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Abouelgreed TA, Amer MA, Mamdouh H, El-Sherbiny AF, Aboelwafa H, Omar OA, Abdelshakour M, Elesawy M, Sonbol M, Maawad AN, Zayed EM, Eldestawy MT. Effects of antisperm antibodies post vasectomy reversal on pregnancy rates. Arch Ital Urol Androl 2024; 96:12335. [PMID: 38700009 DOI: 10.4081/aiua.2024.12335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/12/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE To investigate the correlation between antisperm antibodies (ASAs), pregnancy rates, and the method of conception following vasectomy reversal. This is particularly relevant as patients undergoing vasectomy reversal often express concerns about the potential inhibitory effects of ASAs on achieving pregnancy. Additionally, the American Urological Association guidelines for vasectomy emphasize the need for further research to address this question. PATIENT AND METHODS We conducted a retrospective analysis involving chart reviews and phone interviews with individuals who underwent vasectomy reversal at our institution between May 2015 and April 2023. Patients who underwent vasectomy reversal for reasons other than fertility, as well as those lacking postoperative semen analysis with ASA data, were excluded. We classified patients based on low (below 50%) or high (50% or above) ASA levels determined by their initial postoperative semen analysis. The primary outcome measured was the pregnancy rate, including details on the method of conception. RESULTS A total of 145 patients were subjected to chart review. The median age at the time of surgery was 43 years, with a median obstruction interval of 7.7 years. The median age of their partners was 29 years. The majority (80%) of patients underwent bilateral vasovasostomy. Among them, 60 patients (41.4%) exhibited low (< 50%) ASA levels, while 85 (58.6%) had high (≥ 50%) ASA levels. Follow-up phone interviews were completed by 48 patients. Among them, the 19 men with low ASA levels, 13 (68.4%) achieved pregnancy, with 6 (31.6%) experiencing spontaneous conception. For the 29 men with high ASA levels, 21 (72.4%) achieved pregnancy, including 11 (38%) through spontaneous conception. The p-value from Fisher's exact test was 0.2. CONCLUSIONS Our findings suggest that ASA levels do not show a significant association with either the pregnancy rate or the method of conception following vasectomy reversal.
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Affiliation(s)
- Tamer A Abouelgreed
- Department of Urology, Al-Azhar University, Cairo, Egypt; Gulf medical university, Ajman.
| | - Mohamed A Amer
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Hassan Mamdouh
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Ahmed F El-Sherbiny
- Department of Andrology, International Islamic Center for Population Studies and Research, Al-Azhar University, Cairo.
| | - Hany Aboelwafa
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Omar A Omar
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | | | - Mohammad Elesawy
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Mohamed Sonbol
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Ahmed N Maawad
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
| | - Elsayed M Zayed
- Department of Dermatology & Andrology, Al-Azhar University, Cairo.
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2
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Nam CS, Tooke BP, Strasser O, Hameed MA, Chinnusamy S, Van Til M, Daignault-Newton S, Dupree JM. Antisperm Antibody Levels After Vasectomy Reversal Are Not Associated With Pregnancy Rates or Method of Conception. Urology 2024; 186:154-161. [PMID: 38417465 DOI: 10.1016/j.urology.2024.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/10/2024] [Accepted: 02/21/2024] [Indexed: 03/01/2024]
Abstract
OBJECTIVE To examine the relationship between antisperm antibody (ASA), pregnancy rates, and method of conception following vasectomy reversal, given that before and after vasectomy reversal, patients wonder if ASAs will prevent them from achieving pregnancy and American Urological Association vasectomy guidelines call for additional research to answer this question. METHODS We performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 to 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (≥50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher exact test. RESULTS Two hundred and four patients were chart reviewed. Median age at time of surgery was 40years and median obstruction interval was 7.3years. Median partner age was 32years. One hundred sixty-four (80%) patients underwent bilateral vasovasostomy. Eighty-five patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥50%) ASA levels. Sixty-seven patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher exact test P-value was .2. CONCLUSION ASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal.
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Affiliation(s)
- Catherine S Nam
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI.
| | - Benjamin P Tooke
- Department of Urology, University of California Los Angeles, Los Angeles, CA
| | | | - Mujtaba A Hameed
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | - Sadhana Chinnusamy
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | - Monica Van Til
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
| | | | - James M Dupree
- Department of Urology, Michigan Medicine University of Michigan, Ann Arbor, MI
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3
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Huniadi A, Bimbo-Szuhai E, Botea M, Zaha I, Beiusanu C, Pallag A, Stefan L, Bodog A, Șandor M, Grierosu C. Fertility Predictors in Intrauterine Insemination (IUI). J Pers Med 2023; 13:jpm13030395. [PMID: 36983577 PMCID: PMC10058138 DOI: 10.3390/jpm13030395] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/13/2023] [Accepted: 02/22/2023] [Indexed: 03/01/2023] Open
Abstract
(1) Background: Intrauterine insemination (IUI) is considered a first-line procedure for infertile or hypo-fertile couples among assisted reproductive techniques. In our retrospective study, we identified variables associated with a successful IUI and the probability of obtaining a pregnancy. This is useful to identify couples with a good chance of obtaining a pregnancy through an IUI procedure (2) Methods: The study was conducted at a university-level fertility clinic in Oradea, Romania. Patients eligible to participate in the study were infertile couples who underwent IUI treatment in the interval between January 2015 and October 2020. (3) Results: In our study, we found that duration of infertility, couple age, endometrium thickness, sperm concentration, and motility are important factors in determining the outcome of IUI. Several demographics were measured for each couple including maternal and paternal age, the type and duration of infertility, the number of procedures, the type of ovarian stimulation, number of follicles, endometrial thickness, the type and day of ovulation induction, associated pathology, tubal patency, and pre/post washes sperm count and progressive sperm motility. (4) Conclusions: Fertility prediction studies are necessary, and an individualized prognostic score should be applied for each couple for tailoring their expectations and better counseling.
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Affiliation(s)
- Anca Huniadi
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
- Correspondence:
| | - Erika Bimbo-Szuhai
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Mihai Botea
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Ioana Zaha
- Calla-Infertility Diagnostic and Treatment Center, Constantin A. Rosetti Street, 410103 Oradea, Romania
| | - Corina Beiusanu
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Annamaria Pallag
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 29 Nicolae Jiga Street, 410028 Oradea, Romania
| | - Liana Stefan
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Alin Bodog
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Mircea Șandor
- Department of Surgical Discipline, Faculty of Medicine and Pharmacy, University of Oradea, 1st December Square 10, 410073 Oradea, Romania
| | - Carmen Grierosu
- Department of Clinical Discipline, Apollonia University, 700511 Iasi, Romania
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4
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Mascarenhas M, Jeve Y, Polanski L, Sharpe A, Yasmin E, Bhandari HM. Management of recurrent implantation failure: British Fertility Society policy and practice guideline. HUM FERTIL 2022; 25:813-837. [PMID: 33820476 DOI: 10.1080/14647273.2021.1905886] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Recurrent implantation failure (RIF) is defined as the absence of a positive pregnancy test after three consecutive transfers of good quality embryos. There remains significant variation in clinical practice in the management of RIF. This British Fertility Society (BFS) Policy and Practice guideline analyses the evidence for investigations and therapies that are employed in RIF and provides recommendations for clinical practice and for further research. Evidence for investigations of sperm and egg quality, uterine and adnexal factors, immunological factors and thrombophilia, endocrine conditions and genetic factors and for associated therapies have been evaluated. This guideline has been devised to assist reproductive medicine specialists and patients in making shared decisions concerning management of RIF. Finally, suggestions for research towards improving understanding and management of RIF have also been provided.
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Affiliation(s)
- Mariano Mascarenhas
- Leeds Fertility, Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Glasgow Centre for Reproductive Medicine, The Fertility Partnership, Glasgow, UK
| | - Yadava Jeve
- Birmingham Women's Fertility Centre, Birmingham Women's Hospital, Birmingham, UK
| | - Lukasz Polanski
- Assisted Conception Unit, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Abigail Sharpe
- Leeds Fertility, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Ephia Yasmin
- Department of Women's Health, University College London Hospitals, London, UK
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5
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de Villiers C, Maree L, Katz AA, van der Horst G. The in-vitro effect of gonadotropin-releasing hormones, GnRH-I and GnRH-II, on the motility, vitality and acrosome integrity of Vervet monkey (Chlorocebus aethiops) spermatozoa. Reprod Domest Anim 2022; 57:1394-1405. [PMID: 35877200 DOI: 10.1111/rda.14216] [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: 06/17/2022] [Revised: 07/14/2022] [Accepted: 07/23/2022] [Indexed: 11/29/2022]
Abstract
Two isoforms of the gonadotropin-releasing hormone (GnRH), GnRH-I and GnRH-II, are expressed in mammals, and the presence of one or more GnRH-like peptides has been demonstrated in the male reproductive tract. GnRH and its receptors (GnRHR) are present in human and non-human primate testis, prostate, epididymis, seminal vesicle, spermatozoa and seminal human plasma. GnRH-II is site-specific and acts directly in an inhibitory or stimulatory fashion. Previous studies speculated that GnRH-II could disrupt specific sperm processes, such as sperm motility or capacitation and could be utilized as an effective contraceptive agent. Our study aimed to investigate the in-vitro effects of GnRH-I and GnRH-II on Vervet monkey sperm function. Electro-ejaculated semen samples from 10 Vervet monkeys (Chlorocebus aethiops) were used to select motile sperm populations. Sperm aliquots were incubated with GnRH-I and GnRH-II at different concentrations for 1 h, where after sperm motility and kinematic parameters were assessed using the automated Sperm Class Analyser. Additional sperm aliquots were incubated with two 10-amino acid control peptides, a non-related peptide and an inactive peptide to exclude the possible influence on sperm motility from other peptides with a structure similar to GnRH. Additionally, a GnRHR-I antagonist (GnRHR-A), Cetrorelix, was tested to establish its antagonistic capability on GnRH. The effect of selected concentrations of GnRH-I and GnRH-II on sperm vitality and acrosome intactness was also evaluated after 10- and 60 min exposure. Analysis of the percentage total sperm motility revealed that different concentrations for GnRH-I and GnRH-II inhibited sperm motility significantly. While sperm progressiveness was also notably affected and a trend of decreased sperm kinematics were evident, no effect was found on sperm vitality or acrosome intactness. The non-related and inactive peptides had no impact on sperm motility. The GnRHR-A demonstrated no effect on sperm motility and effectively blocked the inhibitory outcome on the motility of both GnRH isoforms. While GnRH-I or GnRH-II at low-dose concentrations resulted in in-vitro inhibition of sperm motility, it appears to have no adverse effects on other sperm functional parameters evaluated. These collective observations possibly indicate an essential role for GnRH in the in-vivo process of sperm selection in the female reproductive tract.
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Affiliation(s)
- Charon de Villiers
- PUDAC-Delft Animal Facility, South African Medical Research Council, Cape Town, South Africa
| | - Liana Maree
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
| | - Arieh A Katz
- Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Gerhard van der Horst
- Department of Medical Biosciences, University of the Western Cape, Bellville, South Africa
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6
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Pacey A, Hamilton M. 24 years of policy statements, guidelines, and policy and practice articles in Human Fertility. HUM FERTIL 2022. [DOI: 10.1080/14647273.2022.2082148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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7
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Embryologic outcomes among patients using a microfluidics chip compared to density gradient centrifugation to process sperm: a paired analysis. J Assist Reprod Genet 2022; 39:1523-1529. [PMID: 35619041 DOI: 10.1007/s10815-022-02504-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 04/21/2022] [Indexed: 10/18/2022] Open
Abstract
PURPOSE To evaluate embryologic outcomes among paired IVF cycles in which a microfluidics chip was utilized compared to density gradient centrifugation for sperm processing. METHODS This was a retrospective cohort study of 88 paired IVF cycles from patients aged 18-44 years at a university-affiliated IVF center. Fresh cycles from patients undergoing ICSI with sperm processed by a microfluidics chamber (microfluidics cycles) were compared to the same patients' previous ICSI cycles in which sperm was processed via density gradient centrifugation (control cycles). The primary outcome was the high-quality blastulation rate. RESULTS High-quality blastulation rate per oocyte retrieved was significantly higher in the microfluidics group compared to the control group (21.1% versus 14.5%, p < 0.01) as was the blastulation rate per 2PN (42.7% versus 30.8%, p < 0.01). Fertilization rates were significantly higher in the microfluidics group. The euploidy rate per oocyte retrieved was significantly higher in the microfluidics group compared with the control group (8.5% versus 4.3%, p = 0.04), while the euploidy rate per embryo biopsied was comparable (32.6% versus 21.8%, p = 0.09). In patients with male factor infertility, the high-quality blastulation rate was similar between the control and microfluidics cycles. There was a significantly higher blastulation rate among microfluidics cycles in patients without a diagnosis of male factor infertility (p < 0.01). CONCLUSION In this study, several embryologic outcomes, including fertilization rate, high-quality blastulation rate, and euploidy rate, were significantly higher in the microfluidics group compared to the control group. Microfluidics sperm processing may be a way to improve embryologic outcomes.
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8
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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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9
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Abstract
Sperm selection is a clinical need for guided fertilization in men with low-quality semen. In this regard, microfluidics can provide an enabling platform for the precise manipulation and separation of high-quality sperm cells through applying various stimuli, including chemical agents, mechanical forces, and thermal gradients. In addition, microfluidic platforms can help to guide sperms and oocytes for controlled in vitro fertilization or sperm sorting using both passive and active methods. Herein, we present a detailed review of the use of various microfluidic methods for sorting and categorizing sperms for different applications. The advantages and disadvantages of each method are further discussed and future perspectives in the field are given.
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10
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Kumari S, Kotyan S, Sugunan S, Rajanikant GK, Kumar KSS, Adiga SK, Dasappa JP, Kalthur G. The synthesis of a novel pentoxifylline derivative with superior human sperm motility enhancement properties. NEW J CHEM 2021. [DOI: 10.1039/d0nj03522j] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
mPTF1 demonstrated lower genotoxicity, higher affinity for PDEs, & reasonable pharmacokinetic, druglikeness & ADMET properties compared to Pentoxifylline.
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Affiliation(s)
- Sandhya Kumari
- Department of Clinical Embryology
- Kasturba Medical College of Manipal
- Manipal
- Academy of Higher Education
- Manipal
| | - Sukumar Kotyan
- Department of Chemistry
- Mangalore University
- Mangalagangothri
- Mangalore
- India
| | - Sinoy Sugunan
- School of Biotechnology
- National Institute of Technology Calicut
- Calicut
- India
| | - G. K. Rajanikant
- School of Biotechnology
- National Institute of Technology Calicut
- Calicut
- India
| | | | - Satish Kumar Adiga
- Department of Clinical Embryology
- Kasturba Medical College of Manipal
- Manipal
- Academy of Higher Education
- Manipal
| | | | - Guruprasad Kalthur
- Department of Clinical Embryology
- Kasturba Medical College of Manipal
- Manipal
- Academy of Higher Education
- Manipal
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11
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Liu S, Chen Z, Wang H, Yang L, Ma C, Sun L. Prewash and postwash total progressively motile sperm counts have poor predictive value for clinical pregnancy after intrauterine insemination. Int J Gynaecol Obstet 2020; 153:476-482. [PMID: 33119129 DOI: 10.1002/ijgo.13447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 08/27/2020] [Accepted: 10/27/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the predictive value of the prewash and postwash total progressively motile sperm counts (TPMSC) on clinical pregnancy after intrauterine insemination (IUI) . METHODS A review of medical records of women undergoing 2064 IUI cycles in a university hospital between April 2010 and October 2018. RESULTS No pregnancies were seen when the prewash TPMSC was less than 9 million or the postwash TPMSC was less than 2 million. There was no correlation between TPMSC and clinical pregnancies. Further analysis was made in pregnancies after prewash TPMSC of 3-10 million and more than 10 million, and after postwash TPMSC of 10-100 million and more than 100 million. No correlation was found between TPMSC and clinical pregnancy in different strata of female age, infertility duration, type of infertility, type of IUI treatment, and the number of treatment cycles. A negative relationship was found for unstimulated IUI treatment and the number of treatment cycles. The prewash and postwash TPMSC showed no predictive value. CONCLUSION Prewash and postwash TPMSC have poor predictive value for clinical pregnancy in IUI. Cycles with a prewash TPMSC of 10-100 million or postwash TPMSC of 3-10 million could achieve acceptable pregnancy rates with IUI.
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Affiliation(s)
- Shuai Liu
- Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Zhiheng Chen
- Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hui Wang
- Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Li Yang
- Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Caiqi Ma
- Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ling Sun
- Center of Reproductive Medicine, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong, China
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12
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Dcunha R, Hussein RS, Ananda H, Kumari S, Adiga SK, Kannan N, Zhao Y, Kalthur G. Current Insights and Latest Updates in Sperm Motility and Associated Applications in Assisted Reproduction. Reprod Sci 2020; 29:7-25. [PMID: 33289064 PMCID: PMC7721202 DOI: 10.1007/s43032-020-00408-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/08/2020] [Accepted: 11/01/2020] [Indexed: 02/07/2023]
Abstract
Spermatozoon is a motile cell with a special ability to travel through the woman’s reproductive tract and fertilize an oocyte. To reach and penetrate the oocyte, spermatozoa should possess progressive motility. Therefore, motility is an important parameter during both natural and assisted conception. The global trend of progressive reduction in the number and motility of healthy spermatozoa in the ejaculate is associated with increased risk of infertility. Therefore, developing approaches for maintaining or enhancing human sperm motility has been an important area of investigation. In this review we discuss the physiology of sperm, molecular pathways regulating sperm motility, risk factors affecting sperm motility, and the role of sperm motility in fertility outcomes. In addition, we discuss various pharmacological agents and biomolecules that can enhance sperm motility in vitro and in vivo conditions to improve assisted reproductive technology (ART) outcomes. This article opens dialogs to help toxicologists, clinicians, andrologists, and embryologists in understanding the mechanism of factors influencing sperm motility and various management strategies to improve treatment outcomes.
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Affiliation(s)
- Reyon Dcunha
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Reda S Hussein
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Obstetrics and Gynecology, Assiut University, Assiut City, Egypt
| | - Hanumappa Ananda
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Sandhya Kumari
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Satish Kumar Adiga
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India
| | - Nagarajan Kannan
- Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, 55905, USA.,Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN, 55905, USA
| | - Yulian Zhao
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA.,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Guruprasad Kalthur
- Department of Clinical Embryology, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, 576104, India. .,Division of Experimental Pathology and Laboratory Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
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13
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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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14
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Sharma R, Gupta S, Henkel R, Agarwal A. Critical evaluation of two models of flow cytometers for the assessment of sperm DNA fragmentation: an appeal for performance verification. Asian J Androl 2020; 21:438-444. [PMID: 30632487 PMCID: PMC6732896 DOI: 10.4103/aja.aja_109_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Lack of standardized, reproducible protocols and reference values is among the challenges faced when using new or upgraded versions of instruments in reproductive laboratories and flow cytometry. Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay combined with flow cytometry routinely used for diagnostic measurement of sperm DNA fragmentation (SDF) is a unique example. Any change in the setting of the standard instrument, including upgrades of hardware or software, can lead to different results and may affect clinicians’ decision for treatment. Therefore, we compared TUNEL results of SDF obtained from a standard (C6) flow cytometer with a newer version of the same instrument (C6 Plus) and examined the cutoff, sensitivity, and specificity without calibration (adjustment) and after adjustment. Identical sperm preparation and matched acquisition settings were used to examine the performance of two flow cytometers. The strength of agreement of the results between the two observers was also assessed. After adjustment of the settings, overall concordance became high and the two cytometers showed 100% positive and negative predictive value with 100% area under the curve. The overall correlation coefficient observed between C6 and C6 Plus was highly significant (P < 0.0001; r = 0.992; 95% confidence interval [CI]: 0.982–0.997). After adjustment, the two cytometers showed very high precision of 98% and accuracy of >99%. The interobserver agreement on C6 flow cytometer for the two observers was 0.801 ± 0.062 and 0.746 ± 0.044 for C6 Plus. We demonstrated a strong agreement between the samples tested on the two flow cytometers after calibration and established the robustness of both instruments.
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Affiliation(s)
- Rakesh Sharma
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Sajal Gupta
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Ralf Henkel
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA.,Department of Medical Bioscience, University of the Western Cape, Bellville 7535, South Africa
| | - Ashok Agarwal
- American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195, USA
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15
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Sharpe A, Bhandari H, Miller D. Is there a role for phosphodiesterase inhibitors in the treatment of male subfertility? HUM FERTIL 2020; 25:13-23. [PMID: 32666851 DOI: 10.1080/14647273.2020.1793420] [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] [Indexed: 10/23/2022]
Abstract
Intracytoplasmic sperm injection (ICSI) is frequently used to overcome severe deficits in semen quality. Concerns, however, are arising over its increasing use for non-male factor infertility. Moreover, increased risk of cardiovascular disease, congenital abnormalities, aneuploidies and childhood cancers have all been reported in the literature in relation to ICSI and it is possible that the quality of sperm chosen for injection may be an important factor in these unwanted outcomes. Given the wider adoption of ICSI to treat beyond the requirements of male infertility alone, research focussed on alternative methods to diagnose and treat the infertile couple is gaining increasing attention. This review focuses on the information available to date on the use of non-selective phosphodiesterase inhibitors (PDEI), specifically pentoxifylline (PF), caffeine (CF) and theophylline (TP) to stimulate sperm motility, thereby potentially reducing the need for ICSI in certain patient groups who may benefit from either expectant management or from a less stressful, minimally invasive and inexpensive treatment such as intrauterine insemination (IUI). The review focuses firstly on the mechanism of action of PDEI followed by treatment effects on sperm parameters such as motility and hyperactivated motility and sperm DNA integrity. Specific clinical implications are discussed that outline the potential role of PDEI in clinical practice and highlights areas in need of further research.
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Affiliation(s)
- Abigail Sharpe
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | | | - David Miller
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
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16
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Catalase as a Molecular Target for Male Infertility Diagnosis and Monitoring: An Overview. Antioxidants (Basel) 2020; 9:antiox9010078. [PMID: 31963256 PMCID: PMC7022443 DOI: 10.3390/antiox9010078] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 01/24/2023] Open
Abstract
Catalase (CAT) stands out as one of the most efficient natural enzymes when catalysing the split of H2O2 into H2O and O2; H2O2 is one of the reactive oxygen species (ROS) involved in oxidative stress, a process closely related to aging and several health disorders or diseases like male infertility. Some studies have correlated H2O2 with male infertility and catalase with fertility restoration. However, the number of studies conducted with human beings remains scarce. Considering the use of CAT as a molecular target for biochemical analysis, this review summarises the current knowledge on how CAT influences human beings’ male fertility. Thus, three different databases were consulted—Scopus, PubMed and WOS—using single keywords and combinations thereof. A total of 40,823 articles were identified. Adopting inclusion and exclusion criteria, a final database of 197 articles served to conduct this work. It follows from this analysis that CAT could play an important role in male fertility and could become a good target for male infertility diagnosis and monitoring. However, that potential role of CAT as a tool in diagnosis must be confirmed by clinical trials. Finally, guidelines are suggested to reinforce the use of CAT in daily clinical tests for male fertility diagnosis and monitoring.
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17
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Ghasemi A, Amjadi F, Masoumeh Ghazi Mirsaeed S, Mohammad Beigi R, Ghasemi S, Moradi Y, Tahereh Ghazi Mirsaeed S. The effect of Myo-inositol on sperm parameters and pregnancy rate in oligoasthenospermic men treated with IUI: A randomized clinical trial. Int J Reprod Biomed 2019; 17:749-756. [PMID: 31807723 PMCID: PMC6844281 DOI: 10.18502/ijrm.v17i10.5296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 02/21/2019] [Accepted: 06/12/2019] [Indexed: 11/24/2022] Open
Abstract
Background In about 40% of the couples, the cause of infertility problems is attributed to men because of low sperm production and disturbed motility of sperm. Pieces of evidence show that Myo-inositol has a potential role for the treatment of sperm morphology and male fertility. Objective This study aimed to determine the effect of Myo-inositol on the sperm parameters and fertility rate in patients with oligoasthenospermia treated by intrauterine insemination (IUI). Materials and Methods This study was a randomized clinical trial conducted on 37 patients with oligoasthenospermia treated by IUI during 2016-2017. In this study, the patients were randomly divided into two groups of oligoasthenospermia treated with (Case group) and without Myo-inositol (Control group). The case group received 0.5 ml of Myo-inositol with a concentration of 2 mg/ml and incubated at 37°C incubator for 2 hr, but the control group had no interventions. Results The results of this study showed that although there was no significant difference in sperm parameters including sperm motility and concentration before processing with Myo-inositol in the case group, but there was a significant increase in sperm motility during the treatment with Myo-inositol. The therapeutic effect of this method was confirmed on induction of pregnancy in 18% of the treated patients, in such a way that was about twice greater than those who did not receive the drug. Conclusion According to the results of this study, the use of Myo-inositol is efficient enough to change sperm parameters to increase the chance of fertility.
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Affiliation(s)
- Afsane Ghasemi
- Shahid Akbar Abadi Hospital Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Fatemehsadat Amjadi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Anatomical Sciences, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Masoumeh Ghazi Mirsaeed
- Shahid Akbar Abadi Hospital Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Robabeh Mohammad Beigi
- Shahid Akbar Abadi Hospital Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Samaneh Ghasemi
- Shahid Akbar Abadi Hospital Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Yousef Moradi
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Tahereh Ghazi Mirsaeed
- Shahid Akbar Abadi Hospital Clinical Research Development Unit (ShACRDU), Iran University of Medical Sciences (IUMS), Tehran, Iran
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18
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Armstrong S, Atkinson M, MacKenzie J, Pacey A, Farquhar C. Add-ons in the laboratory: hopeful, but not always helpful. Fertil Steril 2019; 112:994-999. [DOI: 10.1016/j.fertnstert.2019.10.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022]
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19
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Wei SY, Chao HH, Huang HP, Hsu CF, Li SH, Hsu L. A collective tracking method for preliminary sperm analysis. Biomed Eng Online 2019; 18:112. [PMID: 31775764 PMCID: PMC6882231 DOI: 10.1186/s12938-019-0732-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 11/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Total motile sperm count (TMSC) and curvilinear velocity (VCL) are two important parameters in preliminary semen analysis for male infertility. Traditionally, both parameters are evaluated manually by embryologists or automatically using an expensive computer-assisted sperm analysis (CASA) instrument. The latter applies a point-tracking method using an image processing technique to detect, recognize and classify each of the target objects, individually, which is complicated. However, as semen is dense, manual counting is exhausting while CASA suffers from severe overlapping and heavy computation. Methods We proposed a simple frame-differencing method that tracks motile sperms collectively and treats their overlapping with a statistical occupation probability without heavy computation. The proposed method leads to an overall image of all of the differential footprint trajectories (DFTs) of all motile sperms and thus the overall area of the DFTs in a real-time manner. Accordingly, a theoretical DFT model was also developed to formulate the overall DFT area of a group of moving beads as a function of time as well as the total number and average speed of the beads. Then, using the least square fitting method, we obtained the optimal values of the TMSC and the average VCL that yielded the best fit for the theoretical DFT area to the measured DFT area. Results The proposed method was used to evaluate the TMSC and the VCL of 20 semen samples. The maximum TMSC evaluated using the method is more than 980 sperms per video frame. The Pearson correlation coefficient (PCC) between the two series of TMSC obtained using the method and the CASA instrument is 0.946. The PCC between the two series of VCL obtained using the method and CASA is 0.771. As a consequence, the proposed method is as accurate as the CASA method in TMSC and VCL evaluations. Conclusion In comparison with the individual point-tracking techniques, the collective DFT tracking method is relatively simple in computation without complicated image processing. Therefore, incorporating the proposed method into a cell phone equipped with a microscopic lens can facilitate the design of a simple sperm analyzer for clinical or household use without advance dilution.
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Affiliation(s)
- Sung-Yang Wei
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Hsuan-Hao Chao
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Han-Ping Huang
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Chang Francis Hsu
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan
| | - Sheng-Hsiang Li
- Department of Medical Research, Mackay Memorial Hospital, Tamsui District, New Taipei City, 25160, Taiwan. .,Mackay Junior College of Medicine, Nursing, and Management, Taipei, 11260, Taiwan.
| | - Long Hsu
- Department of Electrophysics, National Chiao Tung University, Hsinchu, 30010, Taiwan.
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20
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Williams EA, Parker M, Robinson A, Pitt S, Pacey AA. A randomized placebo-controlled trial to investigate the effect of lactolycopene on semen quality in healthy males. Eur J Nutr 2019; 59:825-833. [PMID: 31591650 PMCID: PMC7058571 DOI: 10.1007/s00394-019-02091-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 09/09/2019] [Indexed: 12/25/2022]
Abstract
Purpose Poor sperm quality is a major contributor to infertility in heterosexual couples, but at present there are few empirical therapies. Several studies have examined the role of dietary factors and data from randomized controlled trials suggest that oral antioxidant therapy can improve some sperm parameters. Health benefits of lycopene supplementation have been proposed for a variety of health conditions and here we examine whether it can help improve sperm quality. This study aimed to investigate the effect of 14 mg daily lactolycopene for 12 weeks on semen quality in healthy men. Methods Sixty healthy male participants were recruited and randomized to this double-blind, placebo-controlled parallel study and received either 14 mg/d lactolycopene or a placebo for 12 weeks. The primary endpoint was a change in motile sperm concentration. Secondary endpoints were all other aspects of sperm quality, including the level of sperm DNA damage. Results Fifty-six men completed the intervention and the level of plasma lycopene was significantly increased in the men randomized to receive lycopene supplementation. There was no significant change in the primary endpoint (motile sperm concentration) post-intervention (p = 0.058). However, the proportion of fast progressive sperm (p = 0.006) and sperm with normal morphology (p < 0.001) did improve significantly in response to lactolycopene intervention. Conclusions Supplementation with 14 mg/d lactolycopene improves sperm motility and morphology in young healthy men. Clinical Trial Registry number and website ISRCTN33248724 http://www.isrctn.com/ISRCTN33248724
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Affiliation(s)
- Elizabeth A Williams
- Department of Oncology and Metabolism, Faculty of Medicine Dentistry and Health, Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK.
| | - Madeleine Parker
- Department of Oncology and Metabolism, Faculty of Medicine Dentistry and Health, Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Aisling Robinson
- Department of Oncology and Metabolism, Faculty of Medicine Dentistry and Health, Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Sophie Pitt
- Department of Oncology and Metabolism, Faculty of Medicine Dentistry and Health, Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
| | - Allan A Pacey
- Department of Oncology and Metabolism, Faculty of Medicine Dentistry and Health, Medical School, The University of Sheffield, Beech Hill Road, Sheffield, S10 2RX, UK
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21
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Vinnakota C, Cree L, Peek J, Morbeck DE. Incidence of high sperm DNA fragmentation in a targeted population of subfertile men. Syst Biol Reprod Med 2019; 65:451-457. [PMID: 31550174 DOI: 10.1080/19396368.2019.1668077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Sperm DNA integrity is important for fertility, however the incidence of high levels of DNA fragmentation (DNA fragmentation index (DFI) >30%) is not well described. In 2011, our clinics implemented guidelines for sperm DNA fragmentation (SDF) testing based on risk factors using the sperm chromatin structure assay (SCSA). The aim of this retrospective study is to characterise SDF and associated factors (age, semen parameters, smoking status and BMI) for sub-fertile males (n = 1082) and sperm donors (n = 234). The average DFI was 12.1 ± 9.8%. The distribution of men with low, moderate and high SDF (<15, 15-30 and >30%) was 74.8%, 19.4% and 5.8%, respectively. Men with high DFI were older (45 ± 9.5 vs 38 ± 6.7) and had lower percentage of motile sperm (38.8 ± 16.1% vs 55.3 ± 15.8%) than men with normal DFI. Over 17% of the men in the quartile with the highest age and lowest motility had a high DFI (>30%), compared to a high DFI rate of 2-4% for the other 3 quartiles. Repeat testing following lifestyle interventions was available for 29 couples where the men had high initial DFI (35 ± 9.5%). Of these men, 71.4% had a decrease of DFI into the moderate or low range. This study shows that SDF testing can be targeted based on age and sperm motility, thereby reducing unnecessary testing. Furthermore, we provide evidence that lifestyle modifications can reduce DNA fragmentation in men with high DFI.
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Affiliation(s)
- Chitra Vinnakota
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lynsey Cree
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - John Peek
- Fertility Associates, Auckland, New Zealand
| | - Dean E Morbeck
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.,Fertility Associates, Auckland, New Zealand
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22
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Sinha A, Singh V, Singh S, Yadav S. Proteomic analyses reveal lower expression of TEX40 and ATP6V0A2 proteins related to calcium ion entry and acrosomal acidification in asthenozoospermic males. Life Sci 2019; 218:81-88. [PMID: 30550884 DOI: 10.1016/j.lfs.2018.12.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
AIMS Idiopathic nature of male infertility disorder needs to be investigated by different horizons of molecular biology for its treatment and to device male contraceptive. Further, it can also aid in advancement of assisted reproductive technology (ART), as nowadays the failure and disquiets of ART are consistent. Herein, we have attempted to find out proteins responsible for male infertility by comparing proteome profile of sperms collected from normal control and asthenozoospermic (AS) males. MAIN METHODS Differential proteome profiles were studied by 2-dimensional differential gel electrophoresis (2D-DIGE) and mass spectrometry. The confirmation of proteome profiling results was done by western blotting and ELISA. Quantitative reverse-transcription-PCR was also performed in an independent cohort of AS and normal individuals to investigate the transcriptional regulation of proteins. KEY FINDINGS Although seven differentially regulated proteins were identified, highpoints of the study were two proteins, TEX40 and ATP6V0A2. Lower expression of a crucial sperm motility related protein, TEX40 is reported for the first time in clinically diagnosed AS males in the present investigation. Most likely with reference to previous findings the down regulation of TEX40 leads to fewer entries of calcium ions in the sperm and lower expression of ATP6V0A2 is responsible for acrosomal de-acidification. SIGNIFICANCE Conclusively, the down regulation of these two proteins in AS males might result in diminished sperm motility. The findings can be worthwhile for male contraception and ART management besides their use for male infertility therapy.
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Affiliation(s)
- Ashima Sinha
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India; Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi 110060, India
| | - Virendra Singh
- School of Life Sciences, Jawaharlal Nehru University, New Delhi 110067, India
| | - Sarman Singh
- Department of Laboratory Medicine, Division of Clinical Microbiology & Molecular Medicine, All India Institute of Medical Sciences, New Delhi 110029, India; All India Institute of Medical Sciences, Bhopal, Madhya Pradesh 462020, India
| | - Savita Yadav
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi 110029, India.
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23
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Yoon YE, Kim TY, Shin TE, Lee E, Choi KH, Lee SR, Hong YK, Park DS, Kim DK. Validation of SwimCount™, a Novel Home-Based Device That Detects Progressively Motile Spermatozoa: Correlation with World Health Organization 5th Semen Analysis. World J Mens Health 2019; 38:191-197. [PMID: 30799559 PMCID: PMC7076315 DOI: 10.5534/wjmh.180095] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/03/2018] [Accepted: 12/12/2018] [Indexed: 12/26/2022] Open
Abstract
Purpose We evaluated the usefulness of a home-based device (SwimCount™) compared with World Health Organization (WHO) 5th semen analysis in screening for male fertility in Asian men. Materials and Methods One hundred Asian men who visited CHA Seoul Station Fertility Center for evaluation of fertility were included. Semen samples were analyzed and compared with the SwimCount™ results. An aliquot of 0.5 mL of the semen sample was added to the SwimCount™ and a WHO 5th semen analysis was performed. Results were categorized as low (<5×106/mL), and normal to high (≥5×106/mL) total progressively motile sperm concentration. Receiver operating characteristic curve analysis was performed to evaluate the accuracy of the SwimCount™. Results The mean total progressively motile sperm concentration was 26.7×106/mL. Semen analysis revealed that 28% of the samples were below the threshold count of 5 million/mL total progressively motile sperm concentration. The mean total progressively motile sperm concentration of the light color SwimCount™ result group determined by semen analysis was 7.5×106/mL, and the mean total progressively motile sperm concentration of the moderate to dark color SwimCount™ result group was 34.2×106/mL. An area under the receiver operating characteristic curve of 0.85 (95% confidence interval, 0.77–0.94; p<0.001) was obtained when the SwimCount™ was compared with semen analysis. The sensitivity and specificity were obtained at a cut off value of 5.0×106/mL total progressively motile sperm concentration, giving a sensitivity and specificity of 87.5% and 73.4%. Conclusions We confirmed the reliability of the SwimCount™ as a home-based device for male fertility by evaluating the total progressively motile sperm concentration.
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Affiliation(s)
- Young Eun Yoon
- Department of Urology, Hanyang University College of Medicine, Seoul, Korea
| | | | - Tai Eun Shin
- Andrology Laboratory, CHA Fertility Center, Seoul Station, Seoul, Korea
| | - Eunji Lee
- Andrology Laboratory, CHA Fertility Center, Seoul Station, Seoul, Korea
| | - Kyung Hwa Choi
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Seung Ryeol Lee
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Young Kwon Hong
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dong Soo Park
- Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dae Keun Kim
- Department of Urology, CHA Fertility Center, Seoul Station, CHA University, Seoul, Korea.,Department of Urology, School of Medicine, Graduate School, Hanyang University, Seoul, Korea.
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Malm G, Rylander L, Giwercman A, Haugen TB. Association between semen parameters and chance of fatherhood - a long-term follow-up study. Andrology 2018; 7:76-81. [PMID: 30525303 DOI: 10.1111/andr.12558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 09/20/2018] [Accepted: 09/24/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Evaluation of male fertility includes standard semen analysis; however, there is uncertainty about the value of sperm parameters in predicting fertility. OBJECTIVE To evaluate the association between semen parameters and fatherhood during a long-time period. MATERIALS AND METHODS Semen parameters (total sperm count, concentration, motility, and morphology) and sperm DNA fragmentation Index (DFI) assessed on samples collected from 195 Norwegian men from the general population in 2001/2002 were matched with information about fatherhood until 2015, obtained from the Medical Birth Register. The parameters were dichotomized as normal vs. abnormal according to the WHO reference values from 1999 and 2010. Cut-offs at 20% and 30% were used for DFI. RESULTS Among men who had no children before 2003, those with normal progressive sperm motility had more often become fathers (WHO 1999, cut-off ≥50%, adjusted OR 2.8, 95% CI 1.3-6.1 and WHO 2010, cut-off ≥32%; aOR 4.2, 95% CI 1.1-15). Based on the WHO 1999 reference value, men with normal sperm concentration (≥20 × 106 /mL) had more often become fathers (aOR 3.1, 95% CI 1.1-8.6). Men with progressive sperm motility ≥50% and concentration ≥20 × 106 /mL did more often achieve fatherhood (aOR 8.4, 95% CI 2.1-34). For DFI, there was a borderline significance at cut-off 20% in the group of men who had ever been fathers (OR 2.7, 95% CI 1.0-7.0 p < 0.05). DISCUSSION The results indicate that sperm progressive motility, sperm concentration, and DFI are associated with fatherhood during a longer time period, with sperm motility being most consistent. Although the sample size is relatively small and our results should be replicated in larger studies, they may be of clinical relevance. CONCLUSION Semen parameters may have a diagnostic value not only in a short time frame but also for predicting future fertility potential.
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Affiliation(s)
- G Malm
- Molecular Reproductive Research, Department of Translational Medicine, Lund University, Skane University Hospital, Malmö, Sweden
| | - L Rylander
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - A Giwercman
- Molecular Reproductive Research, Department of Translational Medicine, Lund University, Skane University Hospital, Malmö, Sweden
| | - T B Haugen
- Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway
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Pacey A. Is sperm DNA fragmentation a useful test that identifies a treatable cause of male infertility? Best Pract Res Clin Obstet Gynaecol 2018; 53:11-19. [PMID: 30482660 DOI: 10.1016/j.bpobgyn.2018.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/25/2018] [Indexed: 12/25/2022]
Abstract
The present-day laboratory methods of sperm analysis are a poor predictor of reproductive outcome, and for many years it has been clear that newer and better tests are required. Although many such tests have been proposed, only those which determine sperm DNA quality are still being considered. Of these, several tests of sperm DNA fragmentation are available, although there is presently no consensus about the most appropriate test, the best test specimen (fresh or washed sperm) or what level of fragmentation is of clinical concern. Moreover, although several strategies have been proposed to reduce DNA fragmentation, there is no universal approach and few randomised trials have tested these in a clinical context. As such, most professional bodies do not presently support the use of sperm DNA fragmentation tests, and it is clear that large randomised trials are still required to further evaluate their clinical effectiveness.
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Affiliation(s)
- Allan Pacey
- Department of Oncology and Metabolism, University of Sheffield, Level 4, The Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, United Kingdom.
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Hamano I, Hatakeyama S, Nakamura R, Fukuhara R, Noro D, Tanaka T, Yoneyama T, Yamamoto H, Yoneyama T, Hashimoto Y, Koie T, Yokoyama Y, Ohyama C. Differences in semen characteristics between patients with testicular cancer and other malignancies using various cut-off values. Int J Urol 2018; 25:817-824. [DOI: 10.1111/iju.13732] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/04/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Itsuto Hamano
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Shingo Hatakeyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Rika Nakamura
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Rie Fukuhara
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Daisuke Noro
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Toshikazu Tanaka
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Tohru Yoneyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Hayato Yamamoto
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Takahiro Yoneyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Yasuhiro Hashimoto
- Department of Advanced Transplant and Regenerative Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Aomori Japan
| | - Takuya Koie
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Yoshihito Yokoyama
- Department of Obstetrics and Gynecology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
| | - Chikara Ohyama
- Department of Urology; Hirosaki University Graduate School of Medicine; Hirosaki, Aomori Japan
- Department of Advanced Transplant and Regenerative Medicine; Hirosaki University Graduate School of Medicine; Hirosaki Aomori Japan
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Lemmens L, Kos S, Beijer C, Braat DDM, Jonker MA, Nelen WLDM, Wetzels AMM. Optimization of laboratory procedures for intrauterine insemination: survey of methods in relation to clinical outcome. Andrology 2018; 6:707-713. [PMID: 29959833 DOI: 10.1111/andr.12510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/14/2018] [Accepted: 05/16/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a wide practice variation of used methods and outcomes in IUI in fertility laboratories. Standardization of the IUI procedure is important for reducing inconsistency among laboratories in counseling infertile couples and in pregnancy results. The aim of the study was to evaluate the currently used laboratory procedures of IUI in Dutch fertility laboratories and their effect on IUI pregnancy results. Additionally, the methods for semen analysis (SA) were evaluated, as SA is related to IUI in terms of inseminated sperm number and IUI counseling. MATERIAL AND METHODS This questionnaire survey study was sent to laboratories participating in the Dutch external quality control program for semen analysis (SKML) and consisted of 46 questions concerning laboratory management, methods for semen analysis and IUI, and clinical results. The results were analyzed using univariable and multivariable logistic regression models. RESULTS A total of 52 laboratories (out of 99) provided information on used methodologies for SA or laboratory procedures of IUI and the organization of the laboratory. A wide variability was confirmed in used methods for both SA and IUI. Evaluation of pregnancy results obtained during 3 years (2013-2015) showed that specific used laboratory methods have a significant effect on the probability of becoming pregnant. DISCUSSION AND CONCLUSION Important to remark is that in this survey study cycle-specific data, including variables of the individual couples (age, stimulation protocol, etc), were not included and may have effects on the results. The reported results provide an overview of the current practice performance; however, the organization of fertility laboratories is changing rapidly. The use of standardized methods in IUI is important for optimizing the performance of care and improving pregnancy results. The knowledge on used procedures, however, is limited, and further research on factors involving SA and the IUI procedure is necessary.
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Affiliation(s)
- L Lemmens
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - S Kos
- Department of Clinical Chemistry, Maasstad Hospital, Rotterdam, The Netherlands
| | - C Beijer
- Department of Clinical Chemistry, Atalmedial, Medical Diagnostic Centre, Amsterdam, The Netherlands
| | - D D M Braat
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - M A Jonker
- Department for Health Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - W L D M Nelen
- Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
| | - A M M Wetzels
- Fertility Laboratory, Department of Obstetrics and Gynaecology, Radboud university medical center, Nijmegen, The Netherlands
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Kuriya A, Agbo C, Dahan MH. Do pregnancy rates differ with intra-uterine insemination when different combinations of semen analysis parameters are abnormal? J Turk Ger Gynecol Assoc 2018; 19:57-64. [PMID: 29553043 PMCID: PMC5994814 DOI: 10.4274/jtgga.2017.0082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 03/16/2018] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To evaluate the relationship of one or a combination of semen analysis parameter results on insemination outcomes. MATERIAL AND METHODS A retrospective analysis was performed to evaluate the effect on pregnancy rates in relation to one or more abnormal semen analysis parameters based on the 2010 World Health Organization semen analysis guidelines. RESULTS Nine hundred eighty-one couples underwent 2231 intrauterine insemination cycles at the Stanford Fertility and Reproductive Medicine Center. In our study, the pregnancy rates ranged from 11-25% when an individual or combined semen analysis parameters were analyzed. Similar pregnancy rates were found when one, two, and in most cases three parameters were abnormal. When a single parameter was abnormal among volume, concentration, and motility, pregnancy rates were mainly unaffected. There was the exception of total sperm count where pregnancy rates were diminished when counts were below 39 million (p=0.04). CONCLUSIONS Clearly, total sperm in the specimen and not the concentration of sperm per milliliter was the critical factor for predicting pregnancy. Therefore, a reorganization of semen analysis reports should be done emphasizing the total amount of sperm present and de-emphasizing concentration of sperm.
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Affiliation(s)
- Anita Kuriya
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, Canada
| | - Chioma Agbo
- Department of Emergency Medicine, Stanford University School of Medicine, California, USA
| | - Michael H Dahan
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, McGill University Health Center, Montreal, Canada
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29
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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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30
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Yu S, Rubin M, Geevarughese S, Pino JS, Rodriguez HF, Asghar W. Emerging technologies for home-based semen analysis. Andrology 2017; 6:10-19. [PMID: 29194998 DOI: 10.1111/andr.12441] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 09/21/2017] [Accepted: 10/11/2017] [Indexed: 01/18/2023]
Abstract
With about 70 million cases of infertility worldwide, half of which are caused by male factors, sperm analysis is critical to determine male fertility potential. Conventional semen analysis methods involve complex and manual inspection with a microscope, and these methods are labor intensive and can take several days. Due to unavailability of rapid, convenient, and user-friendly semen analysis tools, many men do not seek medical evaluation, especially in resource-constrained settings. Furthermore, as conventional methods have to be conducted in the laboratories, many men are unwilling to be tested as a result of social stigma in certain regions of the world. One solution can be found in at-home sperm analysis, which allows men to test their semen without the hassle of going to and paying for a clinic. Herein, we examine current at-home sperm analysis technologies and compare them to the traditional laboratory-based methods. In addition, we discuss emerging sperm analysis approaches and describe their limitations and future directions.
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Affiliation(s)
- S Yu
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL, USA
| | - M Rubin
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL, USA.,Department of Computer & Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL, USA
| | - S Geevarughese
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL, USA
| | - J S Pino
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL, USA.,Department of Computer & Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL, USA
| | - H F Rodriguez
- Advanced Reproductive Technologies - LIFE Laboratories, Fertility& Genetics, Plantation, FL, USA
| | - W Asghar
- Asghar-Lab, Micro and Nanotechnology in Medicine, College of Engineering and Computer Science, Boca Raton, FL, USA.,Department of Computer & Electrical Engineering and Computer Science, Florida Atlantic University, Boca Raton, FL, USA.,Department of Biological Sciences, Florida Atlantic University, Boca Raton, FL, USA
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31
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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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32
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Tadros NN, Sabanegh E. Commentary on clinical utility of sperm DNA fragmentation testing: Practice Recommendations of Sperm DNA Fragmentation Testing: Expert Commentaries by Invited Authors and Replies by Guest Editors Contributors from North America. Transl Androl Urol 2017; 6:S374-S376. [PMID: 29082147 PMCID: PMC5643698 DOI: 10.21037/tau.2017.01.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Edmund Sabanegh
- Department of Urology, Cleveland Clinic, Cleveland, Ohio, USA
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33
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Eisenberg ML, Sapra KJ, Kim SD, Chen Z, Buck Louis GM. Semen quality and pregnancy loss in a contemporary cohort of couples recruited before conception: data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study. Fertil Steril 2017; 108:613-619. [PMID: 28863939 DOI: 10.1016/j.fertnstert.2017.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 06/07/2017] [Accepted: 07/10/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To study the relationship between semen quality and pregnancy loss in a cohort of couples attempting to conceive. DESIGN Observational prospective cohort. SETTING Not applicable. PATIENT(S) Three hundred and forty-four couples with a singleton pregnancy observed daily through 7 postconception weeks of gestation. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Association between semen quality and pregnancy loss. RESULT(S) Ninety-eight (28%) of the couples experienced a pregnancy loss after singleton pregnancy. No differences were observed in semen volume, sperm concentration, total sperm count, sperm viability, or sperm morphology (World Health Organization [WHO] and strict criteria) by couple's pregnancy loss status irrespective of whether they were analyzed continuously or as dichotomous variables per the WHO 5th edition semen criteria. A dichotomous DNA fragmentation measure of ≥30% was statistically significantly associated with pregnancy loss. No association was identified with other sperm morphometric or movement measures. Of the 70 couples who re-enrolled after a pregnancy loss, 14 experienced a second loss. Similar findings were identified when examining semen quality from couples with recurrent pregnancy loss. CONCLUSION(S) Although a few trends were identified (e.g., DNA fragmentation), general semen parameters seemed to have little relation with risk of pregnancy loss or recurrent pregnancy loss at the population level. However, given that 30% of pregnancies end in miscarriage and half the fetal genome is paternal in origin, the findings await corroboration.
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Affiliation(s)
| | - Katherine J Sapra
- Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, New York
| | - Sung Duk Kim
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
| | - Zhen Chen
- Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
| | - Germaine M Buck Louis
- Office of the Director, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland
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Ribeiro SC, Muratori M, De Geyter M, De Geyter C. TUNEL labeling with BrdUTP/anti-BrdUTP greatly underestimates the level of sperm DNA fragmentation in semen evaluation. PLoS One 2017; 12:e0181802. [PMID: 28787000 PMCID: PMC5546573 DOI: 10.1371/journal.pone.0181802] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 07/09/2017] [Indexed: 11/19/2022] Open
Abstract
Many studies have now confirmed that sperm DNA fragmentation (SDF) is associated with a poorer outcome of some forms of assisted reproduction technology. For this reason, SDF is an important parameter to evaluate in male fertility assessment. TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay coupled to flow cytometry is one of the most promising methods for SDF quantification. Several kits for the detection of DNA fragmentation are currently available on the market and all are recommended as equally appropriate to quantify SDF. In this work we compared for the first time the efficacy of two different types of TUNEL kits for SDF quantification: one using an indirect antibody-based labeling system (BrdUTP/fluorescein-anti-BrdUTP) and another using a direct labeling system (fluorescein-dUTP). We demonstrated that TUNEL indirect labeling system largely underestimates SDF when compared with the direct labeling, the differences ranging from 19.2% to 85.3% (p<0.05, n = 22). We observed that these differences were most pronounced among dead spermatozoa where indirect labeling stained 40.1% [23.6%, 58.2%] and the direct system 65.7% [36.5%, 90.9%] (n = 10, p<0.05). Interestingly, we found that both systems stained the living spermatozoa with the same efficiency. We showed that the differences are due to the steric hindrance of the antibody during its binding to the BrdUTP. Indeed, after sperm DNA decondensation, the percentages of TUNEL positivity increased significantly from 46.3% [31.8%, 61.7%] to 97.5% [96.1%, 98.8%] (p<0.05, n = 5). Our results are important for future use of TUNEL in clinical practice. Laboratories relying on the use of an antibody-based system heavily underestimate SDF, most particularly in infertile patients with reduced sperm motility. As a consequence, the kit using BrdUTP/fluorescein-anti-BrdUTP should not be recommended as a method to assay DNA damage in semen. This study represents one further step in the standardization of TUNEL among laboratories.
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Affiliation(s)
- Sofia C. Ribeiro
- Clinic of Gynecological Endocrinology and Reproductive Medicine, University Hospital, University of Basel, Basel, Switzerland
| | - Monica Muratori
- University of Florence, Department of Experimental, Clinical and Biomedical Sciences-De Nothe Center of Excellence, Florence, Italy
| | - Maria De Geyter
- Clinic of Gynecological Endocrinology and Reproductive Medicine, University Hospital, University of Basel, Basel, Switzerland
| | - Christian De Geyter
- Clinic of Gynecological Endocrinology and Reproductive Medicine, University Hospital, University of Basel, Basel, Switzerland
- * E-mail:
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Zhang Z, Yang Y, Wu H, Zhang H, Zhang H, Mao J, Liu D, Zhao L, Lin H, Tang W, Hong K, Jiang H. Sodium-Hydrogen-Exchanger expression in human sperm and its relationship with semen parameters. J Assist Reprod Genet 2017; 34:795-801. [PMID: 28432487 DOI: 10.1007/s10815-017-0898-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/27/2017] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Sperm-specific sodium-hydrogen exchanger (sNHE) is essential to maintain sperm normal function in mice; however, its role in human sperm has not been clarified to date. The aim of this study is to investigate the expression pattern of sNHE in human spermatozoa and its relationship with sperm functional parameters. METHOD Semen samples from 68 asthenozoospermic and 61 normozoospermic men were analyzed for sperm concentration, motility, and acrosome reaction, and high motile spermatozoa were collected by swim-up method. The expression of sNHE in spermatozoa was detected by Western blot and immunofluorescence staining. The relationship between sNHE expression and sperm parameters was assessed. RESULTS We identified sNHE is mainly localized to the principal piece of the human sperm tail. The expression of sNHE was positively correlated with sperm concentration, total number, and progressive motility. Moreover, sNHE expression was upregulated in swim-up sperm and associated with most of sperm motility parameters including straight line velocity and curvilinear velocity. Our results also showed that sNHE expression is decreased in sperm from patients with asthenozoospermia compared with that from normal controls. However, no correlation was found between sNHE expression and acrosome reaction in spermatozoa. CONCLUSIONS The expression pattern of sNHE suggested that this protein may be involved in the regulation of sperm motility, and aberration of its expression in sperm may contribute to the pathogenesis of asthenozoospermia.
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Affiliation(s)
- Zhe Zhang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Yuzhuo Yang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Han Wu
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Hongliang Zhang
- Department of Human Sperm Bank, Peking University Third Hospital, Beijing, 100191, China
| | - Haitao Zhang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Jiaming Mao
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, 100191, China
| | - Defeng Liu
- Department of Reproductive Medicine Center, Peking University Third Hospital, Beijing, 100191, China
| | - Lianming Zhao
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Wenhao Tang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Kai Hong
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, 100191, China.
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Urbano LF, Masson P, VerMilyea M, Kam M. Automatic Tracking and Motility Analysis of Human Sperm in Time-Lapse Images. IEEE TRANSACTIONS ON MEDICAL IMAGING 2017; 36:792-801. [PMID: 27875219 DOI: 10.1109/tmi.2016.2630720] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
We present a fully automated multi-sperm tracking algorithm. It has the demonstrated capability to detect and track simultaneously hundreds of sperm cells in recorded videos while accurately measuring motility parameters over time and with minimal operator intervention. Algorithms of this kind may help in associating dynamic swimming parameters of human sperm cells with fertility and fertilization rates. Specifically, we offer an image processing method, based on radar tracking algorithms, that detects and tracks automatically the swimming paths of human sperm cells in timelapse microscopy image sequences of the kind that is analyzed by fertility clinics. Adapting the well-known joint probabilistic data association filter (JPDAF), we automatically tracked hundreds of human sperm simultaneously and measured their dynamic swimming parameters over time. Unlike existing CASA instruments, our algorithm has the capability to track sperm swimming in close proximity to each other and during apparent cell-to-cell collisions. Collecting continuously parameters for each sperm tracked without sample dilution (currently impossible using standard CASA systems) provides an opportunity to compare such data with standard fertility rates. The use of our algorithm thus has the potential to free the clinician from having to rely on elaborate motility measurements obtained manually by technicians, speed up semen processing, and provide medical practitioners and researchers with more useful data than are currently available.
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Lemmens L, Kos S, Beijer C, Brinkman JW, van der Horst FA, van den Hoven L, Kieslinger DC, van Trooyen-van Vrouwerff NJ, Wolthuis A, Hendriks JC, Wetzels AM, Kos S, Beijer C, Brinkman JW, van der Horst FA, van den Hoven L, Kieslinger DC, van Trooyen-van Vrouwerff NJ, Wolthuis A, Wetzels AM. Predictive value of sperm morphology and progressively motile sperm count for pregnancy outcomes in intrauterine insemination. Fertil Steril 2016; 105:1462-8. [DOI: 10.1016/j.fertnstert.2016.02.012] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/14/2016] [Accepted: 02/03/2016] [Indexed: 11/30/2022]
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Woodward B, Tomlinson M, Kirkman-Brown J. Replacing IUI with IVF for initial treatment of unexplained infertility: why this NICE recommendation is cause for concern. HUM FERTIL 2016; 19:80-4. [PMID: 27174661 DOI: 10.1080/14647273.2016.1182220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The latest guidelines from the National Institute for Health and Care Excellence (NICE) for assisted conception recommend that people experiencing unexplained infertility should no longer be offered stimulated intra-uterine insemination (IUI) as a first-line treatment, but rather be directed towards IVF or alternatively be left to expectant management. NICE has acknowledged that the cited evidence leading to this decision was not sufficiently robust. As such, we are concerned that accordance with these new NICE guidelines may result in people with no identifiable cause of their infertility being prematurely referred for IVF treatment. Since IVF constitutes a more invasive and expensive treatment process, which also represents an additional and unnecessary cost pressure to the National Health Service, there is a longstanding need for a robust clinical trial to resolve the uncertainty as to whether one treatment is more appropriate than another. Until such data is available, we suggest that provision of stimulated IUI, in centres achieving a satisfactory live birth rate, represents a significant cost-saving to those commissioning fertility services, with lower risks to people treated.
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Affiliation(s)
- Bryan Woodward
- a Fertility Unit, Nottingham University Hospital , Nottingham , UK
| | - Mathew Tomlinson
- a Fertility Unit, Nottingham University Hospital , Nottingham , UK
| | - Jackson Kirkman-Brown
- b School of Clinical and Experimental Medicine, University of Birmingham , Birmingham , UK ;,c Birmingham Women's Hospital Centre for Human Reproductive Science , Birmingham , UK
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Coughlan C, Clarke H, Cutting R, Saxton J, Waite S, Ledger W, Li T, Pacey AA. Sperm DNA fragmentation, recurrent implantation failure and recurrent miscarriage. Asian J Androl 2016; 17:681-5. [PMID: 25814156 PMCID: PMC4492063 DOI: 10.4103/1008-682x.144946] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Evidence is increasing that the integrity of sperm DNA may also be related to implantation failure and recurrent miscarriage (RM). To investigate this, the sperm DNA fragmentation in partners of 35 women with recurrent implantation failure (RIF) following in vitro fertilization, 16 women diagnosed with RM and seven recent fathers (control) were examined. Sperm were examined pre- and post-density centrifugation by the sperm chromatin dispersion (SCD) test and the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. There were no significant differences in the age of either partner or sperm concentration, motility or morphology between three groups. Moreover, there were no obvious differences in sperm DNA fragmentation measured by either test. However, whilst on average sperm DNA fragmentation in all groups was statistically lower in prepared sperm when measured by the SCD test, this was not seen with the results from the TUNEL assay. These results do not support the hypothesis that sperm DNA fragmentation is an important cause of RIF or RM, or that sperm DNA integrity testing has value in such patients. It also highlights significant differences between test methodologies and sperm preparation methods in interpreting the data from sperm DNA fragmentation tests.
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Affiliation(s)
| | | | | | | | | | | | | | - Allan A Pacey
- Department of Human Metabolism, Academic Unit of Reproductive and Developmental Medicine, University of Sheffield, Level 4, The Jessop Wing, Tree Root Walk, Sheffield, S10 2SF, United Kingdom
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Montanino Oliva M, Poverini R, Lisi R, Carra MC, Lisi F. Treating Woman with Myo-Inositol Vaginal Suppositories Improves Partner's Sperm Motility and Fertility. Int J Endocrinol 2016; 2016:7621942. [PMID: 27403162 PMCID: PMC4923529 DOI: 10.1155/2016/7621942] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/17/2016] [Indexed: 02/03/2023] Open
Abstract
Motility is the feature that allows spermatozoa to actively reach and penetrate the female gamete during fertilization. When this function is altered, and especially decreased, troubles in conceiving may occur. In this study, we demonstrated that treating fertile women with myo-inositol (MI) vaginal suppositories ameliorated their partners' sperm motility and also positively affected their conceiving capacity, without changes in cervical mucus structural and biochemical characteristics. Indeed, by means of the postcoital test on female cervical mucus, a significant improvement especially in progressive sperm motility was recorded after MI suppository use. Concomitantly, after MI treatment, a reduction of immotile spermatozoa percentage was observed. Importantly, MI vaginal supplementation positively correlated with a pregnancy for 5 of the 50 couples enrolled in the study, leading us to speculate that this substance may substantially contribute to create in the cervical mucus an ideal milieu that makes spermatozoa more motile and functionally able to fertilize. Even though the detailed mechanism is still unclear, these results should encourage MI vaginal use for the clinical improvement of male infertility, through their partners.
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Affiliation(s)
- Mario Montanino Oliva
- Department of Obstetrics & Gynecology, Santo Spirito Hospital, 00100 Rome, Italy
- IVF Unit, Villa Mafalda Clinic, 00100 Rome, Italy
- *Mario Montanino Oliva:
| | | | - Rosella Lisi
- IVF Unit, Villa Mafalda Clinic, 00100 Rome, Italy
| | | | - Franco Lisi
- IVF Unit, Villa Mafalda Clinic, 00100 Rome, Italy
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Bozhedomov V, Nikolaeva M, Ushakova I, Lipatova N, Bozhedomova G, Sukhikh G. Functional deficit of sperm and fertility impairment in men with antisperm antibodies. J Reprod Immunol 2015; 112:95-101. [DOI: 10.1016/j.jri.2015.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 08/11/2015] [Accepted: 08/17/2015] [Indexed: 11/27/2022]
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Lockwood GM, Deveneau NE, Shridharani AN, Strawn EY, Sandlow JI. Isolated abnormal strict morphology is not a contraindication for intrauterine insemination. Andrology 2015; 3:1088-93. [PMID: 26384603 DOI: 10.1111/andr.12098] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Revised: 07/16/2015] [Accepted: 07/23/2015] [Indexed: 11/28/2022]
Abstract
This study sought to investigate whether isolated abnormal strict morphology (<5% normal forms) and very low strict morphology (0-1% normal forms) affects pregnancy rates in intrauterine insemination (IUI). This was a retrospective study performed at an Academic Medical Center/Reproductive Medicine Center. Four hundred and eight couples were included for 856 IUI cycles. 70 IUI cycles were performed in couples with abnormal strict morphology and otherwise normal semen parameters. Outcomes were measured as clinical pregnancy rate per IUI cycle as documented by fetal heart activity on maternal ultrasound. Clinical pregnancy rate did not significantly differ between the group with abnormal strict morphology [11/70 (15.7%)] and the normal morphology group [39/281 (13.9%)]. Additionally, there was no significant difference between the pregnancy rate in the abnormal morphology group compared to that of our overall institutional IUI pregnancy rate [145/856 (16.9%)]. Furthermore, there was no significant difference between pregnancy rate in the very low morphology group [3/14 (21.4%)] compared to those with normal morphology or the overall IUI pregnancy rate. Patients with isolated abnormal strict morphology have clinical pregnancy rates similar to those with normal morphology for IUI. Even in those with very low normal forms, consideration of IUI for assisted reproduction should not be excluded.
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Affiliation(s)
- G M Lockwood
- Department of Urology, Froedtert Hospital, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA
| | - N E Deveneau
- Department of Obstetrics and Gynecology, Froedtert Hospital, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA
| | - A N Shridharani
- Department of Urology, Froedtert Hospital, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA
| | - E Y Strawn
- Department of Obstetrics and Gynecology, Froedtert Hospital, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA
| | - J I Sandlow
- Department of Urology, Froedtert Hospital, Medical College of Wisconsin Affiliated Hospitals, Milwaukee, WI, USA
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David I, Kohnke P, Lagriffoul G, Praud O, Plouarboué F, Degond P, Druart X. Mass sperm motility is associated with fertility in sheep. Anim Reprod Sci 2015; 161:75-81. [PMID: 26364125 DOI: 10.1016/j.anireprosci.2015.08.006] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/17/2015] [Accepted: 08/19/2015] [Indexed: 11/18/2022]
Abstract
The study was to focus on the relationship between wave motion (mass sperm motility, measured by a mass sperm motility score, manually assessed by artificial insemination (AI) center operators) and fertility in male sheep. A dataset of 711,562 artificial inseminations performed in seven breeds by five French AI centers during the 2001-2005 time period was used for the analysis. Factors influencing the outcome of the insemination, which is a binary response observed at lambing of either success (1) or failure (0), were studied using a joint model within each breed and AI center (eight separate analyses). The joint model is a multivariate model where all information related to the female, the male and the insemination process were included to improve the estimation of the factor effects. Results were consistent for all analyses. The male factors affecting AI results were the age of the ram and the mass motility. After correction for the other factors of variation, the lambing rate increased quasi linearly from three to more than ten points with the mass sperm motility score depending on the breed and the AI center. The consistency of the relationship for all breeds indicated that mass sperm motility is predictive of the fertility resulting when sperm are used from a specific ejaculate. Nonetheless, predictability could be improved if an objective measurement of mass sperm motility were available as a substitute for the subjective scoring currently in use in AI centers.
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Affiliation(s)
- Ingrid David
- INRA, GenPhySE (Génétique, Physiologie et Systèmes d'Elevage), F-31326 Castanet-Tolosan, France; Université de Toulouse, INP, ENSAT, GenPhySE (Génétique, Physiologie et Systèmes d'Elevage), F-31326 Castanet-Tolosan, France; Université de Toulouse, INP, ENVT, GenPhySE (Génétique, Physiologie et Systèmes d'Elevage), F-31076 Toulouse, France.
| | - Philippa Kohnke
- INRA, CNRS, Université de Tours, Haras Nationaux, SPARC (Station de Physiologie de la Reproduction et des Comportements), 37380 Nouzilly, France
| | - Gilles Lagriffoul
- Institut de l'Elevage, ANIO, BP 42118, 31320 Castanet-Tolosan, France
| | - Olivier Praud
- Université de Toulouse - INPT-UPS, Institut de Mécanique des Fluides, 31000 Toulouse, France
| | - Franck Plouarboué
- Université de Toulouse - INPT-UPS, Institut de Mécanique des Fluides, 31000 Toulouse, France
| | - Pierre Degond
- Department of Mathematics, Imperial College London, London SW7 2AZ, United Kingdom
| | - Xavier Druart
- INRA, CNRS, Université de Tours, Haras Nationaux, SPARC (Station de Physiologie de la Reproduction et des Comportements), 37380 Nouzilly, France
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Muratori M, Marchiani S, Tamburrino L, Cambi M, Lotti F, Natali I, Filimberti E, Noci I, Forti G, Maggi M, Baldi E. DNA fragmentation in brighter sperm predicts male fertility independently from age and semen parameters. Fertil Steril 2015; 104:582-90.e4. [PMID: 26151619 DOI: 10.1016/j.fertnstert.2015.06.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 06/04/2015] [Accepted: 06/04/2015] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To evaluate whether sperm DNA fragmentation (sDF), measured in brighter, dimmer, and total populations, predicts natural conception, and to evaluate the intra-individual variability of sDF. DESIGN Prospective study. SETTING Outpatient clinic and diagnostic laboratory. PATIENT(S) A total of 348 unselected patients and 86 proven fertile men. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) sDF was revealed with the use of terminal deoxynucleotide transferase-mediated dUTP nick-end labeling (TUNEL)/propidium iodide (PI). Receiver operating characteristic (ROC) curves were built before and after matching fertile men to patients for age (76:152) or semen parameters (68:136) or both (49:98). Intra-individual variability of sDF was assessed over 2 years. RESULT(S) Brighter (area under ROC curve [AUC] 0.718 ± 0.54), dimmer (AUC 0.655 ± 0.63), and total (AUC 0.757 ± 0.54) sDF predict male fertility in unmatched and age- or semen parameters-matched subjects. After matching for both age and semen parameters, only brighter (AUC 0.711 ± 0.83) and total (AUC 0.675 ± 0.92) sDF predict male fertility. At high values of total sDF, brighter predicts natural conception better than total sDF. Intra-individual coefficients of variation of sDF were 9.2 ± 8.6% (n = 25), 12.9 ± 12.7% (n = 53), and 14.0 ± 12.6% (n = 70) over, respectively, 100-day and 1- and 2-year periods, appearing to be the most stable of the evaluated semen parameters. CONCLUSION(S) The predictive power of total sDF partially depends on age and semen parameters, whereas brighter sDF independently predicts natural conception. Therefore, brighter sDF is a fraction of sDF that adds new information to the routine semen analysis. At high levels of sDF, distinguishing the two sperm populations improves the predictive power of sDF. Overall, our results support the idea that TUNEL/PI can be of clinical usefulness in the male fertility workup.
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Affiliation(s)
- Monica Muratori
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy.
| | - Sara Marchiani
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Lara Tamburrino
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Marta Cambi
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Francesco Lotti
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Ilaria Natali
- Seminology Laboratory, Azienda USL3 Pistoia, Pistoia, Italy
| | | | - Ivo Noci
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Gianni Forti
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Mario Maggi
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
| | - Elisabetta Baldi
- Department of Experimental, Clinical and Biomedical Sciences, DeNoth Center of Excellence, University of Florence, Florence, Italy
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Lewis SEM. Should sperm DNA fragmentation testing be included in the male infertility work-up? Reprod Biomed Online 2015; 31:134-7. [PMID: 26096033 DOI: 10.1016/j.rbmo.2015.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 05/07/2015] [Indexed: 10/23/2022]
Abstract
A response to the editorial 'Are we ready to incorporate sperm DNA fragmentation testing into our male infertility work-up? A plea for more robust studies' by Erma Drobnis and Martin Johnson.
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Affiliation(s)
- Sheena E M Lewis
- Centre for Public Health, Queen's University, Belfast BT12 6 BJ, Northern Ireland, UK.
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Woodward BJ, Tomlinson MJ. How strict should specimen acceptance or rejection criteria be for diagnostic semen analysis? An opinion. HUM FERTIL 2014; 18:87-91. [PMID: 25292458 DOI: 10.3109/14647273.2014.958577] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Medical laboratory accreditation (previously by Clinical Pathology Accreditation UK Ltd and now by the United Kingdom Accreditation Service) has been integral to improving standards and service quality in the UK. With the recent introduction of the ISO15189 standard, all laboratories offering a clinical diagnostic service are required to demonstrate further improvement, with more emphasis on validation and assessment of the uncertainty levels associated with testing. This applies not only to 'bench testing', but also to the evidence-base for all pre-analytical and post-analytical procedures. To reduce the risk of external influences on andrology test results, semen sample rejection criteria were developed, including confirmation of patient identity, a strict time limit from sample production to testing, the use of toxicity-tested containers, a prescribed sexual abstinence and a need for complete sample collection. However, such criteria were originally developed by the World Health Organization in order to standardise analysis rather than reject testing outright, and should therefore be implemented with caution. Rejecting samples with normal semen parameters because they fail to meet some of the criteria as outlined above would be a waste of resources and adversely affect user (the person who requested or provided the sample) satisfaction. This document evaluates the evidence base underlying commonly used criteria for specimen rejection and suggests how they may be applied more pragmatically in order to improve efficiency and reduce the waste of resources.
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Amaral A, Paiva C, Attardo Parrinello C, Estanyol JM, Ballescà JL, Ramalho-Santos J, Oliva R. Identification of proteins involved in human sperm motility using high-throughput differential proteomics. J Proteome Res 2014; 13:5670-84. [PMID: 25250979 DOI: 10.1021/pr500652y] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Mammalian sperm motility is a prerequisite for in vivo fertilization, and alterations in this parameter are commonly observed in infertile males. However, we still do not have a complete understanding of the molecular mechanisms controlling it. The aim of this study was to identify proteins involved in human sperm motility deficiency by using TMT protein labeling and LC-MS/MS. Two complementary approaches were used: comparison between sperm samples differing in motility (asthenozoospermic versus normozoospermic) and comparison between sperm subpopulations of fractionated normozoospermic samples differing in motility (non-migrated versus migrated). LC-MS/MS resulted in the identification of 1157 and 887 proteins in the first and second approaches, respectively. Remarkably, similar proteomic alterations were detected in the two experiments, with 80 proteins differentially expressed in the two groups of samples and 93 differentially expressed in the two groups of subpopulations. The differential proteins were analyzed by GO, cellular pathways, and clustering analyses and resulted in the identification of core deregulated proteins and pathways associated with sperm motility dysfunction. These included proteins associated with energetic metabolism, protein folding/degradation, vesicle trafficking, and the cytoskeleton. Contrary to what is usually accepted, the outcomes support the hypothesis that several metabolic pathways (notably, mitochondrial-related ones) contribute toward regulating sperm motility.
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Affiliation(s)
- Alexandra Amaral
- Human Genetics Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Faculty of Medicine, University of Barcelona , Casanova 143, 08036 Barcelona, Spain
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Tardif S, Madamidola OA, Brown SG, Frame L, Lefièvre L, Wyatt PG, Barratt CLR, Martins Da Silva SJ. Clinically relevant enhancement of human sperm motility using compounds with reported phosphodiesterase inhibitor activity. Hum Reprod 2014; 29:2123-35. [PMID: 25124668 PMCID: PMC4481575 DOI: 10.1093/humrep/deu196] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
STUDY QUESTION Can we identify compound(s) with reported phosphodiesterase inhibitor (PDEI) activity that could be added to human spermatozoa in vitro to enhance their motility without compromising other sperm functions? SUMMARY ANSWER We have identified several compounds that produce robust and effective stimulation of sperm motility and, importantly, have a positive response on patient samples. WHAT IS KNOWN ALREADY For >20 years, the use of non-selective PDEIs, such as pentoxifylline, has been known to influence the motility of human spermatozoa; however, conflicting results have been obtained. It is now clear that human sperm express several different phosphodiesterases and these are compartmentalized at different regions of the cells. By using type-specific PDEIs, differential modulation of sperm motility may be achieved without adversely affecting other functions such as the acrosome reaction (AR). STUDY DESIGN, SIZE, DURATION This was a basic medical research study examining sperm samples from normozoospermic donors and subfertile patients attending the Assisted Conception Unit (ACU), Ninewells Hospital Dundee for diagnostic semen analysis, IVF and ICSI. Phase 1 screened 43 commercially available compounds with reported PDEI activity to identify lead compounds that stimulate sperm motility. Samples were exposed (20 min) to three concentrations (1, 10 and 100 µM) of compound, and selected candidates (n = 6) progressed to Phase 2, which provided a more comprehensive assessment using a battery of in vitro sperm function tests. PARTICIPANTS/MATERIALS, SETTING, METHODS All healthy donors and subfertile patients were recruited at the Medical Research Institute, University of Dundee and ACU, Ninewells Hospital Dundee (ethical approval 08/S1402/6). In Phase 1, poor motility cells recovered from the 40% interface of the discontinuous density gradient were used as surrogates for patient samples. Pooled samples from three to four different donors were utilized in order to reduce variability and increase the number of cells available for simultaneous examination of multiple compounds. During Phase 2 testing, semen samples from 23 patients attending for either routine diagnostic andrology assessment or IVF/ICSI were prepared and exposed to selected compounds. Additionally, 48 aliquots of prepared samples, surplus to clinical use, were examined from IVF (n = 32) and ICSI (n = 16) patients to further determine the effects of selected compounds under clinical conditions of treatment. Effects of compounds on sperm motility were assessed by computer-assisted sperm analysis. A modified Kremer test using methyl cellulose was used to assess sperm functional ability to penetrate into viscous media. Sperm acrosome integrity and induction of apoptosis were assessed using the acrosomal content marker PSA-FITC and annexin V kit, respectively. MAIN RESULTS AND THE ROLE OF CHANCE In Phase 1, six compounds were found to have a strong effect on poor motility samples with a magnitude of response of ≥60% increase in percentage total motility. Under capacitating and non-capacitating conditions, these compounds significantly (P ≤ 0.05) increased the percentage of total and progressive motility. Furthermore, these compounds enhanced penetration into a cervical mucus substitute (P ≤ 0.05). Finally, the AR was not significantly induced and these compounds did not significantly increase the externalization of phosphatidylserine (P = 0.6, respectively). In general, the six compounds maintained the stimulation of motility over long periods of time (180 min) and their effects were still observed after their removal. In examinations of clinical samples, there was a general observation of a more significant stimulation of sperm motility in samples with lower baseline motility. In ICSI samples, compounds #26, #37 and #38 were the most effective at significantly increasing total motility (88, 81 and 79% of samples, respectively) and progressive motility (94, 93 and 81% of samples, respectively). In conclusion, using a two-phased drug discovery screening approach including the examination of clinical samples, 3/43 compounds were identified as promising candidates for further study. LIMITATIONS, REASONS FOR CAUTION This is an in vitro study and caution must be taken when extrapolating the results. Data for patients were from one assessment and thus the robustness of responses needs to be established. The n values for ICSI samples were relatively small. WIDER IMPLICATIONS OF THE FINDINGS We have systematically screened and identified several compounds that have robust and effective stimulation (i.e. functional significance with longevity and no toxicity) of total and progressive motility under clinical conditions of treatment. These compounds could be clinical candidates with possibilities in terms of assisted reproductive technology options for current or future patients affected by asthenozoospermia or oligoasthenozoospermia. STUDY FUNDING/COMPETING INTEREST(S) This study was funded primarily by the MRC (DPFS) but with additional funding from the Wellcome Trust, Tenovus (Scotland), University of Dundee, NHS Tayside and Scottish Enterprise. The authors have no competing interests. A patent (#WO2013054111A1) has been published containing some of the information presented in this manuscript.
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Affiliation(s)
- Steve Tardif
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK Present address: International Center for Biotechnology, MOFA Global, Mount Horeb, WI 53572, USA
| | - Oladipo A Madamidola
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK Assisted Conception Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK University of Abertay, Dundee DD11HG, UK
| | | | - Lorna Frame
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK
| | - Linda Lefièvre
- Medical School, University of Birmingham, Birmingham B152TG, UK
| | - Paul G Wyatt
- Drug Discovery Unit, College of Life Sciences, University of Dundee, Dundee, UK
| | - Christopher L R Barratt
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK Assisted Conception Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK
| | - Sarah J Martins Da Silva
- Reproductive and Developmental Biology, Medical School, Ninewells Hospital, University of Dundee, Dundee DD1 9SY, UK Assisted Conception Unit, NHS Tayside, Ninewells Hospital, Dundee DD1 9SY, UK
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