[Correlation of sperm mitochondrial membrane potential with semen parameters and outcomes of in vitro fertilization].

OBJECTIVE: To investigate the correlation of sperm mitochondrial membrane potential (MMP) with routine semen parameters and the effect of MMP on the outcomes of in vitro fertilization (IVF). METHODS: We retrospectively analyzed the clinical data on 727 IVF cycles, including 231 fresh transplantation cycles, in our hospital from November 2018 to October 2019. According to the MMP level determined by JC-1 staining and flow cytometry, we divided the patients into a low MMP (≤52%) and a high MMP (> 52%) group and compared the rates of fertilization, clinical pregnancy, abortion and live birth between the two groups. Meanwhile, we analyzed the correlation of sperm MMP with the semen volume, sperm concentration, total sperm count, total sperm motility, percentages of progressively motile sperm (PMS) and morphologically normal sperm (MNS), and sperm DNA fragmentation index (DFI). RESULTS: The fertilization rate was significantly higher in the high MMP than in the low MMP group (85.3% ï¼»2 211/2 592ï¼½ vs 81.7% ï¼»3 910/4 785ï¼½, P < 0.01), and so were the rates of clinical pregnancy (50.00% ï¼»41/82ï¼½ vs 48.32% ï¼»72/149ï¼½, P < 0.05) and live birth (43.90%ï¼»36/82ï¼½ vs 40.94% ï¼»61/149ï¼½, P < 0.05), while the abortion rate was lower in the former than in the latter group (12.20% ï¼»5/41ï¼½ vs 15.28% ï¼»11/72ï¼½, P > 0.05). Statistically significant differences were observed between the two groups in sperm concentration, total sperm motility, percentages of PMS and MNS, and sperm DFI (P< 0.05), but not in the semen volume and total sperm count (P > 0.05). Sperm MMP was found correlated positively with sperm concentration (r = 0.11, P < 0.05), total sperm motility (r = 0.304, P < 0.01) and percentages of PMS (r = 288, P < 0.01) and MNS (r = 458, P < 0.01) but negatively with sperm DFI (r = 0.387, P < 0.01). CONCLUSION: The level of sperm MMP is related to decreased sperm motility, increased sperm abnormality, elevated sperm DFI and reduced IVF rate. It is also an important index for sperm function evaluation and, together with routine semen parameters, helps to comprehensively evaluate and optimize the assisted pregnancy program of infertile men in assisted reproduction technology.

[Correlation of sperm nuclear maturity with the outcomes of in vitro fertilization].

Objective: To investigate the correlation between sperm nuclear maturity and the outcomes of in vitro fertilization (IVF). METHODS: We retrospectively analyzed the clinical data on 1 393 cycles of IVF in our center from September 2018 to May 2020. According to the high DNA stainability (HDS) of sperm, we divided the patients into a mature (HDS ≤ 10%) and an immature sperm nucleus group (HDS > 10%), compared the results of IVF, embryonic development and clinical outcomes between the two groups, and analyzed their correlation with HDS. RESULTS: The rates of fertilization and normal fertilization were significantly higher and that of fertilization failure remarkably lower in the mature than in the immature sperm nuclear group (P < 0.05). There were no statistically significant differences between the two groups in the rates of cleavage, high-quality embryo, blastocyst formation, clinical pregnancy, miscarriage and live birth (P > 0.05). Univariate logistic regression analysis showed that HDS was correlated negatively with the rates of fertilization, normal fertilization and blastocyst formation (P < 0.05), positively with fertilization failure (P < 0.05), but not significantly with the rates of cleavage, high-quality embryo, clinical pregnancy, miscarriage and live birth (P > 0.05). After adjusting for confounding factors by multivariate logistic regression analysis, HDS was found correlated negatively with the fertilization rate (OR = 0.945, 95% CI: 0.918 to 0.972, P < 0.05), positively with fertilization failure (OR = 1.043, 95% CI: 1.010 to －1.078, P < 0.05), but not significantly with the rates of normal fertilization, cleavage, high-quality embryo, blastocyst formation, clinical pregnancy, miscarriage and live birth (P > 0.05). CONCLUSIONS: Sperm nuclear maturity significantly affects the rates of fertilization and fertilization failure in IVF patients. Taking sperm nuclear maturity indicators in consideration in the process of IVF may contribute to comprehensive evaluation of semen and male fertility and guide clinical decision-making.

Serum interleukin-38 and -41 levels as candidate biomarkers in male infertility.

BACKGROUND: Interleukin (IL)-38 and IL-41 are novel cytokines, but their role in male infertility (MI) is unknown. The purpose of this study was to measure the levels of serum IL-38 and IL-41 in patients with MI and correlate these levels with semen indexes. METHODS: Eighty-two patients with MI and 45 healthy controls (HC) were recruited for this study. Semen parameters were detected using computer-aided sperm analysis, Papanicolaou staining, ELISA, flow cytometry, peroxidase staining and enzyme methods. Serum IL-38 and IL-41 levels were determined by ELISA. RESULTS: Serum IL-38 levels were decreased (P < 0.01) in patients with MI compared with HC. Serum IL-41 levels were significantly higher in patients with MI than in HC (P < 0.0001). In patients with MI, serum IL-38 levels were positively correlated with semen white blood cell counts (r = 0.29, P = 0.009), and there was a positive correlation between semen white blood cell counts and sperm concentration (r = 0.28, P = 0.0100) and seminal plasma elastase (r = 0.67, P < 0.0001). Receiver operating characteristic curve analysis showed that the area under the curve of IL-38 for diagnosing MI was 0.5637 (P > 0.05), and the area under the curve of IL-41 for diagnosing MI was 0.7646 (P < 0.0001). CONCLUSIONS: Serum IL-38 levels were significantly lower, and serum IL-41 levels were higher in patients with MI. These results suggest that IL-38 and IL-41 may be novel biomarkers for the diagnosis of MI.

D6 high-quality expanded blastocysts and D5 expanded blastocysts have similar pregnancy and perinatal outcomes following single frozen blastocyst transfer.

Objective: We compared the pregnancy and perinatal outcomes between expanded blastocysts vitrified on D5 versus D6 following single frozen blastocyst transfer. Methods: Clinical data on 7,606 cycles of frozen-thawed blastocyst implantations were retrospectively analyzed. Depending on whether blastocysts were vitrified on D5 or D6 and the transferred blastocysts, the blastocysts were divided into 6 groups: HQB-D5, HQB-D6, 4XC-D5, 4XC-D6, 4CX-D5, and 4CX-D6 groups. The differences in clinical pregnancy rate, live birth rate, first trimester abortion rate, preterm birth rate, gestational age, birth weight, and sex ratio at birth among the groups were compared. Results: Our study showed that there was no difference in pregnancy and perinatal outcomes between the delayed formation of D6 high-quality expanded blastocysts and D5 expanded blastocysts, whether they were high-quality blastocysts or not. For low-quality blastocysts, the clinical pregnancy rate of D5 was higher than that of D6, and D5 was also better than D6 in live birth rate for those with inner cell mass rating B or above, while there was no difference between D5 and D6 for those with inner cell mass rating C. Conclusion: Based on our research, we suggest that when we are developing the implantation strategy, we give priority to the selection of high-quality expanded blastocysts, regardless of D5 and D6, whose clinical outcomes are not different. For low-quality blastocysts, D5 expanded blastocysts are preferred for transfer.

Metal elements associate with in vitro fertilization (IVF) outcomes in 195 couples.

PURPOSE: Environmental factors may affecting reproductive function reduction and embryonic development. Couples who are exposed to heavy metals for a long time may affect the outcome of in vitro fertilization (IVF). To evaluate the effect of elements on IVF outcomes, a total of 195 couples undergoing IVF were included in this study. METHODS: Elements including V, Cr, Mn, Ni, Cu, Zn, As, Mo, Cd, Ba, Hg, Tl, Pb were measured in serum and follicular fluid (FF) samples of female and semen samples of male by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). Multiple linear regression were applied to evaluate the association between metal elements and semen quality parameters and the number of oocytes in MII stage. Poisson regression and the robust variance estimation of the generalized estimation equation were used to evaluate the association between elements and IVF outcomes. RESULTS: The statistical results showed that Cr had a significant negative correlation with total sperm concentration (TSC) and total motile sperm count (TMC), the correlation coefficients were -0.52 (-0.27∼1.43) and -0.4(-1.24, 0.45), respectively. At the same time, Ba was significantly correlated with TSC and TMC, the correlation coefficients were 0.1(-0.15∼0.34) and 0.12(-0.13, 0.36), respectively. Cr, Ba and Pb in follicular fluid (FF) had a significant positive correlation with the number of oocytes in MII stage. The correlation coefficients were 3.15 (0.79, 5.52), 1.54 (-0.27, 3.36), 12.27 (7.49, 17.04). The Tl level of FF was significantly associated with the high probability of blastocyst formation and high-quality blastocysts (RR: 2.83, 95 % CI: 0.92∼7.95; RR: 3.12, 95 % CI: 0.64, 12.84). The Hg level (RR: 3.98, 95 % CI: 0.78∼14.77) and the Ba level in serum (RR: 12.75 95 % CI: 1.31∼89.71) were significantly correlated with high-quality blastocysts. The levels of Ni, Cu, Mo in seminal plasma of men were significantly correlated with blastocyst formation and high-quality blastocysts (RR values were all greater than 1.5). In addition, the level of Ba was significantly correlated with the high probability of blastocyst formation (RR: 1.7, 95 % CI: 1.14∼2.52). CONCLUSION: Our results reveal that Cr, Ba and Pb may affect TSC, TMC and MII oocytes. Moreover, Ba, Cr, As, Hg and Tl in serum and Mo in seminal plasma were related to fertilization results, good embryos, blastocyst formation, high-quality embryos, and pregnancy and live birth rates. Tl in FF may related to the quality of embryonic development, Ba was an important risk factor which closely related to the outcomes of IVF in both male and female. Through our detection and statistical analysis of clinical samples, it is shown that although not all elements will affect the outcome of IVF the key elements we have selected need to arouse our attention, which benifit to the diagnosis and prevention of clinical infertility.