Clinical assessment of the male fertility (original) (raw)
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Assessment of sperm function in fertile and infertile men
Andrologia, 2009
Summary. The sperm function of fertile men (control), infertility patients (experimental), and men with varicocele were compared. The bioassays used were the follicular fluid-induced acrosome reaction, the binding to the zona pellucida, and the penetration of zona-free hamster oocytes. The percentage (mean ± SEM) of reacted spermatozoa was 35 ± 3 in the control, 22±1 in the experimental, and 22 ± 3 in the varicocele. The minimum value of acrosome reaction in control men was 20%. The mean number of zona-bound spermatozoa was 250 ± 30 in the control, 160 ± 28 in the experimental, and 196 ± 44 in the varicocele. The minimum number of zona bound spermatozoa in control men was 50. The mean number of hamster oocytes penetrated was 50 ± 8 in the control, 19 ± 3% in the experimental, and 10 ± 3 in the varicocele. The minimum number of oocytes penetrated in control men was 6%. In the experimental group, 22 men had a normal sperm function, 58 had 1 or 2 bioassays below the minimum (relative dysfunction), and 10 had all bioassay below the minimum (abnormal sperm function). The results of these bioassays could help to reclassify the infertile men in several subgroups.
Semen evaluation: methodological advancements in sperm quality-specific fertility assessment
Animal Bioscience, 2021
Assessment of male fertility is based on the evaluation of sperm. Semen evaluation measures various sperm quality parameters as fertility indicators. However, semen evaluation has limitations, and it requires the advancement and application of strict quality control methods to interpret the results. This article reviews the recent advances in evaluating various sperm-specific quality characteristics and methodologies, with the help of different assays to assess sperm-fertility status. Sperm evaluation methods that include conventional microscopic methods, computer-assisted sperm analyzers (CASA), and flow cytometric analysis, provide precise information related to sperm morphology and function. Moreover, profiling fertility-related biomarkers in sperm or seminal plasma can be helpful in predicting fertility. Identification of different sperm proteins and diagnosis of DNA damage has positively contributed to the existing pool of knowledge about sperm physiology and molecular anomalies associated with different infertility issues in males. Advances in methods and sperm-specific evaluation has subsequently resulted in a better understanding of sperm biology that has improved the diagnosis and clinical management of male factor infertility. Accurate sperm evaluation is of paramount importance in the application of artificial insemination and assisted reproductive technology. However, no single test can precisely determine fertility; the selection of an appropriate test or a set of tests and parameters is required to accurately determine the fertility of specific animal species. Therefore, a need to further calibrate the CASA and advance the gene expression tests is recommended for faster and field-level applications.
Andrologia, 2019
The identification of idiopathic infertility cases, actually, is impossible. Among new functional tests, developed to improve the male fertility diagnosis, the evaluation of spermatic myo-inositol (MI) level, known as Andrositol ® test (AT), is one of the most interesting, considering its weak economic burden and ease of use. The aim of this study was to evaluate the predictive power of AT and its potential use for a preliminary evaluation of semen samples. To evaluate the predictive power of AT, 87 sperm samples were analysed in comparison with spermiogram and sperm chromatin dispersion (SCD) Test, the gold standard analyses for male fertility evaluation. The application of AT resulted very useful for a preliminary sample evaluation, predicting the absence of DNA fragmentation in case of Low Responder samples precisely, and the presence of DNA fragmentation in case of medium or High Responder samples with abnormal morphology, predicting SCD results with a probability of 80% for Medium Responder sample and of 96.7% for High Responder sample. Considering the predictive power of this method, we could imagine, as preliminary qualitative analysis, its application before SCD test, deepening sperm analysis, improving the daily activities of laboratory operators and maintaining a good reliability of sperm evaluation.
International Journal of Aging Research, 2020
According to the World Health Organization, about 8 to 10% of couples worldwide have infertility problems and male internal aspects are the main reasons for half of occurrences of human sterility. Through the spermogram, it is possible to qualitatively and quantitatively analyze semen, contributing to the diagnosis of male fertile state. Objective: To study the relationship among sperm viscosity, concentration, motility and volume parameters and male infertility factors and to show the influence of the subject age on these seminal parameters. Methodology: A survey was conducted in the male infertility database of the Nascer Clinic (Recife / Pernambuco) of men aged 27 to 61 years, with a history of marital infertility, from 2018 to 2019. The subjects studied were grouped into categories according to the classification of the seminal parameters analyzed (volume, concentration, motility and viscosity) in their sperm. Student's t-test was used for normal distribution and Mann-Whitney test for non-normal using the GraphPad Prism 8 program. Results: Among the studied individuals, there was a significant difference (p <0.05) between the populations with obstructive azoospermia and nonobstructive azoospermia and among the percentages of oligozoospermic individuals with obstructive azoospermia. The azoospermia group had a significantly higher average age than the normozoospermia group. Conclusions: This suggests that azoospermia is present in older men, compromising male fertility. Sperm testing should be performed by all men of childbearing age to investigate possible changes in the genesis of gametic cells.
Significance of sperm characteristics in the evaluation of male infertility
Fertility and Sterility, 2006
Objective: To compare sperm characteristics among: patients undergoing infertility evaluation, patients with male factor infertility (MFI), healthy sperm donors, and men with proven fertility; to examine the overlap of sperm characteristics in all four of these groups; and to identify good discriminators of fertility versus infertility among sperm characteristics. Design: Retrospective study. Setting: Male infertility clinic at a tertiary care hospital. Patient(s): Proven fertile men (n ϭ 56), normal donors (n ϭ 91), men presenting for infertility evaluation (n ϭ 406), and MFI patients (n ϭ 166). Intervention(s): None. Main Outcome Measure(s): Routine semen analysis. Result(s): Using current World Health Organization (WHO) reference values, a large group of MFI patients presented with higher sperm concentration (27.5 ϫ 10 6 to 99.2 ϫ 10 6 ), resulting in broader overlap with fertile men and poor sensitivity (0.48).
Volume 13, Number 4, Jan-Mar 2020 Pages: 324-329, 2020
Background Imbalance between production of reactive oxygen species (ROS) and total antioxidant capacity in testis, epididymis, and seminal fluid can eventually lead to infertility. Abnormal sperm chromatin packaging, and DNA fragmentation is considered as the main underlying causes of infertility. Therefore, we aimed to assess relationship between sperm parameters with DNA damage, protamine deficiency, persistent histones, and lipid peroxidation in infertile men with at least one failed cycle after intracytoplasmic sperm injection (ICSI). Materials and Methods In this experimental study, semen samples were collected from infertile men with at least one failed intracytoplasmic sperm injection (ICSI) cycle (n=20). Sperm parameters, DNA damage, protamine de- ficiency, persistent histones, and lipid peroxidation were assessed using computer-assisted sperm analysis (CASA) system, sperm chromatin structure assay (SCSA) and Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assays, chromomycin A3, aniline blue, and BODIPY C11 staining, respectively. Results A negative significant correlation was observed between sperm concentration with percentage of sperm persistent histones (r=-0.56, P=0.02), while positive significant correlations were found between percentage of sperm persistent histones with percentage of abnormal morphology (r=0.54, P=0.02), CMA3-positive spermatozoa (r=o.6, P=0.008) and intensity of lipid peroxidation (r=0.6, P=0.01). In addition, significant correlation was observed be- tween sperm DNA damage with intensity and percentage of lipid peroxidation (r=0.62, P=0.009). Correlation between CMA3-positive spermatozoa and intensity of lipid peroxidation (r=0.5, P=0.03) were also significant. Conclusion Observed significant correlations between sperm functional tests in infertile men with at least one failed ICSI cycle, indicated that the reduction of oxidative stress by antioxidant supplementation may be considered as one therapy approach that can improve sperm function and increase the chance of successful clinical outcomes in next assisted reproductive cycle.
Diagnostic value of advanced semen analysis in evaluation of male infertility
Andrologia, 2020
Couples who are unable to conceive within a year of regular, unprotected sexual intercourse are recommended to seek evaluation. In about 40% of the couples, infertility is caused by a male factor and by both partners in an additional 20% of couples. The underlying causes for male infertility are multifactorial, with about 20% of these cases being idiopathic (Ayaz et al., 2015; Louis et al., 2013). 1.1 | Overview of semen analysis and its implications According to the guidelines of the World Health Organization (WHO, 2010), the clinical evaluation of male patients includes a medical history, physical examination and at least two semen analyses. The conventional semen analysis is very important in identifying the severity of male factor infertility and guiding future analysis and treatment (Agarwal & Bui, 2017). It further includes the determination of volume, pH, colour, viscosity, liquefaction time, number of round cells, sperm total count, concentration, motility and normal sperm morphology. 1.2 | Limitations of semen analysis in predicting fertility status Although standard semen analysis remains the standard of care to initially evaluate male patients with infertility, a routine semen analysis does not accurately identify the aetiology of infertility or predict the reproductive success (Snow-Lisy & Sabanegh, 2013). Routine semen analysis yields variable results due to inter-and intra-observer variability, and it gives no information about sperm dysfunctions at cellular and molecular levels (Agarwal & Bui, 2017; Esteves, 2014). Moreover, the lower reference limits established by the WHO are not applicable to all men as values of semen parameters overlap in fertile and infertile men. Therefore, the exact cause of idiopathic and unexplained male infertility remains unknown, even after performing routine semen analysis (Hamada, Esteves, & Agarwal, 2011; Wallach et al., 1983). Normal semen parameters do not equate with a normal fertilisation potential of spermatozoa (Hamada et al., 2011; Lewis, 2007). As a consequence, more advanced tests are needed to accurately diagnose male infertility and predict pregnancy in couples trying to conceive naturally or couples undergoing assisted reproductive technologies (ART; Oehninger, Franken, & Ombelet, 2014).
Annals of Pathology and Laboratory Medicine, 2017
Background: Infertility is both a clinical and a public problem. Standard semen analysis is the surrogate measure of male fertility in clinical practice to determine prevalence of low sperm count including oligozoospermia and azoospermia and to assess the pattern and distribution of abnormal semen parameters in infertile men. Methods: The retrospective study was conducted with compiling of the data from archival record over a period of three years from June 2013 to June 2016. A total of 933 male partners of women attending the fertility clinic of hospital between the ages of 20 and 50 years were recruited. The samples taken were primary infertility cases using simple random sampling technique. Semen analysis was performed according to the standards outlined by the World Health Organization (5th edition 2010). Parameters outlined included: Appearance, Volume, pH, Sperm concentration, Motility, Morphology, Viability and White cell count. Result: Out of 933 samples, normozoospermia was observed in 659 (70.6%) males, oligozoospermia 170 (18.2%), and azoospermia 104 (11.1%). The azoospermic and oligozoospermic samples had low ejaculated volume, but significantly higher percentage of pus cells in comparison to normozoospermic samples. The oligozoospermic samples had higher percentage of immotile sperms and abnormal morphology in comparison to normozoospermic samples. Asthenozoospermia was observed in 118 (14.2%), teratozoospermia in 24 (2.9%), and oligoteratozoospermia in 11 (1.3%) of samples. Conclusion: Majority of cases of infertility in males show normal sperm count. Oligozoospermia followed by azoospermia is seen in rest of the cases while less sperm motility or less amount of semen are also responsible in some cases.
Semen Analysis and Insight into Male Infertility
Open Access Macedonian Journal of Medical Sciences
Objectives: Semen analysis is the cornerstone for the valuation of the male partner in the infertile couples. This test has been standardized throughout the world through the World Health Organization (WHO) since the1970s by producing, editing, updating, and disseminating a semen analysis manual and guidelines. A retrospective study to give an insight about male infertility. Methods: This retrospective study assessed the semen findings of 1000 men evaluated at the Department of Urology, Al-Kindy Teaching Hospital in Baghdad-Iraq between January 2016 and May 2019. Semen analysis were done for them. Results: According to WHO standard for semen normality, 1000 samples that were analyzed, normospermia was shown in 835 (83.5%)males (95% CI=0.811-0.857) and 12% had oligospermia and the rest 4.5% was azospermia. The normospermic samples had significantly higher levels regarding the following parameters: count per ml (51.30±1.24) (P= 0.001), volume(3.34±2.31)(P=0.0001), pus cell (8.04±1....