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1.
Medicine (Baltimore) ; 98(50): e18317, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31852117

RESUMO

BACKGROUND: Male infertility is a worldwide problem with limitations in the treatment. Phosphodiesterase-5 inhibitors (PDE5is) is the first choice for the treatment of erectile dysfunction (ED), but more and more studies show that it has a certain effect on male infertility in recent years. The literatures of PDE5is related to male infertility have shown inconsistent results, and there is currently no high quality of systematic review to evaluate the effects of PDE5is on semen quality in male infertility patients. METHODS: The electronic databases of MEDLINE, PubMed, Web of Science, EMBASE, Clinicaltrials.org, China National Knowledge Infrastructure Database (CNKI), Wan fang Database, China Biology Medicine Database (CBM), VIP Science Technology Periodical Database, Chinese Clinical Trial Registry and Cochrane Library were retrieved. Grey literature will be searched in Open Grey. Related Randomized controlled trials (RCTs) were collected and selected before October 20, 2019. We will search English literature and Chinese literature with search terms "male infertility", "phosphodiesterase-5 inhibitors", "PDE5i", "Tadalafil", "Sildenafil", "Vardenafil", "Udenafil", "Avanafil", "semen" and "sperm". Sperm concentration, motility and morphology, sperm DNA fragmentation index, number of per ejaculate, sperm viability and adverse events will be evaluated. RevMan 5.3 and Stata 14.0 will be used for Systematic review and Meta-analysis. This protocol reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and we will report the systematic review by following the PRISMA statement. CONCLUSION AND DISSEMINATION: Efficacy and safety of PDE5is on male sperm quality in infertile men will be assessed. The results will be published in a public issue journal to provide evidence-based medical evidence for urologists and andrologists to make clinical decisions. REGISTRATION INFORMATION: PROSPERO CRD42019142980.


Assuntos
Infertilidade Masculina/tratamento farmacológico , Pirimidinas/uso terapêutico , Sulfonamidas/uso terapêutico , Humanos , Infertilidade Masculina/diagnóstico , Masculino , Inibidores da Fosfodiesterase 5/uso terapêutico , Contagem de Espermatozoides , Resultado do Tratamento
2.
Pan Afr Med J ; 33: 316, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692834

RESUMO

Kartagener's syndrome is a rare primitive ciliary dyskinesia (DCP) characterized by a clinical triad: sinusitis, bronchiectasis and complete or incomplete situs inversus. It is a rare congenital autosomal recessive disease. We report a case of Kartagener syndrome in an infertile couple with akinospermia detected using spermogram.


Assuntos
Infertilidade Masculina/diagnóstico , Síndrome de Kartagener/diagnóstico , Espermatozoides/anormalidades , Adulto , Humanos , Achados Incidentais , Masculino
3.
Zygote ; 27(5): 263-271, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31412971

RESUMO

Infertility is an important reproductive health problem, and male infertility is especially important in more than half of infertility cases. Due to the importance of genetic factors in this condition, analysis of semen alone is not enough to recognize men with idiopathic infertility. A molecular non-invasive investigation is necessary to gain valuable information. Currently, microRNAs (miRNAs) are being used as non-invasive diagnostic biomarkers. miRNAs, single-stranded non-coding RNA molecules, act as post-transcriptional gene silencing regulators either by inhibition or repression of translation. Changes in the regulation of miRNAs have been investigated in several different types of male infertility, therefore the biological role of miRNA and gene targets has been defined. The purpose of this study was to review recent research on the altered expression of miRNA in semen, sperm, and testicular biopsy samples in infertile males with different types of unexplained infertility. Changes in miRNA regulation were investigated using microarray and the miRNA levels were confirmed by real-time qRT-PCR. This review explains why creating a non-invasive diagnostic method for male infertility is necessary and how changes in miRNA expression can be used as new diagnostic biomarkers in patients with differing spermatogenic and histopathologic injury.


Assuntos
Infertilidade Masculina/genética , MicroRNAs/genética , Espermatogênese/genética , Regulação da Expressão Gênica , Humanos , Infertilidade Masculina/diagnóstico , Masculino , Espermatozoides/patologia , Espermatozoides/fisiologia
5.
J Clin Pathol ; 72(9): 579-587, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31296604

RESUMO

Subfertility affects one in seven couples and is defined as the inability to conceive after 1 year of regular unprotected intercourse. This article describes the initial clinical evaluation and investigation to guide diagnosis and management. The primary assessment of subfertility is to establish the presence of ovulation, normal uterine cavity and patent fallopian tubes in women, and normal semen parameters in men. Ovulation is supported by a history of regular menstrual cycles (21-35 days) and confirmed by a serum progesterone >30 nmol/L during the luteal phase of the menstrual cycle. Common causes of anovulation include polycystic ovary syndrome (PCOS), hypothalamic amenorrhoea (HA) and premature ovarian insufficiency (POI). Tubal patency is assessed by hysterosalpingography, hystero-contrast sonography, or more invasively by laparoscopy and dye test. The presence of clinical or biochemical hyperandrogenism, serum gonadotrophins (luteinising hormone/follicle stimulating hormone) / oestradiol, pelvic ultrasound to assess ovarian morphology / antral follicle count, can help establish the cause of anovulation. Ovulation can be restored in women with PCOS using letrozole (an aromatase inhibitor), clomifene citrate (an oestrogen antagonist) or exogenous gonadotrophin administration. If available, pulsatile gonadotrophin releasing hormone therapy is the preferred option for restoring ovulation in HA. Spermatogenesis can be induced in men with hypogonadotrophic hypogonadism with exogenous gonadotrophins. Unexplained subfertility can be treated with in vitro fertilisation after 2 years of trying to conceive. Involuntary childlessness is associated with significant psychological morbidity; hence, expert assessment and prompt treatment are necessary to support such couples.


Assuntos
Fertilidade , Infertilidade Feminina/terapia , Infertilidade Masculina/terapia , Técnicas de Reprodução Assistida , Feminino , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/etiologia , Infertilidade Feminina/fisiopatologia , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Infertilidade Masculina/fisiopatologia , Masculino , Ovulação , Valor Preditivo dos Testes , Gravidez , Fatores de Risco , Espermatogênese , Tempo para Engravidar , Resultado do Tratamento
6.
Medicine (Baltimore) ; 98(28): e16358, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31305430

RESUMO

RATIONALE: Infertile men with Y-chromosome microdeletions have been reported to be able to have their own children via intracytoplasmic sperm injection (ICSI). PATIENT CONCERNS: A 27-year-old man with Y-chromosome azoospermia factor c (AZFc) deletions underwent ICSI treatment. The pregnancy showed a high risk for trisomy 21 syndrome (risk value: 1 in 150). DIAGNOSES: The karyotype of the patient was 46, XY, inv (9) (p11q13). His wife had a normal karyotype. Sequence-tagged site-based polymerase chain reaction (PCR) analysis showed that markers sY254 and sY255 were absent. ICSI was performed. Two embryos (6IV, 8II) were transferred to the uterus of the patient's wife. Second-trimester maternal serum triple-screening showed that the pregnancy was high risk for trisomy 21 syndrome (risk value: 1 in 150). Amniocentesis was performed and revealed that the fetal chromosomal karyotype was 46, XX, inv (9) (p11q13). INTERVENTIONS: The couple chose to continue the pregnancy and a healthy girl was born at 39 weeks of gestation. OUTCOMES: An infertile man with AZFc microdeletions can reproduce via ICSI technology. The karyotype inv (9) (p11q13) can be transmitted to offspring. Whether this karyotype has clinical significance, such as causing infertility or variations in prenatal biochemical markers, is unclear. LESSONS: Y-chromosome microdeletions and/or the karyotype inv (9) (p11q13) may cause clinically significant variation in prenatal biochemical markers.


Assuntos
Deleção Cromossômica , Infertilidade Masculina , Gravidez de Alto Risco , Aberrações dos Cromossomos Sexuais , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual , Injeções de Esperma Intracitoplásmicas , Adulto , Cromossomos Humanos Y , Feminino , Humanos , Recém-Nascido , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/reabilitação , Masculino , Gravidez , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/diagnóstico , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/reabilitação
7.
Arch Ital Urol Androl ; 91(2)2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31266282

RESUMO

OBJECTIVE: This exploratory retrospective study aimed to compare the level of Sperm DNA Fragmentation (SDF) and investigate its association with bulk semen parameters, for the first time in Bulgarian patients with varicocele, using a distinct methodology. MATERIAL AND METHODS: Standard semen analysis was performed according to the 2010 criteria of the European Society of Human Reproduction and Embryology - Nordic Association for Andrology (ESHRE-NAFA-2010) and DNA fragmentation was assessed using the Halosperm® kit. The total sample included 28 males: the control group consisted of men with normal genital examination and unknown fertility (n = 10), group one consisted of men with varicocele, normozoospermia and DNA fragmentation > 15% (n = 9) and group two consisted of men with varicocele, abnormal sperm parameters and DNA fragmentation > 15% (n = 9). RESULTS: DNA fragmentation was found to be higher in patients with abnormal sperm parameters (43.78 ± 30.78) compared to the normozoospermic group (21.22 ± 3.93) (p = 0.008). In normozoospermic patients, no statistically significant correlations were observed between SDF and bulk semen parameters. In patients with abnormal sperm parameters, DNA fragmentation exhibited significant very strong negative association with motility (a+b), vitality and typical morphology (p < 0.001). CONCLUSIONS: DNA integrity assays could be used for a better evaluation and management of male infertility, particularly in normozoospermic varicocele patients.


Assuntos
Fragmentação do DNA , Sêmen/metabolismo , Espermatozoides/metabolismo , Varicocele/complicações , Adulto , Bulgária , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Masculino , Estudos Retrospectivos , Análise do Sêmen , Motilidade Espermática , Espermatozoides/patologia , Adulto Jovem
8.
Urologiia ; (3): 101-107, 2019 Jul.
Artigo em Russo | MEDLINE | ID: mdl-31356021

RESUMO

AIM: microdeletions in the AZF region of Y-chromosome, compound heterozygotes of severe and mild CFTR mutations, and long CAG-repeats in the androgen receptor gene (AR) as marker of predisposition are frequently studied as genetic causes of male infertility. A simultaneously testing of the panel including biochemical, immunological, cyto- and molecular genetic markers is often performed during the complex laboratory diagnostics in infertile men. The aim of our work was to identify molecular genetic alterations, which are advisable for simultaneously testing in a man with currently uncertain form of infertility, to increase the informativeness of laboratory diagnostics. MATERIALS AND METHODS: a retrospective study of 885 infertile men was conducted. AZF deletions were determined by multiplex PCR using 10 STS-markers (sY83, sY84, sY86, sY127, sY134, sY143, sY152, sY157, sY254, sY255) and two control loci SRY and AMEL with detection in polyacrylamide gel. Mutations in the CFTR gene (F508del, CFTRdel2.3(21kb), I507del, 1677delTA, 2143delT, 2184insA, 394delTT, W1282X, G542X, N1303K, R334W and 5T) were detected by PCR and SNaPshot. For determination of length of the AR CAG-repeat a fragment analysis of fluorescently labeled PCR products on the 3500xl capillary sequencer was performed. RESULTS: AZF deletions were detected in 8.2% of cases. The largest number of deletions was found in the AZFc subregion (58.9%), while a frequency of deletion in AZFa, AZFb or combined deletions of two and three subregions was 5.5%, 12.3% and 23.3%, respectively. Heterozygous carriage of severe CFTR mutations was detected in 4.7% patients. The most frequent mutation was F508del (83.3%), followed by CFTRdel21kb (7.1%) and W1282X (4.8%). The frequency of the mild splicing 5T mutation was 5.3%, and its incidence was significantly higher than in the previously published control group (p=0.002). AR genotyping revealed that the most prevailing allele was 21 (CAG) (21.5%). Long alleles with 27 or more CAG-trinucleotides were identified in 7.5% of the tested cases. In addition, 7 CAG heterozygotes with Kleinfelter syndrome were found. CONCLUSION: during primary complex laboratory diagnostics in a heterogeneous group of infertile men, it is advisable to detect AZF deletions and the most frequent CFTR mutations, including F508del, CFTRdel21kb, 1677delTA, 2143delT, W1282X and 5T. The more comprehensive analysis of CFTR mutations is justified only in patients with verified obstructive infertility. Sequencing of panels associated with infertility genes using NGS technology is promising.


Assuntos
Regulador de Condutância Transmembrana em Fibrose Cística , Infertilidade Masculina , Oligospermia , Alelos , Biomarcadores , Cromossomos Humanos Y , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Humanos , Incidência , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/genética , Masculino , Mutação , Estudos Retrospectivos
10.
PLoS One ; 14(5): e0216586, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31071133

RESUMO

Sertoli cell-only (SCO) syndrome is a severe form of human male infertility seemingly characterized by the lack all spermatogenic cells. However, tubules of some SCO testes contain small patches of active spermatogenesis and thus spermatogonial stem cells. We hypothesized that these stem cells cannot replicate and seed spermatogenesis in barren areas of tubule because as-of-yet unrecognized deficits in Sertoli cell gene expression disable most stem cell niches. Performing the first thorough comparison of the transcriptomes of human testes exhibiting complete spermatogenesis with the transcriptomes of testes with SCO syndrome, we defined transcripts that are both predominantly expressed by Sertoli cells and expressed at aberrant levels in SCO testes. Some of these transcripts encode proteins required for the proper assembly of adherent and gap junctions at sites of contact with other cells, including spermatogonial stem cells (SSCs). Other transcripts encode GDNF, FGF8 and BMP4, known regulators of mouse SSCs. Thus, most SCO Sertoli cells can neither organize junctions at normal sites of cell-cell contact nor stimulate SSCs with adequate levels of growth factors. We propose that the critical deficits in Sertoli cell gene expression we have identified contribute to the inability of spermatogonial stem cells within small patches of spermatogenesis in some SCO testes to seed spermatogenesis to adjacent areas of tubule that are barren of spermatogenesis. Furthermore, we predict that one or more of these deficits in gene expression are primary causes of human SCO syndrome.


Assuntos
Biomarcadores/metabolismo , Regulação da Expressão Gênica , Infertilidade Masculina/diagnóstico , Síndrome de Células de Sertoli/genética , Células de Sertoli/patologia , Espermatogênese/genética , Adulto , Perfilação da Expressão Gênica , Humanos , Infertilidade Masculina/genética , Masculino , Síndrome de Células de Sertoli/metabolismo , Síndrome de Células de Sertoli/patologia , Células de Sertoli/metabolismo
12.
J Assist Reprod Genet ; 36(7): 1423-1429, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31093866

RESUMO

PURPOSE: It is known that sperm preparation techniques in in vitro fertilisation (IVF) are intended to select the best-quality sperm. The aim of this study is to compare sperm the density gradient method and microfluidic chip (Fertile Plus) method in infertile patients by analysing fertilisation rates, pregnancy rates, and sperm morphology and DNA fragmentation rates posed by these two methods. METHODS: Using semen samples obtained from the patients, sperms were prepared with gradient (n = 312) and microfluidic chip methods (n = 116). Fertilisation and pregnancy rates were compared in the first time and in the recurrent IVF trial patients. In addition, the morphology and DNA fragmentation comparison of sperm samples were evaluated by Toluidine blue in situ chemical staining method. RESULTS: There was no statistically significant difference between fertilisation and pregnancy rates when compared with study groups in first-time IVF treatment patients. However, in recurrent IVF failure patients, there was a significant difference in fertilisation rates but no statistically significant difference was found in pregnancy rates. The microfluidic chip method significantly decreased sperm DNA fragmentation index according to density gradient method. CONCLUSIONS: Microfluidic chip method may be recommended in patients with recurrent unsuccessful in vitro trials. The sperm DNA fragmentation test prior to the treatment will be helpful in selecting the appropriate sperm-washing method.


Assuntos
Fragmentação do DNA , Infertilidade Masculina/diagnóstico , Microfluídica , Espermatozoides/metabolismo , Adulto , Feminino , Fertilização In Vitro , Humanos , Infertilidade Masculina/metabolismo , Infertilidade Masculina/patologia , Masculino , Gravidez , Taxa de Gravidez , Injeções de Esperma Intracitoplásmicas , Motilidade Espermática , Espermatozoides/crescimento & desenvolvimento , Espermatozoides/patologia
13.
Fertil Steril ; 111(6): 1129-1134, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30982604

RESUMO

OBJECTIVE: To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity. DESIGN: Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS). SETTING: Infertility clinics. PATIENT(S): Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome. RESULT(S): Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318-520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4% strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95% CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 106/mL, or motility < 40%. Among couples whose male partner had low TT, 21 (18.8%) had a live birth, compared with 184 (27.5%) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR, 0.60; 95% CI, 0.36, 1.00; adjusted OR, 0.65; 95% CI, 0.38, 1.12). CONCLUSION(S): In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates. CLINICAL TRIAL REGISTRATION NUMBER: NCT01044862.


Assuntos
Infertilidade Masculina/terapia , Inseminação Artificial Homóloga , Espermatogênese , Testosterona/sangue , Adulto , Biomarcadores/sangue , Regulação para Baixo , Feminino , Fertilidade , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/fisiopatologia , Inseminação Artificial Homóloga/efeitos adversos , Nascimento Vivo , Masculino , Estudos Multicêntricos como Assunto , Gravidez , Taxa de Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco , Contagem de Espermatozoides , Motilidade Espermática , Resultado do Tratamento
14.
J Pak Med Assoc ; 69(4): 567-571, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31000864

RESUMO

This study was designed to investigate the hormonal, seminal changes and chromosomal aberrations in cases of male infertility. A total of ten infertile families from Khyber Pakhtunkhwa of Pakistan were included in the study. The families were clinically evaluated by standard criteria; diagnosis of azoospermic and oligospermic males was confirmed. Seminal, hormonal, ultra sonographic and histopathological examinations were carried out for all the affected participants of the study. Karyotyping was performed on peripheral blood lymphocytes according to standard methods. Hormones were altered in six families. Ultrasonographic abnormal finding was observed in six families. Karyotyping analysis revealed numerical aberration in family G (0X) and family I (XXY). The remainingfamilies had no structural or numerical aberration. Y chromosome microdeletion analysis revealed AZFc deletion in both the affected participants of the family C. The remaining families were found normal for microdeletion. The occurrence of chromosomal anomalies and Y chromosome microdeletions among infertile males strongly suggests the need to include these two tests in routine investigations of male in fertility cases.


Assuntos
Azoospermia/genética , Hipogonadismo/genética , Infertilidade Masculina/genética , Oligospermia/genética , Aberrações dos Cromossomos Sexuais , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/genética , Adolescente , Adulto , Deleção Cromossômica , Cromossomos Humanos Y/genética , Proteína 1 Suprimida em Azoospermia/genética , Família , Humanos , Infertilidade Masculina/diagnóstico , Síndrome de Klinefelter/diagnóstico , Masculino , Pessoa de Meia-Idade , Linhagem , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/diagnóstico , Adulto Jovem
15.
Panminerva Med ; 61(2): 104-107, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30990282

RESUMO

Diagnostic testing for male infertility has traditionally been limited to andrology labs. The advent of home-based semen testing has the potential to allow patients to perform testing in the comfort of their home and screen those who need a formal evaluation. An extensive review of the literature was performed. There are several FDA-approved devices for home semen testing. The mechanism of the test and the results provided differ by test. The existing tests are limited in their diagnostic capabilities but may fill a niche for men who do not have access to andrology lab testing or prefer home testing.


Assuntos
Infertilidade Masculina/diagnóstico , Análise do Sêmen/instrumentação , Smartphone , Andrologia , Humanos , Masculino
16.
Panminerva Med ; 61(2): 108-117, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30990283

RESUMO

Oxidative stress is considered a major etiology for male infertility, more specifically idiopathic infertility. The causes of seminal oxidative stress can be intrinsic, such as varicocele or due to the presence of active leukocytes and immature germ cells. Reported external causes are smoking, alcohol or exposure to environmental toxins. Traditional methods to determine the seminal oxidative stress do not evaluate this status directly, but rather measure its components or intermediate products indirectly, instead. The major disadvantages of the traditional methods are related with time and cost as these methods are extremely time consuming and require expensive equipment, consumables and highly skilled laboratory personnel. To overcome these drawbacks, the MiOXSYS® system, a method which directly measures the oxidation-reduction potential (ORP), was developed. The evaluation of the ORP using MiOXSYS® is cost-effective, easy and quick. However, this newly introduced method to evaluate the oxidative status of semen still requires validation in different andrology laboratory settings across the world.


Assuntos
Infertilidade Masculina/diagnóstico , Estresse Oxidativo , Espermatozoides/metabolismo , Biomarcadores , Humanos , Infertilidade Masculina/metabolismo , Masculino , Oxirredução , Espécies Reativas de Oxigênio/metabolismo
17.
Panminerva Med ; 61(2): 118-127, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30990284

RESUMO

Sperm DNA fragmentation (SDF) is an advanced test of sperm function that is utilized during male fertility evaluation. Recently, a guideline was published highlighting the detrimental impact of SDF on sperm function identifying practice-based clinical indications for SDF testing. This review illustrates the commonly utilized SDF measurement techniques and explores the current evidence behind their utility in clinical practice. Patients diagnosed with varicocele, unexplained infertility, recurrent pregnancy loss, recurrent failure of assisted reproductive techniques (ART) and those at risk of lifestyle/environmental exposures are recognized candidates for SDF testing. On a therapeutic level, SDF can help in selecting patients for varicocelectomy, choosing the ART modality and intervention associated with highest pregnancy and live birth outcomes and monitoring treatment response in patients with lifestyle risk factors.


Assuntos
Dano ao DNA , Infertilidade Masculina/diagnóstico , Espermatozoides/metabolismo , Feminino , Fertilização In Vitro , Humanos , Estilo de Vida , Masculino , Gravidez , Técnicas de Reprodução Assistida , Varicocele/diagnóstico , Varicocele/cirurgia
18.
Fertil Steril ; 111(5): 842-850, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31029238

RESUMO

Male infertility is a heterogenous disease process requiring the proper functioning and interaction of thousands of genes. Given the number of genes involved, it is thought that genetic causes contribute to most cases of infertility. Identifying these causes, however, is challenging. Infertility is associated with negative health outcomes, such as cancer, highlighting the need to further understand the genetic underpinnings of this condition. This paper describes the genetic and genomic tests currently available to identify the etiology of male infertility and then will discuss emerging technologies that may facilitate diagnosis and treatment of in the future.


Assuntos
Testes Genéticos/métodos , Infertilidade Masculina/genética , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/genética , Deleção Cromossômica , Cromossomos Humanos Y/genética , Testes Genéticos/tendências , Humanos , Infertilidade Masculina/diagnóstico , Cariotipagem/métodos , Cariotipagem/tendências , Masculino , Análise Serial de Proteínas/métodos , Análise Serial de Proteínas/tendências , Aberrações dos Cromossomos Sexuais , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/diagnóstico
19.
Fertil Steril ; 111(5): 851-863, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31029239

RESUMO

This paper discusses the variety of effective sperm selection techniques that have been developed for use in assisted reproductive technologies. Available methods for isolating the competent sperm in an ejaculate are outlined, as well as techniques for selecting single sperm for use in intracytoplasmic sperm injection procedures. Case-specific methods for selecting the most competent sperm are discussed, with reference to the potential causes of male factor infertility and guidance for the embryologist based on the issues present for each couple seeking treatment.


Assuntos
Técnicas de Reprodução Assistida , Análise do Sêmen/métodos , Motilidade Espermática/fisiologia , Espermatozoides/fisiologia , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/genética , Infertilidade Masculina/fisiopatologia , Masculino , Técnicas de Reprodução Assistida/tendências , Análise do Sêmen/tendências
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