Motile Sperm Organelle Morphology Examination Research Articles

Risk Factors for Persistent Ebola Virus Infection in Semen Among Survivors From Liberia

Background: Long-term persistence of Ebola virus (EBOV) in immunologically privileged sites has been implicated in recent outbreaks of Ebola Virus Disease (EVD) in Guinea and the Democratic Republic of Congo. This study was designed to better understand how the acute course of EVD, convalescence, and host immune and genetic factors may play a role in prolonged viral persistence in semen. Methods: In 2017, a cohort of 131 male survivors of the 2014-2016 outbreak of EVD in Liberia were recruited from a national semen testing program into this case-case study. “Early clearers” were defined as those with two consecutive negative EBOV semen tests by real-time reverse transcriptase polymerase chain reaction (rRT-PCR) at least two weeks apart within 1 year after discharge from the Ebola Treatment Unit (ETU). “Late clearers” had detectable EBOV RNA by rRT-PCR more than one year after ETU discharge. Retrospective histories of their EVD clinical course were collected by questionnaire, followed by complete physical exams and blood work including chemistries, blood counts, hemoglobinopathies, human leukocyte antigen typing, and immunologic/inflammatory markers. Findings: Among 131 participants, 30 demonstrated long-term detection of EBOV RNA in semen by rRT-PCR, up to 852 days after ETU discharge. Compared to early clearers, late clearers were more likely to be older (median 42.5 years, p=0.0001) and reported having experienced fewer severe clinical symptoms (median 2, p=0.006). Late clearers were found to more frequently have lens opacifications (OR 3.9, 95%CI 1.1-13.3, p=0.03), after accounting for age. Finally, late clearers also exhibited elevated total serum IgG3 titers (p=0.007) and increased expression of the HLA-C*03:04 allele (OR 0.14, 95% CI 0.02-0.70, p=0.007). Interpretation: Older age and decreased illness severity may play a significant role in determining the clearance of EBOV from the semen of survivors. Immune and host genetic factors including total serum IgG3 and HLA-C*03:04 may mediate that interaction. In addition, our finding that late clearers were more likely to have lens opacifications after accounting for age suggests that individuals with EBOV persistence in semen may also have EBOV persistence in other immunologically protected sites, such as the eye. Identifying risk factors for viral persistence in semen among male survivors is critical to inform screening efforts and prevent recurrent outbreaks of EBOV. Funding Information: This was work was supported by funds from the CDC Foundation and the Centers for Disease Control and Prevention. This project has also been funded in whole or in part with federal funds from the Frederick National Laboratory for Cancer Research, under Contract No. HHSN261200800001E. Declaration of Interests: The authors report no competing interests. Ethics Approval Statement: The study protocol was approved by the CDC and Liberia MoH Institutional Review Boards and Meharry Medical College (for hemoglobinopathy testing).

Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility.

Agents for ovarian stimulation for intrauterine insemination (IUI) in ovulatory women with infertility.

The effect of endometrial scratching on pregnancy rate after failed intrauterine insemination: A Randomised Controlled Trail

IntroductionEndometrial injury (ES) has been suggested as intervention to increase probability of pregnancy in women undergoing assisted reproductive technologies. Majority of studies reported that ES improves outcome in Invitro fertilisation,Intrauterine Insemination(IUI) and natural conceptions: however, the size and quality of studies are poor which questions the presence of any beneficial effect. The present study was done to evaluate the effect of endometrial scratching on pregnancy rate after previous failed Intrauterine Insemination and to assess the pain and bleeding following the procedure. Material and methodsRandomized controlled trial. One hundred sixty-eight women (Eighty-four in each group) with primary/secondary infertility were recruited and randomized into intervention and control group using block randomization. Intervention group underwent ES using pipelle’s canula on D8 or D9 of menstrual cycle. Three cycles of ovulation induction with Clomiphene citrate and gonadotrophins followed by IUI was done. The primary end point was clinical pregnancy rate. Pain and bleeding after the procedure were evaluated as secondary outcomes.The study was conducted from June 2017 to June 2019.Main results.The cumulative clinical pregnancy rate in ES group was 22.2 % in comparison 9.8 % in control group. In the intent to treat analysis, with a p value of 0.03 calculated from Chi-square test(p < 0.05) there was statistically significant difference in the pregnancy rate between Intervention and Control group. Efficacy of intervention was found to be Fourteen Percent (14 %). Fifty-one women (63 %) had marked a VAS pain score of 4–5 and Twelve women(12.2 %) experienced mild spotting post procedure. Two patients in ES group had miscarriage and no case of multiple pregnancy in both the groups. ConclusionEndometrial Scratching improves clinical pregnancy rate in patients with Unexplained infertility and mild male factor infertility with previous failed IUI cycles. ES will be an inexpensive alternative to IVF for couples after IUI failures especially in developing countries, with an acceptable pregnancy rate and does not demand any special qualification or equipment and can be trained easily in primary settings. Larger and adequately powered studies are needed to elucidate the beneficial effects of endometrial scratching on implantation.

Bovine Herpesvirus Types 5 (BoHV5): A New and Emerging Threat in Indian Cattle

Bovine herpesvirus 5 (BoHV-5) belongs to the genus varicellovirus family herpesviridae and is a causative agent of meningo-encephalitis in cattle. BoHV-5 can replicates in the central nervous system (CNS) to cause encephalitis and establishes latency in the trigeminal ganglion of either naturally infected cattle or experimentally inoculated laboratory animals. BoHV 5 was first time reported in Australia in 1962 and subsequently reported in Latin Ameican countries Argentina, Brazil and Uruguay. Few cases of BoHV5 infection has also been reported in USA and Europe. Recently, the BoHV5 infection was reported in Indian cattle for the first time. The BoHV5 was isolated from aborted cattle and characterized as BoHV5 subtype A and this finding may necessitate inclusion of BoHV5 test protocol in testing of semen for sexually transmitted diseases. Because BoHV5 infection in cattle recently reported in India so, it is needed to explore the similarity of the isolates with earlier reported isolates and to check it’s pathogenicity to cause encephalitis in natural host and in experimental animals like rabbits, rat, guniea pig etc. Beside this, we have to explore the information about co-infection of BoHV5 with other viral, bacterial, fungal as well as parasitic agents.

SPERM VERY LONG CHAIN POLYUNSATURATED FATTY ACID (VLC-PUFA) CONCENTRATION: RELATION TO SEMEN PARAMETERS AND LIVE-BIRTH OUTCOME IN A MULTICENTER TRIAL

Sperm cell membranes contain many lipids that are essential to its structure and function. These lipids include Very Long Chain PUFA (VLC-PUFA ≥ 28 carbons). Prior studies in animal models have suggested that VLC-PUFAs are important for normal fertility.We have previously demonstrated a significant positive correlation between VLC-PUFA and sperm concentration in 70 infertile men undergoing treatment. We hypothesized that the sperm VLC-PUFA-containingsphingolipid concentration is correlated not only with sperm parameters, but also with the outcome of live birth following conventional therapy for unexplained and mild male factor infertility.

SPERM DNA FRAGMENTATION TEST IN ADDITION TO GENERAL SEMEN TEST MAY LEAD TO ELUCIDATION OF POTENTIAL FACTORS FOR PREDICTING IVF OUTCOMES

Female factors are very important in determining the success of in vitro fertilization (IVF). However, many reports have shown that male factors also affect the success or failure of IVF. Therefore, the sperm evaluation is important, semen examination criteria based on conventional methods alone is not a primary factor of consideration for determining IVF embryonic potential, pregnancy rates, and miscarriage rates after transplantation. We performed and analyzed the sperm DNA fragmentation index (DFI) and general semen test based on the WHO criteria and compared the two using semen factors. This study was conducted from June 2020 to December 2020. A total of 134 male patients with the main complaint of infertility who requested semen testing were included. We evaluate sperm motility using an automatic sperm analyzer based on the WHO criteria and sperm morphology via the Kruger test (general semen tests). DFI and general semen test were conducted in accordance with the WHO criteria, and correlations between the two tests were investigated. The WHO criteria were set as the cutoff value for each of the following factors: fluid volume, concentration, motility, and normal morphology, and compared with the DFI results. The mean age of the 134 patients at the time of the sperm tests was 38.8±6.0 years (range=26-52 years). The subjects had a mean DFI of 15.6±11.5% and the DFI increased with age (r=0.2319, p<0.01). In contrast, the concentration, motility, and normal morphology decreased as the DFI increased (concentration; r=-0.1992, p<0.05; motility; r=-0.2672, p<0.01; normal morphology; r=-0.2881, p<0.001). Patients who satisfied the WHO criteria in terms of sperm concentration, motility, and normal morphology had a significantly lower DFI than the group that did not satisfy the criteria (concentration p<0.05; motility p<0.01; normal morphology p<0.01). Therefore, evaluation with a general semen test based on the WHO criteria should be regarded as a qualitative evaluation of all factors other than fluid volume. Male infertility due to DFI should be suspected when in vitro fertilization results are poor despite normal semen findings based on the WHO criteria. The results of this study suggest that the DFI test may be an important evaluation in follow-up semen analyses.

MP21-07 PERCEPTIONS OF FERTILITY AMONG MEN WITH ABNORMAL SEMEN PARAMETERS WHO HAVE NOT UNDERGONE UROLOGIC EVALUATION

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP21)1 Sep 2021MP21-07 PERCEPTIONS OF FERTILITY AMONG MEN WITH ABNORMAL SEMEN PARAMETERS WHO HAVE NOT UNDERGONE UROLOGIC EVALUATION Minh Pham, Siddhant Ambulkar, Richard Fantus, Matthew Hudnall, Jeremy Lai, James Wren, Nelson Bennett, Gregory Auffenberg, David Chu, Robert Brannigan, and Joshua Halpern Minh PhamMinh Pham More articles by this author , Siddhant AmbulkarSiddhant Ambulkar More articles by this author , Richard FantusRichard Fantus More articles by this author , Matthew HudnallMatthew Hudnall More articles by this author , Jeremy LaiJeremy Lai More articles by this author , James WrenJames Wren More articles by this author , Nelson BennettNelson Bennett More articles by this author , Gregory AuffenbergGregory Auffenberg More articles by this author , David ChuDavid Chu More articles by this author , Robert BranniganRobert Brannigan More articles by this author , and Joshua HalpernJoshua Halpern More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002006.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Reproductive endocrinologists (REI) are the gatekeepers for infertility care and often initiate the male partner evaluation, including the order and review of semen testing. This may lead to patient misperceptions regarding fertility status and whether to pursue urologic evaluation. In these men, we aimed to evaluate patient perceptions of fertility status after REI evaluation. METHODS: We surveyed adult men with abnormal semen analyses over a 1-year period who did not see a reproductive urologist. Questionnaires were administered by email and/or telephone, collecting demographic and clinical data, as well as perceptions of reproductive health. Primary self-reported outcomes were: 1) Did the patient recall being informed of an abnormal semen test result? 2) Did the patient consider their fertility status abnormal? A secondary outcome was urology referral. Multivariable logistic regression models were fit, adjusting for abnormal semen parameters. RESULTS: Of 310 men contacted, 85 (27.4%) responded. After excluding men who reported seeing a urologist, our cohort included 75 men. Seventeen (22.6%) men recalled being told their semen analysis was abnormal, and 14 (18.7%) understood their fertility was abnormal. Multivariable logistic regression (Table) showed that oligospermia, but not other semen parameter abnormalities, was significantly associated with men being told their semen analysis was abnormal (odds ratio [OR]: 7.52; 95% confidence interval [CI]: 1.77–32.1; p=0.006) & believing they had abnormal fertility (OR: 5.78; 95% CI: 1.22–27.3, p=0.027). Only 6 (8%) men reported receiving a referral to urology. CONCLUSIONS: The majority of men with impaired semen parameters seen by REI-only had inaccurate perceptions of their semen test results and fertility status. This was accompanied by a low rate of urologic referral, which represents missed opportunities for male partner evaluation. These data highlight the critical role for the reproductive urologist in counseling and caring for couples presenting for initial fertility evaluation. Source of Funding: Grant support K23DK125670 (NIDDK) to Dr. Chu © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e348-e348 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Minh Pham More articles by this author Siddhant Ambulkar More articles by this author Richard Fantus More articles by this author Matthew Hudnall More articles by this author Jeremy Lai More articles by this author James Wren More articles by this author Nelson Bennett More articles by this author Gregory Auffenberg More articles by this author David Chu More articles by this author Robert Brannigan More articles by this author Joshua Halpern More articles by this author Expand All Advertisement Loading ...

Lactate dehydrogenase C4 (LDH-C4) is essential for the sperm count and motility: A case-control study

Background: The lactate dehydrogenase C4 (LDH-C4) isoenzyme is an important enzyme involved in metabolic processes that are needed for spermatogenesis and sperm motility. Objectives: This study aims to assess the activity and kinetic parameters (maximum velocity, Vmax and Michaelis constant, Km) of LDH-C4 in fertile and infertile (azoospermia and oligospermia) men in Baghdad City, Iraq. Methods: A total of 120 participants (80 infertile and 40 healthy fertile men) were included in the current study. The patients were sub-grouped into: 40 infertile men with oligospermia, and 40 infertile men with azoospermia. The oligospermia patients were further subdivided into subgroups based on sperm count and motility. Semen samples were obtained by masturbation after 3-5 days abstain for seminal fluid analysis. The microscopic test included the assessment of the count, motility and morphology of the sperms. In addition, the coulometric assay was used for measuring the activity and kinetic parameters of LDH-C4 enzyme. Results: The activity of LDH-C4 is significantly higher in fertile men when compared with infertile subjects (fertile: 403.13±189.90, oligospermia: 110.01±58.13, azoospermia: 39.06±28.15; p≤0.01). Statistically significant differences in LDH-C4 activity were also noted among patients with oligospermia based on sperms count and motility. Based on sperms’ count in patients with oligospermia, a significantly higher LDH-C4 activity (p≤0.01) was noted in those with higher sperm count (10-15 million/ml) when compared to others who have lesser count. Significant elevation in enzyme activity (p≤0.01) was also observed in oligospermia patients with higher percentages of motile sperms when compared with others who have fewer percentages of motile sperms. Moreover, the highest Vmax value (0.483 mmol/L.min) and the lowest Km value (0.39 mmol/L) were recorded in fertile men. While, the lowest Vmax value (0.174 mmol/L.min) and the lowest Km value (0.75 mmol/L) were detected in azoospermia patients. Conclusions: Our results suggest that LDH-C4 is essential for the count and motility of sperm and may be considered as a therapeutic approach for infertility.

P–063 The influence of lifestyle factors on sperm quality by motile sperm organelle morphology examination (MSOME)

Abstract Study question This study aimed to investigate the influence of lifestyle factors on sperm quality according to Motile Sperm Organelle Morphology Examination (MSOME) criteria. Summary answer The introduction of MSOME permits the examination of subcellular defect like nuclear vacuoles at hight magnification (6000x) in real time on vital sperm. What is known already It is increased accepted that lifestyle factors have an impact on sperm quality. Recent evidence shows that the selection of spermatozoa based on the analysis of morphology under high magnification may have a positive impact on embryo development in cases with severe male factor infertility and/or previous implantation failures. Therefore, MSOME has been considered as representing an improvement in the evaluation of semen quality. Although numerous studies have shown the influences of nutrition, lifestyle, age on semen quality, only very few study, have considered the influence of these factors on the vacuolization rate in semen analysis (MSOME criteria) Study design, size, duration The objective of this prospective study was to compare the semen parameters of 87 male patients undergoing evaluation or treatment of infertility at Unit of Pathophysiology of Reproduction ad PMA-Santa Maria Goretti Hospital -Latina according to MSOME and WHO (World Health Organization) criteria between January and September 2019.Written informed consent was obtained from all partecipant of this study. Participants/materials, setting, methods The subjects were divided into three groups according to age: Group 1 ≤ 35 yearş group II ,36–40 years; and Group III ≥ to 41 years .All patients filled a questionnaire answering questions regarding age, BMI, caffeine and alcohol consumptions, smoking and nutrition behavior. Were excluded from the study patients with chromosomal alteration. For multifactorial lifestyle influence patients were evaluated with a point base system with a cut-off &amp;gt;2 and cut off&amp;lt;3 for unhealthy style. Main results and the role of chance There was no difference between the groups with regard all semen parameters such as volume, concentration, number of leukocytes, morphology and vitality (%).The percentage of spermatozoa with LNV (Large Nuclear vacuoles) was significantly higher in the older group than in the younger (I and II) (39,14±13,74 vs 31,8±12 and 31,7 ±13,4 rispectively (p &amp;lt; 0,05)which does not correspond to a worsening of semen morphology. Regression analysis demonstrated a correlation between the percentage of spermatozoa with LNV and male age (r = –0,1) (p &amp;lt; 0,001). There was no correlation between lifestyle parameters ad enviroments factors . Comparing the semen parameters of healthy and unhealthy population we found no difference except a significantly higher number of spermatozoa with vacuoles in the unhealthy population (p &amp;lt; 0.001) Limitations, reasons for caution Although the sample examined in this study is limited in size and other studies are needed to confirm this evidence, the data available to us support the routine use of MSOME for ICSI and as a criterion for semen analysis with potential clinical repercussions. Wider implications of the findings: To date, there are few works in the literature that analyze the relationship between the morphology assessed with the MSOME and the age of the patients and the results are conflicting. To our knowledge many works agree with our results. Trial registration number Not applicable

P–029 Identification of spermatozoa by unsupervised learning from video data

Abstract Study question Can artificial intelligence (AI) algorithms identify spermatozoa in a semen sample without using training data annotated by professionals? Summary answer Unsupervised AI methods can discriminate the spermatozoon from other cells and debris. These unsupervised methods may have a potential for several applications in reproductive medicine. What is known already Identification of individual sperm is essential to assess a given sperm sample’s motility behaviour. Existing computer-aided systems need training data based on annotations by professionals, which is resource demanding. On the other hand, data analysed by unsupervised machine learning algorithms can improve supervised algorithms that are more stable for clinical applications. Therefore, unsupervised sperm identification can improve computer-aided sperm analysis systems predicting different aspects of sperm samples. Other possible applications are assessing kinematics and counting of spermatozoa. Study design, size, duration Three sperm-like paint images were manipulated using a graphic design tool and used to train our AI system. Two paintings have an ash colour background and randomly distributed white colour circles, and one painting has a predefined pattern of circles. Selected semen sample videos from a public dataset with videos obtained from 85 participants were used to test our AI system. Participants/materials, setting, methods Generative adversarial networks (GANs) have become common AI methods to process data in an unsupervised way. Based on single image frames extracted from videos, a GAN (SinGAN) can be trained to determine and track locations of sperms by translating the real images into localization paintings. The resulting model showed the potential of identifying the presence of sperms without any prior knowledge about data. Main results and the role of chance Visual comparisons of localization paintings to real sperm images show that inverse training of SinGANs can track sperms. Converting colour frames into grayscale frames and using grayscale synthetic sperm-like frames showed the best visual quality of generated localization paintings of sperm frames. Feeding real sperm video frames to the SinGAN at different scaling factors, which is defining the resolution of the input image, showed different quality levels of generated sperm localization paintings. A sperm frame given to the algorithm with a scaling factor of one leads to random sperm tracking, while the scales two to four result in more accurate localization maps than scaling levels five to eight. In contrast, scales from six to eight result in an output close to the input frame. The proposed method is robust in terms of the number of spermatozoa, meaning that the detection works well for samples with a low or high sperm count. For visual comparisons, visit our Github page: https://vlbthambawita.github.io/singan-sperm/. The sperm tracking speed of our SinGAN using an NVIDIA 1080 graphic processing unit, is around 17 frames per second, which can be improved by using parallel video processing capabilities. This shows the capability of using this method for real-time analysis. Limitations, reasons for caution Unsupervised methods are hard to train, and the results need human verification. The proposed method will need quality control and must be standardized. Unsupervised sperm tracking SinGAN may identify blurry bright spots as non-existing sperm heads which may restrict the use of SinGAN sperm tracking for sperm counting. Wider implications of the findings: Assessment of semen samples according to the WHO guidelines is subjective and resource-demanding. This unsupervised model might be used to develop new systems for less time-consuming and more accurate evaluation of semen samples. It may also be used for real-time analysis of prepared spermatozoa for use in assisted reproduction technology. Trial registration number N/A

Patterns of sperm storage in twice-mated Queensland fruit flies

Polyandry, whereby females mate with more than one male in a reproductive cycle, can result in sperm competition or cryptic female choice, and have fitness implications for both sexes. Understanding patterns of sperm storage in twice-mated females can provide valuable insights to mechanisms that mediate sperm use and paternity. In the Queensland fruit fly, Bactrocera tryoni (Qfly), and other insects that are managed by the Sterile Insect Technique (SIT), polyandry can reduce the efficacy of this pest control method. Patterns of sperm storage in twice-mated Qflies were studied by developing three fly lines that are homozygous for different alleles of a microsatellite marker (Bt32) and using a combination of quantitative real time polymerase chain reaction (qPCR) and capillary electrophoresis-based techniques to quantify and genotype sperm in each spermatheca. Female Qflies consistently stored fewer sperm from their second mate than from their first mate. Further, asymmetry between the spermathecae in the distribution of sperm stored from the first mate appears to in part determine the distribution of sperm stored from the second mate, likely because of constraints in storage capacity in the two spermathecae. Implications of these findings for elucidating pattern of sperm competition in this species, and for SIT, are discussed.

Male vitamin D status and male factor infertility

To determine the association between vitamin D levels in the male partner and fertility outcomes in couples with mild male factor infertility. Secondary analysis of a randomized, controlled trial. Nine fertility centers in the United States. Men (n = 154) with sperm concentration between 5 and 15 million/mL, motility ≤40%, or normal morphology ≤4% were eligible. Female partners were ovulatory, ≤40 years old, and had documented tubal patency. Men provided semen and blood at baseline for semen analysis and 25-hydroxyvitamin D (25(OH)D) levels. They were randomly assigned to receive a vitamin formulation including vitamin D 2,000 IU daily or placebo for up to 6 months. Couples attempted to conceive naturally during the first 3 months and with clomiphene citrate with intrauterine insemination of the female partner in months 4 through6. Primary: sperm concentration, motility, morphology, and DNA fragmentation at baseline. Secondary: cumulative pregnancy, miscarriage, and live birth rates. Semen parameters and sperm DNA fragmentation were not statistically significantly different between men with vitamin D deficiency and men with 25(OH)D levels ≥20 ng/mL. In addition, clinical pregnancy and live birth rates were similar. Male 25(OH)D level <20 ng/mL was associated with a higher rate of pregnancy loss (adjusted odds ratio 9.0; 95% confidence interval 1.3 to 61.3). Vitamin D deficiency in the male partner did not significantly impact semen parameters or treatment outcomes. Further study is warranted to better characterize the rate of miscarriage in couples with male vitamin D deficiency.

Effects of lead, cadmium, copper and zinc levels on the male reproductive function.

This study aimed to investigate the effects of heavy metals on measures of male fertility. One hundred and two infertile men with occupational exposure and thirty fertile men were included in this study. Blood and urinary levels of lead, cadmium, zinc and copper were measured by atomic absorption spectrophotometry. Semen parameters and a motile sperm organelle morphology examination were also performed. Measures of hormonal levels, oxidation-reduction potential, DNA fragmentation index and chromatin condensation were assessed for all participants. Heavy metals levels, oxidative stress and DNA quality were significantly higher in the infertile group compared to controls. FSH and testosterone levels were lower in the infertile group. A urinary cadmium level was positively associated with abnormal sperm morphology (r=.225, p<.05). Normal morphology was inversely correlated with the duration of the exposure (r=-.227, p=.022). The blood lead level was positively related to the level of testosterone (r=.223, p=.031). Cadmium and lead blood levels were positively correlated with the level of chromatin decondensation (r=.528, p<.001; r=.280, p=.017). Our study showed that occupational exposure to heavy metals is very harmful to reproductive health. DNA quality and oxidative stress investigations must be recommended for reprotoxic exposed patients prior to in vitro fertilisation treatment.

Quinoa Mitigates Chlorfenapyr-Induced Testicular Toxicity in Rats

Chlorfenapyr (Chf), belongs to a new chemical class calledhalogenated pyrroles, used extensively in Egypt. Negative effects of pesticides on the male reproductive system have been shown broadly. In recent years, the use of medicinal herbs in reducing pesticide toxicity has increased worldwide; one of these herbals is Quinoa seeds (QS), contains high amount of protein, vitamins, and minerals. Our study evaluated the effects of QS on testicular toxicity in rats exposed to Chf. Twenty rats were divided into four groups; group (I) as control was fed on basal diet only, group (II) QS at 30% from the basal diet, group (III) 180 mg/kg b.w/day of Chf, was fed on basal diet only and group (IV) Chf at 180 mg/kg b.w/day plus QS at 30% from the basal diet, the experimental period was four weeks. Rats were sacrificed and blood serum, sperm, and sexual organs samples were collected for biochemical and histomorphological studies. Results revealed that Chf treated animals showed sagging testicles with increased the testis relative weights. This effect was associated with a decline in count, motility, and viability of sperms, and increased sperm abnormality, and a decrease in sex hormones level (P<0.05). On the other hand, QS showed improvement in almost all estimated parameters and mitigated all the toxic effects of Chf, which was confirmed with the histological examination of the testis. So, we can encourage QS consumption as a clue for the toxicity and infertility problems revealed as a result of chlorfenapyr exposure.

Clinical application value of Inhibin B alone or in combination with other hormone indicators in subfertile men with different spermatogenesis status: A study of 324 Chinese men.

BackgroundIn this study, we investigated the clinical value of serum Inhibin B alone or in combination with other hormone indicators in subfertile men.MethodsThis is a multicenter study involving 324 men from different cities in China. Testicular volume, routine semen analysis, serum Inhibin B, anti‐Müllerian hormone (AMH), follicle‐stimulating hormone (FSH), luteinizing hormone (LH), testosterone, estradiol, and prolactin were measured. Testicular tissue samples were also analyzed in 78 of 129 patients with azoospermia to distinguish impaired spermatogenesis from obstructive azoospermia.ResultsThe concentration of Inhibin B, FSH, and AMH is related to spermatogenesis. For men with impaired spermatogenesis, including mild‐to‐moderate oligozoospermia (IMO) and severe oligozoospermia (ISO), serum levels of Inhibin B and FSH are highly correlated with sperm counting. However, in patients with idiopathic moderate oligozoospermia or severe oligozoospermia, there was no significant correlation between Inhibin B (or FSH) and sperm concentration. The upper cutoff value of Inhibin B to diagnose ISO is 58.25 pg/ml with a predictive accuracy of 80.65%. To distinguish between nonobstructive azoospermia (NOA) and obstructive azoospermia (OA), the area under the curve (AUC) for AMH + Inhibin B + FSH is very similar to Inhibin B (0.943 vs. 0.941). The cutoff level of Inhibin B to diagnose nonobstructive azoospermia is 45.9 pg/ml with a positive and negative prediction accuracy of 97.70% and 85.71%, respectively.ConclusionIn summary, Inhibin B is a promising biomarker alone or in combination with other hormone indicators for the diagnosis of testicular spermatogenesis status, helping clinical doctors to distinguish NOA from OA.

Intrauterine insemination (IUI) with or without letrozole for unexplained or mild male factor infertility: A randomized pilot study

ObjectiveTo study the feasibility of a randomized controlled trial (RCT) comparing intrauterine insemination (IUI) with and without letrozole in couples with unexplained or mild male factor infertility Study designWe performed a randomized pilot study including 100 couples with unexplained or mild male factor infertility in the Reproductive Medicine Centre of Peking University Third Hospital in China. The couples scheduled for IUI were randomized to IUI with or without ovarian stimulation (letrozole) for up to 3 cycles within a time horizon of 4 months. Women in the letrozole group received 5 mg oral letrozole daily starting from cycle day 3–5 for 5 days. Women in the natural cycle IUI group did not receive any ovarian stimulation before IUI. The primary outcome is ongoing pregnancy leading to live birth. The study was registered under trial number NCT03455426 ResultsBetween March 2018 and January 2019, 158 couples were eligible to participate after initial screening and 100 (63.3 %) couples agreed to participate. Of the 100 recruited couples, 50 were randomly allocated to IUI with letrozole and 50 to natural cycle IUI. Live birth occurred in 12 women (24.0 %) in the letrozole group and 10 women (20.0 %) in the natural cycle group (RR 1.20 (95 % CI 0.57–2.52)). Clinical pregnancy rates were 28 % and 26 % in the letrozole group and natural cycle group respectively (RR 1.08 (95 % CI 0.56–2.05). There were no multiple pregnancies in both groups. Patients were willing to be randomized and useful information was gained to plan a definitive trial. ConclusionsWe showed that an RCT comparing IUI with letrozole versus natural cycle IUI in couples with unexplained or mild male factor infertility is feasible and acceptable.

A new open-source hardware device to measure vertical sperm motility and concentration.

Sperm motility and concentration are commonly evaluated parameters in semen analysis. Those parameters are assessed objectively with commercial instrumentation such as computer-assisted sperm analysis systems (CASA) and hemocytometer. In CASA systems, sperm motility is assessed in the horizontal plane imposed by the stage of the microscope. Thus, there is lack of measurement of the vertical velocity of sperm. The female reproductive tract is a tridimensional space which the sperm traverse to reach the ovum, and there is a need for instruments measuring parameters more relevant to this real-world situation. In this report we describe the design, construction and use of an open-source hardware (OSH) device for evaluation of the vertical velocity of sperm, called UPSPERM. This device was also used to measure sperm concentration, and agreement with hemocytometer was evaluated. Bland-Altman analysis shows good agreement between these two methods of sperm counting. As a first application of UPSPERM, we evaluated the changes in boar sperm motility at distinct pH values between 7.0 and 8.0. The UPSPERM results showed that the vertical velocity of sperm was highest at pH7.6 and 7.8. We propose that our UPSPERM offers a reliable and affordable option for obtaining measurements of vertical velocity and sperm concentration.

Simplified sperm testing devices: a possible tool to overcome lack of accessibility and inconsistency in male factor infertility diagnosis. An opportunity for low- and middle- income countries.

Manual semen assessment (MSA) is a key component in a male's fertility assessment. Clinicians rely on it to make diagnostic and treatment decisions. When performed manually, this routine laboratory test is prone to variability due to human intervention which can lead to misdiagnosis and consequently over- or under- treatment. For standardisation, continuous training, quality control (QC) programs and pricy Computer-Assisted Sperm Analysis (CASA) systems have been proposed, yet, without resolving intra- and inter-laboratory variability. In response, promising simplified sperm testing devices, able to provide cost-effective point-of-care male infertility diagnosis are prospected as a plausible solution to resolve variability and increase access to sperm testing. A throughout literature research for semen testing, sperm analysis, smart-phone assisted semen analysis, 'at-home' semen testing, male infertility, infertility in developing countries, infertility in low- and middle-income countries (LMIC) and quantitative sperm analysis was performed. A total of 14 articles, specific to 'at-home' simplified sperm assessment, were included to treat the core subject. Continuous training and consistent QC, are sine qua none conditions to achieve accurate and comparable MSA. Compliance does not rule-out variability, nevertheless. Emerging simplified sperm assessment devices are an actual alternative to resolve the lack of standardisation and accessibility to sperm analysis. YO ® , SEEM ® , and ExSeed ® are commercially available, user-friendly smartphone-based devices which can accurately measure volume, sperm concentration (millions/ml) and total motile sperm count. More broadly, by cost-effectiveness, availability, accuracy and convenient application, these devices could effectively select patients for first-line artificial reproduction treatments such as intrauterine insemination. Accuracy and cost-effectiveness make smart-phone based sperm testing devices a practical and realistic solution to overcome variability in MSA. Importantly, these tools represent an actual opportunity to standardise and improve male subfertility diagnosis and treatment, especially in LMIC. However, before clinical application is possible, guidelines, further testing with special attention on accuracy in washed sperm, availability, cost-benefit and reliability are required.

Role of Sonoelastography in Predicting Positive Sperm Retrieving in Patients with Non-Obstructive Azoospermia

Background: Infertility is an important public health problem , almost 10-30 % is due to azoospermia.Elastography is a new ultrasound modality which simply could evaluate the internal elasticity of the testis &amp;finally give an idea about the presence or absence of sperms.Objective: To evaluate the validity of sonoelastography in predicting positive sperm retrieving in patientwith azoospermia.Patients and Methods: A cross sectional study performed in Al-Sader Teaching Hospital / fertility center&amp; radiology department during the period from 1st September 2017 to 1st September 2018, included 98patients /196 testes) with azoospermia by B-mode U/S, Doppler study (RI) &amp; Elastography (strain ratio) ,then biopsies obtained for all patientsResults: Only (136) testes were subjected to biopsy. Testicular volume &amp; strain ratio were the most importantfactors which suggest that the testis will give a positive or negative sperm retrieving. Low volume + highstrain NSR (bad prognosis) while high volume + low strain PSR (good prognosis).These findings of SR were 75.7% sensitive, 93% specific, with 78% and 92% positive and negativepredictive values, respectively and an accuracy of 89%.Conclusion: Strain Elastography results have been validated and were differed significantly betweenpatients with abnormal sperms count than those without. This Technique provides a promising way to getmore accurate diagnostic results.

Male cellular telephone exposure, fecundability, and semen quality: results from two preconception cohort studies.

To what extent is exposure to cellular telephones associated with male fertility? Overall, we found little association between carrying a cell phone in the front pants pocket and male fertility, although among leaner men (BMI <25 kg/m2), carrying a cell phone in the front pants pocket was associated with lower fecundability. Some studies have indicated that cell phone use is associated with poor semen quality, but the results are conflicting. Two prospective preconception cohort studies were conducted with men in Denmark (n = 751) and in North America (n = 2349), enrolled and followed via the internet from 2012 to 2020. On the baseline questionnaire, males reported their hours/day of carrying a cell phone in different body locations. We ascertained time to pregnancy via bi-monthly follow-up questionnaires completed by the female partner for up to 12 months or until reported conception. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs) for the association between male cell phone habits and fecundability, focusing on front pants pocket exposure, within each cohort separately and pooling across the cohorts using a fixed-effect meta-analysis. In a subset of participants, we examined selected semen parameters (semen volume, sperm concentration and sperm motility) using a home-based semen testing kit. There was little overall association between carrying a cell phone in a front pants pocket and fecundability: the FR for any front pants pocket exposure versus none was 0.94 (95% CI: 0.0.83-1.05). We observed an inverse association between any front pants pocket exposure and fecundability among men whose BMI was <25 kg/m2 (FR = 0.72, 95% CI: 0.59-0.88) but little association among men whose BMI was ≥25 kg/m2 (FR = 1.05, 95% CI: 0.90-1.22). There were few consistent associations between cell phone exposure and semen volume, sperm concentration, or sperm motility. Exposure to radiofrequency radiation from cell phones is subject to considerable non-differential misclassification, which would tend to attenuate the estimates for dichotomous comparisons and extreme exposure categories (e.g. exposure 8 vs. 0 h/day). Residual confounding by occupation or other unknown or poorly measured factors may also have affected the results. Overall, there was little association between carrying one's phone in the front pants pocket and fecundability. There was a moderate inverse association between front pants pocket cell phone exposure and fecundability among men with BMI <25 kg/m2, but not among men with BMI ≥25 kg/m2. Although several previous studies have indicated associations between cell phone exposure and lower sperm motility, we found few consistent associations with any semen quality parameters. The study was funded by the National Institutes of Health, grant number R03HD090315. In the last 3 years, PRESTO has received in-kind donations from Sandstone Diagnostics (for semen kits), Swiss Precision Diagnostics (home pregnancy tests), Kindara.com (fertility app), and FertilityFriend.com (fertility app). Dr. L.A.W. is a fibroid consultant for AbbVie, Inc. Dr. H.T.S. reports that the Department of Clinical Epidemiology is involved in studies with funding from various companies as research grants to and administered by Aarhus University. None of these studies are related to the current study. Dr. M.L.E. is an advisor to Sandstone Diagnostics, Ro, Dadi, Hannah, and Underdog. Dr. G.J.S. holds ownership in Sandstone Diagnostics Inc., developers of the Trak Male Fertility Testing System. In addition, Dr. G.J.S. has a patent pending related to Trak Male Fertility Testing System issued. N/A.