Assisted Conception Techniques: Which One to Choose (original) (raw)
Related papers
2017
D espite the ongoing controversies regarding the accuracy and predictive power of routine semen analysis, it continues to be used by many clinicians worldwide as the de facto test for male infertility (Int Braz J Urol 2014; 40:443-53). In its best practice statement for the evaluation of the infertile male, the AUA has proposed the use of advanced tests of sperm function in certain patients to enhance the diagnostic accuracy of semen analysis, specifically in cases of unexplained infertility, recurrent pregnancy loss, or failure of intrauterine insemination (IUI) and in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) (The Optimal Evaluation of the Infertile Male. AUA Best Practice Statement, 2010). As explained in this article, these new tests have the potential to improve our ability to better diagnose and treat complicated male infertility patients.
An update on the management of male infertility
The Obstetrician & Gynaecologist, 2020
Key content Male infertility underlies or contributes to up to 50% of infertility cases; current therapeutic interventions rely on assisted reproductive technology (ART), as medical or surgical treatments have limited value in enhancing semen quality or parameters. Lifestyle factors that affect male fertility could offer a therapeutic opportunity; however, their modification seems to be of variable benefit. In the quest for sperm functional assessment and selection tests, there is controversy over which patients, if any, should be tested for sperm DNA fragmentation, as well as which test to perform. Sperm selection techniques for intracytoplasmic sperm injection do not appear to significantly improve treatment outcomes or live birth rates. Routinely performed genetic tests are effective in determining aetiology in approximately 20% of infertile men; however, newer genetic tests could enhance diagnosis and change the future management of male infertility. Learning objectives To summa...
Are specialized sperm function tests clinically useful in planning assisted reproductive technology?
International braz j urol, 2020
40-year-old male patient and 32-year-old female partner, with a history of primary infertility of two years duration. The workup revealed idiopathic mild oligoasthenotheratozoospermia, and no apparent female infertility factors. The couple has failed three intrauterine insemination (IUI) cycles, planning more IUI cycles but also considering in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
Sperm function and assisted reproduction technology
Reproductive Medicine and Biology, 2005
The evaluation of different functional sperm parameters has become a tool in andrological diagnosis. These assays determine the sperm's capability to fertilize an oocyte. It also appears that sperm functions and semen parameters are interrelated and interdependent. Therefore, the question arose whether a given laboratory test or a battery of tests can predict the outcome in in vitro fertilization (IVF).
Advances in male infertility treatment through Assisted Reproductive Technology
IntechOpen eBooks, 2023
Male infertility is responsible for 40-50% of human infertility. Earlier treatment options for male factor infertility included timed intercourse, intrauterine insemination, or in vitro fertilization. These techniques are not helpful in severe male factor infertility cases as either the sperm number is extremely low or sperm motility is very poor. The introduction of intracytoplasmic sperm injection has opened the door for numerous advancements as only one sperm is needed for one egg. It has enabled men with few or no sperm in their ejaculates to have their own offspring. Surgical sperm retrieval techniques, with or without the help of a microscope, have been invented to retrieve sperm from the epididymis or testicular tissue. The clinical outcomes after the utilization of these techniques are similar to those obtained after the use of ejaculated sperm. Preimplantation genetic tests are now available to detect chromosomal aneuploidies, single gene defects, or chromosomal structural rearrangements in embryos created by using normal or defective sperm or eggs. This chapter explains in a comprehensible way, the basic and the more advanced assisted reproductive technologies to treat male factor infertility.
In vitro fertilization/intracytoplasmic sperm injection for male infertility
Indian Journal of Urology, 2011
Progress in the field of assisted reproduction, and particularly micromanipulation, now heralds a new era in the management of severe male factor infertility, not amenable to medical or surgical correction. By overcoming natural barriers to conception, in vitro fertilization and embryo transfer (IVF-ET), subzonal sperm insemination, partial zona dissection, and intracytoplasmatic injection of sperm (ICSI) now offer couples considered irreversibly infertile, the option of parenting a genetically related child. However, unlike IVF, which necessitates an optimal sperm number and function to successfully complete the sequence of events leading to fertilization, micromanipulation techniques, such as ICSI, involving the direct injection of a spermatozoon into the oocyte, obviate all these requirements and may be used to alleviate severe male factor infertility due to the lack of sperm in the ejaculate due to severely impaired spermatogenesis (non-obstructive azoospermia) or non-reconstructable reproductive tract obstruction (obstructive azoospermia). ICSI may be performed with fresh or cryopreserved ejaculate sperm where available, microsurgically extracted epididymal or testicular sperm with satisfactory fertilization, clinical pregnancy, and ongoing pregnancy rates. However, despite a lack of consensus regarding the genetic implications of ICSI or the application and efficacy of preimplantation genetic diagnosis prior to assisted reproductive technology (ART), the widespread use of ICSI, increasing evidence of the involvement of genetic factors in male infertility and the potential risk of transmission of genetic disorders to the offspring, generate major concerns with regard to the safety of the technique, necessitating a thorough genetic evaluation of the couple, classification of infertility and adequate counseling of the implications and associated risks prior to embarking on the procedure. The objective of this review is to highlight the indications, advantages, limitations, outcomes, implications and safety of using IVF/ICSI for male factor infertility to enable a more judicious use of these techniques and maximize their potential benefits while minimizing foreseen complications.
An update on the clinical assessment of the infertile male
2011
Male infertility is directly or indirectly responsible for 60% of cases involving reproductive-age couples with fertility-related issues. Nevertheless, the evaluation of male infertility is often underestimated or postponed. A coordinated evaluation of the infertile male using standardized procedures improves both diagnostic precision and the results of subsequent management in terms of effectiveness, risk and costs. Recent advances in assisted reproductive techniques (ART) have made it possible to identify and overcome previously untreatable causes of male infertility. To properly utilize the available techniques and improve clinical results, it is of the utmost importance that patients are adequately diagnosed and evaluated. Ideally, this initial assessment should also be affordable and accessible. We describe the main aspects of male infertility evaluation in a practical manner to provide information on the judicious use of available diagnostic tools and to better determine the etiology of the most adequate treatment for the existing condition.