[The correlation between sperm DNA damage and IVF-ET clinical pregnancy outcomes in different BMI population with normal routine semen examination].

OBJECTIVE: To analyze the correlation between sperm DFI, HDS and IVF-ET pregnancy outcomes in different BMI populations with normal routine semen examination. METHODS: The clinical data of 199 cycles of IVF-ET were retrospectively analyzed. Sperm chromatin structure analysis based on flow cytometry was used to detect sperm DFI and HDS. The correlation between sperm DFI, HDS and pregnancy outcome of IVF-ET were analyzed. RESULTS: The sperm DFI was negatively correlated with IVF-ET pregnancy in overweight (24.0 kg/m2≤BMI<28.0 kg/m2) population (OR=0.935, P=0.043). In the normal BMI group (18.5 kg/m2≤BMI < 24.0 kg/m2), the clinical pregnancy outcome of IVF-ET was not significantly correlated with sperm DFI, and was negatively correlated with male age (OR=0.744, P=0.020). In the obese population (BMI ≥ 28.0 kg/m2) , there was no significant correlation between the clinical pregnancy outcome of IVF-ET and sperm DNA fragmentation index (DFI) , but a negative correlation with male BMI (OR = 0.779, P = 0.043). CONCLUSION: The male BMI affected the correlation between sperm DFI and IVF-ET pregnancy outcomes: ①Sperm DFI was only associated with IVF-ET clinical pregnancy outcome in the overweight population; ② In normal BMI and obese populations, male age and male BMI were important factors affecting IVF-ET clinical pregnancy outcome respectively; ③No correlation was found between sperm HDS and IVF-ET pregnancy outcomes.

[Assisted reproductive technology for male patients with end-stage renal disease: A case-based discussion on strategies and ethical issues].

OBJECTIVE: To explore normalized and reasonable strategies of assisted reproductive technology (ART) for patients with end-stage renal disease (ESRD) under ethical supervision based on the experience with a case of ART for an ESRD male. METHODS: A male patient with ESRD successfully fathered a child through in vitro intracytoplasmic sperm injection (ICSI) in our center. We performed an epidemiological analysis, reviewed the relevant literature and explored the feasibility, ethical issues and strategies of ART for male patients with ESRD. RESULTS: ESRD affected the reproductive hormone levels, sperm quality and erectile function of the patient. Considering the contradictions between the reproductive right and the uncertainty of disease prognosis of the patient and the health of the offspring and his wife, we comprehensively evaluated the physical and mental conditions of the patient, obtained the informed consent, submitted the case to the Ethics Committee of Reproductive Medicine. CONCLUSIONS: With respect to ART for ESRD patients, importance should be attached to their rights of reproduction and choice of reproductive technology. In the process of ART, the physical conditions of the patient ought to be evaluated comprehensively and rigorously, and the related ethical principles followed strictly.

[Application of calcium ionophore A23187 in ICSI for globozoospermia: A report of 2 cases and review of the literature].

OBJECTIVE: To investigate the pathogenesis of globozoospermia, fertilization ability of round-headed sperm, and the application value of assisted oocyte activation in intracytoplasmic sperm injection (ICSI) for the wives of glohozoospermia men. METHODS: We collected oocytes from the wives of 2 globozoospermia patients and randomly divided them into two groups after ICSI to receive calcium ionophore A23187-activation and conventional treatment, respectively. We reviewed the relevant literature published at home and abroad, and discussed the etiology of globozoospermia, fertilization ability of round-headed sperm, and treatment options for this disease. RESULTS: Quality embryos were obtained in the A23187-activation group while no fertilized oocytes, oocyte cleavage, quality embryos, or blastular formation were found in the conventional treatment group. Both women achieved pregnancy and gave birth to healthy neonates after transfer of the quality embryos from the A23187-activation group. CONCLUSION: Calcium ionophore A23187 can be applied to ICSI for the wives of globozoospermia men and bring about desirable clinical outcomes. Meanwhile, attention should be paid to its safety.