Normal Sperm Concentration Research Articles

FSH can improve semen parameters in patients with idiopathic oligoasthenoteratozoospermia: A systematic review and meta-analysis.

Follicle-stimulating hormone (FSH) is commonly used in assisted reproductive technology to promote the development and maturation of follicles in female patients. However, there is no consensus on treating FSH in males with idiopathic oligoasthenoteratozoospermia (iOAT), especially in patients with normal serum FSH levels. To determine the role of FSH in improving semen quality in patients with iOAT, we conducted a detailed search in the commonly used database to find all studies on FSH in the treatment of iOAT. We compared the results, including semen volume, sperm count, sperm concentration, percentage of forward sperm motility, percentage of total sperm motility, percentage of normal forms and DNA fragmentation index (DFI) between the two groups treated with FSH or not. A total of 12 randomized controlled trials and one retrospective case-control study, including 924 people, were included in our meta-analysis. We found that sperm counts (MD 17.75; 95% CI 11.53-23.98 and p < 0.00001) were significantly increased in patients treated with FSH, along with improvements in sperm concentration (MD 4.52; 95% CI 1.46-7.58 and p=0.004), percentage of normal forms (MD 2.87; 95% CI 0.19-5.56 and p=0.04) and DFI (MD -12.62; 95% CI -19.27-5.97 and p=0.002). However, we found no significant differences in the two groups' changes in other semen parameters. The use of FSH can improve some semen parameters in patients with iOAT, such as sperm count, percentage of normal forms, sperm concentration and DFI.

Effects of Covid-19 vaccination on different semen parameters

BackgroundThe possible effects of COVID-19 vaccines on reproductive health and male fertility in particular have been discussed intensely by the scientific community and the public since their introduction during the pandemic. On news outlets and social media platforms, many claims have been raised regarding the deleterious effects of COVID-19 vaccines on sperm quality without scientific evidence. In response to this emerging conflict, we designed this study to evaluate and assess the effect of the Pfizer-BioNTech mRNA COVID-19 vaccine on male fertility represented by the semen analysis parameters.ResultsComparing the semen parameters of the participants before and after vaccination, no statistically significant effects on semen volume, pH or normal sperm concentration and morphology were shown. However, there were statistically significant differences on total sperm motility (P = 0.05) and progressive motility (P = 0.02). These differences are clinically insignificant given the fact that both readings before and after vaccination were within the normal ranges, according to the WHO manual guidelines for the examination and processing of human semen.ConclusionOur data suggest that the Pfizer-BioNTech mRNA COVID-19 vaccine has no deleterious effects on semen parameters.

P-053 Sperm chromatin integrity in men from infertile couples with teratozoospermia and normozoospermia

Abstract Study question What is the relationship between sperm morphology and sperm chromatin integrity (SCI) in patients with normal sperm concentration (SC) and motility (SM)? Summary answer SCI violations in form of sperm DNA fragmentation (SDF) and incomplete protamination (IP) are more common in teratozoospermia, even when SC and SM are normal What is known already Deterioration of sperm chromatin integrity in the form of SDF and IP are the significant factors affecting male reproductive potential (WHO, 2021). Study design, size, duration This multicenter retrospective cross-sectional study included 479 men aged 18-45 years who were observed for infertility for more than 1 year. Participants/materials, setting, methods Only men: 1) with sperm concentration and motility that were not lower than the 5% centile according to WHO-2021 (16 million/ml and 30%, respectively), 2) without any inflammatory processes in genitourinary organs, 3) with obtained tests for SCI were included in the study. The men were divided into 3 groups (gr.) depending on the percentage of morphologically abnormal forms: I - 86-95% (n = 229), II - 96-99% (n = 228), III - 100% (n = 22). Main results and the role of chance The mean SDF in groups I, II, III were 9.0% (6-15), 12.0% (8-16) and 16.5% (13-20) (pI-II = 0.009; pII-III = 0.002; pI-III = 0.001), respectively. SDF index (Halosperm® Assay) in groups I, II, and III were 1.3 (1.2-1.5), 1.4 (1.3-1.5), and 1.5 (1.4-1.7), respectively (pI-II = 0.004; pII-III = 0.001; pI-III = 0.009). In 23% (I), 27% (II), and 55% of cases (III) the SDF value exceeded the threshold value (&amp;gt;15%) (pI-II &amp;gt; 0.05; pII-III &amp;lt;0.02; pI-III &amp;lt;0.005). Histone-positive sperm were revealed in 17% (12-23), 19.5% (13-27), and 31% (19-42) of cases in groups I, II, and III, respectively (pI-II &amp;gt; 0.05; pII-III = 0.014; pI-III = 0.02); The 30% of SDF threshold value was exceeded in groups I, II, and III, in 12%, 20%, and 52% of cases (pI-II &amp;lt; 0.05; pII-III &amp;lt; 0.005; pI-III &amp;lt; 0.001). Limitations, reasons for caution The reference values of SDF and the proportion of histone-positive sperm have not yet been determined properly, even in WHO 2021, therefore, the prevalence of SCI abnormalities in various spermiological diseases needs to be clarified in the future. Wider implications of the findings SCI and IP can be applied more widely in the investigation of men from infertile couples, especially, men with teratozoospermia. It should also be considered in men from infertile couples with normal semen parameters. Trial registration number Not applicable

P-038 Comparison of three methods of semen analysis: A novel at-home sperm test kit, a computer-assisted assessment and an embryologist

Study questionHow does computer-assisted semen analysis (CASA) (Lenshooke, LOGIXX) and at-home sperm testing (ExSeed) compare with manual methodology assessment of male fertility based on WHO criteria (5thEdition); a three-method comparison study.Summary answerAll methods showed good agreement for concentration and limited agreement for motility highlighting the need for further development of alternatives to manual assessment.What is known alreadySeveral studies have shown good correlation between CASA systems and laboratory-based manual semen analysis, but only a few have carried out a three-way comparison study. One of which showed positive correlation with motility and concentration between a smartphone-based semen analysis and laboratory-based CASA system and positive correlation between concentration and motility between the smartphone-based CASA system and microscopic-based results. The at-home sperm test kit may play a role in motivating infertile males to visit clinics for early diagnosis and also reducing the need for multiple visits to the fertility clinic for repeat semen analyses.Study design, size, durationFifty patients (between 29 and 56 years) attending a fertility clinic were included in the study between September 2021 to December 2021. Semen samples were split into 3 aliquots and evaluated using manual semen assessment (MSA) according to the WHO 5th Edition (2010) guidelines, the ExSeed Home Sperm Test (HST) and the LensHooke® X1 PRO Semen Quality Analyzer (CASA).Participants/materials, setting, methodsThe semen samples were collected from fifty participants at CARE Fertility Tunbridge Wells. The samples were placed in an incubator at 37°C for 30 minutes to liquefy. After liquefaction, sperm concentration, total motility, total motile sperm count (TMSC) and normal morphology were evaluated. Spearman’s Rank correlations (>0.7) and Chi-squared tests were used and the p-value < 0.05 was considered as statistically significant.Main results and the role of chanceAll variables were highly significantly (p < 0.0002) positively correlated between all 3 methods.The greatest correlations were obtained for sperm concentration (CASA/HST: r = 0.826; MSA/HST: r = 0.870; MSA/CASA: r = 0.871) and TMSC (MSA/CASA: p = 0.792; CASA/HST: r = 0.800; MSA/HST: r = 0.854). Correlations for motility were markedly lower (MSA/HST: r = 0.611; CASA/HST: r = 0.717; MSA/LCASA: r = 0.750). The lowest correlation was found for morphology (MSA/CASA: r = 0.500). The HST device does not determine morphology.As compared to MSA, using the HST device agreement for normal or low sperm concentration (≥15 × 106/mL or < 15 × 106/mL respectively) was identified in 84.3% of the cases, whereas 94.0% with CASA. The agreement between CASA and HST was 82.0%. For total motility ≥ or < 40%, the agreements were 68.0% (CASA/HST), 56.9% (MSA/HST) and 82.0% (MSA/CASA), respectively.For the identification of patients with normal morphology >4%, the agreement between MSA and CASA was 30%.Limitations, reasons for cautionThe small sample size was 50 cases. The home testing device does not assess morphology. Furthermore, it is difficult to ascertain whether a consumer would carry out the analysis with this device with the same accuracy as an embryologist.Wider implications of the findingsThe need for repeated semen analyses, the effect of the COVID-19 pandemic and the discomfort some patients feel in a clinical setting, necessitate the need for evaluation of novel semen analysis approaches. These emerging technologies have potential to be more patient friendly, convenient and efficient than standard semen assessment methods.Trial registration numbernot applicable

P714: EFFECT OF TYROSINE KINASE INHIBITORS ON MALE FERTILITY IN PATIENTS WITH CHRONIC PHASE CHRONIC MYELOID LEUKAEMIA

Background: With the current availability of 3+ generations of tyrosine kinase inhibitors (TKIs) and the resultant survival benefit, chronic phase chronic myeloid leukaemia (CP-CML) is considered a chronic disease for most patients. Consequently, haematologists are faced more with questions regarding the effects of treatment on fertility and pregnancy outcomes. Whilst the teratogenic effect of TKIs is well established, data on their effect on fertility, and especially male fertility, are scarce. Semen analysis parameters (sperm number, motility and morphology) remain the cornerstone in assessing male fertility, despite its limitations in comprehensively assessing sperm functions. Aims: To compare semen analysis parameters before and after TKI therapy in CP-CML patients treated in the haematology department of Imperial College Healthcare NHS Trust (ICHNT). Methods: In collaboration with the Andrology Department, newly diagnosed men with CP-CML are offered sperm banking before starting cytoreductive or TKI therapy, and sperm analyses are routinely undertaken. Patients treated with TKIs who had sperm banking at diagnosis were invited for repeat semen analysis. Treatment history and semen analysis parameters were collected from patients’ paper/electronic medical records. Median and range were used to summarize continuous non-parametric data. Paired sample t-test was used to compare continuous semen analysis parameters before and after TKI therapy. Double-sided p value of < 0.05 was considered as statistically significant. SPSS version 25 software was used for statistical analysis. Results: Twenty-five patients were identified to have a semen analysis performed around the time of starting TKI therapy and were approached for repeat testing. Of those, 13 refused to participate, 1 was an international patient no longer residing in the UK and 1 stopped TKI therapy for treatment free remission trial. Therefore, 10 patients were finally included. Median age at diagnosis was 35.6 years (range: 22.9-45.4) and patients were diagnosed between 2001 to 2014. Six and 2 patients received hydroxyurea and interferon α, respectively, before TKI therapy. Six patients received 1 TKI (imatinib (IM), n = 4; nilotinib (NIL), n = 1; bosutinib (BOS), n = 1), 2 received 2 TKIs (IM followed by NIL), and 2 received 3 TKIs (IM, DAS, NIL and IM, NIL, DAS). Switches were for failure and/or intolerance. Median duration of TKI therapy at the time of repeat semen analysis was 5.9 years (range: 3.3-16.5). Patients 6 and 10 had the initial semen analysis after 736 and 475 days, respectively, from commencing TKI therapy and all remaining patients had it before starting. All patients had a deep molecular response at the time of the repeat semen analysis. The differences between sperm concentration, % progressive motility and % total motility were all non-statistically significant (p = 0.457, 0.535, and 0.574, respectively). In 2 patients the semen parameters were below the reference ranges in both occasions. Morphology (% normal forms) was less than the reference 4% in the repeat samples of 5 patients (Table 1). Image:Summary/Conclusion: In our cohort, no significant differences were found in sperm concentration or motility before and after treatment with different TKIs for a prolonged period. The relevance of the finding of a low % of normal forms, in the presence of normal sperm concentration and motility, in some of the patients in the semen sample after TKI therapy is not clear. Studies with larger sample size would be needed to confirm or refute our findings.

Relationship between paternal factors and embryonic aneuploidy of paternal origin

To determine if there is a relationship between paternal factors and embryonic aneuploidy of paternal origin using preimplantation genetic testing for aneuploidy (PGT-A). Retrospective cohort. Academic. Couples undergoing invitro fertilization with PGT-A. None. To determine if there is an association between paternal age, body mass index (BMI), or semen analysis parameters and paternal aneuploidy. From January 2015-2020, 453 invitro fertilization cycles (1,720 embryos) underwent PGT-A using single nucleotide polymorphism microarrays with parental support bioinformatics. The mean (±SD) was 36.5 (±3.5) years for maternal age, 39.5 (±5.5) years for paternal age, 24.7 (±5.0) kg/m2 for maternal BMI, and 27.6 (±4.3) kg/m2 for paternal BMI. Embryonic aneuploidy of paternal origin was found in 8.4% (144/1,720) embryos. There were 1,533 embryos with a recorded paternal BMI. Rates of embryonic aneuploidy of paternal origin were similar between men across BMI groups: BMI 18-24.9 kg/m2 was 7.2% (referent); BMI 25-29.9 kg/m2 was 8.4% (odds ratio [OR], 1.12; 95% confidence interval [CI], 0.79-1.82); and BMI ≥30 kg/m2 was 9.1% (OR, 1.31; 95% CI, 0.83-2.08). There were 854 embryos from men with a normal and 866 from men with an abnormal semen analysis. No differences were found in the rate of embryonic aneuploidy of paternal origin between men with normal and abnormal sperm concentration, total count, motility, progressive motility, or morphology. No significant difference was seen in rates of aneuploidy between men aged <50 years and those aged ≥50 years (OR, 1.69; 95% CI, 0.96-2.98). No association was found between paternal age, BMI, or semen analysis parameters and paternal aneuploidy.

Supplemental dietary curcumin improves testicular hemodynamics, testosterone levels, and semen quality in Baladi bucks in the non-breeding season

Improving the reproductive performance outside the breeding season could have a great impact on the animals' breeding industry. Curcumin (CUR) is a polyphenol known for its multi-effects on different biological issues due to its antioxidant, anti-inflammation, and anti-apoptotic properties. This study aimed, for the first time, to assess the supplemental dietary CUR effects on Baladi bucks’ reproductive performance in the non-breeding season. Ten Baladi bucks were used and allocated to two groups: the CON group received the basal diet only (n = 5); and the CUR group received the basal diet supplemented with CUR (200 mg/kg diet; n = 5) daily for six weeks. Testicular hemodynamics [TH; resistive index (RI), pulsatility index (PI), end-diastolic velocity (EDV), peak systolic velocity (PSV), and colored area toward the testes/pixels(CA)], testicular traits [testicular volume (TV) and echotexture (TE)], reproductive hormones [FSH, LH, testosterone (T) and estradiol 17β (E2)], nitric oxide levels (NO), and semen quality [mass motility (MM; score 0–5), progressive motility (PM%), normal sperm (NS%), viability (SV%) and sperm concentration (SC × 109/ml)] were evaluated. The examinations were started one week before CUR dietary inclusion (W-1) and continued once weekly until two weeks after the CUR withdrawal (W0–W8). Significant (P < 0.001) improvement was recorded in TH (RI, PI, EDV, PV, and CA) from W3 to W5 in the CUR group compared to the CON group. Testosterone and NO levels significantly (P < 0.001) increased in the CUR group in relation to the CON group; whereas E2, FSH, and LH were not affected by supplementation of CUR. Marked improvements (P < 0.01) in the semen quality parameters were noted in the CUR group. A significant increase in TV and a decrease in TE (P < 0.01) was recorded in the CUR group compared to the CON group. In conclusion, dietary supplementation of CUR at a 200 mg/kg diet improved the reproductive performance of Baladi bucks in the non-breeding season as evidenced by significant improvement of testicular hemodynamics, testosterone, and NO levels and semen quality.

PD20-05 HIGH PREVALENCE OF HORMONAL ABNORMALITIES IN MEN WITHOUT OLIGOSPERMIA

You have accessJournal of UrologyCME1 May 2022PD20-05 HIGH PREVALENCE OF HORMONAL ABNORMALITIES IN MEN WITHOUT OLIGOSPERMIA Matthew Hudnall, Bailey Goyette, Minh Pham, Jeremy Lai, Justin Dubin, Richard Fantus, James Wren, Nelson Bennett, Robert Brannigan, and Joshua Halpern Matthew HudnallMatthew Hudnall More articles by this author , Bailey GoyetteBailey Goyette More articles by this author , Minh PhamMinh Pham More articles by this author , Jeremy LaiJeremy Lai More articles by this author , Justin DubinJustin Dubin More articles by this author , Richard FantusRichard Fantus More articles by this author , James WrenJames Wren More articles by this author , Nelson BennettNelson Bennett 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.0000000000002558.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Newly updated male infertility guidelines from the American Urological Association recommend against universal hormone evaluation with measured levels of follicle stimulating hormone (FSH) and testosterone (T) in men with normal semen parameters due to prior limited data suggesting a low prevalence of abnormalities in this cohort. We sought to compare the prevalence of abnormal hormone parameters among men with and without sperm concentration abnormalities to determine the value of universal hormonal screening during fertility evaluation. METHODS: We retrospectively evaluated all men who underwent semen analysis (SA) and hormonal evaluation (morning serum T, FSH) at a large, integrated academic healthcare system between January 2002 and May 2021. Men were excluded if they had a prescription for T-modulating medications prior to index SA or if semen parameters were missing. Sperm concentration was dichotomized at 15 million/mL according to World Health Organization (WHO) criteria. Men with hormonal evaluation >1 year following index SA were excluded. We compared median and interquartile range (IQR) T and FSH levels according to sperm concentration using Kruskal-Wallis test. Differences in prevalence of low testosterone (<300 ng/dL) and abnormal FSH (>7.6 mIU/mL) were determined using Chi-square test. RESULTS: A total of 1,164 men had a morning serum T. There was no difference in median T among men with normal vs abnormal sperm concentration (316 ng/dL, interquartile range [IQR] 250-399 vs 316 ng/dL, IQR [253-419]; p=0.515). FSH level was measured in 1,261 men. Median FSH was higher among men with sperm concentration <15 million/mL (6 IU/mL, IQR 3.85-10.7 vs 3.8 IU/mL, IQR 2.7-5.7; p <0.001). Among men with ≥15 million/mL concentration, 44.1% were found to have low T (p=0.874) and 10.8% had an FSH ≥7.6 mIU/mL (p <0.001) (Table 1). Among men with ≥15 million/mL sperm concentration who underwent both T and FSH evaluation, 43.6% had at least 1 hormonal abnormality (Table 2). CONCLUSIONS: A large percentage of men with normal semen analysis had low T, challenging prior literature. As low T may have long-term implications for both fertility and overall health, providers should consider universal T screening in men presenting for fertility evaluation. Source of Funding: N/A © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e357 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Matthew Hudnall More articles by this author Bailey Goyette More articles by this author Minh Pham More articles by this author Jeremy Lai More articles by this author Justin Dubin More articles by this author Richard Fantus More articles by this author James Wren More articles by this author Nelson Bennett More articles by this author Robert Brannigan More articles by this author Joshua Halpern More articles by this author Expand All Advertisement PDF DownloadLoading ...

Impact of Vitamin C on Gene Expression Profile of Inflammatory and Anti-Inflammatory Cytokines in the Male Partners of Couples with Recurrent Pregnancy Loss

Immune system disorders and increased inflammation in the male reproductive system can lead to fetal risk in the early stages of development and implantation. Antioxidants such as vitamin C can play a protective role against sperm inflammatory reactions. This study aimed to evaluate the effect of vitamin C on the expression of inflammatory and anti-inflammatory cytokine genes in the male partners of couples with recurrent pregnancy loss. In this randomized clinical trial, twenty male partners of couples with RPL were examined for sperm parameters and expression profile of some inflammatory and anti-inflammatory cytokine genes before and after treatment with vitamin C. There was a statistically significant higher rate of normal morphology and sperm concentration in each patient before and after treatment with vitamin C (p ≤ 0.05). The mRNA levels of interleukin 6 and tumor necrosis factor-alpha were significantly decreased in the sperm of patients after treatment with vitamin C compared to before treatment. In contrast, the gene expression levels of interleukin 4 and transforming growth factor-beta showed a significant increase in the sperm of patients after treatment with vitamin C. Oral daily administration of vitamin C may be effective in the fertility potential of male partners of couples with RPL not only through the improvement of the sperm parameters but also by modulating the expression profile of inflammatory and anti-inflammatory genes. Further studies on protein levels are needed to clarify the role of TNF-⍺ and IFN-γ as a prognostic value in evaluating the recurrent abortion risk in infertile male partners. This trial is registered with IRCT20180312039059N1.

Quantitative karyological analysis of immature germ cells from ejaculate with normal sperm count

Introduction. The number of immature germ cells (IGCs) in ejaculate and the ratio of these cells at different stages of their differentiation can reflect meiotic progression and the state of spermatogenesis. Quantitative karyological analysis of immature germ cells from the ejaculate (QKA IGCs) makes it possible to distinguish and analyze all the stages of cell differentiation during spermatogenesis.Purpose. To analyze the spermatogenesis in men with impaired fertility and possible correlation between semen analysis and QKA IGCs parameters. Materials and methods. We analyzed 52 semen samples with normal sperm concentration, normal ejaculate volume and pH. Sperm examination according to WHO criteria and QKA IGCs from the ejaculate were performed (patent of L.F. Kurilo No. 2328736, 2007). According to the number of leukocytes, we divided two groups: a group with normal concentration of leukocytes in the ejaculate (group 1, n = 34) and a group with leukospermia (group 2, n = 18).Results. Increased IGCs index was found in 56 % of the samples in group 1 and 61 % of the samples in group 2. A positive statistically significant correlation was found between the number of spermatocytes I and sperm concentration (group 1), as well as the number of spermatocytes I and morphologically normal spermatozoa (group 2). The average number of non-divided spermatids in group 2 was statistically higher than in group 1. A negative statistically significant correlation was found between the number of non-divided spermatids and the number of morphologically normal spermatozoa, as well as the concentration of germ cells (group 2). Increased IGCs index was found in both pathozoospermia and normozoospermia.Conclusions. The QKA IGCs is an independent method for spermatogenesis evaluation and can be recommended as part of the protocol for examining men with reproductive disorders along with standard semen analysis.

LOW PERCENTAGE MOTILITY WHEN SPERM CONCENTRATION IS NORMAL DOES NOT APPEAR TO BE A CAUSE OF UNEXPLAINED FAILURE TO HAVE A LIVE DELIVERY DESPITE IN VITRO FERTILIZATION (IVF)

Some data suggest that sperm with very low motile density can lead to a trend for a lower chance of a live delivery following in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) even despite the transfer of embryos with apparent normal morphology. The purpose of the present study was to see if low % motility in the presence of normal sperm concentration can also be a subtle cause of unexplained infertility. Couples were identified who were sharing donor oocytes when both male partners had normal concentrations of their sperm (≥20x106/mL) but where one had motility <30% and the other ≥50%. Subsequent fertilization rates, embryo quality, as evidence by number of blastomeres on day 3 transfer, and pregnancy rates were determined. ICSI was used or not according to the discretion of the physician. Tabled 1Pregnancy rates based on % motility for shared oocyte cycles when sperm concentration ≥20 mill/mLMotility<30%≥50%# cycles3737% fertilized70.5%70.1%% 6-8 cell day 360.6%70.7%% clinical pregnancy/transfer58.3%68.0%% miscarriage/clinical pregnancy live0.0%35.3%% delivered58.3%44.0%% implantation31.3%40.0% Open table in a new tab There were no statistical differences or trends that would suggest that low % motile sperm, despite normal sperm concentration, leads to embryos with a lower chance to achieve a live delivery. With no trends seen at all, the study will not be continued. Based on other studies, there is a suggestion that sperm from men with very low motile density, used for IVF-ET, the embryos formed, though appearing to be morphologically normal, may be the cause of lower live delivered pregnancy rates. This raised the question as to the possibility that sperm with very low MD may be more likely to have chromosome defects. That data was also based on similar evaluation of matched pairs sharing one pool of oocytes, thus ruling out an oocyte factor. It does not seem that low percentage of sperm motility is a subtle cause of unexplained infertility when sperm concentration was normal based on this pilot study.

DOES THE LOW SPERM CONCENTRATION ON THE DAY OF INTRAUTERINE INSEMINATION (IUI) AFFECT THE REPRODUCTIVE OUTCOME OF IUI CYCLES

The conventional semen analysis is known to have high intra-individual and inter-individual variability. Low sperm concentration on the day of intrauterine insemination (IUI) could raise concerns in patients and clinicians. The present study is aimed to estimate the prevalence of of low sperm concentration on the day of IUI and its effect on pregnancy rate in men with normal sperm concentration on initial evaluation.1,2

THE EFFECT OF INSEMINATION METHODS ON EMBRYO MOSAICISM IN PREIMPLANTATION GENETIC TESTING FOR ANEUPLOIDY (PGT-A) CYCLES

The objective of this study was to determine if conventional insemination vs. intracytoplasmic sperm injection (ICSI) results in a higher incidence of embryo mosaicism in IVF cycles with PGT-A. This exempt retrospective chart review was evaluated and approved by the Eastern Virginia Medical School Institutional Review Board. Cycle data were collected for 545 IVF cycles with PGT-A between July 2018 to October 2020 with one of the following methods of insemination: all ICSI (N = 369), all conventional insemination (IVF; N = 103), or a combination of both ICSI and IVF (COMBO; N = 73). A total of 2,672 embryos were biopsied from these cycles, and samples were sent to a single genetics facility for testing with next generation sequencing. Rates of euploid, aneuploid and mosaic embryos were compared between insemination methods by analyzing the aggregate data by two proportional z-tests. Secondary outcomes – including embryos fertilized, good day 3 development, total blastocyst development, mosaic embryo anomalies, clinical uterine gestation (CIG), and implantation rate – were analyzed by two proportional z-tests, and the Pearson chi-square test was used to compare outcomes for frozen embryo transfers (FET). Statistical analysis was performed using Intellectus Statistics software, and a p-value of less than 0.05 was defined as statistically significant, with a 95% confidence interval. Rates of mosaicism were similar between ICSI and conventional insemination when examining total aggregate data (11% vs. 11%), COMBO cycles, intra-cohort comparison, oocyte age groups, and normal and oligospermic semen samples. A significant difference was only found between embryos from testicular cycles and oligospermic cycles (17% vs. 9%, p=0.019). Occurrences of increased aneuploidy with ICSI, when compared to conventional insemination, were found from aggregate data (p=0.006), COMBO cycles (p<0.001), all IVF vs. IVF embryos from COMBO cycles (p=0.007), maternal age ≥38 (p=0.033), and in cycles with normal sperm concentration (p=0.001). However, FET outcomes, including pregnancy loss and implantation, did not differ between insemination methods. Within mosaic embryos, significantly higher percentages were seen of low-level compared to high-level (p=<0.001) and whole chromosome vs. segmental (p<0.001) mosaicism, but there were no differences found for the same comparisons by insemination type. Conventional insemination did not have a significant impact on levels of embryo mosaicism, and the only significant increase in mosaicism resulted from testicular samples. Although more research is needed, this study did observe a significant increase in aneuploidy from ICSI-derived embryos, which may suggest the use of ICSI preferably for cycles with male infertility only.

Using Data Mining to Assist in Predicting Reproductive Outcomes Following Varicocele Embolization.

We carried out a retrospective analysis of infertile couple data using several methodologies and data analysis techniques, including the application of a novel data mining approach for analyzing varicocele treatment outcomes. The aim of this work was to characterize embolized varicocele patients by ascertaining the improvement of some of their clinical features, predicting the success of treatment via pregnancy outcomes, and identifying data patterns that can contribute to both ongoing varicocele research and the more effective management of patients treated for varicocele. We retrospectively surveyed the data of 293 consenting couples undergoing infertility treatment with male varicocele embolization over a 10-year period, and sperm samples were collected before and at 3, 6, and 12 months after varicocele embolization treatment and analyzed with World Health Organization parameters—varicocele severity grades were assessed with medical assessment and scrotal ultrasound, patient personal information (e.g., age, lifestyle, and embolization complications) was collected with clinical inquiries, and varicocele embolization success was measured through pregnancy outcomes. Varicocele embolization significantly improved sperm concentration, motility, and morphology mean values, as well as sperm chromatin integrity. Following this study, we can predict that a male patient without a high varicocele severity grade (with grade I or II) has a 70.83% chance of conceiving after embolization treatment if his partners’ age is between 24 and 33 with an accuracy of 70.59%. Furthermore, male patients successful in achieving pregnancy following embolization are mostly characterized by having a normal sperm progressive motility before treatment, a normal sperm concentration after treatment, a moderate to low varicocele severity grade, and not working in a putatively hazardous environment.

The outcome of intra-cytoplasmic sperm injection (ICSI): do the sperm concentration and motility matter?

The male-factor subfertility was reported to be 30% globally; thus, the intracytoplasmic sperm injection (ICSI) procedure was implemented to improve the overall in vitro fertilization (IVF) rates. Nevertheless, at least 10% of fertilization failure still occurs. Concerning this issue, we explored the association of sperm concentration and motility with the quality of embryo development and pregnancy outcome in IVF-ICSI cycles. Retrospective analysis of 109 couples with male factor were done over 14months in a tertiary university hospital in Malaysia. The data were divided into four groups; Group I: normal sperm parameters, Group II: normal sperm concentration but reduced total sperm motility, Group III: reduced sperm concentration and motility, Group IV: reduced sperm concentration but normal sperm motility. Only fresh semen samples and fresh embryo transfers were included. The fertilization, cleavage rate, embryo quality and pregnancy outcome were assessed. Overall, group I had the highest oocytes yield and ICSI attempted; (10.12+6.50), whereas the lowest was in group IV; (7.00+2.82). Group II revealed the highest fertilization and cleavage rates; (54.14+25.36), (55.16+26.06), thus not surprisingly resulting in the highest number of good embryos and highest clinical pregnancy rates. The lowest cleavage and pregnancy rates were seen in group IV. However, all the outcomes were not statically significant (p>0.05). Similar fertilization rate and comparable pregnancy outcome was seen among couples with normal and reduced sperm concentration and motility.

Honey Improves Sperm Parameters in High Cholesterol Diet-Fed Male Rabbits

Overconsumption of a high-energy diet has a negative impact on sperm motility, morphology, vitality and concentration. Hence, this study aims to investigate the effects of honey on sperm parameters of high cholesterol diet-fed rabbits and compare its effects with atorvastatin. Forty-eight male New Zealand white rabbits were assigned into 6 groups: Control (C): commercial pellet; CH: commercial pellet and 600 mg/kg/day Trihoney; HCD: 1% cholesterol diet; DH1: 1% cholesterol diet and 300 mg/kg/day Trihoney; DH2: 1% cholesterol diet and 600 mg/kg/day Trihoney; DAt: 1% cholesterol diet and 2 mg/kg/day atorvastatin. After 12 weeks, each rabbit was anaesthetized. Sperm were obtained from the cauda of the epididymis. Percentages of progressive (PM) and total motility (TM) were assessed using light microscope. Vitality and morphology were assessed using Eosin-Nigrosin stain. Sperm concentration was calculated using haemocytometer. Administration of 1% cholesterol diet reduced the percentages of PM, TM and normal sperm. Treatment with atorvastatin reduced the percentages of PM, TM, live and normal sperm. A marked reduction in sperm concentration was detected in the HCD and DAt groups. Trihoney groups expressed significantly higher percentages of PM, TM, normal sperm, live sperm and sperm concentration than the HCD and DAt groups. These results indicate that Trihoney has the potential to minimize the negative impacts of a high cholesterol diet on sperm parameters.

Association of GH gene polymorphism with growth and semen traits in rabbits

&lt;p&gt;Although growth hormone (&lt;em&gt;GH&lt;/em&gt;) gene mutations are described in several species, the studies concerning their variabilities and associations with economic traits in rabbits are scarce, particularly associations with semen traits. A total of 149 rabbit bucks from five populations (V-line=36, Moshtohor line=28, APRI line=42, cross ½A½M=23, and Gabali=20) were used in the present study to identify polymorphism of c.-78 C&amp;gt;T single nucleotide polymorphism (SNP) of &lt;em&gt;GH&lt;/em&gt; gene among these populations and to investigate the association of &lt;em&gt;GH&lt;/em&gt; gene polymorphism with body weight (BW), daily weight gain (DG) and semen traits. DNA was extracted from blood samples for genotyping of c.-78 C&amp;gt;T SNP of &lt;em&gt;GH&lt;/em&gt; gene based on polymerase chain reaction with the restriction fragment length polymorphism (PCR-RFLP) technique. The genetic diversity of SNP C&amp;gt;T of &lt;em&gt;GH&lt;/em&gt; gene was assessed in terms of genotypic and allelic frequencies, effective number of alleles (Ne), observed (Ho) and expected (He) heterozygosity, Hardy-Weinberg equilibrium (HWE), reduction in heterozygosity due to inbreeding (F&lt;sub&gt;IS&lt;/sub&gt;) and polymorphism information content (PIC). Three genotypes of TT, CC and TC of PCR product of 231 bp of &lt;em&gt;GH&lt;/em&gt; gene were detected and all the populations were in HWE in terms of &lt;em&gt;GH&lt;/em&gt; gene. The highest Ne was obtained for the Moshtohor line (1.978), while the lowest allelic numbers were obtained for V-line (1.715) and Gabali breed (1.800). The highest genotype frequency of &lt;em&gt;GH&lt;/em&gt; gene was 0.48 in TT genotype of V-line, 0.21 in CC genotype of Moshtohor line, 0.67 and 0.56 in TC genotype of ½A½M and Gabali rabbits (&lt;em&gt;P&lt;/em&gt;&amp;lt;0.05). The highest frequency for C allele was recorded by Moshtohor line (0.45) and the lowest frequency by Gabali (0.32). The genetic diversity scores for &lt;em&gt;GH&lt;/em&gt; gene were intermediate (Ho=0.551, He=0.471, PIC=0.358). The values of Ho ranged from 0.444 in V-line to 0.667 in ½A½M cross, while the values of He were 0.425 in V-line and 0.508 in Moshtohor line. The values of PIC were moderate and ranged from 0.332 in V-line to 0.375 in M-line. The highest F&lt;sub&gt;IS&lt;/sub&gt; was observed in Moshtohor line (0.042) and the lowest value was observed in ½A½M cross (–0.413). The CT genotype of &lt;em&gt;GH&lt;/em&gt; gene showed the highest and significant values for body weights at 4, 8, 10 and 12 wk (542, 1131, 1465 and 1861 g) and daily gains at intervals of 4-6 and 8-10 wk (23.1 and 26.5 g). Additionally, the CT genotype recorded the highest and significant values for volume of ejaculate (1.1 mL), sperm motility (57.6%), live sperm (85.6%), normal sperm (93.1%) and sperm concentration in semen (611×106/mL), along with the lowest and significant values for dead sperms (14.4%) and abnormal sperms (6.9%).&lt;/p&gt;

Effects of firefighting on semen parameters: an exploratory study.

Lay summaryFirefighters are occupationally exposed to heat intensities and chemical concentrations that may affect fertility. Twenty firefighters participated in an exploratory study assessing fertility of firefighters via an online survey and semen analysis. Data analysis included consideration of demographic characteristics, reproductive history and occupational exposures. Overall, firefighter semen parameters were below World Health Organisation reference values designating fertility in men. Firefighters younger than 45 years had a higher incidence of abnormal semen parameters (42%) than those aged 45 years or greater (9%). Increased rank and higher levels of occupational and/or personal hygiene were associated with improved semen quality. Increased frequency of fire exposure was associated with a reduction in normal forms, volume, sperm concentration and total sperm count. Sperm clumping was greater than 10% in 26% of samples, suggesting reduced semen quality. This exploratory study provides novel data that support the hypothesis of an association between semen quality and firefighter’s occupational exposure to toxic environments.

Serum amyloid P component: a new biomarker for low sperm concentration?

Serum amyloid P component (SAP) is present in seminal plasma, on spermatozoa, and in different tissues of the male reproductive tract, but its function is not known. The aims of this study were to determine if the concentration of SAP in seminal plasma is associated with commonly assessed semen parameters and to investigate if SAP could be a new, indirect biomarker for these parameters. In a cross-sectional study of 203 young volunteers, the concentration of SAP in seminal plasma was measured with a in-house developed enzyme-linked immunosorbent assay. Scatter plots, Pearson's correlation coefficients (r), and linear regression models were produced, and SAP showed a statistically significant correlation with sperm concentration (r = 0.75), sperm number (r = 0.68), semen volume (r = −0.19), progressive sperm motility (r = 0.24), and sperm immotility (r = −0.20). When the study group was dichotomized, SAP could be used to discriminate samples with a sperm concentration < or ≥5 × 106 ml−1, 15 × 106 ml−1, or 40 × 106 ml−1, and in receiver operating characteristic curves, the corresponding areas under the curves were 0.97, 0.93, and 0.82, respectively, with P < 0.001 for all three cutoff values studied. The concentration of SAP in seminal plasma showed a strong, positive correlation with the concentration of spermatozoa in semen. SAP may be used as a new indirect potential biomarker for sperm concentration in fresh and in frozen, stored samples. In addition, it is envisaged that the assay could be developed into a home fertility test to differentiate between a low and a normal sperm concentration.

Point-of-care semen analysis of patients with infertility via smartphone and colorimetric paper-based diagnostic device.

Male infertility affects millions of males worldwide and is rising in prevalence due to social and environmental conditions. However, men often feel too embarrassed to receive a semen analysis in the hospital due to social stigmas. To overcome this problem, we developed a 3‐(4,5‐Dimethyl‐2‐thiazolyl)‐2,5‐diphenyl‐2H‐tetrazolium bromide test strip to distinguish semen samples with low total motile sperm concentration from those with normal motile sperm concentration. This is a point‐of‐care colorimetric semen analytical method with a one‐step, inexpensive, equipment‐free evaluation process, and adequate accuracy validated in a 42‐sample clinical trial. In this study, results were evaluated visually and with a smartphone application. Using visual observation methods, the area under the curve (AUC) was 0.71 (95% of confidence interval = 0.55–0.86; p = 0.021), sensitivity was 41%, specificity was 95%, positive predictive value was 90%, negative predictive value (NPV) was 59.4%, and accuracy was 67%. Using a smartphone recording and analytical system, AUC was 0.766 (95% of confidence interval = 0.612–0.92; p = 0.003), sensitivity was 96%, specificity was 65%, PPV was 75%, NPV was 92.9%, and accuracy was 80.9%. This work demonstrated a screening tool that could elevate semen analysis to the level of routine healthcare and provide for private, in‐home self‐assessment.