Evaluation Of Male Infertility Research Articles

Andrology laboratory technique for analysis of semen in men with azoospermia.

Discovery of spermatozoa during the 17th century led to developing technologies for semen analysis in the early 1900s, and then, standard techniques were implemented during the 20th century. Semen analysis has a pivotal role in the male infertility evaluation, and azoospermia is an important finding. Azoospermia is identified in 15% of infertile men. However, the accurate laboratory assessment of azoospermia poses certain technical challenges. Laboratories currently perform semen assessment with great variability; thus, a standard method should be used. Planning suitable management and determining the cause of infertility require a precise evaluation of azoospermia. This review aims to address the definition of azoospermia and highlight laboratory methods in the assessments of azoospermia. Basic methods such as centrifugation, repeat pellet analysis, and staining and advanced methods such as genetic testing and biomarkers have been discussed. These methods have helped in standardizing the protocol for accurate azoospermia assessments with less variability.

Low-serum antimüllerian hormone is linked with poor semen quality in infertile men screened for participation in a randomized controlled trial

ObjectiveStudies investigating associations between serum anti-Müllerian Hormone (AMH) and semen quality in infertile men have shown conflicting results. Here, we investigated possible associations between serum AMH and semen quality in infertile men. DesignInfertile men were included during screening for participation in FITMI, a double-blinded, placebo-controlled 1:1, single-center randomized clinical trial. SubjectsAt the screening visit, 400 participants produced a semen sample and had their serum analyzed for AMH. Main Outcome MeasuresSerum AMH and semen quality ResultsAll men were stratified according to serum AMH in quartiles (Q1-Q4). Men in the lowest quartile had a lower sperm concentration (million/mL) (Q1: 8.0 vs. Q2: 10.4 vs. Q3: 11.0 vs. Q4: 13.0; p=0.006), total sperm count (million) (Q1: 29.1 vs. Q2: 38.2 vs. Q3: 44.4 vs. Q4: 55.7; p=0.022), sperm motility (%) (Q1: 41 vs. Q2: 57 vs. Q3: 50 vs. Q4: 53; p=0.042), and progressive sperm motility (%) (Q1: 31 vs. Q2: 44 vs. Q3: 35 vs. Q4: 40; p=0.031) compared with the other quartiles. Moreover, men with a sperm concentration < 2 million/mL had a lower serum AMH compared with men having 2-16 million/mL and > 16 million/mL (31 pmol/L vs. 38 pmol/L vs. 43 pmol/L, respectively; p=0.015). In accordance, men with sperm motility < 20% had a lower serum AMH compared with men with sperm motility 20-42%, and > 42% (31 pmol/L vs. 43 pmol/L. vs. 39 pmol/L, respectively; p=0.008). ConclusionThis study shows that low serum AMH is associated with poor semen quality in infertile men, which implies that serum AMH may have clinical value during the evaluation of male infertility.

Isolated teratozoospermia: revisiting its relevance in male infertility: a narrative review.

Basic semen analysis is the first step in the evaluation of male infertility. It includes an assessment of sperm morphology which is believed to reflect on overall spermatogenesis and sperm function. Teratozoospermia, defined as abnormal sperm morphology, is frequently present in association with severe oligoasthenozoospermia, but isolated teratozoospermia (in the presence of normal counts and motility) is a poorly understood clinical entity with conflicting implications in terms of fertility potential and treatment strategies. The following paper aims to: (I) discuss the classification of sperm morphology, causes, and molecular mechanism of teratozoospermia; (II) analyze the clinical significance and potential treatment options of isolated teratozoospermia as a cause of male infertility and a predictor of fertility outcome; and (III) provide a SWOT (strengths, weaknesses, opportunities, and threats) analysis based on the existing literature on this topic. A comprehensive search from database inception to 25 April 2023 was conducted in PubMed for relevant papers relating to isolated teratozoospermia in male infertility. Finally, seven systematic reviews/reviews/meta-analyses and 81 original articles were synthesized into the current narrative review. Classification of sperm morphology has evolved significantly since the first edition of the World Health Organization (WHO) Manual of Human Semen Analysis. Kruger's strict criteria are the most used classification and have been shown to correlate with fertility outcomes. There are many causes of teratozoospermia including genetic and environmental factors and physical conditions like varicocele. Teratozoospermia correlates with sperm DNA damage, elevated oxidative stress, low antioxidant function, and apoptotic alterations, which can result in impaired spermatozoa function and lower pregnancy rates. However, the clinical correlation between teratozoospermia and assisted reproductive technology (ART) outcome shows conflicting data with recent meta-analyses suggesting that isolated teratozoospermia was not associated with poor fertility outcomes from ART and that intrauterine insemination (IUI) can be an effective option even in the presence of teratozoospermia. There is very limited data on effective therapeutic options to treat idiopathic isolated teratozoospermia. The opportunity for future research is huge to fill the gap in the medical literature on this topic. Contemporary literature on isolated teratozoospermia shows conflicting results in terms of its actual clinical implication in male infertility and the utility of available treatment options. Further research is warranted on this clinical entity to improve sperm function and future paternity.

P-40 A rare cause of male infertility: 46, XX testicular disorder of sex development

Abstract Introduction 46, XX testicular disorder of sex development (DSD) is a rare condition with an estimated incidence of 1 per 20,000 individuals. The clinical spectrum ranges from ambiguous genitalia that is usually diagnosed at birth, to male infertility that is diagnosed in the adult years. However, the diagnosis of 46, XX DSD in an individual presenting with infertility may be challenging due to occult clinical findings. A thorough physical examination as well as clinical suspicion is required for diagnosis. Clinical Case A 22-year-old male presented to the urology clinic for infertility despite at least 3 years of regular unprotected intercourse. On physical examination, his testicles were palpable bilaterally in the scrotum with small volumes. Laboratory results revealed hypergonadotropic hypogonadism and his spermiogram revealed azoospermia. Abdominopelvic ultrosonagraphy (US) was reported normal except abdominal situs inversus. Tumor markers for a probable testicular tumor were negative. He was referred to medical genetic department. His family history was unremarkable except for parental consanguineouty. The chromosomal analyze revealed a 46, XX karyotype, and fluorescence in situ hybridization (FISH) disclosed that the SRY gene locus was translocated to the X chromosome: 46,x,der(x) t(x;Y) (sry+); SRY + AZF a,b,c microdeletion. The patient was consulted to the endocrinology department for further evaluation of hypogonadism. On physical exam, he had eunuchoid habitus with incomplete virilization, bilateral and symmetric gynecomastia. The height, and body mass index of the patient was 165 cm, and 29.2 kg/m2, respectively. The testicles were bilaterally palpable in the scrotum, with a volume of 4 mL each. His luteinizing hormone (LH), follicle-stimulating hormone (FSH) and total testosterone levels were 14 mUI/mL (laboratory reference: 1.5–9 mUI/mL), 42 mUI/mL (1.4–18 mUI/mL), and 140 ng/dl (197-700 ng/dL), respectively. The bone age matched his chronological age. Bone densitometry revealed osteopenia. A direct X-ray of the thorax showed thoracic situs inversus, he diagnosed with situs inversus totalis. Detailed genetic analyses could not be done concerning this diagnosis due to financial constraints. He had no history of lung infections that ruled out Kartagener's syndrome. Treatment was started with monthly intramuscular testosterone injections of 250 mg/ml. The patient and his family received genetic counseling, including advice that assisted reproduction will not work owing to AZFabc deletion. Conclusion 46, XX DSD is an uncommon genetic disorder that is rarely identified during the evaluation of male infertility. Clinical suspicion and a comprehensive physical exam are keys for diagnosis. Genetic analysis is essential for definitive diagnosis. A multidisciplinary is required for treatment and follow-up. Psychological support and genetic counseling are also critical for the management of these patients.

Innovative technology for evaluation of sperm DNA double-strand breaks diagnoses male factor infertility and prevents reproductive failures

Neutral comet assay has been available for two decades to evaluate sperm double-strand breaks (DSBs). However, its clinical usability is limited due to its complex and time-consuming procedure, as well as the lack of a standardized scoring system. The aim of this study was to: develop a rapid diagnostic method for DSBs, Sperm DNA Fragmentation Releasing Assay (SDFR), and explore the association between DSBs and reproductive outcomes. We pioneered the use of polyacrylamide (PA) for embedding sperm chromatin and optimized the porosity of PA to be between 10 and 13%. The refined PA network allowed the trapping of DSBs, which dispersed halo on an immunological slide; in contrast, intact chromatin failed to develop a halo. A strong correlation was showed between reproducible values obtained from SDFR and neutral comet assay. SDFR were responsive to dose-/time-dependent simulated DSBs, indicating high sensitivity and specificity. Furthermore, we conducted a retrospective study of couples with embryonic aneuploidy screening, and recording DSB profiles of the male partners. Our findings revealed that DSB enabled to predict embryonic aneuploidy whereas basic semen parameters did not. In conclusion, SDFR offers a rapid and user-friendly approach for evaluating DSBs, with potential implications for predictive healthcare in reproductive medicine.

Male infertility.

Clinical infertility is the inability of a couple to conceive after 12 months of trying. Male factors are estimated to contribute to 30-50% of cases of infertility. Infertility or reduced fertility can result from testicular dysfunction, endocrinopathies, lifestyle factors (such as tobacco and obesity), congenital anatomical factors, gonadotoxic exposures and ageing, among others. The evaluation of male infertility includes detailed history taking, focused physical examination and selective laboratory testing, including semen analysis. Treatments include lifestyle optimization, empirical or targeted medical therapy as well as surgical therapies that lead to measurable improvement in fertility. Although male infertility is recognized as a disease with effects on quality of life for both members of the infertile couple, fewer data exist on specific quantification and impact compared with other health-related conditions.

ROLE OF TRANS RECTAL AND SCROTAL ULTRA SONOGRAPHY IN MALE INFERTILITY.

Introduction: Infertility is known as major problem as life crisis for many couples. Investigation of male infertility isassuming greater importance with male factors implicated as it caused half of the infertile couples. Infertility is defined as infertility is a disease of reproductive system defined by failure to achieve the clinical pregnancy after 12 months or more of regular unprotected sexual intercourse. It is also define as failure of couple to conceive after 12 months of regular intercourse without the use of contraception in women &lt;35 years; and regular intercourse after 6 months without the use of contraception in women ≥ years. A recent report on the status of infertility in India, states that nearly 50% of infertility is related to the reproductive anomalies or disorders in the male. Male infertility include as pretesticular, testicular and post testicular causes. Common causes may be due to deficiencies in the semen and semen quality is used as a surrogate measure of male fecundity. Testicular causes are mainly cryptorchidism, varicocele exposure to gonadotoxins and post testicular causes which included disorders and obstruction of ejaculation and erectile dysfunction. There are many studies which found that sperm count of less than 10 million per milliliter is also suboptimal for fertility; however there is no cut off value of sperm count that is diagnostic of infertility. The common investigations done in evaluating fertility is Ultrasound examinations of scrotum and semen analysis. Ultrasound is a very useful modality for assessing the testicular size which is also related to condition like epididymo-orchitis, varicocele and undescended testis. Aim: The main aim of this study is to deteremine the used of ultra sonography in the evaluation of male infertility and to compared with clinical and surgical findings. All the patients were referred to the Department of Radiology for Material and Methods: transrectal and scrotal ultrasonography with high frequency transducer having a frequency of 7.5 MHz and Color Doppler wherever indicated. In this study all male patients with infertility and abnormal semen analysis and with the case of infertility with coincident scrotal findings on clinical examination were included. Transrectal ultrasound was done by positioned in left lateral decubitus position. On each side testis and epididymis was identified as completely as possible and compared for symmetry, size, texture and vascularity. In this study patients with abnor Result: mality were found in highest number on clinical palpation and ultrasound was varicocele. In 36 cases Varicocele was detected on clinical examination and 48 cases in ultrasound. In 18 cases Hydrocele wasdetected in clinical examination and Ultrasound. In 10 cases epididymal cysts were detected in clinical findings and 12 cases were found in Ultrasound Findings whereas 6 cases of epididymitis was found in ultrasound and only 2 case in clinical examination. Therefore the total number of abnormalities was found by ultrasound which was significantly greater as compared to physical examination. The p-value was 0.001 which shows statistically significant. Transrectal ultrasound ena Conclusion: bles high resolution imaging of prostate, seminal vesicles and distal vas deferens and is implicated in diagnosing the cause of obstructive azoospermia. Therefore Imaging plays an important complementary role to clinical examination and laboratory analyses for the detection of precise anatomy and level of abnormality. Hence transrectal and scrotal ultrasound provides valuable information in the diagnostic evaluation of infertile men and pathological conditions can be detected on ultrasound compared to clinical palpation

Detection of sperm cells by single-stage and two-stage deep object detectors

Today, infertility is a common health concern that affects approximately 15%–20% of the world population. The evaluation of male patients with infertility includes diverse examination and laboratory tests in comparison to female patients. In the evaluation of male infertility, sperm specimens are examined in terms of morphometry, concentration, and motility. Detection of sperm is the critical step to determine the concentration and motility parameters. In this study, a fusion approach of deep learning-based object detection techniques is utilized in the sperm detection problem for obtaining more accurate and consistent concentration and motility characteristics of sperm specimens. First, 12 sperm specimen videos acquired from different infertile patients were recorded. Then, regions in the video frames were labeled as sperm and non-sperm by the experts. Two different scenarios have been tested over the labeled dataset. Differently arranged train and test data ratios were also utilized for each scenario. In the first scenario, deep learning-based object detection algorithms were individually performed for the sperm detection of patient-oriented videos in terms of different train/test split ratios. Videos with the lowest mAP (mean Average Precision) values resulted in the first scenario were selected for the second scenario as target videos. The rest of the videos were used for model training without any patient-oriented manner. In the second scenario, the detection performance for more challenging videos is aimed to increase by using different videos instead of using the small part of the same video in the model training. Additionally, a fusion idea of the utilized deep learning-based techniques was proposed and performed over these low mAP resulted videos to increase the detection performance. The results are compared regarding the general mAP, class-wise APs, and training time. In the first scenario, YOLOv5 achieved the best results, while the proposed fusion approach achieved the best mAP scores in the second scenario.

Investigation on the mechanisms of human sperm DNA damage based on the proteomics analysis by SWATH-MS

BackgroundSpermatozoa have the task of delivering an intact paternal genome to the oocyte and supporting successful embryo development. The detection of sperm DNA fragmentation (SDF) has been emerging as a complementary test to conventional semen analysis for male infertility evaluation, but the mechanism leading to SDF and its impact on assisted reproduction remain unclear. Therefore, the study identified and analyzed the differentially expressed proteins of sperm with high and low SDF.MethodsSemen samples from men attended the infertility clinic during June 2020 and August 2020 were analyzed, and sperm DNA fragmentation index (DFI) was detected by the sperm chromatin structure assay. Semen samples with low DFI (< 30%, control group) and high DFI (≥ 30%, experimental group) were optimized by density gradient centrifugation (DGC), and the differentially expressed proteins of obtained sperm were identified by the Sequential Window Acquisition of All Theoretical Mass Spectra Mass Spectrometry (SWATH-MS) and performed GO and KEGG analysis.ResultsA total of 2186 proteins were identified and 1591 proteins were quantified, of which 252 proteins were identified as differentially expressed proteins, including 124 upregulated and 128 downregulated. These differentially expressed proteins were involved in metabolic pathways, replication/recombination/repair, acrosomal vesicles, kinase regulators, fertilization, tyrosine metabolism, etc. Western blotting results showed that the expression levels of RAD23B and DFFA proteins and the levels of posttranslational ubiquitination and acetylation modifications in the experimental group were significantly higher than those in the control group, which was consistent with the results of proteomics analysis.ConclusionsProteomic markers of sperm with high DNA fragmentation can be identified by the SWATH-MS and bioinformatic analysis, and new protein markers and posttranslational modifications related to sperm DNA damage are expected to be intensively explored. Our findings may improve our understanding of the basic molecular mechanism of sperm DNA damage.

The Global Andrology Forum (GAF): Structure, Roles, Functioning and Outcomes: An Online Model for Collaborative Research.

There are no published examples of a global online research collaborative in andrology. We describe the development, profile and member characteristics of the first consortium of this type, the Global Andrology Forum (GAF). An online survey sent to all GAF members collected demographic information (sex, age, experience, academic title, degrees, country, specialty, profession). It also tapped data on members' characteristics e.g., skills in research, software and statistics; preferred activities; time commitments; expected roles; and interest in participating in research, in GAF's scientific activities and collaborative online research. The findings were analyzed and tabulated. We outline members' demographic and professional characteristics and scientific achievements to date. A narrative approach outlined GAF's structure and functioning. A total of 418 out of 540 members completed the survey and were included in the analysis (77.4% response rate). The sample comprised mainly urologists (34.2%) and a third of the respondents had practiced for >15 years (33.3%). Up to 86.1% of the members expressed interest in being actively engaged in writing scientific articles. A third of the sample (37.1%) could dedicate 4 to 6 hours/week. Few respondents reported skills in statistics and artwork (2.6% and 1.9% respectively). Members were assigned to specific roles based on their expertise and experiences. Collaborative working ensured the timely completion of projects while maintaining quality. For outcomes, GAF published 29 original articles within one year of its creation, with authors from 48 countries spanning topics that included varicocele, sperm DNA damage, oxidative stress, semen analysis and male infertility, oocyte/embryo, and laboratory issues of assisted reproductive technique (ART) and male infertility evaluation. GAF is a successful global online andrology research model. A healthy number of scientific articles have been published. Given such effectiveness, adopting the GAF model could be useful for other disciplines that wish to create and coordinate successful international online research groups.

The effect of sperm DNA fragmentation on in vitro fertilization outcomes of unexplained infertility

BackgroundInfertility is caused by heterogeneous risks, but most of them are unexplained. The sperm DNA Fragmentation Index (DFI) was increasingly acknowledged as a parameter for the evaluation of male infertility. This study aimed to investigate the association between sperm DFI and laboratory and clinical outcomes in a population with unexplained infertility. MethodsThe clinical data of an infertile population was collected for the selection of reproductive patients with unexplained infertility. The authors classified the patients with normal sperm parameters in a control group (DFI < 25%) and an observation group (DFI ≥ 25%) and compared the difference in basal characteristics, laboratory, and clinical outcomes between the two groups. The authors conducted a correlation analysis to examine the relationship between DFI and the number of D3 good-quality embryos, as well as the clinical pregnancy rate and live birth rate. A total of 176 cases were enrolled in the retrospective study. ResultsThe observation group (n = 88) showed advanced male age, lower sperm concentration, progressive motility, and morphology assessment than the control group. In addition, lower No. of D3 good-quality embryos, clinical pregnancy rate, and the live birth rate were shown in the observation group. A negative correlation between the DFI and No. of D3 good-quality embryos (rs = -0.347, p < 0.001) or live birth rate (rs = -0.185, p = 0.028) was shown. ConclusionsSperm DFI was a good indicator for the prediction of D3 good-quality embryos in unexplained infertility couples, but it did not provide sufficient information regarding clinical pregnancy outcome but live pregnancy outcome.

EDITORIAL COMMENT

This interesting article concludes that “home semen testing can significantly reduce the time for evaluation and treatment for male factor infertility.” This conclusion, based on the assumption and supported by the use of multiple layers of statistical modeling, predicts that a man, discovering that his sperm count is significantly low after using a convenient at-home test, will now promptly find his way to a urologist's office. The validity of this clinical paradigm is beyond the scope of statistical manipulation.

Association between Sperm Morphology and Altered Sperm microRNA Expression

Evaluation of male infertility has been based on semen analysis for years. As this method can be subjective at times, there is a scientific tendency to discover stable and quantifiable biomarkers. This study included 28 couples who underwent an in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycle. The couples were assigned into two groups, according to sperm morphology. Couples where the males were normozoospermic were placed in the control group (15 participants), while couples where males had teratozoospermia were placed in the study group (13 participants). Thirteen candidate miRNAs were selected for qPCR analysis, based on our literature search. We determined significant under-expression of nine miRNAs (miR-10a-5p/-15b-5p/-26a-5p/-34b-3p/-122-5p/-125b-5p/-191-5p/-296-5p and let-7a-5p) in spermatozoa from patients with teratozoospermia compared to the controls, whereas expression levels of four miRNAs (miR-92a-3p/-93-3p/-99b-5p/-328-3p) did not significantly differ between the study and control groups. The expression levels of all 13 included miRNAs were significantly positively correlated with each other and significantly positively associated with spermatozoa morphology, excluding miR-99b-5p. There were no other significant associations between miRNA expression and sperm quality parameters. Only expression levels of miR-99b-5p were significantly positively correlated with good-quality day 3 embryo rate (ρ = 0.546; p = 0.003), while other variables of the IVF/ICSI cycle outcome showed no significant associations with miRNA expression profiles. This is one of the rare studies providing an insight directly into miRNA profiles in regard to sperm morphology. We identified nine miRNAs that could serve as biomarkers of spermatozoa quality in regard to teratozoospermia.

Long-Term Follow-Up after Testicular Torsion: Prospective Evaluation of Endocrine and Exocrine Testicular Function, Fertility, Oxidative Stress and Erectile Function.

This study investigates endocrine and exocrine testicular function, oxidative stress (OS) in semen, and erectile function in patients who underwent surgery for suspected testicular torsion (TT). We evaluated 49 patients over a mean follow-up of 101 months: n = 25 patients treated with surgical exploration, n = 20 patients treated with detorsion, and n = 4 treated with orchiectomy. We performed semen analysis including Male infertility Oxidative System (MyOxSIS) analysis, physical examination, and evaluation of endocrine and erectile function. OS, erectile function and spermiogram categories did not differ significantly between the groups. The interval from the onset of symptoms to surgery differed significantly between groups (p &lt; 0.001). Preservation of the testes was associated with a higher round cell count (p = 0.002) and follicle stimulating hormone (FSH, p = 0.003). OS showed a significant positive correlation with the spermiogram category (0.337; p = 0.022). A negative correlation was observed between OS and age (p = 0.033), sperm concentration (p &lt; 0.001) and total sperm count (p = 0.006). Endocrine, exocrine and erectile function are not significantly affected by TT in the long term. Orchiectomy results in elevated FSH and a lower round cell count compared to preservation of the testis.

Vitamin D Deficiency in Infertile Males with Oligospermia: A Cross-sectional Comparative Study

Introduction: The male factor responsible for infertility includes oligospermia. According to WHO criteria, oligospermia is sperm concentration less than 15 million per millilitre of semen. Vitamin D is a steroid hormone synthesized in the skin and derived from the diet. A serum level less than 20 ng/dl is regarded as vitamin D deficiency. The deficiency of vitamin D has been linked to many reproductive disorders. This study was designed to analyze the association between serum vitamin D level and oligospermia. Methods: A cross-sectional comparative study was conducted in the Department of Reproductive Endocrinology and infertility of Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period of July 2018 to June 2019. There are 157 infertile males with oligospermia in one group and 157 infertile males with normozoospermia in another group. A base line semen analysis for evaluation of male infertility was done, and serum vitamin D level was estimated. Results: The mean vitamin D level is 16.75+5.75 ng/ml in males with oligospermia and 19.83+5.33 ng /ml in males with normozoospermia. By the threshold defined, all the infertile males are deficient in vitamin D. The difference between the circulating levels of vitamin D in the two groups is statistically significant (p&lt;0.05). VitaminD deficiency is 4.25 times more in infertile males with oligospermia than in males with normozoospermia. Conclusion: Vitamin D deficiency is associated with oligospermia in infertile males. J Bangladesh Coll Phys Surg 2022; 40: 253-256

Ejaculation: the Process and Characteristics From Start to Finish.

Semen analysis serves as the initial step in the evaluation of male infertility. However, given the difficulty in interpreting abnormal findings, physicians and patients often struggle with understanding the results. In this review, we aim to review the normal physiology of ejaculation and create an accessible resource for interpreting abnormal semen volume, viscosity, liquefaction, pH, appearance, and color. Emerging evidence has revealed that men with genitourinary tract infections have a greater number of seminal leukocytes, which may result in clumping of motile sperm and altered morphology. Hence, these patients may have abnormal sperm parameters secondary to their health status. Recent findings have further characterized the semen liquefaction process, suggesting that increased levels of semenogelin and decreased levels of proteases and plasminogen activators (e.g., urokinase and chymotrypsin) may be associated with the failure of semen to convert to a watery consistency. This article creates a resource which may be referenced when abnormalities in semen analysis are encountered. We offer a comprehensive overview of normal ejaculation physiology and abnormal variants in male ejaculate volume-including aspermia, anejaculation, retrograde ejaculation, and hypo- and hyperspermia-and their potential etiologies. Additionally, we discuss several processes (infection, inflammation, and dysfunction of male sex glands) which may affect semen viscosity, liquefaction, and pH. Finally, our discussion of the potential colors of male ejaculate is meant to reduce the anxiety of both patient and provider. Through a better understanding of the process and varying characteristics of ejaculation, physicians may adequately counsel their patients on abnormal findings and concerns regarding infertility.

Severe Oligospermia Treatment with Testicular Sperm Using “ICSI”

Introduction: Assisted reproductive technology has been developed significantly throughout the past few years, particularly diagnosing and treating male infertility. Many studies have been performed showing that Intracytoplasmic Sperm Injection (ICSI) is a successful method to attain clinical pregnancy and live birth through impaired spermatozoa characteristics or low sperm count, such as severe oligospermia. Severe oligospermia indicates low sperm count, which in some cases leads to azoospermia. Severe oligospermia can be caused by several factors such as genetics or medication. In search of efficient treatment for couples with Severe oligospermia, numerous retrospective and prospective researches have reported high pregnancy and live birth rates through testicular sperm for men with severe oligospermia and cryptozoospermia with or without high sperm DNA damage. The research showed that the use of testicular sperm in combination with ICSI yielded a high pregnancy rate and live births over another source of sperm, such as ejaculated sperms. Moreover, the use of ICSI in severe oligospermia has shown successful fertilization and pregnancy.&#x0D; Methods: In search for effective treatment for couples with severe male factor, a number of small retrospective and prospective studies have reported high pregnancy and live birth rates using testicular sperm for men with necrozoospermia, cryptozoospermia and oligozoospermia with or without elevated sperm DNA damage. Although the data suggest that there may be some benefit in performing testicular sperm retrieval (TSR)-ICSI in select groups of non-azoospermic infertile men, there are potential risks involved with TSR. Clinicians should balance these risks prior to the recommendation of TSR-ICSI on the result of a semen analysis or sperm DNA test alone. Careful evaluation and management of male factor infertility is important. The use of TSR-ICSI in the absence of specific sperm DNA defects is still experimental.&#x0D; Discussion: In 1992 and subsequently, several reports indicated that ICSI was a successful technique to achieve clinical pregnancy and live birth using spermatozoa with severely impaired characteristics. The initial optimism over the ability of ICSI to overcome significant sperm abnormalities was later tempered by the findings of more recent publications suggesting that some sperm deficits may not be as effectively treated with ICSI.&#x0D; Conclusion: Severe oligospermia indicates low sperm count, which can lead to male infertility; severe oligospermia which can be overcome through ICSI. Genetic factors like microdeletions of the Y chromosome (Yq) can cause severe oligospermia or chemotherapy molecules, affecting the sperm count directly.

Evaluation and assessment of male infertility in Primary care; A review

Infertility is a common condition seen in primary care practices. The World Health Organization estimates that 9% of couples worldwide struggle with fertility issues and that the male factor contributes to 20-30% of all infertility cases. The diagnosis of infertility in men is primarily based on semen analysis. The main parameters of semen include concentration, appearance, and motility of sperm. Recently, the demand for infertility services has increased, and infertile couples are seen frequently by primary care physicians. A flexible, patient-centred approach is indicated. This article outlines the Family Physician`s evaluation of male infertility and indications for referral to a male infertility specialist. Key words: Male infertility, primary care, spermatogenesis, azoospermia.

Role of trans rectal ultrasonography for evaluation of male infertility with low semen volume

Role of trans rectal ultrasonography for evaluation of male infertility with low semen volume

The association of male infertility with telomere length: A case control study

To study the relevance of sperm telomere length and infertility in men.: Our case-control study included twenty-five males in couple, who were subfertile/infertil (test group) and twenty-five healthy males (control group) with proven paternity in the age group 21-35 years. The Absolute Sperm Telomere length (aSTL) was measured by real-time PCR. We investigated whether any significant difference in the aSTL value existed between the groups and analysed the relationship between aSTL and other sperm parameters.The mean (SE) aSTL recorded in the infertile cases was significantly shorter than for the control group; 140.60 (6.66) Kb/genome and 239.63 (12.32) Kb/genome respectively (p &amp;#60;0.001) A moderate positive correlation was eminent between aSTL kb/genome and the total sperm count mil/ml (rho= 0.54, p&amp;#60;0.001), progressive sperm motility (rho= 0.56, p=&amp;#60;0.001) and sperm viability (rho= 0.51 p=0.032) in the infertile group. The measurement of aSTL by real-time PCR is a simple and rapid method that offers further paramount information with respective to the quality of sperm. It is befitted for epidemiological studies, hence opening new perspectives in the evaluation of male infertility. Our study was confined to men aged between 21-35 years. Further comparative studies are needed to explore the significance of STL and infertility in older males. Additional studies will help illumine the significance of aSTL as a prognostic biomarker in assisted reproduction.