ABSTRACT
The extent of spermatogenic impairment on intracytoplasmic sperm injection (ICSI) outcomes and the risk of major birth defects have been little assessed. In this study, we evaluated the relationship between various spermatogenic conditions, sperm origin on ICSI outcomes, and major birth defects. A total of 934 infertile men attending the Center for Reproductive Medicine of Ren Ji Hospital (Shanghai, China) were classified into six groups: nonobstructive azoospermia (NOA; n = 84), extremely severe oligozoospermia (esOZ; n = 163), severe oligozoospermia (sOZ, n = 174), mild oligozoospermia (mOZ; n = 148), obstructive azoospermia (OAZ; n = 155), and normozoospermia (NZ; n = 210). Rates of fertilization, embryo cleavage, high-quality embryos, implantation, biochemical and clinical pregnancies, abortion, delivery, newborns, as well as major birth malformations, and other newborn outcomes were analyzed and compared among groups. The NOA group showed a statistically lower fertilization rate (68.2% vs esOZ 77.3%, sOZ 78.0%, mOZ 73.8%, OAZ 76.6%, and NZ 79.3%, all P < 0.05), but a significantly higher implantation rate (37.8%) than the groups esOZ (30.1%), sOZ (30.4%), mOZ (32.6%), and OAZ (31.0%) (all P < 0.05), which was similar to that of Group NZ (38.4%). However, there were no statistically significant differences in rates of embryo cleavage, high-quality embryos, biochemical and clinical pregnancies, abortions, deliveries, major birth malformations, and other newborn outcomes in the six groups. The results showed that NOA only negatively affects some embryological outcomes such as fertilization rate. There was no evidence of differences in other embryological and clinical outcomes with respect to sperm source or spermatogenic status. Spermatogenic failure and sperm origins do not impinge on the clinical outcomes in ICSI treatment.
Subject(s)
Female , Humans , Infant, Newborn , Male , Pregnancy , Azoospermia/therapy , China , Oligospermia/therapy , Pregnancy Rate , Retrospective Studies , Sperm Injections, Intracytoplasmic/methods , Sperm Retrieval , Spermatogenesis , SpermatozoaABSTRACT
OBJECTIVE@#To observe the clinical effect of herb-separated moxibustion on segmental conception vessel combined with low-frequency transcutaneous electrical acupoint stimulation (TEAS) for asthenospermia and oligospermia.@*METHODS@#A total of 105 patients with asthenospermia and oligospermia were randomly divided into a combination group, a TEAS group and a medication group, 35 cases in each one. In the medication group, vitamin E capsules, coenzyme Q10 capsules，@*RESULTS@#Compared before treatment, except for the sperm morphology 2 months into treatment in the medication group, the semen routine indexes 2, 3 months into treatment were improved in the 3 groups (@*CONCLUSION@#Herb-separated moxibustion on segmental conception vessel combined with low-frequency TEAS can improve semen routine, reduce sperm oxidative stress damage for patients with asthenospermia and oligospermia, and the clinical efficacy is better than the medication and TEAS.
Subject(s)
Humans , Male , Acupuncture Points , Moxibustion , Oligospermia/therapy , Sperm Motility , SpermatozoaABSTRACT
Intracytoplasmic injection with testicular spermatozoa has become a routine treatment in fertility clinics. Spermatozoa can be recovered in half of patients with nonobstructive azoospermia. The use of immature germ cells for intracytoplasmic injection has been proposed for cases in which no spermatozoa can be retrieved. However, there are low pregnancy rates following intracytoplasmic injection using round spermatids from men with no elongated spermatids or spermatozoa in their testes. The in vitro culture of immature germ cells to more mature stages has been proposed as a means to improve this poor outcome. Several years after the introduction of intracytoplasmic injection with elongating and round spermatids, uncertainty remains as to whether this approach can be considered a safe treatment option. This review outlines the clinical and scientific data regarding intracytoplasmic injection using immature germ cells and in vitro matured germ cells.
Subject(s)
Female , Humans , Male , Pregnancy , Oligospermia/therapy , Sperm Injections, Intracytoplasmic/methods , Sperm Maturation/physiology , Spermatids/physiology , Spermatids/transplantation , Spermatogenesis , Sperm Injections, IntracytoplasmicABSTRACT
Objetivo: Evaluar los resultados de ICSI realizadas con espermatozoides frescos y congelados obtenidos desde biopsias testiculares en pacientes azoospermicos desde junio 2003 a julio 2005 en el Hospital Clínico de la Universidad de Chile. Pacientes y Método: Catorce pacientes portadores de azoospermia fueron sometidos a biopsia testiculares con fines diagnósticos y terapéuticos. Las biopsias de 11 pacientes fueron realizadas el día previo a la aspiración folicular femenina y en 3 casos se utilizaron espermatozoides móviles criopreservados meses antes del procedimiento ICSI. Se cuantifico el número de pacientes en los que rescataron espermatozoides; y las tasas de fecundación y embarazo en los grupos de espermatozoides frescos y criopreservados. Resultados: En los 14 pacientes evaluados se recuperaron espermatozoides. En 3 casos se utilizaron espermatozoides congelados obtenidos de biopsias previas, y en 11 casos espermatozoides frescos para ICSI. Se obtuvieron 6 embarazos en el grupo de espermatozoides frescos y dos embarazos en el grupo de espermatozoides congelados. La tasa de fecundación en ambos grupos fue similar, 64,3 por ciento y 60,7 por ciento respectivamente. Conclusión: Nuestro trabajo demuestra que es posible obtener tasas de fecundación y embarazo semejantes con el uso de espermatozoides frescos y congelados obtenidos a partir de biopsias testiculares en pacientes azoospermicos. Recomendamos la criopreservación de espermatozoides testiculares cada vez que se realice una biopsia testicular y se encuentren espermatozoides, puesto que esto permitirá su uso posterior sin tener que someter al paciente a nuevas cirugías.
Objective: To report eight pregnancies obtained by intracitoplasmic sperm injection (ICSI) using fresh and frozen spermatozoa obtained by testicular sperm extraction (TESE) from 14 azoospermic patients. Patients and Methods: Fourteen azoospermic patients underwent TESE for ICSI. Eleven TESE were made the day previous the oocyte retrieval and three were made the previous months in association with sperm cryopreservation. We evaluated the fertilization and pregnancy rate in both groups: fresh and frozen spermatozoa. Results: Fertilization rate in both groups of patients was similar 64.3 percent and 60.7 percent respectively. Six pregnancies were obtained in patients with fresh spermatozoa and two in the frozen spermatozoa group. Conclusions: We demonstrate that is possible to obtain similar fertilization and pregnancy rates using fresh and frozen spermatozoa from TESE. To decrease the number of testicular biopsies and aborted ICSI cycles we recommend spermatozoa cryopreservation every time a diagnosis testicular biopsy is made in patients with azoospermia.
Subject(s)
Humans , Male , Female , Pregnancy , Adult , Middle Aged , Spermatozoa/physiology , Sperm Injections, Intracytoplasmic , Oligospermia/therapy , Reproductive Techniques, Assisted , Cryopreservation , Ovulation Induction , Testis/cytology , Embryo Transfer , Pregnancy RateABSTRACT
The aim of the study was to find out the effect of different natural herbal products on patients having impotence of unknown cause. A descriptive study. This study was conducted from January,2002 to December, 2003 in SOPD of Abbasi Shaheed Hospital, Karachi. This was hospital base study conducted in 50 patients of age ranging from 25-60 years attending Surgical Out Patients Department [SOPD] of Abbasi Shaheed Hospital, Karachi. The catchments area of hospital is mostly the district central Karachi with poor socio-economic status of the patients. The subjects included in the study were married active and healthy men. All individuals were proper clinical history along with examinations was recorded on proforma. Some specific investigations were done to rule out any cause of impotence and side effects were also recorded. Data collected was analyzed by statistical tests. The results were analyzed which showed that out of 50 patients 39 [78.0%] got benefit from the product, 08 [16%] had improvement in their symptoms while 03 [06%] had no improvement at all. These products Anacardium occidental, Asparagus descends, Cureuligo orchiodes, Orchis mascula and Macuna pruriens are natural herbal products gather in capsule known as Successor, which can be safely given to the patients having impotence of unknown cause. It has also been observed that there was some increased in sperm count on semen analysis seen in oligospermia cases. It can results in increase the motility and sperm count
Subject(s)
Humans , Male , Herbal Medicine/drug effects , Social Class , Anacardium , Asparagus Plant , Sperm Count/drug effects , Oligospermia/therapy , Sperm Motility , Outcome Assessment, Health CareABSTRACT
OBJECTIVES: To study the outcome of sperm retrieval and intracytoplasmic sperm injection (ICSI) from obstructive azoospermic men. METHOD: Overall, 50 sperm retrieval procedures were performed in 45 obstructive azoospermic men, followed by 57 ICSI procedures with fresh epididymal spermatozoa (n=40), fresh testicular spermatozoa (n=4) or frozen-thawed epididymal spermatozoa (n=13). RESULTS: Sperm retrieval was accomplished via percutaneous epididymal sperm aspiration (PESA) in 42 cases, testicular sperm aspiration (TESA) in 1 case and testicular sperm extraction (TESE) in 2 cases. TESA and TESE were only applied when PESA failed to produce enough spermatozoa for simultaneous ICSI. PESA was successful in 92 per cent of cases. Fertilization rate after ICSI was 79.6 per cent of the metaphase II oocytes. Seventy one embryo transfers were performed using both fresh and frozen thawed embryos resulting in clinical pregnancy in 39.4 per cent. Ongoing pregnancy was achieved in 35.2 per cent. CONCLUSION: ICSI has been shown to give a high fertilization and pregnancy rate with epididymal and testicular spermatozoa retrieved from obstructive azoospermic men. PESA is a noninvasive and simple technique for retrieving spermatozoa from obstructive azoospermic men. Therefore, it is suitable as the primary sperm recovery technique in patients with obstructive azoospermia.
Subject(s)
Embryo Transfer , Humans , Male , Oligospermia/therapy , Specimen Handling , Sperm Injections, Intracytoplasmic , Spermatozoa , SuctionABSTRACT
Intracytoplasmic sperm injection (ICSI) has been successfully used to achieve fertilization and pregnancies for patients with extreme oligoastheno-zoospermia using ejaculated sperms or patients with azoospermia using epididymal or testicular sperms. The aim of this study was to compare the fertilization rate after ICSI using ejaculated, epididymal and testicular sperms. Between January and September 1997, 10 azoospermic men underwent percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE) to recover sperm for ICSI. A total of 5 PESA cases and 5 TESE cases were performed at the Center for Assisted Reproduction & Embryology. Thirty-one patients performed ICSI using ejaculated sperms during the same period of time were used as a control group. ICSI using ejaculated sperms, epididymal sperms from PESA and testicular sperms from TESE was a highly successful technique, achieving fertilization rates of 78.5 per cent, 83.3 per cent and 80.8 per cent, respectively. Good fertilization rates were achieved without significant differences among the various sperm sources.
Subject(s)
Cytoplasm , Ejaculation , Epididymis , Female , Fertilization , Humans , Male , Oligospermia/therapy , Pregnancy , Sperm Capacitation , Sperm Maturation , TestisABSTRACT
Duzentos e cinquenta e seis pacientes com azoospermiaforam estudados. Desses, 81 (36,6 por cento) eram portadores de azoospermia excretora. Dos pacientes com azoospermia excretora, 25 apresentavam agenesia bilateral do deferente, 28 obstruçäo ao nível do epidídimo e 28 azoospermia pós-vasectomia. Três pacientes com agenesia dos deferentes foram tratados através da confecçäo de espermatocele artificial. Os pacientes com obstruçäo do epidídimo foram submetidos a anastomose microcirúrgica ipidídimo-deferencial término-terminal e os pacientes vasectomizados à reconstruçäo microcirúrgica em dois planos. Nos casos de espermatocele näo houve gravidez. Nos doentes submetidos à epidídimo-vasostomia houve 60 por cento de recanalizaçäo e 30 por cento de gravidez. Nos pacientes submetidos à reversäo microcirúrgica da vasectomia houve 100 por cento de restabelecimento da permeabilidade e 78,5 por cento de gravidez
Subject(s)
Humans , Male , Adult , Middle Aged , Infertility, Male/surgery , Infertility, Male/therapy , Microsurgery , Oligospermia/therapyABSTRACT
This study included 50 couples during the period from March 1993 till January 1996. All were suffering from primary infertility one to six years with no apparent cause, except male factor in the form of oligospermia with sperm count <20 millions/ml. The age of the male partner ranged between 28 and 42 years, while of the female partner ranged between 26 and 38 years. They were divided into two groups. The first group [n=28] have done 40-treatment cycle. While the second group [n=22] have done 28-treatment cycle. There was no significant difference between the two groups. All female partners were given the same induction protocol using CC and hMG and follow up by folliculometry and E2 plasma level. Once, one or more follicle reached size >/17 mm, 5000 IU hGG was given i.m. Thirty-three hours after administration of hCG, patients were randomly assigned to either IUI with 0.5 ml washed sperm [group I] or FSP with 4 ml husband washed sperm [group 2]. It was concluded that, FSP is a promising technique, which needs further study on a large group of patients suffering from various causes of infertility
Subject(s)
Humans , Male , Female , Oligospermia/therapy , Insemination, Artificial, Homologous/methods , Infertility/therapy , Sperm Count/methods , Spermatozoa , Insemination, Artificial , Fallopian Tubes , Uterus/physiology , Oligospermia/etiologyABSTRACT
Mycobacterium tuberculosis is still an important cause of epididymitis that leads to obstructive azoospermia in developing countries. We present a case of obstructive azoospermia due to tuberculous epididymitis treated by the combined microsurgical epididymal sperm aspiration-intracytoplasmic sperm injection [MESA-ICSI] procedure. Although the transfer of the embryos did not result in pregnancy, normal fertilization and the development of embryos were achieved by MESA-ICSI