Identification and clinical implication of a novel variant of SPAG17 gene resulting in Familial severe asthenozoospermia

BackgroundSevere or complete asthenozoospermia is a rare entity that can lead to male infertility. In this study, we explored whether different extents of severe or complete asthenozoospermia could affect intracytoplasmic sperm injection (ICSI) outcomes and compared the ICSI outcomes using testicular spermatozoa with those using ejaculated spermatozoa in couples with complete asthenozoospermia.ResultsNinety-seven couples with severe or complete asthenozoospermia who underwent ICSI between January 2014 and December 2018 were included. According to the sperm category used in ICSI, patients were categorized into four groups: ejaculated progressive motile sperm group (Ep-group), ejaculated non-progressive motile sperm group (En-group), ejaculated immotile sperm group (Ei-group), and testicular sperm group (TESE-group). We compared the baseline characteristics, hormone profile, semen parameters, normal fertilization, good-quality embryos on day 3, transferred embryos, and ICSI outcomes in the four groups. The clinical pregnancy rate was significantly increased in the Ep-group (65.4%, P = 0.019) and TESE-group (63.6%, P = 0.035) compared with that in the Ei-group (23.1%). The ongoing pregnancy rate in the Ei-group was significantly lower than that in the Ep-group (23.1% vs. 61.5%, P = 0.041). Moreover, the biochemical pregnancy rate, ongoing pregnancy rate, and live birth rate were much lower in the Ei-group than in the TESE-group (30.8% vs. 63.6%, 23.1% vs. 40.4% and 23.1% vs. 40.4%, respectively).ConclusionsIn couples with complete asthenozoospermia, testicular spermatozoa should be preferred to ejaculated spermatozoa for obtaining a better ICSI outcome. With the appropriate selection of testicular spermatozoa, the extent of severe or complete asthenozoospermia may not affect the ICSI outcomes. Future studies with a larger sample size are warranted to validate these findings.

Effect of injected spermatozoa morphology on the outcome of intracytoplasmic sperm injection in humans

To identify new mutations in DNAH17 that cause male infertility and analyze intracytoplasmic sperm injection (ICSI) outcomes in patients with DNAH17 mutations. A total of five cases of new DNAH17 mutations exhibiting the multiple morphological abnormalities of the sperm flagella (MMAF) phenotype were identified through semen analysis and genetic testing. They were recruited at our reproductive medicine center from September 2018 to July 2022. Information on DNAH17 genetic mutations and ICSI outcomes was systematically explored following a literature review. Three novel compound mutations in DNAH17 were identified in patients with male infertility caused by MMAF. This study and previous publications included 21 patients with DNAH17 mutations. DNAH17 has been associated with asthenozoospermia and male infertility, but different types of DNAH17 variants appear to be involved in different sperm phenotypes. In 11 couples of infertile patients with DNAH17 mutations, there were 17 ICSI cycles and 13 embryo transplantation cycles. Only three men with DNAH17 variants ultimately achieved clinical pregnancy with their partners through ICSI combined with assisted oocyte activation (AOA). Loss-of-function mutations in DNAH17 can lead to severe sperm flagellum defects and male infertility. Patients with MMAF-harboring DNAH17 mutations generally have worse pregnancy outcomes following ICSI. ICSI combined with AOA may improve the outcome of assisted reproductive techniques (ARTs) for men with DNAH17 variants.

Influence of the cumulus cells exposed to exogenous luteinizing hormone (LH) activity during ovarian stimulation on human embryo development and intracytoplasmic sperm injection (ICSI) outcomes

The aim of this study was to investigate whether there is a relationship of young boar testes size with semen traits and with productive traits. The dimensions (length, width and volume) of each testis and semen traits (semen volume, percentage of sperm with progressive motility, sperm concentration, total number of sperm in semen, percentage of sperm with normal acrosome, percentage of sperm with major and minor morphological defects, osmotic resistance test value and activity of aspartate aminotransferase in seminal plasma) were determined on 120 young boars aged 6 months. At 180 day of age, the boars backfat thickness and leanness (by ultrasonic apparatus) and body weight were also measured. The average daily gain was determined in the period from 70 to 180 days of age of the boars. The results showed that the sperm concentration, total number of sperm in semen and percentage of progressive motile sperm were a significantly positively correlated with width and volume of the left (p ≤ 0.01) and right testis (p ≤ 0.05) and with total volume of both testes (p ≤ 0.01). But the highest values of correlation coefficients were found between the width of the left testis and sperm concentration, total number of sperm in semen and percentage of progressive motile sperm. A correlations of dimensions (length and width) and volume of testes with other semen traits were very low and statistically non-significant. The volume of testes (left and right testis and total testes) was significantly positively correlated with body weight at 180 days of age and daily gain (p ≤ 0.01), but lower correlation coefficient was between left testis and daily gain (p ≤ 0.05), whereas correlations were low and non-significant with leanness and backfat thickness.

Cryopreservation of rare testicular-retrieved spermatozoa for intracytoplasmic sperm injection (ICSI) in patients with severe oligozoospermia and azoospermia remains a major challenge in clinical practice. This study evaluated the Cryopiece system as a potential technique to cryopreserve rare human spermatozoa for ICSI. Small numbers of ejaculated (24 patients) and testicular (13 patients) spermatozoa were cryopreserved using the Cryopiece system. The total number of recovered spermatozoa and motility were assessed after thawing. Thirty-seven couples underwent ICSI using spermatozoa cryopreserved by the Cryopiece system, and ICSI outcomes (rates of fertilization, embryo cleavage, and clinical pregnancy) were evaluated. The average sperm post-thaw retrieval rate was 79.1%, and motility was 29.7%. Ejaculated spermatozoa had a higher post-thaw motility (32.5%) than testicular spermatozoa (21.8%; P = 0.005). ICSI achieved a fertilization rate of 61.9%, embryo cleavage rate of 84.6%, and clinical pregnancy rate of 43.3%. The ICSI outcomes in the ejaculated and testicular frozen-thawed spermatozoa were similar. Assisted oocyte activation (AOA) after ICSI with motile (72.1%) or immotile (71.9%) spermatozoa resulted in a significantly higher fertilization rate than that when using motile spermatozoa without AOA (52.0%; P = 0.005). However, AOA did not enhance the clinical pregnancy rate (55.6% or 40.0% vs 35.3%; P = 0.703). The Cryopiece system is simple and useful for the cryopreservation of small numbers of ejaculated or testicular spermatozoa for ICSI in patients with severe oligozoospermia or nonobstructive azoospermia.

Background: Semen must be of good quality to achieve satisfactory conception rate in any artificial insemination (AI) programme. The objectives of the present study were to evaluate the quality of frozen semen of Brahman bulls and compare the same semen derived from different sources. Methods: Fifteen frozen semen straws of Brahman bulls derived from 3 different sources (5 straws from each source) were evaluated with respect to volume, motility, concentration of spermatozoa and morphology of spermatozoa. Volume of semen was determined by micropipette, concentration was evaluated by haemocytometer technique, motility and progressive motility were evaluated by computer assisted sperm analyser (CASA), spermatozoa with normal acrosome, midpiece and tail were evaluated in formol-saline fixed semen and spermatozoa with normal head morphology were evaluated by Farley staining technique. Moreover, presence or absence of bacteria in semen was evaluated by Gram’s staining technique. Results: The overall semen volume, concentration, motile percentage, progressive motile percentage, percentage of spermatozoa with normal acrosome, midpiece and tail, and percentage of normal head morphology were 0.19±0.01 ml, 30.87±3.4x106/ml, 56.47±24.2 (%), 16.23±9.8 (%), 88.23±2.1 (%) and 95.1±1.6 (%), respectively. When compared, similar volume of semen (0.19 ml) was found in all frozen semen derived from different sources. The difference in percentage of motile spermatozoa between source B and C was significant (P<0.05). The difference in spermatozoa with normal acrosome, midpiece and tail in semen between source A and B was significant (P<0.05). The difference in the percentage of progressive motile spermatozoa, the concentration of spermatozoa and normal head morphology in semen among different sources of semen was not significant (P>0.05). The difference in percentage of motile spermatozoa, the percentage of progressive motile spermatozoa, the concentration of spermatozoa, normal acrosome, midpiece and tail, normal head morphology in semen between locally produced and foreign semen was not significant (P>0.05). All examined 15 semen samples were negative for presence of bacteria. Conclusions: Although the quality of frozen semen derived from Brahman bulls seems to be within normal limit, the post-AI conception rate should be determined to evaluate the fertilizing capacity of the used semen.

The purpose of this in vitro study was to determine the effect of copper (Cu) on the motility and viability of spermatozoa in the presence of different culture media. Specifically, we examined the dose- and time-dependent effect of copper ions (Cu2+) on the motility and viability of spermatozoa during different time periods (Time 0 h, 1 h, 24 h). The percentage of motile spermatozoa and progressive motile spermatozoa was determined after exposure to concentrations of 3.9; 7.8; 15.6; 31.2; 62.5; 125; 250; 500; 1000 μM/L of Cu2+ using the Sperm VisionTM CASA (Computer Assisted Semen Analyzer) system. The cell viability was measured by the MTT (metabolic activity) assay. The initial spermatozoa motility in the presence of Cu2+ in physiological saline solution (PS) showed slight increased values at doses <31.20 μM/L of Cu2+ compared to the control group. The long-term cultivation (Time 24 h) reduced the average motility values in all experimental groups (P < 0.001) in comparison to the control group. Identical spermatozoa motility was detected for the percentage of progressive motile spermatozoa during all time periods. The culture medium containing 20 % bovine serum albumin (BSA), triladyl and 5 % glucose increased the overall percentage of spermatozoa motility after 1 h of cultivation. A concurrently maintained motility of spermatozoa at doses <62.50 μM/L of Cu2+ during the long-term in vitro cultivation confirms the protective effect of albumin. The cell viability was decreased significantly (P < 0.001) in all experimental groups with copper administration. The obtained data point out that Cu2+ at high doses is a toxic element on the spermatozoa motility, which subsequently disrupts the viability of cells. However, using a suitable culture medium containing an energy component- and protein-rich substrate, the spermatozoa motility could increase.

Using the male gamete for assisted reproduction: past, present, and future.

The study was conducted to evaluate the effect of semen collection method for reduction of the deleterious interaction between the enzymes of bulbourethral gland and egg yolk during the dilution and storage of buck semen by three different level of egg yolk. Ten bucks were used in this study; the bucks were divided into two groups (five bucks in each group). Semen samples were collected once a week for four weeks from the bucks in first group using an artificial vagina, and from the animals in second group using an electroejaculator. The collected semen samples were diluted with sodium citrate extender with three different level of egg yolk (5, 10 and 20%). Extend semen samples were stored at 5 °C for three days. Computer assisted sperm analysis and Sperm Class Analyzer® were used for evaluation of the buck semen samples. Sperm motility parameters were evaluated which includes; percentage of motile sperm, percentage of progressive motile sperm, the value of the linear velocity (VSL), the value of the average velocity (VAP), the value of the curvilinear velocity (VCL), and the amplitude of lateral movement of the head (ALH). Results showed that all sperm motility parameters under the different level of egg yolk in semen samples that collected by artificial vagina were significantly higher than those which collected by electroejaculator. The percentage of motile sperm and progressive motile sperm of samples that collected by artificial vagina were higher at 10% of egg yolk, while these motility parameters were higher at 5% of egg yolk for semen samples that collected by electroejaculator. The differences between the two methods of semen collection in VCL and ALH were clear and the values were higher in samples that collected using the artificial vagina. The values of VSL, VAP and VCL of semen samples that collected by artificial vagina were higher at the second day than first day of semen storage under 10% of egg yolk. In conclusion, there are effects of the semen collection method on ability of dilution and storage of buck semen, and using of artificial vagina and 10% of egg yolk is recommended for buck semen dilution and storage.

The aim of this study was to analyze the influence of autoantibodies against spermatozoa present in the semen on the outcome of in vitro fertilization with intracytoplasmic sperm injection (ICSI). We performed a retrospective analysis of clinical and laboratorial data from a six year-period ICSI cycles. Screening for the presence of ASA in the semen, by using the direct immunobeads test (IBT), was available for 351 cycles. According to the percentage of antibody-bound spermatozoa in the semen, we divided the cycles in four groups: I (n = 194): 0%-10% ASA; II (n = 107): 11%-20%; III (n = 33): 21%-50% and IV (n = 17): 51%-100% ASA. Additionally, a group of 349 ICSI cycles performed with ejaculated spermatozoa from oligo/asthenozoospermic men who had insufficient number of motile sperm available for ASA screening was included for comparison. ICSI outcomes were compared among groups and included fertilization rate (2 PN), cleavage rate, cleavage velocity, embryo quality, clinical pregnancy and miscarriage rates. Data were examined statistically, with an alpha level of 5% considered significant. Fertilization, cleavage rate and velocity, percentage of good quality embryos, as well as clinical pregnancy and miscarriage rates did not differ among different ASA levels groups. ICSI outcomes in men exhibiting different levels of autoimmunity against spermatozoa did not differ from those with severely abnormal seminal parameters. Our data indicate that intracytoplasmic sperm injection (ICSI) outcomes are not influenced by ASA levels on sperm.

GnRH agonist and antagonist protocols for stage I–II endometriosis and endometrioma in in vitro fertilization/intracytoplasmic sperm injection cycles

ObjectiveGeneral hospitals admit lower gestational age neonates than maternal and child health care centers, therefore associated with a higher morbidity and mortality. This study aimed to assess the etiology and clinical characteristics of neonatal sepsis in different medical setting models.MethodsNeonates admitted to 5 tertiary medical centers, including one national general hospital, two maternal and child health care hospitals and two regional general hospitals, in central-south China with culture-proven sepsis between January 2010 and December 2019 were included in the study. We compared maternal and neonatal characteristics, pathogen distribution, treatment and neonatal outcomes among 3 different medical setting models in this retrospective cohort.ResultsWe identified 757 episodes of culture-proven sepsis in 757 neonates. The predominant pathogens were coagulase-negative staphylococci, Klebsiella pneumoniae, Escherichia coli and Group B streptococci. A total of 683 neonates with detailed information were involved in further comparison; 54.6% were from the national general hospital, 35.9% were from the maternal and child health care hospital, and 9.5% were from the regional general hospital. Neonates in national and regional general hospitals had significantly lower gestational age and birthweight (P < 0.001). Patterns of pathogen distribution were different among these medical setting models. Early-onset sepsis was more common in maternal and child health care hospitals (61.4% vs. 42.1% vs. 46.7%, P < 0.001), while hospital-acquired late-onset sepsis was more common in national and regional general hospitals (32.7% vs. 33.3% vs. 11.4%, P < 0.001). The proportion of complications or comorbidities of neonates in maternal and child health care hospitals were significantly lower than neonates in national and regional general hospitals (P < 0.001). The case fatality rate was significantly higher in regional general hospitals (10.8% vs. 3.2% vs. 0.8%, P = 0.001).ConclusionWe report distinct patterns of clinical characteristics, pathogens and outcomes in patient subgroups with neonatal sepsis from national general hospital, maternal and child health care hospital and regional general hospital. It might have some implications for improvement of prevention, management and empirical antibiotic use in neonatal sepsis in different setting models, especially in resource-limited settings from middle and low-income countries.

The health care department of county-level Maternal and Child Health care Hospital is an important part of maternal and children health care institutions, constructing a set of scientific and standard of performance appraisal index for the health care department is a prerequisite for improving the service objectives of county-level maternal and children health care institutions. This article designed a set of scientific and practical performance evaluation index system for the health care department of county-level Maternal and Child Health care Hospital through literature analysis, in-depth interviews, key performance indicators and Delphy law. The pertinence of evaluation index selection, the distribution rationality of each index weight coefficient and the better operability with scientifically designed evaluation index system could provide a useful reference for the performance appraisal of the health care department of county-level Maternal and Child Health care Hospital.

The relationship between isolated teratozoospermia and clinical pregnancy after in vitro fertilization with or without intracytoplasmic sperm injection: a systematic review and meta-analysis