Recombinant gonadotropin therapy to improve spermatogenesis in nonobstructive azoospermic patients - A proof of concept study

ABSTRACT Purpose: Nonobstructive azoospermia (NOA) associated with primary spermatogenic failure is a common cause of male infertility usually considered untreatable; however, some reports have suggested that hormonal stimulation to boost the intra-testicular testosterone level and spermatogenesis might increase the chance of achieving pregnancy using homologous sperm. Materials and Methods: We report a series of eight NOA males who received long-term treatment with recombinant human chorionic gonadotropin twice a week for spermatogenesis stimulation. Six males received additional recombinant follicle-stimulating hormone (FSH) supplementation 150-225 IU twice weekly. Results: After recombinant gonadotropin therapy, viable spermatozoa were retrieved from the ejaculate in two patients and by testicular sperm aspiration (TESA) in another two subjects. Singleton spermatozoon retrieved from testes were frozen by vitrification on Cell-Sleeper devices. Two live births were obtained after intracytoplasmic sperm injection with ejaculated spermatozoa and one live birth and an ongoing pregnancy using thawed spermatozoa from TESA. Conclusion: Our proof-of-concept study indicates that hormonal therapy with recombinant gonadotropins could be considered in infertile men with NOA as an alternative to sperm donation. Large-scale studies are needed to substantiate hormone stimulation therapy with recombinant gonadotropins in routine clinical practice for this severe form of male infertility.

Recombinant gonadotropin therapy to improve spermatogenesis in nonobstructive azoospermic patients - A proof of concept study.

PURPOSE: Nonobstructive azoospermia (NOA) associated with primary spermatogenic failure is a common cause of male infertility usually considered untreatable; however, some reports have suggested that hormonal stimulation to boost the intra-testicular testosterone level and spermatogenesis might increase the chance of achieving pregnancy using homologous sperm. MATERIALS AND METHODS: We report a series of eight NOA males who received long-term treatment with recombinant human chorionic gonadotropin twice a week for spermatogenesis stimulation. Six males received additional recombinant follicle-stimulating hormone (FSH) supplementation 150-225 IU twice weekly. RESULTS: After recombinant gonadotropin therapy, viable spermatozoa were retrieved from the ejaculate in two patients and by testicular sperm aspiration (TESA) in another two subjects. Singleton spermatozoon retrieved from testes were frozen by vitrification on Cell-Sleeper devices. Two live births were obtained after intracytoplasmic sperm injection with ejaculated spermatozoa and one live birth and an ongoing pregnancy using thawed spermatozoa from TESA. CONCLUSION: Our proof-of-concept study indicates that hormonal therapy with recombinant gonadotropins could be considered in infertile men with NOA as an alternative to sperm donation. Large-scale studies are needed to substantiate hormone stimulation therapy with recombinant gonadotropins in routine clinical practice for this severe form of male infertility.

Cubes on a string: a series of linear coordination polymers with cubane-like nodes and dicarboxylate linkers.

A series of semicrystalline and amorphous one-dimensional (1D) polymeric chains consisting of cubane-like CoII4L4 units (L = S-1,2-bis(benzimidazol-2-yl)ethanol) and dicarboxylates were synthesized and characterized by single crystal diffraction and X-ray total scattering. The polycationic chains are composed of [Co4L4(dicarboxylate)]2+ monomeric units, while one molecular dicarboxylate counterion is balancing the charge of each monomer. The linear compound series has five members, and the crystal structures were solved for [Co4L4(tph)](tph) and [Co4L4(ndc)](ndc), where tph = terephthalate and ndc = 2,6-naphthalenedicarboxylate. Partly crystalline compounds were produced by slow assembly at elevated temperature (over days), while the amorphous compounds were formed by fast precipitation (within minutes). Pair distribution function (PDF) analysis based on X-ray total scattering data reveals the presence of the cubane-like entity in both the amorphous and semicrystalline samples. While the powders are non-porous, precipitation is a fast and versatile method to produce compounds with cubane-like centres with moderate surface areas of 17-49 m2 g-1 allowing for surface chemical reactions. The powders have a high concentration of Lewis base sites as verified by their selective adsorption of CO2 over N2. The use of an amorphous cubane-like polymer for the electrocatalytic oxygen evolution reaction was demonstrated.

Characterization of a diversity of tetraphyllidean and rhinebothriidean cestode larval types, with comments on host associations and life-cycles.

Life-cycles of marine tapeworms of the orders Tetraphyllidea and Rhinebothriidea are poorly known primarily because their larvae typically lack species level, taxonomically distinguishing adult characteristics and using morphology they can be identified to genus, family or order only. This large-scale study conducted in the northern Gulf of Mexico includes adult cestodes (25 species) collected from sharks and rays (Elasmobranchii, eight species) and larval cestodes (27 species) collected from teleosts (Neopterygii, 46 species), bivalves and gastropods (Mollusca, 24 species), and shrimps (Crustacea, five species), comprising a phylogenetically (75 species in three phyla, 14 orders and 46 families) and ecologically (e.g., benthic, epibenthic, pelagic, euryhaline, stenohaline) diverse array of hosts of larval cestode. Molecular biology and morphology informed larval identification and facilitated the circumscription of suites of morphological features representing distinct larval types (i.e., collective groups). A total of 198 specimens comprising adult and larval tetraphyllideans and rhinebothriideans assigned to 12 genera were characterized for the partial (D1-D3) lsrDNA gene and analyzed separately and in combination with data derived from species belonging to an additional 21 genera available from GenBank. Eight larval types were identified and matched to one or several genera of Tetraphyllidea or Rhinebothriidea; morphological variation within these larval types was also documented. In combination with published reports of unique larval morphologies, 15 larval types were established and a key to their larvae presented. Overall, teleosts figured prominently in the life-cycles of tetraphyllideans and rhinebothriideans. Intermediate host specificity at the level of cestode genus was euryxenous, but limited host records suggest that host specificity at the level of cestode species may be more strict. To our knowledge, this is the first published study that approaches the elucidation of marine tapeworm life-cycles by incorporating morphological, molecular biological and phylogenetic methods using specimens collected on a regional scale and from wild-caught hosts from four metazoan phyla.

Blood flukes (Digenea: Aporocotylidae) of stingrays (Myliobatiformes: Dasyatidae): Orchispirium heterovitellatum from Himantura imbricata in the Bay of Bengal and a new genus and species of Aporocotylidae from Dasyatis sabina in the northern Gulf of Mexico.

We redescribe Orchispirium heterovitellatum based on the holotype and 3 original voucher specimens collected from the mesenteric blood vessels of scaly whiprays Himantura imbricata (Bloch and Schneider, 1801) (as Dasyatis imbricatus) captured in the western Bay of Bengal off Waltair, India. We emend the diagnosis of Orchispirium to include anterior sucker present, testis looping, cirrus sac enveloping large internal seminal vesicle, oviducal seminal receptacle present, and metraterm short and thin-walled. We describe Myliobaticola richardheardi n. gen., n. sp. based on live observations, light microscopy, and scanning electron microscopy of adult specimens collected from between the cardiac trabeculae of Atlantic stingrays Dasyatis sabina (Lesueur, 1824) captured in Mississippi Sound (type locality), Mississippi, and Apalachicola Bay, Florida. The new species has a minute, aspinous body lacking lateral tubercles; an aspinous and eversible anterior sucker lacking a peduncle; a posterior esophageal swelling; an inverse U-shaped intestine; smooth ceca terminating in the anterior body half; a looping testis lacking lobes; a cirrus sac enveloping a large internal seminal vesicle; a medial and primarily post-testicular ovary; an oviducal seminal receptacle; a postgonadal uterus flanking the internal seminal vesicle; a short and thin-walled metraterm; and a common genital pore. It lacks a pharynx and Laurer's canal. No other named aporocotylids infect a member of cohort Batoidea or have the combination of an aspinous body, an aspinous anterior sucker, a posterior esophageal swelling, an inverse U-shaped intestine, a looping testis, a cirrus sac enveloping a large internal seminal vesicle, and a common genital pore; these observations indicate that O. heterovitellatum and M. richardheardi are closely related. The discovery of a second species representing a second genus of Aporocotylidae in diamond stingrays (Dasyatidae) suggests that Batoidea is an undersampled host group for aporocotylid infections.