ABSTRACT
Infertility affects millions globally, with advanced parental age posing a significant risk. This case report details a couple who experienced secondary infertility for 12 years. Following multiple unsuccessful attempts at assisted reproductive technology (ART), a personalized treatment regimen involving platelet-rich plasma (PRP) perfusion and laser-assisted hatching (LAH) resulted in a successful pregnancy. Diagnostic evaluations identified specific reproductive challenges, leading to tailored interventions. A positive pregnancy outcome was achieved after PRP treatment enhanced endometrial thickness and LAH facilitated embryo implantation. This case highlights the importance of individualized treatment strategies in infertility management and proves the potential efficacy of PRP and LAH in overcoming recurrent implantation failure. Further research is needed to explain the roles of PRP and LAH in improving pregnancy outcomes, especially in older parents and couples with a history of failed in vitro fertilization (IVF) treatments.
ABSTRACT
Sperm morphology significantly influences the fertilization capacity of male germ cells. Morphological abnormalities are frequently associated with an overproduction of reactive oxygen species (ROS), leading to further sperm damage and subsequent infertility. This case study examines a couple facing infertility, with male factor infertility identified as the primary issue, characterized by teratozoospermia and a high DNA fragmentation index (DFI). The objective was to assess the efficacy of zeta potential (ZP) as a sperm sorting technique for intracytoplasmic sperm injection (ICSI) in patients showing high DNA fragmentation. A 34-year-old male with abnormal sperm parameters underwent ICSI using the ZP technique for sperm separation, while his 28-year-old female partner received ovarian stimulation. This intervention resulted in the development of two good-quality blastocysts, resulting in a successful embryo transfer (ET) and a positive pregnancy outcome. Previous attempts using conventional assisted reproductive technologies (ART), including in vitro fertilization (IVF), followed by ICSI and ET, as well as other sperm selection methods, were not successful. The ZP-based approach demonstrated significant benefits by selecting spermatozoa with optimal parameters, such as negative membrane potential, thereby enhancing the success rate. This case emphasizes the advantages of personalized treatment strategies in managing male infertility and highlights the potential of advanced sperm sorting techniques in improving fertility outcomes.
ABSTRACT
Factors, including exposure to substances like organophosphorus compounds (OPCs), have been linked to fertility issues, which are a growing concern. In this case study, a 29-year-old farmer and his 26-year-old wife, married for the past five years, faced challenges conceiving despite several attempts. It was found that the husband's exposure to OPCs like chlorpyrifos, malathion, diazinon, etc., had impacted the quality of his sperm. However, after undergoing treatments and making lifestyle changes such as panchakarma therapy and taking Shilajit supplements, there was an improvement in sperm quality. Through in vitro fertilization using physiological intracytoplasmic sperm injection, successful fertilization and the development of high-quality blastocysts were achieved. This case demonstrates the potential for addressing infertility caused by toxins through a blend of traditional medicinal practices and modern reproductive technologies. It underscores the need for research into strategies that can reduce the effects of OPC exposure on male fertility.
ABSTRACT
Low sperm count and motility in oligoasthenozoospermia present significant challenges to conception. This case report involves a couple, a 28-year-old female and a 35-year-old male, experiencing secondary infertility for four years. The male partner's habits of alcohol consumption and smoking were potential infertility factors. Semen analysis revealed a total sperm count of 10 million/mL, with total motility at 30% and progressive motility at 5%. The couple underwent intracytoplasmic sperm injection (ICSI), using advanced sperm separation techniques to isolate motile and morphologically normal sperm. Despite the suboptimal sperm parameters, this approach resulted in successful fertilization and pregnancy. The female partner's preparation involved a short antagonist treatment, leading to the retrieval of eight oocytes, seven of which were mature. A positive urine pregnancy test and ultrasound confirmed the pregnancy, with ß-hCG at 798 mIU/mL. This case highlights the potential of individualized treatments in managing oligoasthenozoospermia, emphasizing their promise in improving assisted reproductive outcomes despite mixed research results.
ABSTRACT
Male infertility is significantly affected by bacteriospermia, defined by the presence of bacteria in semen. This case report aims to address the effects of bacteriospermia and its correlation with semen characteristics, sperm DNA fragmentation (SDF), and reproductive outcomes. The 33-year-old male was diagnosed with bacteriospermia caused by two gram-negative bacteria: Escherichia coli and Klebsiella pneumoniae. It was found that sperm parameters such as mobility, number, and morphology were compromised in sperm, indicating poor fertility. In addition, SDF analysis has revealed a high DNA fragmentation index (DFI), emphasizing the detrimental effects of bacteriospermia on the integrity of sperm. Antibiotic therapy and antioxidant supplements have been used as therapeutic measures to reduce the impact of bacterial infections and DNA damage caused by oxidative stress (OS). Follow-up assessments showed significant improvements in the integrity of the sperm DNA and the resolution of microbial colonization, which ultimately led to successful in vitro fertilization (IVF) and embryo transfer (ET), leading to a positive pregnancy outcome.
ABSTRACT
Polycystic ovary syndrome (PCOS) is an endocrinological disorder affecting women of reproductive age, characterized by hormonal imbalance leading to metabolic and reproductive dysregulations. This case report revolves around a 30-year-old husband and his 27-year-old partner. The male partner had normozoospermia, and the female spouse had PCOS, according to the couple's diagnostic evaluations. The female patient received ovarian stimulation specifically to assist with PCOS, and the retrieved oocytes were then matured in vitro. After intracytoplasmic sperm injection (ICSI), fertilization and embryonic development were successful. Treatment of PCOS-related infertility presents many challenges, and in vitro maturation (IVM) and its potential as an effective assisted fertility method are discussed. To optimize treatment outcomes, the conclusion shows the importance of IVM and other assisted reproductive techniques for infertility. It also focuses on the necessary continuous research and clinical experience. Clinical pregnancy was confirmed by measuring serum beta-human chorionic gonadotropin (ß-hCG) levels followed by ultrasound sonography (USG), which showed a normal growth rate of the fetus.
ABSTRACT
Giant mucinous cystadenocarcinoma of the ovary is rarely described. Huge ovarian masses are mostly benign, but malignancy should be ruled out by investigations and clinical assessment. Here, we present a case of a large mucinous cystadenocarcinoma of the ovary in a 48-year-old postmenopausal woman. Imaging examinations revealed a large cystic tumor that filled the whole abdominal cavity. Despite the difficulties presented by the size of the tumor and its malignant potential, laparotomy was carried out, which included bilateral salpingo-oophorectomy, total abdominal hysterectomy, exploration of other intra-abdominal organs, and pelvic lymphadenectomy. Histopathology indicated the presence of mucinous cystadenocarcinomas. Adjuvant chemotherapy was given post-operatively, and the patient maintained remission during follow-up. This case emphasizes the need for early detection by simple imaging modalities such as ultrasonography in cases of ovarian masses. Most adnexal masses, if detected early, are amenable to surgical management with a good prognosis. Large masses underline the need for a multidisciplinary approach to improve patient outcomes.
ABSTRACT
Globozoospermia is a rare sperm morphological abnormality characterized by a lack of acrosomes and post-acrosomal sheaths, defects in the cytoskeleton around the nucleus, and separated nuclear membranes. In this case, the study outlines the treatment of a 32-year-old male patient diagnosed with globozoospermia. The couple, facing primary infertility for seven years, had already undergone unsuccessful assisted reproductive technology treatments, such as two intrauterine inseminations and one in vitro fertilization. They opted for intracytoplasmic sperm injection (ICSI) with assisted oocyte activation (AOA) using a calcium (Ca) ionophore. The semen analysis showed globozoospermia, which indicated that ICSI was required for fertilization. Post-fertilization, embryo quality was assessed; three were in cleavage-stage embryos, and two grade 4AA and 3AA blastocysts and the rest were arrested at 2 pronuclear (2PN) stages, revealing successful embryo development. This case report implies that using AOA with Ca ionophores enhanced the fertilization outcomes and could be a helpful intervention strategy for patients with globozoospermia.
ABSTRACT
This case report describes the use of smooth endoplasmic reticulum aggregates-positive (SERa+) oocytes along with intracytoplasmic sperm injection (ICSI), supplemented with granulocyte-macrophage colony-stimulating factor (GM-CSF), aiming to enhance fertilization rates and reproductive outcomes. A 39-year-old woman, facing primary infertility for the past seven years, received assisted reproductive treatment (ART), which included adding GM-CSF to the culture medium and culture SERa+ oocytes before ICSI. Clinical results, embryo quality, fertilization rates, and other fertility parameters were used to track the patient's progress toward this individualized approach that led to a positive twin pregnancy and healthy twin babies.
ABSTRACT
Infertility affects couples worldwide. Among these, obstructive azoospermia (OA) is a common cause. In some cases, the lack of spermatozoa in ejaculation results from blockages in the male reproductive tract. In this case study, we discuss an infertile male diagnosed with OA following three years of unsuccessful attempts at conception. The male had a history of bilateral inguinal hernia repair due to congenital bilateral absence of the vas deferens. Diagnostic assessments confirmed azoospermia. Microscopic epididymal sperm aspiration (MESA) was performed for sperm retrieval due to its efficacy and reduced postoperative pain, testicular atrophy, and decreased testosterone levels. The retrieved sperm was processed using SpermMobil media for intracytoplasmic sperm injection. Following successful fertilization, embryo transfers resulted in a positive pregnancy test. This case highlights the significance of specific treatment approaches for OA, specifically the effectiveness of MESA and SpermMobil in achieving successful outcomes in assisted reproduction technology for male infertility.
ABSTRACT
Assisted reproductive technologies (ART) enable these patient's spermatozoa to fertilize the oocyte and create viable and healthy offspring, but the effectiveness of the various procedures still has room to increase. In the field of assisted reproductive technology, the need to improve fertility results has led to the development of novel sperm selection strategies. Laser-assisted selection of immotile sperm (LAISS) appears to be a promising strategy, harnessing the power of modern optical instruments to better the selection process and, ultimately, maximize the probability of successful fertilization. This technology takes advantage of sperm cells' distinctive features, such as shape, form, and motility patterns, that can be sensitively changed by laser forces. Using precision laser manipulation, spermatozoa with desirable features can be precisely targeted, improving the overall quality and viability of the sperm population. The existence of an elevated percentage of DNA-damaged sperm in a patient's ejaculation may be one of the key factors decreasing ART outcomes. As a result, one of the most difficult tasks in reproductive medicine is ensuring the best quality of spermatozoa utilized in ART, particularly with regard to genetic integrity. The most recent approaches for preparing and selecting human spermatozoa by LAISS techniques are covered here, with an emphasis on those that have been shown to improve.
ABSTRACT
In this report, we present the clinical management of a male patient diagnosed with non-obstructive azoospermia (NOA), a condition characterized by the absence of sperm in the ejaculate due to impaired spermatogenesis. A 37-year-old patient underwent two surgical procedures: testicular sperm aspiration (TESA) and percutaneous epididymal sperm aspiration (PESA). Surprisingly, the beta-human chorionic gonadotropins (ß-HCG) testing that followed produced promising findings suggesting NOA syndrome may be reversible. Theophylline and pentoxifylline, phosphodiesterase inhibitors with immunomodulatory effects, were creatively used in this case study to increase sperm viability and activation after PESA. Hyaluronic acid was also used as an additional therapy because it is well known for aiding in sperm development and binding to oocytes. The patient underwent hyaluronic acid, which can potentially increase the fertilization rate and improve the selection of sperm. This in-depth case study offers insightful information on the effective management of NOA by combining theophylline, pentoxifylline, and hyaluronic acid. The results highlight the ability of these therapies to revive spermatogenesis, offering a cutting-edge method of treating male infertility. More research is required to clarify the underlying processes and confirm the effectiveness of this strategy in more successful reproductive medicine therapies.