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Nemov VC, Pavlovic ZJ, Imudia AN. Reply to Editorial Comment on "Predictive Value of Teratospermia During Initial Sperm Analysis on the Success of Intrauterine Insemination Cycles". Urology 2024:S0090-4295(24)00828-8. [PMID: 39306305 DOI: 10.1016/j.urology.2024.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 09/13/2024] [Indexed: 10/14/2024]
Affiliation(s)
- Valerie C Nemov
- University of South Florida, Morsani College of Medicine, Tampa, FL
| | | | - Anthony N Imudia
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL; Shady Grove Fertility, Tampa Bay, FL
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Pavlovic ZJ, Nemov VC, Sarkar P, Jahandideh S, Devine K, Imudia AN. Predictive Value of Teratospermia During Initial Sperm Analysis on the Success of Intrauterine Insemination Cycles. Urology 2024:S0090-4295(24)00629-0. [PMID: 39089498 DOI: 10.1016/j.urology.2024.07.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/06/2024] [Accepted: 07/18/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE To evaluate the predictive value of sperm morphology, specifically teratospermia, seen during initial semen analysis on the success of intrauterine insemination (IUI) cycles and pregnancy outcomes. METHODS A retrospective cohort analysis on patients undergoing IUI at a large US fertility network. Baseline demographic characteristics, primary infertility diagnoses, and pregnancy outcomes were recorded. A total of 27,925 IUI cycles in 16,169 unique patients were analyzed. IUI cycles were grouped by a sperm morphology of 1% (n = 3799), 2% (n = 5506), 3% (n = 4857), or 4% or greater (n = 13,763). The outcome measures were pregnancy rate (positive pregnancy test), clinical pregnancy rate (CPR) (ultrasound confirmation of a gestational sac with a yolk sac around 5-6 weeks), live birth rate, and miscarriage rate. RESULTS Sperm morphology is a significant predictor of pregnancy rate (P = <.001), CPR (P =.011), and live birth rate (P = .026) following IUI. In each of these outcome measures, patients with 1% normal forms had the lowest percentage of success, and patients with 4% or greater normal forms had the most success. Relative outcome percentages, however, were similar in each group. Live birth rates in the 1%, 2%, 3%, and >4% group were 12.3%, 13.1%, 12.7%, and 13.9%, respectively. Sperm morphology is not a significant predictor of miscarriage rate per clinical pregnancy post-IUI (P = .054). CONCLUSION Sperm morphology was a statistically significant predictor of pregnancy, clinical pregnancy, and live birth but not miscarriage rate after an IUI cycle. Higher morphology percentages were associated with increasingly favorable outcomes. However, the small observed differences did not demonstrate clinical significance.
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Affiliation(s)
- Zoran J Pavlovic
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL.
| | - Valerie C Nemov
- University of South Florida, Morsani College of Medicine, Tampa, FL
| | - Papri Sarkar
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL
| | - Samad Jahandideh
- Shady Grove Fertility Reproductive Science Center, Rockville, MD
| | - Kate Devine
- Shady Grove Fertility Reproductive Science Center, Rockville, MD
| | - Anthony N Imudia
- Department of Obstetrics and Gynecology, University of South Florida, Morsani College of Medicine, Tampa, FL; Shady Grove Fertility Center, Tampa Bay, FL
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Cheng LG, Miller D, Pelzman D, Wecht A, Hwang K. High rate of isolated teratospermia in a population of fertile men and the questionable clinical utility of sperm morphology. F S Rep 2024; 5:140-144. [PMID: 38983740 PMCID: PMC11228780 DOI: 10.1016/j.xfre.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 07/11/2024] Open
Abstract
Objective To better understand the impact of sperm morphology on fertility by assessing sperm morphology in a population of known fertile men. Design A prospective cohort study. Setting Fertility center associated with the university. Patients Healthy men >18 years of age were recruited to provide one semen sample before a vasectomy appointment scheduled between March 2020 and November 2022. Patients were included in the study when they had at least one biologic child and no history of difficulty achieving pregnancy or fertility procedures. Interventions None. Main Outcome Measures Sperm morphology. Results A total of 68 patients (mean age 36.7 years) were included. Thirty-eight (55.9%) patients had 3% or lower normal sperm morphology, including two patients who had 0 normal morphology. The most common morphologic abnormalities were head-shaped defects (n = 59, 84.3%), followed by coiled tails (n = 14, 20.3%). Count, concentration, motility, and progressive motility were normal in >90% of patients. Conclusions More than half (55.9%) of fertile male patients had lower than normal sperm morphology in our study. The results of our study further question the clinical relevance of sperm morphology on fertility outcomes and when the current approach in assessing morphology is too strict.
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Affiliation(s)
- Lucille G Cheng
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David Miller
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Daniel Pelzman
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Anna Wecht
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Kathleen Hwang
- Department of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Jia YL, Wu YB, Yu L, Zheng Y, Yang TT, Wang YY, Zhou B, Zhang L, Li FP. Normal sperm head morphometric reference values in fertile Asian males. Asian J Androl 2024; 26:315-320. [PMID: 38048168 PMCID: PMC11156450 DOI: 10.4103/aja202356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/21/2023] [Indexed: 12/06/2023] Open
Abstract
Sperm head morphology is crucial for male factor infertility diagnosis and assessment of male reproductive potential. Several criteria are available to analyze sperm head morphology, but they are limited by poor methodology comparability and population applicability. This study aimed to explore comprehensive and new normal morphometric reference values for spermatozoa heads in fertile Asian males. An automated sperm morphology analysis system captured 23 152 stained spermatozoa from confirmed fertile males. Of these samples, 1856 sperm head images were annotated by three experienced laboratory technicians as "normal". We employed 14 novel morphometric features to describe sperm head size (head length, head width, length/width ratio, and girth), shape (ellipse intersection over union, girth intersection over union, short-axis symmetry, and long-axis symmetry), area (head, acrosome, postacrosomal areas, and acrosome area ratio), and degrees of acrosome and nuclear uniformity. This straight-forward method for the morphometric analysis of sperm by accurate visual measurements is clinically applicable. The measured parameters present valuable information to establish morphometric reference intervals for normal sperm heads in fertile Asian males. The presented detailed measurement data will be valuable for interlaboratory comparisons and technician training. In vitro fertilization and andrology laboratory technicians can use these parameters to perform objective morphology evaluation when assessing male fertilization potential.
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Affiliation(s)
- Ye-Lin Jia
- Laboratory of Andrology, West China Second University Hospital Human Sperm Bank, Chengdu 610000, China
| | - Ying-Bi Wu
- Laboratory of Andrology, West China Second University Hospital Human Sperm Bank, Chengdu 610000, China
| | - Lin Yu
- Laboratory of Andrology, West China Second University Hospital Human Sperm Bank, Chengdu 610000, China
| | - Yan Zheng
- Laboratory of Andrology, West China Second University Hospital Human Sperm Bank, Chengdu 610000, China
| | - Ting-Ting Yang
- Laboratory of Andrology, West China Second University Hospital Human Sperm Bank, Chengdu 610000, China
| | - Yan-Yun Wang
- Laboratory of Molecular Translational Medicine, Center for Translational Medicine, Chengdu 610061, China
| | - Bin Zhou
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610061, China
| | - Lin Zhang
- NHC Key Laboratory of Chronobiology, West China Second University Hospital, Sichuan University, Chengdu 610000, China
| | - Fu-Ping Li
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610061, China
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Pelzman DL, Sandlow JI. Sperm morphology: Evaluating its clinical relevance in contemporary fertility practice. Reprod Med Biol 2024; 23:e12594. [PMID: 38915912 PMCID: PMC11194684 DOI: 10.1002/rmb2.12594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/06/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024] Open
Abstract
Background The World Health Organization (WHO) recommends reporting sperm morphology in a standard semen analysis. However, the clinical utility and prognostic value of morphology is often debated. Methods We reviewed and summarized studies that assessed both the benefits and limitations of sperm morphology in the context of natural fertility, assisted reproductive technologies, and recurrent pregnancy loss. We additionally describe possible environmental and anatomical etiologies of teratozoospermia. Results Sperm morphology evaluation has continuously evolved since the release of the first WHO manual in 1980. Initially, several large studies reported significant inverse associations between fertility outcomes and teratozoospermia. Most recent studies, however, fail to show an association between sperm morphology and natural or assisted fertility outcomes. Conclusion Sperm morphology analysis may have limited diagnostic and prognostic value. Providers should be aware of these limitations when counseling or managing infertile patients.
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Affiliation(s)
- Daniel L. Pelzman
- Department of UrologyMedical College of WisconsinMilwaukeeWisconsinUSA
| | - Jay I. Sandlow
- Department of UrologyMedical College of WisconsinMilwaukeeWisconsinUSA
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Gómez-Torres MJ, Luna-Romero J, Fernández-Colom PJ, Aizpurua J, Avilés M, Romero A. Human Sperm Head Vacuoles Are Related to Nuclear-Envelope Invaginations. Int J Mol Sci 2023; 24:10027. [PMID: 37373176 DOI: 10.3390/ijms241210027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 05/30/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
Nuclear vacuoles are specific structures present on the head of the human sperm of fertile and non-fertile men. Human sperm head vacuoles have been previously studied using motile sperm organelle morphology examination (MSOME) and their origin related to abnormal morphology, abnormal chromatin condensation and DNA fragmentation. However, other studies argued that human sperm vacuoles are physiological structures and consequently, to date, the nature and origin of the nuclear vacuoles remains to be elucidated. Here, we aim to define the incidence, position, morphology and molecular content of the human sperm vacuoles using transmission electron microscopy (TEM) and immunocytochemistry techniques. The results showed that ~50% of the analyzed human sperm cells (n = 1908; 17 normozoospermic human donors) contained vacuoles mainly located (80%) in the tip head region. A significant positive correlation was found between the sperm vacuole and nucleus areas. Furthermore, it was confirmed that nuclear vacuoles were invaginations of the nuclear envelope from the perinuclear theca and containing cytoskeletal proteins and cytoplasmic enzyme, discarding a nuclear or acrosomal origin. According to our findings, these human sperm head vacuoles are cellular structures originating from nuclear invaginations and contain perinuclear theca (PT) components, allowing us to define a new term of 'nuclear invaginations' rather than 'nuclear vacuoles'.
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Affiliation(s)
- María José Gómez-Torres
- Departamento de Biotecnología, Facultad de Ciencias, Universidad de Alicante, 03690 Alicante, Spain
- Cátedra Human Fertility, Universidad de Alicante, 03690 Alicante, Spain
| | - Javier Luna-Romero
- Departamento de Biotecnología, Facultad de Ciencias, Universidad de Alicante, 03690 Alicante, Spain
| | - Pedro José Fernández-Colom
- Departamento de Ginecología (Medicina Reproductiva), Hospital Universitario y Politécnico La Fe, 46026 Valencia, Spain
| | - Jon Aizpurua
- Cátedra Human Fertility, Universidad de Alicante, 03690 Alicante, Spain
- IVF Spain, Reproductive Medicine, 03540 Alicante, Spain
| | - Manuel Avilés
- Departamento de Biología Celular e Histología, Facultad de Medicina, Universidad de Murcia IMIB-Arrixaca, Campus Mare Nostrum, 30100 Murcia, Spain
| | - Alejandro Romero
- Departamento de Biotecnología, Facultad de Ciencias, Universidad de Alicante, 03690 Alicante, Spain
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Ghorbaninejad Z, Eghbali A, Ghorbaninejad M, Ayyari M, Zuchowski J, Kowalczyk M, Baharvand H, Shahverdi A, Eftekhari-Yazdi P, Esfandiari F. Carob extract induces spermatogenesis in an infertile mouse model via upregulation of Prm1, Plzf, Bcl-6b, Dazl, Ngn3, Stra8, and Smc1b. JOURNAL OF ETHNOPHARMACOLOGY 2023; 301:115760. [PMID: 36209951 DOI: 10.1016/j.jep.2022.115760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ethnopharmacological studies for drug discovery from natural compounds play an important role for developing current therapeutical platforms. Plants are a group of natural sources which have been served as the basis in the treatment of many diseases for centuries. In this regard, Ceratonia siliqua (carob) is one of the herbal medicine which is traditionally used for male infertility treatments. But so far the main mechanisms for effects of carob are unknown. Here, we intend to investigate the ability of carob extract to induce spermatogenesis in an azoospermia mouse model and determine the mechanisms that underlie its function. AIM OF THE STUDY This is a pre-clinical animal model study to evaluate the effect of carob extract in spermatogenesis recovery. METHODS We established an infertile mouse model with the intent to examine the ability of carob extract as a potential herbal medicine for restoration of male fertility. Sperm parameters, as well as gene expression dynamics and levels of spermatogenesis hormones, were evaluated 35 days after carob administration. RESULTS Significant enhanced sperm parameters (P < 0.05) showed that the carob extract could induce spermatogenesis in the infertile mouse model. Our data suggested an anti-apototic and inducer role in the expressions of cell cycle regulating genes. Carob extract improved the spermatogenesis niche by considerable affecting Sertoli and Leydig cells (P < 0.05). The carob-treated mice were fertile and contributed to healthy offspring that matured. Our data confirmed that this extract triggered the hormonal system, the spermatogenesis-related gene expression network, and signaling pathways to induce and promote sperm production with notable level (P < 0.05). We found that the aqueous extract consisted of a polar and mainly well water-soluble substance. Carob extract might upregulate spermatogenesis hormones via its amino acid components, which were detected in the extract by liquid chromatography-mass spectrometry (LC-MS). CONCLUSION Our results strongly suggest that carob extract might be a promising future treatment option for male infertility. This finding could pave the way for clinical trials in infertile men. This is the first study that has provided reliable, strong pre-clinical evidence for carob extract as an effective candidate for fertility recovery in cancer-related azoospermia.
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Affiliation(s)
- Zeynab Ghorbaninejad
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; Department of Developmental Biology, University of Science and Culture, Tehran, Iran; Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Atiyeh Eghbali
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; Department of Developmental Biology, University of Science and Culture, Tehran, Iran; Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahsa Ghorbaninejad
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; Department of Genetics, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Mahdi Ayyari
- Department of Horticultural Science, Tarbiat Modares University, Tehran, Iran
| | - Jerzy Zuchowski
- Department of Biochemistry and Crop Quality, Institute of Soil Science and Plant Cultivation, State Research Institute, Puławy, Poland
| | - Mariusz Kowalczyk
- Department of Biochemistry and Crop Quality, Institute of Soil Science and Plant Cultivation, State Research Institute, Puławy, Poland
| | - Hossein Baharvand
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; Department of Developmental Biology, University of Science and Culture, Tehran, Iran
| | - Abdolhossein Shahverdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
| | - Poopak Eftekhari-Yazdi
- Department of Embryology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
| | - Fereshteh Esfandiari
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Kups M, Gill K, Rosiak-Gill A, Harasny P, Machalowski T, Grabowska M, Kurzawa R, Sipak O, Piasecka M. Evaluation of selected semen parameters and biomarkers of male infertility - preliminary study. F1000Res 2022; 11:591. [PMID: 38434001 PMCID: PMC10905134 DOI: 10.12688/f1000research.121622.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 03/05/2024] Open
Abstract
Background: Because the etiopathogenesis of male infertility is multifactorial our study was designed to clarify the relationship between standard semen parameters, testicular volume, levels of reproductive hormones and the fragmentation of sperm nuclear DNA (SDF). Methods: Patients (n = 130) were clustered as subjects: 1) with an abnormal volume (utrasonography) of at least one testis (<12 mL) or with a normal volume of testes and 2) with abnormal levels of at least one of the reproductive hormones (FSH, LH, PRL, TSH, total T - electrochemiluminescence method) or with normal hormonal profiles and 3) with high level of SDF (>30%), moderate (>15-30%) or low (≤15%) (sperm chromatin dispersion test). Results: In subjects with a decreased testicular volume and in subjects with abnormal levels of reproductive hormones, decreased basic semen parameters were found. Participants with abnormal testicular volume had a higher percentage of SDF and a higher level of FSH (Mann-Whitney U test). In turn, men with a high level of SDF had lower testicular volume and conventional sperm parameters than men with a low level of SDF (Kruskal-Wallis test). Conclusions: We showed that spermatogenesis disorders coexisted with decreased testicular volume and increased FSH levels. The disorders of spermatogenesis were manifested by reduced basic sperm characteristics and a high level of sperm nuclear DNA damage.
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Affiliation(s)
- Michal Kups
- The Fertility Partnership Vitrolive in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-483, Poland
- Department of Urology and Oncological Urology, Regional Specialist Hospital in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-455, Poland
| | - Kamil Gill
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Aleksandra Rosiak-Gill
- The Fertility Partnership Vitrolive in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-483, Poland
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Patryk Harasny
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
- Department of Urology and Urological Oncology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-111, Poland
| | - Tomasz Machalowski
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
- Department of Perinatology, Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Pomeranian Medical University in Szczecin, Police, West Pomeranian Voivodeship, 72-010, Poland
| | - Marta Grabowska
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Rafal Kurzawa
- The Fertility Partnership Vitrolive in Szczecin, Szczecin, West Pomeranian Voivodeship, 70-483, Poland
- Department of Gynecology and Reproductive Health, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Olimpia Sipak
- Department of Obstetrics and Pathology of Pregnancy, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
| | - Malgorzata Piasecka
- Department of Histology and Developmental Biology, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, Szczecin, West Pomeranian Voivodeship, 71-210, Poland
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Ernandez J, Gu C, Kathrins M. Awareness and reporting of globozoospermia among in vitro fertilization and andrology laboratories: A national survey. Andrologia 2022; 54:e14474. [PMID: 35587120 DOI: 10.1111/and.14474] [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: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/28/2022] [Indexed: 11/30/2022] Open
Abstract
Globozoospermia (GZ) is a rare disorder found in less than 0.1% of infertile men in which spermatozoa lack acrosomes necessary for penetration of an oocyte. While methods have been demonstrated to allow globozoospermic men to achieve a viable pregnancy with their partner, the Wold Health Organization considers identifying and reporting GZ on semen analysis to be 'important'. Our study aims to determine if and to what extent in vitro fertilization (IVF) laboratories nationwide recognize and report GZ on semen analysis reports. We constructed an IRB-approved survey sent nationwide to IVF and andrology clinic laboratory directors listed by the Society for Assisted Reproductive Technology and/or the American Society for Reproductive Medicine. Results from the survey were de-identified for analysis. A total of 490 surveys were sent with a response rate of 10% (n = 51). Most respondents (66%) practiced in a private, rather than academic, setting. A majority of respondents were confident in their technicians' knowledge of GZ (86%) and ability to identify it on a sample (94%). However, only half of respondents noted a space to report the concern for GZ to the ordering physician, and 25% of respondents did not feel their clinic was able to identify patients where there is a concern for GZ. Similarly, 84% of respondents did not report a percent of acrosome-deficient sperm. Less than half of respondents reported that their clinic has previously diagnosed GZ. Though the majority of respondents felt that their laboratory technicians would be able to identify GZ, a significant minority felt that their clinic did not have means to be able to report concern for GZ. This may be due to the absence of a proper channel to report a concern for GZ, a lack of knowledge about the condition, or failure to distinguish GZ from a broader reported percentage of morphologically abnormal sperm. Given evidence that the diagnosis of GZ may be under-reported in the United States, there should be a national standard for laboratory technicians to be trained to recognize GZ and be able to report their suspicion to the ordering clinician.
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Affiliation(s)
- John Ernandez
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Catherine Gu
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Martin Kathrins
- Division of Urology, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Kleshchev M, Osadchuk A, Osadchuk L. Impaired semen quality, an increase of sperm morphological defects and DNA fragmentation associated with environmental pollution in urban population of young men from Western Siberia, Russia. PLoS One 2021; 16:e0258900. [PMID: 34679097 PMCID: PMC8535459 DOI: 10.1371/journal.pone.0258900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/08/2021] [Indexed: 01/01/2023] Open
Abstract
Poor sperm morphology and an elevated DNA fragmentation level are considered to be related to spermiogenesis malfunctions as a result of genetic mutations and effects of environmental factors, including industrial pollution. Standardized cross-sectional population studies of sperm morphology defects and sperm DNA fragmentation, especially in regions with increased environmental pollution may be helpful to investigate an influence of industrial pollution and other population-related factors on spermiogenesis process. The aim of present study was to estimate an influence industrial pollution on sperm morphogenesis and sperm DNA fragmentation in men from the general population of the Western Siberia. The Novosibirsk and Kemerovo cities are located to same climatic conditions in Western Siberia but the Kemerovo city is characterized by increased environmental pollution especially by particulate matter (PM). The male volunteers living in Novosibirsk (n = 278) and Kemerovo (n = 258) were enrolled. Percentages of sperm morphological defects are counted after staining native ejaculate smears by Diff-Quick kits. DNA fragmentation was estimated by a SCSA technique. The residents of Kemerovo were characterized by lowered sperm count and sperm motility, elevated DNA fragmentation, poor sperm morphology and increased incidence of morphological effects of head (pyriform, elongated, round, abnormal acrosome and vacuolated chromatine), asymmetrical neck insertion and excess residual cytoplasm. Moreover, elevated DNA fragmentation was associated with lowered sperm count, sperm motility and increased percentages of several sperm morphology defects, with the place of residence affecting the relationships between conventional semen parameters, sperm morphology and DNA fragmentations. Our study suggests that excessive sperm head elongation and impaired acrosome formation can contribute to sperm morphology deterioration in men from polluted areas. Regional features in the relationships between sperm morphology, sperm count and DNA fragmentation were shown, suggesting an importance of studying sperm morphology pattern in men from different regions.
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Affiliation(s)
- Maxim Kleshchev
- Department of Human Molecular Genetic, Federal Research Center ‘Institute of Cytology and Genetics’, the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
- * E-mail:
| | - Alexander Osadchuk
- Department of Human Molecular Genetic, Federal Research Center ‘Institute of Cytology and Genetics’, the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Ludmila Osadchuk
- Department of Human Molecular Genetic, Federal Research Center ‘Institute of Cytology and Genetics’, the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
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Candela L, Boeri L, Capogrosso P, Cazzaniga W, Pozzi E, Belladelli F, Baudo A, Ravizzoli A, Ventimiglia E, Viganò P, Alfano M, Abbate C, Cornelius J, Mattei A, Montorsi F, Salonia A. Correlation among isolated teratozoospermia, sperm DNA fragmentation and markers of systemic inflammation in primary infertile men. PLoS One 2021; 16:e0251608. [PMID: 34097690 PMCID: PMC8184012 DOI: 10.1371/journal.pone.0251608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/28/2021] [Indexed: 01/03/2023] Open
Abstract
Aim To assess the prevalence of isolated teratozoospermia (iTZS) in a cohort of infertile and fertile men; explore the relationship between iTZS, inflammatory parameters and sperm DNA fragmentation index (SDF) in the same cohort. Materials and methods 1824 infertile men and 103 fertile controls. Semen analysis, the neutrophil-to-lymphocyte ratio (NLR) and serum hormones were investigated. DFI was tested in infertile men only. According to 2010 WHO semen analysis, patients were categorized in 3 sub-groups of isolated sperm defects: isolated oligozoospermia (iOZS), isolated asthenozoospermia (iAZS) and iTZS. Descriptive statistics and linear regression models tested the association between clinical variables and inflammatory markers. Results Among infertile men, iAZS, iTZS, and iOZS were found in 13.9%, 11.9% and 4.1% participants, respectively. iTZS was found in 37 (35.9%) fertile men. Infertile men with iTZS had higher NLR values than those with iOZS, iAZS and men with normal semen parameters (all p<0.001). FSH and LH were higher and inhibin B lower in iOZS infertile men compared to all other groups (p≤0.001). Hormonal characteristics were similar between iTZS infertile and fertile men. Similarly, iTZS infertile men had higher SDF than all other groups (all p<0.001). Infertile men with iTZS had higher NLR values than fertile men with iTZS (p<0.01). Linear regression analysis showed that, in infertile men, iTZS was associated with SDF and NLR (all p≤0.01). Conclusions iTZS was found in 11.9% of infertile men but it was even more prevalent in fertile controls. Infertile men with iTZS had higher NLR than fertile controls and increased SDF values than infertile participant with iAZS, iOZS, or normal semen parameters. No differences in hormonal characteristics were found between infertile and fertile men with iTZS.
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Affiliation(s)
- Luigi Candela
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology, Foundation IRCCS Ca’ Granda–Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology and Andrology, Ospedale di Circolo and Macchi Foundation,Varese, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Federico Belladelli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Baudo
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Ravizzoli
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Obstetrics and Gynaecology Department, IRCCS Ospedale San Raffaele, Milan, Italy
- Division of Genetics and Cell Biology, Reproductive Sciences Laboratory, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Costantino Abbate
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Julian Cornelius
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Agostino Mattei
- Department of Urology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
- University Vita-Salute San Raffaele, Milan, Italy
- * E-mail:
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12
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Wald G, Punjani N, Hayden R, Feliciano M, Dudley V, Goldstein M. Assessing the clinical value of the Kruger strict morphology criteria over the World Health Organization fourth edition criteria. F S Rep 2021; 2:176-180. [PMID: 34278351 PMCID: PMC8267392 DOI: 10.1016/j.xfre.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To assess if the newer Kruger strict morphology (WHO5; normal ≥4%) adds any clinical value beyond the criteria of the World Health Organization fourth edition (WHO4; normal ≥14%). Design Retrospective study. Setting Tertiary hospital. Patients Men without known azoospermia who had semen analysis (SA) collected over a 10-year period of time. Interventions Morphology classification under Kruger WHO5 strict criteria and WHO4 criteria. Main Outcome Measures Correlation between the WHO5 and WHO4 morphological classifications. Results A total of 4,510 SAs were identified during the study period. Of these, both Kruger WHO5 and WHO4 morphologies were included in 932 SAs (20.7%) from a total of 691 men. The median age of the men was 37 years (interquartile range, 32.0-43.8 years). The mean (±SD) semen volume, sperm concentration, and motility were 2.6 ± 1.4 mL, 50.0 ± 35.6 × 106/mL, and 53.1% ± 18.6%, respectively. The correlation between the WHO4 and WHO5 morphology assessments was high (Spearman correlation coefficient = 0.94). Only 545 (58.5%) of 932 SAs had abnormal Kruger WHO5 morphology, of which 543 (99.6%) of 545 also had abnormal morphology by the WHO4 criteria. Conclusions The Kruger WHO5 and WHO4 morphologic criteria correlate closely. Only two men (0.4%) with an abnormal Kruger morphology had normal WHO4 morphology. Given the limited predictive value of sperm morphology, the additional cost and effort of Kruger criteria may not be warranted in lieu of, or in addition to, the WHO4 classification.
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Affiliation(s)
- Gal Wald
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York
| | - Nahid Punjani
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York
| | - Russell Hayden
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York
| | - Miriam Feliciano
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York
| | - Vanessa Dudley
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York
| | - Marc Goldstein
- Center for Reproductive Medicine and Surgery, Institute for Reproductive Medicine and Department of Urology, Weill Cornell Medicine, New York, New York
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13
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Mazaheri Moghaddam M, Mazaheri Moghaddam M, Hamzeiy H, Baghbanzadeh A, Pashazadeh F, Sakhinia E. Genetic basis of acephalic spermatozoa syndrome, and intracytoplasmic sperm injection outcomes in infertile men: a systematic scoping review. J Assist Reprod Genet 2021; 38:573-586. [PMID: 33452591 DOI: 10.1007/s10815-020-02008-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/08/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Acephalic spermatozoa syndrome (ASS) is known as a severe type of teratozoospermia, defined as semen composed of mostly headless spermatozoa that affect male fertility. In this regard, this systematic review aimed to discuss gene variants associated with acephalic spermatozoa phenotype as well as the clinical outcomes of intracytoplasmic sperm injection (ICSI) treatment for the acephalic spermatozoa-associated male infertility. METHODS A systematic search was performed on PubMed, Embase, Scopus, and Ovid databases until May 17, 2020. This systematic scoping review was reported in terms of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) statement. RESULTS Twenty articles were included in this systematic review. Whole-exome and Sanger sequencing have helped in the identification of variants in SUN5, PMFBP1, BRDT, TSGA10, DNAH6, HOOK1, and CEP112 genes as possible causes of this phenotype in humans. The results of the ICSI are conflicting due to both positive and negative reports of ICSI outcomes. CONCLUSION ASS has a genetic origin, and several genetic alterations related to the pathogenesis of this anomaly have been recently identified. Notably, only SUN5 and PMFBP1 mutations are well-known to be implicated in ASS. Accordingly, more functional studies are needed to confirm the pathogenicity of other variants. ICSI could provide a promising treatment for acephalic spermatozoa-associated male infertility. Besides the importance of sperm head-tail junction integrity, some other factors, whether within the sperm cell or female factors, may be involved in the ICSI outcome.
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Affiliation(s)
- Marziyeh Mazaheri Moghaddam
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Madiheh Mazaheri Moghaddam
- Department of Genetics and Molecular Medicine, School of Medicine, Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran
| | - Hamid Hamzeiy
- Tabriz Genetic Analysis Centre (TGAC), Tabriz University of Medical Sciences, Tabriz, Iran.,Genomize Inc., Istanbul, Turkey
| | - Amir Baghbanzadeh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fariba Pashazadeh
- Research Center for Evidence-Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ebrahim Sakhinia
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. .,Tabriz Genetic Analysis Centre (TGAC), Tabriz University of Medical Sciences, Tabriz, Iran.
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14
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Zhao W, Jing J, Shao Y, Zeng R, Wang C, Yao B, Hang D. Circulating sex hormone levels in relation to male sperm quality. BMC Urol 2020; 20:101. [PMID: 32680497 PMCID: PMC7367383 DOI: 10.1186/s12894-020-00674-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 07/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although sex hormones play critical roles in spermatogenesis and sperm maturation, it remains inconclusive whether circulating sex hormones can serve as non-invasive biomarkers to improve the assessment of sperm quality. METHODS We systematically evaluated the association of various sex hormones in serum with sperm quality among 338 men in subfertile couples. Concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH), total testosterone (TT), total estradiol (E2), and sex hormone-binding globulin (SHBG) were detected by chemiluminescent immunoassay. Free testosterone and estradiol were calculated using a validated algorithm. A generalized liner regression model controlling for lifestyle factors was used to evaluate the associations with sperm count, concentration, motility, and morphology. RESULTS After adjusting for age, body mass index, current smoking and alcohol drinking, LH, FSH, and TT levels were all inversely associated with sperm motility (all P for trend < 0.05); however, in mutual adjustment analysis, only LH remained an inverse association with sperm motility after adjusting for FSH and TT levels (P for trend = 0.04). Higher concentrations of LH were also associated with lower sperm progressive motility (P for trend = 0.04). Moreover, LH and FSH levels were both inversely associated with normal sperm morphology (P for trend = 0.04 and 0.02, respectively). CONCLUSIONS Increased levels of LH are associated with poor sperm motility and morphology, suggesting that LH may play a central role in sperm maturation. Future studies are warranted to assess potential clinical utility of LH for risk stratification and tailed prevention of male infertility.
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Affiliation(s)
- Wei Zhao
- Reproductive Medical Center, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, China
| | - Jun Jing
- Reproductive Medical Center, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, China
| | - Yong Shao
- Reproductive Medical Center, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, China
| | - Rong Zeng
- Reproductive Medical Center, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, China
| | - Cencen Wang
- Reproductive Medical Center, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, China
| | - Bing Yao
- Reproductive Medical Center, Jinling Hospital Affiliated Medical School of Nanjing University, Nanjing, China.
- Reproductive Medical Centre, Nanjing Jinling Hospital, Nanjing University School of Medicine, 305 Zhongshan East Road, Nanjing, 210002, Jiangsu, China.
| | - Dong Hang
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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15
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Farber NJ, Madhusoodanan VK, Gerkowicz SA, Patel P, Ramasamy R. Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist. ACTA ACUST UNITED AC 2019; 2. [PMID: 31723937 DOI: 10.21037/gpm.2019.09.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Obstetricians and gynecologists, and in particular reproductive endocrinologists (REIs), are typically the gatekeepers and first-line providers for couples initially seeking an infertility evaluation. A timely referral to a reproductive urologist may improve pregnancy outcomes in certain clinical scenarios. This review examines the evidence behind circumstances requiring referral and delivers practice-based recommendations on commonly encountered scenarios in the clinic. Scenarios that should prompt referral to a reproductive urologist include semen analysis (SA) abnormalities (e.g., asthenozoospermia, azoospermia, globozoospermia, leukocytospermia, necrozoospermia, oligospermia), recurrent intrauterine insemination (IUI)/in vitro fertilization (IVF) failure, and idiopathic recurrent pregnancy loss (RPL). Conversely, deferment is appropriate in the cases of isolated teratozoospermia and subclinical varicocele. Men with infertility are also at higher risk for other comorbid conditions and should have at least a baseline evaluation by a primary care physician. Coordination of care between a REI and reproductive urologist is critical in several clinical scenarios and expedient referral can improve reproductive outcomes.
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Affiliation(s)
- Nicholas J Farber
- Department of Urology, Cleveland Clinic Foundation, The Glickman Urological & Kidney Institute, Cleveland, OH, USA
| | | | | | - Premal Patel
- Department of Urology, University of Miami, Miami, FL, USA
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16
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Danis RB, Samplaski MK. Sperm Morphology: History, Challenges, and Impact on Natural and Assisted Fertility. Curr Urol Rep 2019; 20:43. [PMID: 31203470 DOI: 10.1007/s11934-019-0911-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW The classification of morphologically normal sperm has been progressively redefined. Concurrently, our understanding of the significance of sperm morphology in relation to male factor infertility has evolved. In this review, we will discuss the evolution of sperm morphology assessment and factors that contribute to its measurement variability. We will examine the impact of sperm morphology on natural pregnancy, IUI, IVF, and ICSI outcomes. RECENT FINDINGS There is a lack of consensus on sperm morphology classification, technique, and inter-observer grading variability. Current evidence suggests sperm morphology has low predictive value for pregnancy success, for both natural and assisted reproduction. Additionally, the threshold for what is considered an adequate percentage of morphologically normal sperm has changed over time. These variables have called into question the relevance of this variable in predicting fertility outcomes. Our understanding of the impact of sperm morphology on reproductive outcomes continues to evolve and seems to play less of a role than initially thought.
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Affiliation(s)
- Rachel B Danis
- Division of Reproductive Endocrinology, University of Southern California, 2020 Zonal Avenue, IRD 534, Los Angeles, CA, 90033, USA.
| | - Mary K Samplaski
- Institute of Urology, University of Southern California, 1441 Eastlake Avenue, Suite 7416, Los Angeles, CA, 90089, USA
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17
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Microfluidic Devices for Gamete Processing and Analysis, Fertilization and Embryo Culture and Characterization. Bioanalysis 2019. [DOI: 10.1007/978-981-13-6229-3_7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
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18
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Razavi S, Khadivi F, Hashemi F, Bakhtiari A. Effect of Zinc on Spermatogenesis and Sperm Chromatin Condensation in Bleomycin, Etoposide, Cisplatin Treated Rats. CELL JOURNAL 2018; 20:521-526. [PMID: 30123998 PMCID: PMC6099135 DOI: 10.22074/cellj.2019.5522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/29/2018] [Indexed: 11/04/2022]
Abstract
Objective The incidence rate of testicular cancer among young males is high. Co-administration of bleomycin, etoposide
and cisplatin (BEP) has increased survival rate of patients with testicular cancer. Although BEP is one of the most effective
treatment for testicular cancer, but it severely affects the reproductive system that ultimately leads to infertility. In addition to its
antioxidant activity, zinc has an important role in progression of spermiogenesis. This study aimed to evaluate the effect of zinc
on sperm parameters, chromatin condensation and testicular structure after BEP treatment.
Materials and Methods In this experimental study, 40 male rats were divided into 4 groups (control, BEP, BEP+ zinc and
zinc) and examined for 2 spermatogenesis periods (i.e. 18 weeks). The rats in BEP and BEP+ zinc group were treated with
BEP at appropriate doses (0.75, 7.5, and 1.5 mg/kg) for three cycles of three weeks. Zinc at a dose of 10 mg/kg/day was
administered to BEP+ zinc and zinc groups. After 18 weeks, we assessed sperm parameters, and excessive histone in sperm
chromatin using aniline blue staining, as well as testicular structure and germ line cells using periodic acid-Schiff staining.
Results After BEP treatment, significant decreases were observed in normal sperm morphology, motility, and
concentration, as well as alterations in rat sperm chromatin condensation and testicular tissue (P<0.001). Furthermore,
after zinc consumption for 9 weeks, we observed significant improvements of sperm parameters and chromatin
condensation as well as a significant retrieval of spermatogonia, leydig cells and tubular architecture (P<0.05).
Conclusion Zinc administration after chemotherapy with BEP in testicular cancer might be potentially useful in declining the
off target consequence associated with oxidative stress.
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Affiliation(s)
- Shahnaz Razavi
- Department of Anatomical Science, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Farnaz Khadivi
- Department of Anatomical Science, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.,Department of Anatomical Science, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hashemi
- Department of Anatomical Science, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Bakhtiari
- Department of Anatomical Science, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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19
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Paul F, Obajimi GO, Kolade CO. Is semen analysis without strict criteria misleading decisions in IVF? A prospective systematic study. Int J Reprod Biomed 2018; 16:459-462. [PMID: 30234187 PMCID: PMC6129371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Sperm morphology has been strongly linked to fertilization. This makes it an important component in semen analysis. They are usually assessed by world health organization (WHO) standard or Kruger strict criteria in in-vitro fertilization (IVF) centers all over the world. Sperm count, motility, and morphology together form the basis by which patients are allocated into IVF or intra-cytoplasmic sperm injection. OBJECTIVE This study aimed to compare fertilization rates in standard IVF from patients with normal sperm count and motility with and without morphological assessment by WHO guideline. MATERIALS AND METHODS In this prospective cohort study, sperm count, motility, and morphology of 504 men candidate for IVF program over a three years period in our center were evaluated in two groups: Group A (case group) included men with normal sperm count and motility but with a poor morphology and group B (control group) included men with normal sperm count, motility and morphology evaluated by WHO criteria. Fertilization rate in both groups were then analyzed after 16-18 hr post insemination. RESULTS Fertilization rate was higher in group B (p=0.028). Participants in group B, apart from having a normal sperm count (32.9±7.2) and motility (62.4±8.9), have a strict morphology of ≥30%. Our result has shown that spermatozoa in group B had a higher fertilization rate (71.4%). Though the sperm count (36.4±6.7) and motility (66.3±7.4) in group A were slightly higher (p=0.058 and p=0.060 respectively) than group B, the fertilization rate was lower. CONCLUSION Our study showed that sperm morphology could be a very important consideration before decisions towards allocation of patients into IVF or intra-cytoplasmic sperm injection.
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Affiliation(s)
- Faduola Paul
- Vine Branch Fertility Clinic, Mokola, Ibadan, Nigeria.
| | - Gbolahan Oladele Obajimi
- University of Ibadan, College of Medicine, Department of Obstetrics and Gynaecology and University College Hospital, Ibadan, Nigeria.
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20
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Piccolomini MM, Bonetti TC, Motta EL, Serafini PC, Alegretti JR. How general semen quality influences the blastocyst formation rate: Analysis of 4205 IVF cycles. JBRA Assist Reprod 2018; 22:89-94. [PMID: 29672007 PMCID: PMC5982551 DOI: 10.5935/1518-0557.20180022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective To select embryos with higher implantation potential, the extended culture
has been the most frequently applied strategy worldwide, and consequently
leads to higher live birth rates per transfer. Sperm quality is a
determining feature, and it may influence the outcomes of IVF from
fertilization to embryo development. Therefore, we hypothesize that
blastocyst formation may also be impaired by general semen quality. Methods We analyzed 4205 IVF cycles. Four study groups were designed according to
semen quality: normal, mild alteration, severe alteration and epididymis.
All cycles were intended to extend embryo culture until the blastocyst
stage, and embryo development was evaluated. Results Regarding cleavage rate, the normal and mild alteration semen groups were
equivalent, and the severe alteration and epididymis semen groups were
equivalent to each other. The blastocyst formation rate decreased with semen
quality. At least one blastocyst formed in 79.9% of cycles for the normal
semen group, whereas the percentage of cycles with the formation of at least
one blastocyst was slightly lower for the mild alteration (75.6%), severe
alteration (76.4%) and epididymis (76.8%) semen groups. A multivariate
logistic regression showed that for each additional cleaved embryo on day 3,
the chance of having at least one blastocyst doubles. Additionally, the
chance of having at least one blastocyst decreased when semen presented mild
or severe alterations. Conclusion The general quality of sperm is a good predictor of blastocyst formation,
significantly affecting the likelihood of having at least one blastocyst at
the end of the cycle. Based on our findings, it is necessary to consider
general semen quality and the number of cleaved embryos when forecasting the
possibility of blastocyst formation and transfer in an extended culture
system.
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Affiliation(s)
| | - Tatiana Cs Bonetti
- Huntington - Medicina Reprodutiva. São Paulo, Brazil.,Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, Brazil
| | - Eduardo La Motta
- Huntington - Medicina Reprodutiva. São Paulo, Brazil.,Disciplina de Ginecologia Endocrinológica, Departamento de Ginecologia, Escola Paulista de Medicina da Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, Brazil
| | - Paulo C Serafini
- Huntington - Medicina Reprodutiva. São Paulo, Brazil.,Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo (FMUSP). São Paulo, Brazil
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21
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Clinical assessment of the male fertility. Obstet Gynecol Sci 2018; 61:179-191. [PMID: 29564308 PMCID: PMC5854897 DOI: 10.5468/ogs.2018.61.2.179] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 09/06/2017] [Accepted: 09/26/2017] [Indexed: 02/08/2023] Open
Abstract
The evaluation of infertility in males consists of physical examination and semen analyses. Standardized semen analyses depend on the descriptive analysis of sperm motility, morphology, and concentration, with a threshold level that must be surpassed to be considered a fertile spermatozoon. Nonetheless, these conventional parameters are not satisfactory for clinicians since 25% of infertility cases worldwide remain unexplained. Therefore, newer tests methods have been established to investigate sperm physiology and functions by monitoring characteristics such as motility, capacitation, the acrosome reaction, reactive oxygen species, sperm DNA damage, chromatin structure, zona pellucida binding, and sperm-oocyte fusion. After the introduction of intracytoplasmic sperm injection technique, sperm maturity, morphology, and aneuploidy conditions have gotten more attention for investigating unexplained male infertility. In the present article, recent advancements in research regarding the utilization of male fertility prediction tests and their role and accuracy are reviewed.
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22
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Agarwal A, Bui AD. Oxidation-reduction potential as a new marker for oxidative stress: Correlation to male infertility. Investig Clin Urol 2017; 58:385-399. [PMID: 29124237 PMCID: PMC5671957 DOI: 10.4111/icu.2017.58.6.385] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 10/15/2017] [Indexed: 01/08/2023] Open
Abstract
Male infertility affects men worldwide. Oxidative stress (OS), characterized by an overabundance of reactive oxygen species (ROS) or a deficiency of antioxidants, is one of the major causes of male infertility. OS causes damage at the molecular level, which impairs lipids, proteins, and DNA. The cyclic cascade of redox reactions weakens sperm function which leads to poor semen parameters and eventual sterility. There is a need for advanced diagnostic tests that can quickly and accurately detect OS. Most commonly used assays can only measure single constituents of OS. However, the MiOXSYS System introduces a new strategy to detect OS by measuring the oxidation-reduction potential (ORP)--a direct evaluation of the redox balance between ROS and antioxidants. The MiOXSYS System has shown promise as a diagnostic tool in the evaluation of male infertility. This review explores the concept of ORP, details the principle of the MiOXSYS System, and summarizes the findings in clinical studies that support ORP measurement in semen.
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Affiliation(s)
- Ashok Agarwal
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA
| | - Albert Danh Bui
- American Center for Reproductive Medicine, Department of Urology, Cleveland Clinic, Cleveland, OH, USA.,Ohio University Heritage College of Osteopathic Medicine, Athens, OH, USA
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