhus, Denmark
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Zhu DL, Zhang HG, Wang RX, Jiang YT, Liu RZ. Re-evaluation of the value of sperm morphology in classical in vitro fertilization in a Northeastern Chinese population. J Int Med Res 2019; 47:4134-4142. [PMID: 31280631 PMCID: PMC6753564 DOI: 10.1177/0300060519860324] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective This study aimed to re-evaluate the clinical value of a 4% cut-off threshold of sperm morphology in in vitro fertilization (IVF) in a cohort of a Northeastern Chinese population. Methods A total of 375 IVF cycles that met strict inclusion criteria were included. These cycles were conducted with semen analysis and oocyte fertilization. A total of 188 embryo-transferred cycles proceeded. According to sperm morphology, 375 cycles were divided into group 1 (329 cycles, <4% normal sperm morphology rate [NSMR]) and group 2 (46 cycles, ≥4% NSMR), and 188 transferred cycles into group A (151 cycles, < 4% NSMR) and group B (37 cycles, ≥4% NSMR). Results The fertilization and normal fertilization rates were significantly lower in group 1 than in group 2. The normal fertilization rate was significantly correlated with an NSMR < 4% or ≥4%, but the fertilization rate was not significantly correlated with the NSMR. No significant differences were found in pregnancy outcomes between groups A and B. Conclusions This study suggests that infertile patients with an NSMR < 4% are more likely to have a poor normal fertilization status in IVF.
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Affiliation(s)
- Dong-Liang Zhu
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital of Jilin University, Changchun, China
| | - Hong-Guo Zhang
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital of Jilin University, Changchun, China
| | - Rui-Xue Wang
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital of Jilin University, Changchun, China
| | - Yu-Ting Jiang
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital of Jilin University, Changchun, China
| | - Rui-Zhi Liu
- Center for Reproductive Medicine and Center for Prenatal Diagnosis, First Hospital of Jilin University, Changchun, China
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Minas A, Najafi G, Jalali AS, Razi M. Fennel induces cytotoxic effects against testicular germ cells in mice; evidences for suppressed pre-implantation embryo development. ENVIRONMENTAL TOXICOLOGY 2018; 33:841-850. [PMID: 29761655 DOI: 10.1002/tox.22570] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Abstract
Foeniculum vulgare (FVE; fennel) is an aromatic plant belonging to Umbelliferae family, which is widely used in traditional societies because of its different pharmaceutical properties. To uncover the fennel-derived essential oil (FVEO)-induced effects on male reproductive potential, 24 mature male albino mice were divided into, control, 0.37, 0.75, and 1.5 mg kg-1 FVEO-received groups. Following 35 days, the animals were euthanized and the testicular tissue and sperm samples were collected. The histological alterations, tubular differentiation (TDI), spermiogenesis (SPI) indices, apoptosis ratio, and RNA damage of germinal cells were analyzed. Moreover, the sperm count, motility, viability, chromatin condensation, and DNA fragmentation were assessed. Finally, the pre-implantation embryo development including; the percentage of zygote, 2-cell embryos and blastocysts were assessed. Observations showed that the FVEO, dose dependently, increased histological damages, resulted in germ cells dissociation, depletion, nuclear shrinkage and significantly (P < .05) decreased tubular differentiation and spermiogenesis ratios. Moreover, the FVEO-received animals (more significantly in 1.5 mg kg-1 -received group) exhibited decreased sperm count, viability, and motility and represented enhanced percentage of sperms with decondensed chromatin and DNA fragmentation. Finally, the animals in FVEO-received group showed diminished zygote formation and represented decreased pre-implantation embryo development compared to control animals. In conclusion, our data showed that, FVEO albeit at higher doses, is able to adversely affect cellular DNA and RNA contents, which in turn is able to negatively affect the sperm count and morphology. All these impairments are able to negatively affect the fertilization potential as well as pre-implantation embryo development.
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Affiliation(s)
- Aram Minas
- Department of Basic Science, Faculty of Veterinary, Urmia University, Urmia, Iran
| | - Gholamreza Najafi
- Department of Basic Science, Faculty of Veterinary, Urmia University, Urmia, Iran
| | - Ali Shalizar Jalali
- Department of Basic Science, Faculty of Veterinary, Urmia University, Urmia, Iran
| | - Mazdak Razi
- Department of Basic Science, Faculty of Veterinary, Urmia University, Urmia, Iran
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Tomlinson MJ, Naeem A. CASA in the medical laboratory: CASA in diagnostic andrology and assisted conception. Reprod Fertil Dev 2018; 30:850-859. [DOI: 10.1071/rd17520] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 01/15/2018] [Indexed: 01/22/2023] Open
Abstract
CASA has been used in reproductive medicine and pathology laboratories for over 25 years, yet the ‘fertility industry’ generally remains sceptical and has avoided automation, despite clear weaknesses in manual semen analysis. Early implementers had difficulty in validating CASA-Mot instruments against recommended manual methods (haemocytometer) due to the interference of seminal debris and non-sperm cells, which also affects the accuracy of grading motility. Both the inability to provide accurate sperm counts and a lack of consensus as to the value of sperm kinematic parameters appear to have continued to have a negative effect on CASA-Mot’s reputation. One positive interpretation from earlier work is that at least one or more measures of sperm velocity adds clinical value to the semen analysis, and these are clearly more objective than any manual motility analysis. Moreover, recent CASA-Mot systems offer simple solutions to earlier problems in eliminating artefacts and have been successfully validated for sperm concentration; as a result, they should be viewed with more confidence in relation to motility grading. Sperm morphology and DNA testing both require an evidence-based consensus and a well-validated (reliable, reproducible) assay to be developed before automation of either can be of real clinical benefit.
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Tomlinson MJ. Uncertainty of measurement and clinical value of semen analysis: has standardisation through professional guidelines helped or hindered progress? Andrology 2017; 4:763-70. [PMID: 27529487 DOI: 10.1111/andr.12209] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Accepted: 04/05/2016] [Indexed: 01/01/2023]
Abstract
This article suggests that diagnostic semen analysis has no more clinical value today than it had 25-30 years ago, and both the confusion surrounding its evidence base (in terms of relationship with conception) and the low level of confidence in the clinical setting is attributable to an associated high level of 'uncertainty'. Consideration of the concept of measurement uncertainty is mandatory for medical laboratories applying for the ISO15189 standard. It is evident that the entire semen analysis process is prone to error every step from specimen collection to the reporting of results and serves to compound uncertainty associated with diagnosis or prognosis. Perceived adherence to published guidelines for the assessment of sperm concentration, motility and morphology does not guarantee a reliable and reproducible test result. Moreover, the high level of uncertainty associated with manual sperm motility and morphology can be attributed to subjectivity and lack a traceable standard. This article describes where and why uncertainty exists and suggests that semen analysis will continue to be of limited value until it is more adequately considered and addressed. Although professional guidelines for good practice have provided the foundations for testing procedures for many years, the risk in following rather prescriptive guidance to the letter is that unless they are based on an overwhelmingly firm evidence base, the quality of semen analysis will remain poor and the progress towards the development of more innovative methods for investigating male infertility will be slow.
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Affiliation(s)
- M J Tomlinson
- Fertility Unit, Nottingham University Hospital, Nottingham, UK
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Moshari S, Nejati V, Najafi G, Razi M. Insight into curcumin nanomicelle-induced derangements in male reproduction potential: An experimental study. Andrologia 2017; 50. [DOI: 10.1111/and.12842] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2017] [Indexed: 11/27/2022] Open
Affiliation(s)
- S. Moshari
- Department of Biology; Faculty of Basic Science; Urmia University; Urmia Iran
| | - V. Nejati
- Department of Biology; Faculty of Basic Science; Urmia University; Urmia Iran
| | - G. Najafi
- Department of Basic Science; Faculty of Veterinary Medicine; Urmia University; Urmia Iran
| | - M. Razi
- Department of Basic Science; Faculty of Veterinary Medicine; Urmia University; Urmia Iran
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Ameliorative effect of omega-3 on spermatogenesis, testicular antioxidant status and preimplantation embryo development in streptozotocin-induced diabetes in rats. Int Urol Nephrol 2017. [DOI: 10.1007/s11255-017-1636-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Kovac JR, Smith RP, Cajipe M, Lamb DJ, Lipshultz LI. Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction. Asian J Androl 2017; 19:39-42. [PMID: 27751992 PMCID: PMC5227671 DOI: 10.4103/1008-682x.189211] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
In couples with infertility, abnormal strict morphology of 0% normal forms (NF) is a criterion to proceed rapidly to in vitro fertilization (IVF). Since no data currently exist, we investigated the outcomes for men with 0% NF to determine reproductive success without the use of assisted reproductive technologies (ART). A cohort of 24 men with 0% NF were identified (2010-2013) with 27 randomly selected men with ≥4% NF as controls. Patient charts were reviewed with men contacted and administered an Institutional Review Board (IRB)-approved telephone questionnaire to ascertain outcomes. After a median follow-up time of 2.5 years, 29.2% of men with 0% NF did not require ART for their first pregnancy (controls = 55.6%, P ≤ 0.05). When all pregnancies were analyzed together, men with 0% NF achieved twenty pregnancies of which 75% did not require IVF (controls = thirty pregnancies; 76.7% did not require IVF). The average age of men and female partners was similar between men with 0% NF and ≥4% NF. All men had normal follicle-stimulating hormone (FSH), testosterone, prolactin, sex hormone-binding globulin (SHBG), and estradiol. Although, global semen parameters were worse in men with 0% NF, when a first pregnancy was a natural conception (NC), 100% of men with 0% NF (n = 7/7) and 37.5% of controls (n = 3/8) went on to have a subsequent pregnancy via NC. Men with 0% NF conceived without IVF in 29.2% of cases compared to 55.6% of controls. Strict morphology should not be used to predict fertilization, pregnancy, or live birth potential. In men with 0% NF, alternative modalities should be considered before immediate IVF.
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Affiliation(s)
- Jason R Kovac
- Center of Reproductive Medicine and the Department of Molecular and Cellular Biology, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Ryan P Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Miguel Cajipe
- Center of Reproductive Medicine and the Department of Molecular and Cellular Biology, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Dolores J Lamb
- Center of Reproductive Medicine and the Department of Molecular and Cellular Biology, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
| | - Larry I Lipshultz
- Center of Reproductive Medicine and the Department of Molecular and Cellular Biology, Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
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Yurdakok B, Tekin K, Daskin A, Filazi A. Effects of Polychlorinated Biphenyls 28, 30 and 118 on Bovine SpermatozoaIn Vitro. Reprod Domest Anim 2014; 50:41-7. [DOI: 10.1111/rda.12447] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Accepted: 10/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- B Yurdakok
- Department of Pharmacology and Toxicology; Ankara University Faculty of Veterinary Medicine; Ankara Turkey
| | - K Tekin
- Department of Artificial Insemination and Reproduction; Ankara University Faculty of Veterinary Medicine; Ankara Turkey
| | - A Daskin
- Department of Artificial Insemination and Reproduction; Ankara University Faculty of Veterinary Medicine; Ankara Turkey
| | - A Filazi
- Department of Pharmacology and Toxicology; Ankara University Faculty of Veterinary Medicine; Ankara Turkey
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