Fertility Preservation In Men Research Articles

Utilizing artificial intelligence in academic writing: an in-depth evaluation of a scientific review on fertility preservation written by ChatGPT-4.

To evaluate the ability of ChatGPT-4 to generate a biomedical review article on fertility preservation. ChatGPT-4 was prompted to create an outline for a review on fertility preservation in men and prepubertal boys. The outline provided by ChatGPT-4 was subsequently used to prompt ChatGPT-4 to write the different parts of the review and providefive references for each section. The different parts of the article and the references provided were combined to create a single scientific review that was evaluated by the authors, who are experts in fertility preservation. The experts assessed the article and the references for accuracy and checked for plagiarism using online tools. In addition, both experts independently scored the relevance, depth, and currentness of the ChatGPT-4's article using a scoring matrix ranging from 0 to 5 where higher scores indicate higher quality. ChatGPT-4 successfully generated a relevant scientific article with references. Among 27 statements needing citations, four were inaccurate. Of 25 references, 36% were accurate, 48% had correct titles but other errors, and 16% were completely fabricated. Plagiarism was minimal (mean = 3%). Experts rated the article's relevance highly (5/5) but gave lower scores for depth (2-3/5) and currentness (3/5). ChatGPT-4 can produce a scientific review on fertility preservation with minimal plagiarism. While precise in content, it showed factual and contextual inaccuracies and inconsistent reference reliability. These issues limit ChatGPT-4 as a sole tool for scientific writing but suggest its potential as an aid in the writing process.

Endocrinology: what's new in 2023

This overview provides a selection of studies published in 2023 with an impact on clinical practice. In reproductive endocrinology, important studies have addressed fertility preservation in men with Klinefelter's syndrome, the cardiovascular safety of testosterone replacement therapy, and a novel therapy, fezolinetant, for vasomotor symptoms of menopause. The updated European recommendations concerning adrenal incidentalomas will considerably modify current clinical practice. Based on a solid epidemiological work, the prevalence of pituitary adenomas has been confirmed to affect about 1 per 1000 individuals. Finally, a large British study allows to refine the benefit-risk profile of the three options available for the treatment of hyperthyroidism.

Fertility and fertility preservation in men

Fertility preservation is of high importance for patients prior to treatment that can impair fertility. The individual risk of becoming infertile after afertility-reducing therapy depends on the type and duration of therapy, surgical technique, dose and combination of gonadotoxic drugs or radiation applied, and individual predisposition. Cryopreservation of ejaculated sperm is the standard procedure for creating afertility reserve in men. In cases of azoospermia or inability to obtain semen by masturbation, testicular sperm can be obtained by (micro-)testicular sperm extraction (TESE) and cryopreserved. In case of retrograde ejaculation, sperm collection can be attempted by rectal electrostimulation or after off-label administration of imipramine from postmasturbatory urine. The cryopreserved sperm can be stored permanently in the gaseous phase of liquid nitrogen before being used in fertility therapy. In Germany, approval according to §20b of the German Medicines Act (AMG) is amandatory requirement for performing cryopreservation of sperm and testicular tissue; approval according to §20c of the AMG must be obtained for use. For prepubertal boys, it is possible to cryopreserve dormant spermatogonial stem cells as part of an experimental procedure.

Fertility preservation in men and women: Where are we in 2021? Are we rising to the challenge?

Demand for fertility preservation in women for oncologic, nononcologic, and personal reasons has increased dramatically. Meeting that demand is a major challenge, and we are rising to the challenge. Mature oocyte cryopreservation after ovarian stimulation and ovarian tissue cryopreservation are both methods endorsed by the American Society for Reproductive Medicine (formerly The American Fertility Society), and numerous papers confirmed their efficacy. In girls and women with leukemia or cancers who are at a high risk of ovarian metastasis and who may not be eligible for ovarian tissue transplantation, restoration of fertility can only be achieved by invitro methods. Male fertility preservation has also become a pressing issue and is extensively reviewed in the present journal issue.

Preservation of fertility in men with benign and malignant brain tumors

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Suppression of transforming growth factor-beta signaling enhances spermatogonial proliferation and spermatogenesis recovery following chemotherapy.

Could small molecules (SM) which target (or modify) signaling pathways lead to increased proliferation of undifferentiated spermatogonia following chemotherapy? Inhibition of transforming growth factor-beta (TGFb) signaling by SM can enhance the proliferation of undifferentiated spermatogonia and spermatogenesis recovery following chemotherapy. Spermatogonial stem cells (SSCs) hold great promise for fertility preservation in prepubertal boys diagnosed with cancer. However, the low number of SSCs limits their clinical applications. SM are chemically synthesized molecules that diffuse across the cell membrane to specifically target proteins involved in signaling pathways, and studies have reported their ability to increase the proliferation or differentiation of germ cells. In our experimental study, spermatogonia were collected from four brain-dead individuals and used for SM screening in vitro. For in vivo assessments, busulfan-treated mice were treated with the selected SM (or vehicle, the control) and assayed after 2 (three mice per group) and 5weeks (two mice per group). We investigated the effect of six SM on the proliferation of human undifferentiated spermatogonia in vitro using a top-bottom approach for screening. We used histological, hormonal and gene-expression analyses to assess the effect of selected SM on mouse spermatogenesis. All experiments were performed at least in triplicate and were statistically evaluated by Student's t-test and/or one-way ANOVA followed by Scheffe's or Tukey's post-hoc. We found that administration of SB431542, as a specific inhibitor of the TGFb1 receptor (TGFbR1), leads to a two-fold increase in mouse and human undifferentiated spermatogonia proliferation. Furthermore, injection of SB to busulfan-treated mice accelerated spermatogenesis recovery as revealed by increased testicular size, weight and serum level of inhibin B. Moreover, SB administration accelerated both the onset and completion of spermatogenesis. We demonstrated that SB promotes proliferation in testicular tissue by regulating the cyclin-dependent kinase (CDK) inhibitors 4Ebp1 and P57 (proliferation inhibitor genes) and up-regulating Cdc25a and Cdk4 (cell cycle promoting genes). The availability of human testis was the main limitation in this study. This is the first study to report acceleration of spermatogenesis recovery following chemotherapy by administration of a single SM. Our findings suggest that SB is a promising SM and should be assessed in future clinical trials for preservation of fertility in men diagnosed with cancer or in certain infertility cases (e.g. oligospermia). This study was supported by Royan Institute and National Institute for Medical Research Development (NIMAD, grant no 963337) granted to H.B. The authors have no conflict of interest to report.

Sperm cryopreservation for fertility preservation in men with non-malignant diseases

Advanced cancer treatments have improved the prognosis of cancer survivors. Simultaneously cancer treatments such as chemotherapy have been known to cause harmful effect on fertile capacity. Therefore, the peri-treatment fertility preservation in AYA patients is of crucial importance and recommended in the guideline of ASCO. However, as for non-malignant disease, there have been few reports on peri-treatment fertility preservation ever. Gonadotoxic agents such as alkylating agents are often used for non-malignant diseases. Of course, pretreatment fertility preservation for such cases are thought to be essential. In this study, we retrospectively investigated the cases sperm cryopreservation was attempted for non-malignant diseases. This study retrospectively assessed the medical records of patients with non-malignant diseases who attempted sperm cryopreservation at the Reproduction Center of Yokohama City University Medical Center between January 2012 and September 2017. The following information was extracted from the medical records: age, type of disease, timing of consultation (the status prior to or immediately after treatment), treatment to be performed or ongoing treatment, pre-freeze semen parameters, success or failure of cryopreservation, and maintenance status of cryopreservation. Moreover, we compared semen characteristics and feasibility of cryopreservation with cases of malignancies observed during same period in our facility. All patients provided written informed consent prior to their participation. The study design was approved by the institutional review board of our facility. A total of 217 patients were referred and attempted sperm cryopreservation in Yokohama City University Medical Center from January 2012 to September 2017. Of those, 12 patients (5.5 %) were in status peri-treatment of non-malignant diseases at the time of consultation. The median age was 29.5 years (range: 18–51 years). Breakdown of original diseases was aplastic anemia (3), interstitial pneumonia (2), eosinophilic granulomatosis with polyangiitis (2), and others (5: collagen disease etc). Breakdown of therapeutic regimen was cyclophosphamide with hematopoietic stem cell transplantation (9), cyclosporine (1), and methotrexate (1). Mean sperm concentration was significantly higher than that of patients with malignancies (58.26±42.53 vs. 27.13±29.08 million/ml, P＜0.001). And in all cases, sperm cryopreservation was successfully carried out. Of the 5 cases referred from our own institution, 3 were still in maintenance, and in 2 cases, samples were discarded on their request. On the other hand, of 7 cases referred from other institutions, 5 patients have not visited our hospital. For patients with non-malignant diseases, pretreatment sperm cryopreservation should be carried out before gonadotoxic treatment. In addition, establishing a network that encourages patients to visit us for maintenance of cryopreservation is thought to be essential because patients from other facilities did not visit for maintenance at a higher rate.

Fertility Preservation in Men Affected by Cancer

Fertility Preservation in Men Affected by Cancer

Preservation of fertility in men with brain tumors

Preservation of fertility in men with brain tumors

Prevalence of abnormal semen analysis and levels of adherence with fertility preservation in men undergoing therapy for newly diagnosed cancer: A retrospective study in 2906 patients.

Sperm cryopreservation (freezing) should be offered to all men with cancer due to risk of infertility. However, many men with cancer already have impaired spermatogenesis prior to sperm cryopreservation. Furthermore, physical ill-health may hinder attendance of freeze visits. Investigating both the distribution of sperm functions and freeze attendance rates in men with newly diagnosed cancer, may identify patients benefiting from targeted reproductive fertility support. We performed a retrospective study of 2906 male patients undergoing sperm cryopreservation prior to cancer therapy at a single UK tertiary centre between 1989 and 2013; all patients were asked to attend three hospital semen collection visits prior to cancer therapy. Fifteen per cent (433/2906) of men with newly diagnosed cancer had severely impaired semen quality (i.e., sperm total motile count, TMC<1 million) during the first semen collection visit. However, patients with severely impaired semen quality had the poorest attendance of subsequent semen collection visits despite being requested to do so (non-attendance in TMC<1 million: 43.4%; TMC<1-30million: 35.7%, P<0.05 vs. <1million; TMC>30million: 33.2%, P<0.01 vs. <1million). This study expands understanding of the semen quality of men with newly diagnosed cancer, and their ability to adhere to fertility preservation recommendations. Our data suggest that patients with the poorest semen quality paradoxically suffer the poorest attendance rates of sperm cryopreservation appointments prior to commencing cancer therapy. We suggest that additional support may be of clinical benefit to men with newly diagnosed cancer and TMC<1 million sperm.

Fertility Preservation in Men: Overview of Current and Emerging Trends

Fertility Preservation in Men: Overview of Current and Emerging Trends

Update on fertility preservation from the Barcelona International Society for Fertility Preservation-ESHRE-ASRM 2015 expert meeting: indications, results and future perspectives.

STUDY QUESTIONWhat progress has been made in fertility preservation (FP) over the last decade?SUMMARY ANSWERFP techniques have been widely adopted over the last decade and therefore the establishment of international registries on their short- and long-term outcomes is strongly recommended.WHAT IS KNOWN ALREADYFP is a fundamental issue for both males and females whose future fertility may be compromised. Reproductive capacity may be seriously affected by age, different medical conditions and also by treatments, especially those with gonadal toxicity. There is general consensus on the need to provide counselling about currently available FP options to all individuals wishing to preserve their fertility.STUDY DESIGN, SIZE, DURATIONAn international meeting with representatives from expert scientific societies involved in FP was held in Barcelona, Spain, in June 2015.PARTICIPANTS/MATERIALS, SETTING, METHODSTwenty international FP experts belonging to the American Society of Reproductive Medicine, ESHRE and the International Society of Fertility Preservation reviewed the literature up to June 2015 to be discussed at the meeting, and approved the final manuscript. At the time this manuscript was being written, new evidence considered relevant for the debated topics was published, and was consequently included.MAIN RESULTS AND THE ROLE OF CHANCESeveral oncological and non-oncological diseases may affect current or future fertility, either caused by the disease itself or the gonadotoxic treatment, and need an adequate FP approach. Women wishing to postpone maternity and transgender individuals before starting hormone therapy or undergoing surgery to remove/alter their reproductive organs should also be counselled accordingly. Embryo and oocyte cryopreservation are first-line FP methods in post-pubertal women. Metaphase II oocyte cryopreservation (vitrification) is the preferred option. Cumulative evidence of restoration of ovarian function and spontaneous pregnancies after ART following orthotopic transplantation of cryopreserved ovarian tissue supports its future consideration as an open clinical application. Semen cryopreservation is the only established method for FP in men. Testicular tissue cryopreservation should be recommended in pre-pubertal boys even though fertility restoration strategies by autotransplantation of cryopreserved testicular tissue have not yet been tested for safe clinical use in humans. The establishment of international registries on the short- and long-term outcomes of FP techniques is strongly recommended.LIMITATIONS, REASONS FOR CAUTIONGiven the lack of studies in large cohorts or with a randomized design, the level of evidence for most of the evidence reviewed was three or below.WIDER IMPLICATIONS OF THE FINDINGSFurther high quality studies are needed to study the long-term outcomes of FP techniques.STUDY FUNDING/COMPETING INTEREST(S)None.TRIAL REGISTRATION NUMBERN/A.

Update on fertility preservation from the Barcelona International Society for Fertility Preservation–ESHRE–ASRM 2015 expert meeting: indications, results and future perspectives

What progress has been made in fertility preservation (FP) over the last decade? FP techniques have been widely adopted over the last decade and therefore the establishment of international registries on their short- and long-term outcomes is strongly recommended. FP is a fundamental issue for both males and females whose future fertility may be compromised. Reproductive capacity may be seriously affected by age, different medical conditions and also by treatments, especially those with gonadal toxicity. There is general consensus on the need to provide counselling about currently available FP options to all individuals wishing to preserve their fertility. An international meeting with representatives from expert scientific societies involved in FP was held in Barcelona, Spain, in June2015. Twenty international FP experts belonging to the American Society of Reproductive Medicine, ESHRE and the International Society of Fertility Preservation reviewed the literature up to June 2015 to be discussed at the meeting, and approved the final manuscript. At the time this manuscript was being written, new evidence considered relevant for the debated topics was published, and was consequently included. Several oncological and non-oncological diseases may affect current or future fertility, either caused by the disease itself or the gonadotoxic treatment, and need an adequate FP approach. Women wishing to postpone maternity and transgender individuals before starting hormone therapy or undergoing surgery to remove/alter their reproductive organs should also be counselled accordingly. Embryo and oocyte cryopreservation are first-line FP methods in postpubertal women. Metaphase II oocyte cryopreservation (vitrification) is the preferred option. Cumulative evidence of restoration of ovarian function and spontaneous pregnancies after ART following orthotopic transplantation of cryopreserved ovarian tissue supports its future consideration as an open clinical application. Semen cryopreservation is the only established method for FP in men. Testicular tissue cryopreservation should be recommended in pre-pubertal boys even though fertility restoration strategies by autotransplantation of cryopreserved testicular tissue have not yet been tested for safe clinical use in humans. The establishment of international registries on the short- and long-term outcomes of FP techniques is strongly recommended. Given the lack of studies in large cohorts or with a randomized design, the level of evidence for most of the evidence reviewed was 3 or below. Further high quality studies are needed to study the long-term outcomes of FP techniques. None. N/A.

The protective effect of regucalcin against radiation-induced damage in testicular cells

AimsRegucalcin (RGN), a protein broadly expressed in the male reproductive tract, has shown to have beneficial effects on spermatogenesis suppressing chemical-induced apoptosis. This study aimed to evaluate whether RGN overexpression ameliorates the spermatogenic phenotype after radiation treatment. Main methodsTransgenic rats overexpressing RGN (Tg-RGN) and their wild-type (Wt) counterparts were exposed to a single dose of X-rays (6Gy), and at ten weeks after irradiation, the testicular status and the epididymal sperm parameters were evaluated. The expression of RGN and several cell cycle and apoptosis regulators, the enzymatic activity of caspase-3, and RGN immunostaining were also assessed. Key findingsTg-RGN animals displayed higher gonadosomatic index, and augmented sperm viability and motility relatively to their Wt counterparts after irradiation, as well as higher frequency of normal sperm morphology and a diminished incidence of head-defects. The differences in reproductive parameters were underpinned by a lower rate of apoptosis, as evidenced by the reduced activity of caspase-3, lower levels of caspase-8, and increased Bcl-2/Bax ratio in the testis of Tg-RGN animals. Supporting the involvement of RGN in the anti-apoptotic response, an enhanced expression of RGN was observed in irradiated rats. SignificanceTransgenic-overexpression of RGN protected against radiation-induced testicular damage, which strengthens the role of this protein protecting cells from the damage of external agents. These findings also indicated that the modulation of RGN testicular levels would be a mechanism for fertility preservation in men undergoing oncological treatment.

Editorial Comment

This is an interesting experimental study on the protective role of scrotal cooling in mice, aiming to reduce cytotoxic effect of cisplatin over spermatogenesis. 1 Aminsharifi A. Hekmati P. Noorafshan A. et al. Scrotal cooling to protect against cisplatin-induced spermatogenesis toxicity: Preliminary outcome of an experimental controlled trial. Urology. 2016; https://doi.org/10.1016/j.urology.2015.12.062 Abstract Full Text Full Text PDF Scopus (8) Google Scholar The possibility of using an extremely simple approach that might benefit fertility preservation in men undergoing cisplatin chemotherapeutic treatment is noteworthy.

Novel Drug Therapies for Fertility Preservation in Men Undergoing Chemotherapy: Clinical Relevance of Protector Agents.

Cancer has been affecting a growing number of children, adolescents and adult males in reproductive age. Male reproductive potential is adversely affected by chemotherapeutic drugs and patients are at risk for prolonged infertility. Fertility recovery is related to the chemotherapeutic agent and dosage used, being thus difficult to predict. As a result, there is a strong need to identify a natural or synthetic compound that is able to preserve male fertility without interfering with the efficacy of the chemotherapeutic regimen. New procedures, as well as several drugs, are being investigated to assess their efficiency in protecting male reproductive functions from the chemotherapy side-effects. This review provides an overview of the wide range of chemotherapeutic drugs regularly used in cancer treatment and their detrimental effects on male fertility. In addition, it also assesses the existing protector agents for male fertility and their usefulness in preserving and protecting male reproductive functions exposed to chemotherapeutics. Several protector agents for male fertility are being studied, and results are promising. Nonetheless, further research must be implemented to identify a supplemental therapy that addresses the multiple side effects of chemotherapy on male reproductive function. Until such therapy is discovered, it is fundamental that all fertility preservation options are discussed with patients, before treatment is initiated, to assure parenthood.

Editorial Comment

The long-term impact of cancer treatment on reproductive function has become increasingly relevant in recent years given the number of successful treatment options. The American Society of Clinical Oncology 1 Loren A.W. Mangu P.B. Beck L.N. et al. Fertility preservation for patients with cancer: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013; 31: 2500-2510 Crossref PubMed Scopus (1095) Google Scholar and the American Society for Reproductive Medicine 2 Ethics Committee of American Society for Reproductive MedicineFertility preservation and reproduction in patients facing gonadotoxic therapies: a committee opinion. Fertil Steril. 2013; 100: 1224-1231 Abstract Full Text Full Text PDF PubMed Scopus (218) Google Scholar recommend that, when possible, at-risk patients bank sperm before gonadotoxic cancer therapy. Despite these guidelines, sperm cryopreservation before the initiation of cancer treatment remains underused. 3 Tournaye H. Dohle G.R. Barratt C.L. Fertility preservation in men with cancer. Lancet. 2014; 384: 1295-1301 Abstract Full Text Full Text PDF PubMed Scopus (92) Google Scholar Unfortunately, some men do not have access to a sperm banking facility because they either live far away or are too sick to travel. Therefore, it is critical that we identify a reliable and an efficient method to cryopreserve sperm at a remote location. The authors 4 Agarwal A. Sharma R. Gupta S. Sharma R. NextGen® home sperm banking kit: outcomes of offsite vs onsite collection—preliminary finding. Urology. 2015; 85: 1339-1346 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar present a pilot feasibility study of a sperm banking kit (NextGen®; Path-Tec, Columbus, GA) that can be used at home or at a site away from the sperm banking facility. This study 4 Agarwal A. Sharma R. Gupta S. Sharma R. NextGen® home sperm banking kit: outcomes of offsite vs onsite collection—preliminary finding. Urology. 2015; 85: 1339-1346 Abstract Full Text Full Text PDF PubMed Scopus (10) Google Scholar appears to be the first study to evaluate the outcomes after sperm cryopreservation attempted at a remote location. Several kits similar to NextGen have been marketed for sperm cryopreservation (OverNite Male (ReproTech, Ltd.), Priority Male (Cryogenic Laboratories, Inc. part of Fairfax Cryobank), and @Home). However, none of the providers appear to have published their outcomes. NextGen® Home Sperm Banking Kit: Outcomes of Offsite vs Onsite Collection—Preliminary FindingsUrologyVol. 85Issue 6PreviewTo compare cryosurvival rates between remote collections with NextGen kit (offsite) and onsite collection of semen samples from infertile men and those with cancer. Full-Text PDF ReplyUrologyVol. 85Issue 6PreviewWe read with interest the thoughtful comments by the authors1 into the need for fertility options for cancer patients. NextGen® (Path-Tec, Columbus, GA) Remote Home Sperm Banking Kit is an innovative, product evaluated in a clinical setting and specially designed for men with cancer who are about to undergo treatment, which can render them infertile. Many of these men often reside at remote locations and do not have ready access to sperm banking facilities or often times are unable to travel to a sperm bank laboratory. Full-Text PDF

Fertility preservation in men with cancer.

Due to recent advances in medical technologies, cancer has become more curable and chronic, and post-treatment quality of life, including male fertility, has become an important issue. Cancer itself can affect spermatogenesis through complex interactions, and cancer treatment such as surgery, radiotherapy and chemotherapy, all have certain detrimental effects on spermatogenesis. Currently, sperm cryopreservation before cancer treatment is the mainstay of fertility preservation, and is recommended by numerous guidelines. Although fertility preservation should be discussed with all cancer patients before treatment, it still remains underused. Postpubertal patients who are unable to bank sperm may undergo testicular sperm extraction before treatment. For prepubertal boys, there is no clinically established guideline for fertility preservation. Investigations such as spermatogonial stem cell culture are ongoing, and may lead to clinical options for fertility preservation in the future.

Fertility Preservation in the Male with Cancer

This article reviews the current concepts, recommendations, and principles of fertility preservation in men with cancer. Obstacles to sperm banking are addressed, as well as future directions for fertility-preserving technologies. All cancer therapies--chemotherapy, radiation, and surgery--are potential threats to a man's reproductive potential. Additionally, cancer itself can impair spermatogenesis. Thus, sperm cryopreservation prior to initiating life-saving cancer treatment offers men and their families the best chances to father biologically-related children and should be offered to all men with cancer before treatment. Better patient and provider education, as well as deliberate, coordinated strategies at comprehensive cancer care centers, are necessary to make fertility preservation for male cancer patients a priority during pre-treatment planning.

2034 POLYMERIZED ALGINIC ACID BEAD AND SPERM INJECTION THROUGH MICRO-MANIPULATION AS A VEHICLE FOR CRYOPRESERVATION AND RECOVERY OF SMALL NUMBERS OF HUMAN SPERM

You have accessJournal of UrologyInfertility: Basic Research, Physiology, Pathophysiology1 Apr 20132034 POLYMERIZED ALGINIC ACID BEAD AND SPERM INJECTION THROUGH MICRO-MANIPULATION AS A VEHICLE FOR CRYOPRESERVATION AND RECOVERY OF SMALL NUMBERS OF HUMAN SPERM James Hotaling, Ji Wen, Jessica Belmonte, Craig Niederberger, and Gail S. Prins James HotalingJames Hotaling Chicago, IL More articles by this author , Ji WenJi Wen Shandong, China, People's Republic of More articles by this author , Jessica BelmonteJessica Belmonte Chicago, IL More articles by this author , Craig NiederbergerCraig Niederberger Chicago, IL More articles by this author , and Gail S. PrinsGail S. Prins Chicago, IL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2453AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES While routine cryopreservation of human sperm is effective for normozoospermic specimens, severe oligozoospermic samples are limited by the marked reductions in sperm motility and viability post-thaw. This is exacerbated in TESE when retrieval can yield <1000 sperm. Alternative methods are required that enable sufficient post-thaw sperm recovery, ideally in several aliquots, to permit multiple ICSI attempts. Herein, we describe a novel technique involving microinjection of limited sperm numbers into pre-formed polymerized alginate beads that can be frozen and thawed individually. METHODS Semen samples were collected from normospermic men (n=10), sperm were washed in Ham's F10 and a portion was frozen using standard cryoprotocol. Fresh alginate beads were formed by dropping 10 ul 7.3 mg/ml alginic acid into 135 mM CaCl2. Spermatozoa (n=10 to 1000) were aspirated and injected into individual alginate beads using a Nikon-Narigishe micromanipulator. Individual beads were transferred to freezing medium in 0.5 ml vials and frozen in liquid nitrogen. Following thaw, beads were solubilized in Na-citrate and sperm recovered by micromanipulator aspiration to fresh Ham'sF-10. Post-thaw sperm recovery, viability and motility were assessed for both cryopreservation methods and compared to fresh parameters. RESULTS Greater than 90% of injected spermatozoa were recovered from alginate beads post-thaw supporting the efficacy of this technique for successful cryopreservation of limited sperm. There was a significant post-thaw decline in sperm motility and viability using alginate bead or standard cryopreservation as compared to neat semen, respectively (Motility: 21.97%, 36.45% vs 69.40%; Viability: 48.78%, 51.33% vs 80.45%). The significant decrease in motility (21.97% vs 36.45% motile post-thaw, P<0.05) between alginate cryopreservation vs standard protocol was counter-balanced by higher viability of the immotile sperm in alginate beads (26.81% vs 14.93%, P<0.05). There was no difference in sperm viability post-thaw using either cryoprotocol (alginate: 48.78% vs standard: 51.33%, P>0.05). CONCLUSIONS Microinjection of sperm into pre-made alginate beads yields equivalent viable sperm post-thaw as standard cryopreservation. Coupled with high post-thaw yield, this approach provides a previously unrealized opportunity for fertility preservation in men with limited sperm numbers recovered by TESE and may permit multiple ICSI attempts from a single tissue sample obviating further surgery. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e835 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information James Hotaling Chicago, IL More articles by this author Ji Wen Shandong, China, People's Republic of More articles by this author Jessica Belmonte Chicago, IL More articles by this author Craig Niederberger Chicago, IL More articles by this author Gail S. Prins Chicago, IL More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...