Seroepidemiology of Treponema pallidum, Mycoplasma hominis, and Ureaplasma urealyticum in fertility treatment-seeking patients in the Emirate of Abu Dhabi, United Arab Emirates

BACKGROUND

Several genital pathogens affect fertility. The study estimated the seroprevalence of Treponema pallidum, Ureaplasma urealyticum, and Mycoplasma hominis and identify specific factors associated with exposure to at least one of these pathogens in patients seeking fertility treatment in the Emirate of Abu Dhabi, United Arab Emirates.

METHODS

A seroepidemiological survey was conducted in a major fertility clinic in the Emirate of Abu Dhabi. Serum samples were screened for eight immunoglobulins (IgG, IgM, and IgA) against T. pallidum, U. urealyticum, and M. hominis using enzyme-linked immunoassays. Factors associated with seropositivity to at least one of the pathogens were investigated.

RESULTS

The study surveyed 308 patients seeking fertility treatment (mean age: 36.1 ± 6.8 years). Most patients were female (88.0%), 24.9% had at least one chronic comorbidity, 19.3% had a previous genital infection, and 68.1% had been diagnosed with infertility for ≥ 6 months. Ig seroprevalence of T. pallidum (IgG: 3.0%, IgM: 3.2%), U. urealyticum (IgG: 2.6%, IgM: 2.0%), and M. hominis (IgG: 33.9%) was 6.4%, 4.6%, and 49.0%, respectively. Nearly one quarter (23.0%) and one decile (9.2%) of the patients exhibited evidence of ongoing infection (IgM seropositivity) or recent infection (IgA seropositivity) with M. hominis, respectively. Overall, 53.0% of the patients were seropositive for at least one of the screened immunoglobulins. Patients with an education level of secondary schooling or below (66.2%) or those who were unemployed (61.1%) had a higher seroprevalence of IgG antibodies compared with patients with college or higher-level education (48.4%) or those who were employed (48.1%) (p < 0.05).

CONCLUSION

Exposure to T. pallidum or U. urealyticum was relatively low, whereas that to M. hominis was common in the surveyed patients. Enhanced awareness and screening programmes for genital pathogens are crucial to prevent and control the transmission of infections and reduce the growing burden of infertility.

Chlamydia trachomatis Seroepidemiology and Associated Factors in Fertility Treatment-Seeking Patients in the Abu Dhabi Emirate, United Arab Emirates

PURPOSE

This study was designed to investigate the seroepidemiology of and identify factors associated with exposure to Chlamydia trachomatis ( C. trachomatis ) in fertility treatment-seeking patients in Abu Dhabi Emirate, United Arab Emirates.

METHODS

A total of 308 fertility treatment-seeking patients were surveyed. Seroprevalence of past (IgG positive), current/acute (IgM positive), and active infection (IgA positive) with C. trachomatis was quantified. Factors associated with exposure to C. trachomatis were identified.

RESULTS

Overall, 19.0%, 5.2%, and 1.6% found to have past, acute/recent, and ongoing active infection with C. trachomatis , respectively. Overall, 22.0% of the patients were seropositive to any of the 3 to C. trachomatis antibodies. Male compared with female patients (45.7% vs. 18.9%, P < 0.001) and current/ex-smokers compared with nonsmokers (44.4% vs. 17.8%) had higher seropositivity. Patients with a history of pregnancy loss had higher seropositivity compared with other patients (27.0% vs. 16.8%), particularly recurrent pregnancy losses (33.3%). Current smoking (adjusted odds ratio [aOR], 3.8; 95% confidence interval, 1.32-11.04) and history of pregnancy loss (adjusted odds ratio [aOR], 3.0; 95% confidence interval, 1.5-5.8) were significantly associated with higher odds of exposure to C. trachomatis .

CONCLUSIONS

The observed high seroprevalence of C. trachomatis , particularly in patients with a history of pregnancy loss, possibly indicates the contribution of C. trachomatis to the growing burden of infertility in the United Arab Emirates.

Characterization of Fertility Clinic Attendees in the Abu Dhabi Emirate, United Arab Emirates: A Cross-Sectional Study

This study describes the primary and secondary infertility in patients attending fertility clinics and reports factors associated with primary infertility. A cross-sectional survey was conducted in two fertility clinics in Abu Dhabi Emirate, United Arab Emirates (UAE) between December 2020 and May 2021. The collected information covered sociodemographic, lifestyle, medical, and fertility-related characteristics. The mean age and age at marriage (±SD) of the 928 patients were 35.7 (±6.7) and 25.2 (±6.3) years, respectively. Of the total, 72.0% were obese and overweight, 26.6% reported a consanguineous marriage, and 12.5% were smokers. Secondary infertility (62.5%) was more frequent than primary infertility (37.5%). Primary infertility was inversely associated with age (aOR, 0.94, 95% CI: 0.91-0.98) and not being overweight (aOR, 0.6, 95% CI: 0.4-0.9) while positively associated with a nationality other than Middle Eastern nationality (aOR, 1.9, 95% CI: 1.1-3.3), married for ≤5 years (aOR, 6.0, 95% CI: 3.9-9.3), in a nonconsanguineous marriage (aOR, 2.4, 95% CI: 1.5-3.9), having a respiratory disease (aOR, 2.3, 95% CI: 1.1-4.6), an increased age at puberty (aOR, 1.2, 95% CI: 1.0-1.3), and self-reported 6-<12 months (aOR, 2.4, 95% CI: 1.2-5.1) and ≥12 months (aOR, 3.4, 95% CI: 1.8-6.4) infertility. Patients with primary infertility were more likely to be diagnosed with infertility of an ovulation, tubal, or uterine origin (aOR, 3.9, 95% CI: 1.9-7.9). Secondary infertility was more common than primary infertility. Several preventable fertility-related risk factors including overweight, smoking, and diabetes were found to be common among the fertility clinic attendees.

Herpes simplex virus type 2 seroprevalence and associated factors in fertility-treatment-seeking population: A cross-sectional survey in the United Arab Emirates

Background

Herpes simplex virus type 2 (HSV-2) is a common genitally-transmitted viral infection affecting more than 400 million individuals globally. In the United Arab Emirates (UAE), in specific at-risk population groups, the burden of HSV-2 has not been reported. This study investigated the prevalence of HSV-2 IgG antibodies in patients seeking fertility treatment and characterized patients with seropositivity to HSV-2 IgG antibodies.

Methodology

A cross-sectional sample of patients seeking fertility treatment in a major fertility clinic in Abu Dhabi, UAE was surveyed from April to May 2021. Patients were consecutively invited to complete self-administered questionnaires and provide blood for HSV-2 testing. Information on sociodemographics, medical history, and infertility was collected. Serum specimens were screened using an enzyme-linked immunosorbent assay for HSV-2 IgG antibodies detection.

Results

Two hundred and ninety-nine patients were surveyed and provided blood samples. The mean age of the patients was 35.9 ± 6.8 [mean ± standard deviation (SD)] years with 89.3% being women. Sixty-six percent were overweight or obese, 25.0% had at least one chronic comorbidity, and 19.6% reported ever-had genital infection. More than two-thirds (68.3%) of the patients were infertile for ≥ 6 months. Of the 42 infertile males, 69.0% had an abnormal semen analysis. HSV-2 IgG antibodies was detected in 12.4% of patients. The HSV-2 IgG seropositive patients had a higher mean age (39.5 vs. 35.4 years; p < 0.001) compared to seronegative patients. HSV-2 IgG antibodies seropositivity was more common in males (15.6%) than females (12.0%), in patients with secondary (14.1%) vs. primary (9.2%) infertility, or in males with abnormal (10.3%) vs. normal (7.7%) semen.

Conclusion

Exposure to HSV-2 at any time in patients seeking fertility treatment in the UAE was found to be slightly common in more than one out of 10 patients. Tailored health campaigns on HSV-2 prevention are warranted.

Tangent vector-based gradient method with l12-regularization: Iterative half thresholding algorithm for CS-MRI

OBJECT

This paper presents a new method using tangent vector-based l₁₂-regularization for compressed sensing MR image reconstruction.

MATERIALS AND METHODS

The proposed method with l₁₂-regularization is tested on four datasets: (i) 1-D sparse signal (ii) numerical cardiac phantom, (iii & iv) two sets of in-vivo cardiac MRI datasets acquired using 30 receiver coil elements with Cartesian and radial trajectories on 3T scanner. The results are compared with standard CS reconstruction, which utilizes l₁-regularization. The experiments were also conducted for two different types of samplings: (i) cartesian sub-sampling and (ii) 2D random Gaussian sub-sampling.

RESULTS

The quality of the reconstructed images is validated through Root Mean Square Error (RMSE) and Peak Signal-to-Noise Ratio (PSNR). The results show that the proposed method outperforms the standard CS reconstructions in our experiments with an improvement of 54.8% in RMSE and 14.3% in terms of PSNR. Moreover, the Gaussian random sub-sampling-based image reconstruction results are better than the Cartesian sub-sampling-based reconstruction results.

CONCLUSION

The results show that the proposed method yields a good sparse signal approximation and superior convergence behavior, which implies a promising technique for the reconstruction of cardiac MR images as compared to the conventional CS algorithm.

Development of Ficus religiosa extract-loaded emulsion system for topical application: Characterization and stability evaluation

Purpose: To develop, optimize and characterize a topical (W/O) emulsion containing 4 % Ficus religiosa extract for cosmeceutical purposes. Methods: The ethanol extract of Ficus religiosa was obtained by Soxhlet method. Various formulations were developed using paraffin oil, emulsifier (Abil®-EM 90) and purified water at different proportions, and their physical stability was assessed under different stress conditions, to enable selection of the most stable formulation. The optimized formulation based on stability studies was chosen for evaluation of different physical properties, i.e., color, liquefaction, phase separation, centrifugation, pH, droplet size and rheology, under accelerated conditions for 12 weeks. Results: The optimized formulation (F4) contained ethanol extract (4.0 %), Abil®-EM 90 (3.5 %), paraffin oil (14.0 %) and purified water (78.5 %), and remained stable on centrifugation under all stress conditions. The pH of the formulation remained within the specified range for human skin pH i.e. 4.5 – 6.0, and droplet size of dispersed phase also persisted within the size range of macroemulsion (1 – 100 μm) throughout the study period. Rheological properties of the formulation showed shear thinning response, and flow index value less than 1 resulted in pseudoplastic flow of emulsion. Conclusion: These results suggest that the optimized emulsion system was stable and can serve as a good medium for topical delivery of various natural substances.

Photocatalytic, Bactericidal and Molecular Docking Analysis of Annealed Tin Oxide Nanostructures

Nanosized tin oxide was fabricated with a simple and cost-effective precipitation technique and was analyzed by performing x-ray powder diffraction (XRD), Fourier-transform infrared (FT-IR) spectroscopy, high-resolution transmission electron (HR-TEM) microscopy, energy-dispersive x-ray (EDX) and UV-Vis spectroscopy. The XRD results revealed that tin oxide particles possessed typical orthorhombic structure and exhibited improved crystallinity with annealing. Calcination at 250 °C produced predominantly orthorhombic SnO which transformed to SnO₂ at higher temperatures of 500 and 750 °C. HRTEM and FESEM images showed existence of agglomeration within the particles of tin oxide. The absorption was found to increase up to a certain annealing temperature followed by a decrease, which was recorded via UV-Vis spectroscopy. The effect of annealing temperature on dye decomposition behavior of synthesized photocatalysts was studied. It was noted that annealing temperature affects the size of synthesized particles, band gap width and photoactivity of tin oxide. The sample prepared at 500 °C followed first-order kinetics and exhibited maximum photocatalytic reactivity toward methylene blue. The experimental results obtained from the present study indicate that SnO₂ is a promising and beneficial catalyst to remove contaminants from wastewater and environment. The antimicrobial evaluation of SnO annealed at 500 °C against selected targets such as E. coli and S. aureus depicted significant inhibition zones in comparison with 250 and 750 °C samples. Furthermore, molecular docking predictions of SnO₂ nanoparticles (NPs) were performed against active pocket of β-lactamase and DNA gyrase enzyme belonging to cell wall and nucleic acid biosynthetic pathway, respectively. The fabricated NPs showed good binding score against β-lactamase of both E. coli (- 5.71 kcal/mol) and S. aureus (- 11.83 kcal/mol) alongside DNA gyrase (- 9.57 kcal/mol; E. coli and - 8.61 kcal/mol; S. aureus). These in silico predictions suggested SnO₂ NPs as potential inhibitors for selected protein targets and will facilitate to have a clear understanding of their mechanism of action that may contribute toward new antibiotics discovery.

In vitro evaluation of transdermal patches of flurbiprofen with ethyl cellulose

This study was aimed to determine effects of penetration enhancers and plasticizers on drug release from rationally designed formulations of flurbiprofen based transdermal drug delivery system. Matrix type transdermal patches were formulated with ethyl cellulose (EC) as a polymer by using plate casting method. The plasticizers such as propylene glycol (PG) and dibutyl phthalate (DBP), and enhancers such as Span 20, Tween 20, sodium lauryl sulfate (SLS), isopropyl myristate (IPM) and ethanol (EtOH) were formulated in different concentrations in the patches. Such different combinations of polymer with various enhancers and plasticizers in patches were evaluated for their effect on the physicochemical properties and drug release behavior of flurbiprofen. The drug release study was carried out by the paddle-over-disk method and permeation of drug was performed by Franz diffusion cell using rabbit skin. Patches having ethanol with ethyl cellulose showed more uniformity in the physical properties while the smoothness and clarity of patches containing sodium lauryl sulfate were not satisfactory. The drug release from patches followed Higuchi and Korsmeyer-Pappas model while maximum drug release was obtained by isopropyl myristate (903 microg). It was concluded that the patches having ethyl cellulose with isopropyl myristate and propylene glycol are more useful for transdermal patches of flurbiprofen.

Neutron spectrometry and dosimetry study at two research nuclear reactors using Bonner sphere spectrometer (BSS), rotational spectrometer (ROSPEC) and cylindrical nested neutron spectrometer (NNS)

Neutron spectrometry and subsequent dosimetry measurements were undertaken at the McMaster Nuclear Reactor (MNR) and AECL Chalk River National Research Universal (NRU) Reactor. The instruments used were a Bonner sphere spectrometer (BSS), a cylindrical nested neutron spectrometer (NNS) and a commercially available rotational proton recoil spectrometer. The purposes of these measurements were to: (1) compare the results obtained by three different neutron measuring instruments and (2) quantify neutron fields of interest. The results showed vastly different neutron spectral shapes for the two different reactors. This is not surprising, considering the type of the reactors and the locations where the measurements were performed. MNR is a heavily shielded light water moderated reactor, while NRU is a heavy water moderated reactor. The measurements at MNR were taken at the base of the reactor pool, where a large amount of water and concrete shielding is present, while measurements at NRU were taken at the top of the reactor (TOR) plate, where there is only heavy water and steel between the reactor core and the measuring instrument. As a result, a large component of the thermal neutron fluence was measured at MNR, while a negligible amount of thermal neutrons was measured at NRU. The neutron ambient dose rates at NRU TOR were measured to be between 0.03 and 0.06 mSv h⁻¹, while at MNR, these values were between 0.07 and 2.8 mSv h⁻¹ inside the beam port and <0.2 mSv h⁻¹ between two operating beam ports. The conservative uncertainty of these values is 15 %. The conservative uncertainty of the measured integral neutron fluence is 5 %. It was also found that BSS over-responded slightly due to a non-calibrated response matrix.

Evaluation of the adsorption potential of titanium dioxide nanoparticles for arsenic removal

The adsorption potential of titanium dioxide (TiO2) nanoparticles for removing arsenic from drinking water was evaluated. Pure and iron-doped TiO2 particles are synthesized via sol-gel method. The synthesized TiO2 nanoparticles were then immobilized on ordinary sand for adsorption studies. Adsorption isotherms were conducted on the synthesized nanoparticles as well as the sand coated with TiO2 nanoparticles under varying conditions of air and light, namely, the air-sunlight (A-SL), air-light (AL), air-dark (AD) and nitrogen-dark (ND). X-ray diffraction (XRD) analysis showed that the pure and iron-doped TiO2 nanoparticles were in 100% anatase crystalline phase with crystal sizes of 108 and 65 nm, respectively. Adsorption of arsenic on the three adsorbents was non-linear that could be described by the Freundlich and Langmuir adsorption models. Iron doping enhanced the adsorption capacity of TiO2 nanoparticles by arresting the grain growth and making it visible light responsive resulting in a higher affinity for arsenic. Similarly, the arsenic removal by adsorption on the sand coated with TiO2 nanoparticles was the highest among the three types of sand used. In all cases, As(V) was adsorbed more compared with As(III). The solution pH appeared to be the most important factor in controlling the amount of arsenic adsorbed.

Evaluating bacteriophage P22 as a tracer in a complex surface water system: the Grand River, Michigan

Viruses are important pathogens in both marine and fresh water environments. There is a strong interest in using bacteriophages as tracers because of their role as model viruses, since dissolved chemical tracers may not adequately describe the behavior of viruses that are suspended colloids. Despite a large number of studies that examined the transport of bacteriophages in the subsurface environment, few studies examined phage transport in large and complex surface water systems. In this paper we report the results of a dual tracer study on a 40 km reach of the Grand River, the longest river in Michigan, and we examine the performance of bacteriophage P22 relative to a chemical tracer (Rhodamine WT). Our analysis based on the transient storage (TS) model indicated that P22 can be successfully used as a tracer in complex surface water environments. Estimated P22 inactivation rates were found to be in the range 0.27-0.57 per day (0.12-0.25 log10 per day). The highest inactivation rate was found in a reach with high suspended solids concentration, relatively low dissolved organic carbon content, and sediment with high clay content. Estimated TS model parameters for both tracers were found to be consistent with surficial geology and land use patterns. Maximum storage zone sizes for the two tracers were found in different river reaches, indicating that different processes contributed to TS within the same reach for the two tracers. This model can be used to examine the arrival times and concentrations of human viral pathogens released from untreated sewage at recreational areas.

Fertility preservation of boys undergoing anti-cancer therapy: a review of the existing situation and prospects for the future

With the advancement of medical science, most cancers in children are now treatable, the cure rate being almost 85%. In boys, one side effect of treatment (chemotherapy and radiotherapy) is destruction of the sperm precursor cells in the testis, resulting in the failure of sperm formation after puberty, and consequent infertility. At the time of anti-cancer treatment, future fertility of the boy patient is at the very bottom of the relative quality of life (RQL) parameters list; however, in adults infertility is an important issue following cure from cancer. In this article we have first reviewed the existing situation with regard to the state of the art of fertility preservation in young boys with cancer, and have then raised clinical and ethical issues and suggested a way forward. The review concludes with the emphasis that certain important issues still need to be resolved and, until these are, then the different techniques available should be confined to approved, ethical clinical trials where efficacy and safety can be fully evaluated.

Should ICSI be the treatment of choice for all cases of in-vitro conception?

The objective of this study was to examine different clinical scenarios of in-vitro conception, viz. fertilization with conventional IVF, IVF with high insemination concentration (HIC) and intracytoplasmic sperm injection (ICSI), and assess on a sibling oocyte comparison the hypothesis that ICSI should be performed in all cases requiring in-vitro conception. ICSI with husband's spermatozoa had a higher incidence of fertilization as compared with IVF or IVF with HIC with donor spermatozoa (if previous failure of fertilization had occurred) for unexplained infertility. Similarly, ICSI with husband's spermatozoa had as high an incidence of fertilization as IVF with donor spermatozoa for patients with severe oligozoospermia, asthenozoospermia and/or teratozoospermia, even when the spermatozoa were not selected for their morphology. Two studies were performed to assess ICSI in potential oocyte-related failure of IVF, viz. when fertilization occurred in >50% of oocytes for one group of patients, and in <50% of oocytes in a second group. In both of these studies a significant proportion of the oocytes that failed to fertilize with conventional IVF eventually fertilized after ICSI. The overall conclusion was that ICSI as a first option offers a higher incidence of fertilization, maximizes the number of embryos and minimizes the risk of complete failure of fertilization for all cases requiring in-vitro conception. However, among other concerns, current knowledge of ICSI as an outcome procedure does not provide the confidence to use this process in all cases of IVF for the time being.

Successful metaphase chromosome analysis of human elongated spermatids using mouse oocytes

Human elongated spermatids from azoospermic patients were inserted into mouse oocytes by intracytoplasmic sperm injection (ICSI). The injection resulted in survival rates of 46.5% (180 out of 387) and activation rates of 36.1% (65 out of 180). The rate of two pronuclear (2PN) formation was 35.4% (23 out of 65). Only 34.8% (eight out of 23) metaphase chromosome spreads from 2PN zygotes could be analysed; however, all were of normal karyotype. Cytogenetic analysis at the first metaphase revealed that human elongated spermatid chromosomes were able to undergo replication in a heterogeneous environment.

Evaluation of the fertilization potential of freshly isolated, in-vitro cultured and cryopreserved human spermatids by injection into hamster oocytes

The clinical potential for fertilization was examined by using the human sperm-hamster oocyte assay system after microinjection of round (RS), elongating (ES) or elongated (EtedS) spermatids retrieved from obstructive and non-obstructive azoospermic patients. Freshly isolated, in-vitro cultured and cryopreserved spermatids were utilized. For each category of microinjected spermatids, we demonstrated that the more mature the injected spermatid, the higher the incidence of fertilization (for freshly isolated spermatids, P < 0.006 and P < 0.008, for in-vitro cultured spermatids, P < 0.007 and P < 0.007 and for cryopreserved spermatids, P < 0.006 and P < 0.007 for obstructive and non-obstructive azoospermic patients respectively). Short term in-vitro culture of the spermatogenic cells did not improve the incidence of fertilization. However, cryopreservation significantly decreased (P < 0.001) the incidence of fertilization when each corresponding spermatogenic cell stage was compared. The incidence of fertilization was not statistically different when corresponding stages of spermatogenic cells were compared from obstructive and non-obstructive patients.

Can we justify spermatid microinjection for severe male factor infertility?

During 1995 and 1996 the first spermatid pregnancies were announced with both round spermatid (ROSI) and elongated spermatid (ELSI) injections. These publications were flanked by live births from ROSI in a number of animal species, with resulting offspring appearing normal, healthy and fertile. However, the live births in humans heralded a scientific and ethical debate on the clinical use of this technology; and in a number of countries nationwide moratoria prohibiting spermatid microinjection were enjoined. Concerns surrounded the biological condition of spermatids and clinical implications of utilizing an immature spermatozoon for conception. Nevertheless, case reports and a few scientific studies on human spermatid conception have been published in recent years, and further polemic on testicular histopathology and prognosis has ensued. This paper reviews the current arguments on the clinical use of ROSI and ELSI, and evaluates the biology of the main contributory components of a spermatozoon to the subsequent embryo, namely the genetic material, the microtubular organizing complex and the putative oocyte activating factor. We also consider the relevant testicular histopathology and likely outcome in the context of the current birth rate from ROSI and ICSI. We conclude by considering the way forward for infertile men who require this technology to become genetic fathers, and whether the time is now appropriate to consider clinical trials.

Isolation, purification and assessment of viability of spermatogenic cells from testicular biopsies of azoospermic men

The success of spermatid microinjection has generated many concerns. In particular, there is a lack of appropriate methodology for the isolation of large homogeneous populations of spermatids, with minimum loss of viability, from the testicular tissue of azoospermic men. Here we have compared two different isolation methods -- velocity sedimentation under unit gravity (VSUG) combined with discontinuous Percoll centrifugation (DPC), and separation with fluorescent-activated cell sorter (FACS) using light in the visible range -- to determine the most suitable method for the isolation of spermatids. Total mixed cell count/gram of testicular parenchyma was significantly higher in obstructive azoospermic men compared with non-obstructive azoospermic men (P < 0.001). The results of the comparison showed that in obstructive azoospermic patients the difference in the yields of primary spermatocytes produced by the two techniques was not significant, but for round and elongating spermatids the FACS separation proved to be the better method (P < 0.001). Similarly, in non-obstructive azoospermic patients, FACS separation proved to be superior, giving increased yields of primary spermatocytes and round and elongating spermatids compared with VSUG combined with DPC method (P < 0.001). More than 99 % of the separated cells retained their viability after FACS separation. As large homogeneous populations of viable spermatids can be separated with FACS in a relatively short period of time, FACS separation is the most suitable method for the isolation of spermatids from testicular biopsy tissue.

Short-term in-vitro culture and cryopreservation of spermatogenic cells used for human in-vitro conception

Testicular cell suspensions were prepared from obstructive and non-obstructive azoospermic men and were cultured in vitro for 96 h as (i) mixed cell populations and (ii) isolated homogeneous populations of primary spermatocytes, round spermatids and elongating spermatids. The cells lost their viability gradually during the first 24 h period. By 72 h almost 90% of the cells were non-viable. Isolated pure fractions showed better viability at each time interval (P < 0.0005). Throughout the culture period primary spermatocytes, elongating spermatids and other non-spermatogenic cells showed no change in their morphology, but almost 22% of round spermatids showed growth of flagella. Most of the round spermatids developed their flagella during the first 4-8 h period of culture. Isolated pure round spermatids showed better flagellar growth compared with mixed cell suspensions (P < 0.0005). The spermatogenic cells were successfully cryopreserved. However, when mixed spermatogenic cell suspensions were cryopreserved, more cells lost their viability compared with when isolated pure fractions were cryopreserved (P < 0.0005).