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1.
Cells ; 11(8)2022 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-35455999

RESUMO

We present a multidisciplinary approach for predicting how sperm cells with various morphologies swim in three-dimensions (3D), from milliseconds to much longer time scales at spatial resolutions of less than half a micron. We created the sperm 3D geometry and built a numerical mechanical model using the experimentally acquired dynamic 3D refractive-index profiles of sperm cells swimming in vitro as imaged by high-resolution optical diffraction tomography. By controlling parameters in the model, such as the size and shape of the sperm head and tail, we can then predict how different sperm cells, normal or abnormal, would swim in 3D, in the short or long term. We quantified various 3D structural factor effects on the sperm long-term motility. We found that some abnormal sperm cells swim faster than normal sperm cells, in contrast to the commonly used sperm selection assumption during in vitro fertilization (IVF), according to which sperm cells should mainly be chosen based on their progressive motion. We thus establish a new tool for sperm analysis and male-infertility diagnosis, as well as sperm selection criteria for fertility treatments.


Assuntos
Infertilidade Masculina , Espermatozoides , Fertilização In Vitro , Humanos , Infertilidade Masculina/terapia , Masculino , Imagem Óptica , Motilidade Espermática
2.
Adv Sci (Weinh) ; 9(11): e2104362, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35419997

RESUMO

Sperm motility is a significant predictor of male fertility potential and is directly linked to fertilization success in both natural and some forms of assisted reproduction. Sperm motility can be impaired by both genetic and environmental factors, with asthenozoospermia being a common clinical presentation. Moreover, in the setting of assisted reproductive technology clinics, there is a distinct absence of effective and noninvasive technology to increase sperm motility without detriment to the sperm cells. Here, a new method is presented to boost sperm motility by increasing the intracellular rate of metabolic activity using high frequency ultrasound. An increase of 34% in curvilinear velocity (VCL), 10% in linearity, and 32% in the number of motile sperm cells is shown by rendering immotile sperm motile, after just 20 s exposure. A similar effect with an increase of 15% in VCL treating human sperm with the same setting is also identified. This cell level mechanotherapy approach causes no significant change in cell viability or DNA fragmentation index, and, as such, has the potential to be applied to encourage natural fertilization or less invasive treatment choices such as in vitro fertilization rather than intracytoplasmic injection.


Assuntos
Astenozoospermia , Infertilidade Masculina , Animais , Bovinos , Fertilização In Vitro , Humanos , Infertilidade Masculina/terapia , Masculino , Motilidade Espermática , Espermatozoides
3.
Andrology ; 10(4): 642-659, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35246969

RESUMO

BACKGROUND: Necrozoospermia is a condition found in 0.2%-0.4% of male infertility cases. The causes of necrozoospermia are multiple: they can be related to testicular and/or post-testicular damage. Additionally, these causes most often involve the production of reactive oxygen species (ROS) and/or sperm DNA fragmentation (SDF) which can reduce the chances of spontaneous pregnancy or affect the outcome of assisted reproductive technologies. OBJECTIVE: To focus on potential etiologies of necrozoospermia, its diagnosis and its therapeutic management especially before the employment of ICSI. METHODS: Authors searched PubMed/Medline, Web of Science, Cochrane Library, Google and Institutional websites for medical subheading terms and free text words referred to "necrozoospermia", "sperm vitality", "sperm viability", SDF and "ICSI". RESULTS: We identified 12 main etiologies of necrozoospermia responsible for either a decrease of sperm vitality, a mild, a moderate or a severe necrozoospermia. In case of a confirmed decreased vitality, a thorough check-up should be conducted and if available, etiological treatment should be proposed. Therapeutic management could also include repeated ejaculations, drug treatments, the use of ICSI with ejaculated or surgically extracted spermatozoa in case of a non-treatable necrozoospermia. DISCUSSION AND CONCLUSION: The potential causes of necrozoospermia should be investigated because many of them could be corrected, thus avoiding the use of ICSI. Moreover, if ICSI procedure remains necessary, the therapeutic management of necrozoospermia could also improve the chances of success by reducing oxidative stress and/or SDF.


Assuntos
Infertilidade Masculina , Injeções de Esperma Intracitoplásmicas , Fragmentação do DNA , Feminino , Humanos , Infertilidade Masculina/genética , Infertilidade Masculina/terapia , Masculino , Gravidez , Injeções de Esperma Intracitoplásmicas/métodos , Espermatozoides
4.
J Assist Reprod Genet ; 39(3): 757-764, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35166991

RESUMO

PURPOSE: To evaluate the unknown genetic causes of teratozoospermia, and determine the pathogenicity of candidate variants. METHODS: A primary infertile patient and his family members were recruited in the West China Second University Hospital of Sichuan University. Whole-exome sequencing was performed to identify causative genes in a man with teratozoospermia. Immunofluorescence staining and western blotting were applied to assess the pathogenicity of the identified variant. Intracytoplasmic sperm injection (ICSI) was used to assist fertilization for the patient with teratozoospermia. RESULTS: We performed whole-exome sequencing (WES) and detected a novel homozygous frameshift mutation of c.335_336del [p.E112Vfs*3] in DNAJB13 on a primary infertile male patient. Intriguingly, we identified abnormal sperm morphology in this patient, with recurrent respiratory infections and chronic cough. Furthermore, we confirmed that this mutation resulted in negative effects on DNAJB13 expression in the spermatozoa of the affected individual, causing ultrastructural defects in his sperm. Remarkably, our staining revealed that DNAJB13 was expressed in the cytoplasm of primary germ cells and in the flagella of spermatids during spermiogenesis in humans and mice. Finally, we are the first group to report a favorable prognosis using ICSI for a patient carrying this DNAJB13 mutation. CONCLUSION: Our study revealed a novel homozygous frameshift mutation of c.335_336del [p.E112Vfs*3] in DNAJB13 involved in teratozoospermia phenotype. Our study greatly expands the spectrum of limited DNAJB13 mutations, and is expected to provide a better understanding of genetic counseling diagnoses and subsequent treatment of male infertility.


Assuntos
Infertilidade Masculina , Teratozoospermia , Animais , Proteínas Reguladoras de Apoptose/genética , Axonema/genética , Humanos , Infertilidade Masculina/terapia , Masculino , Camundongos , Chaperonas Moleculares/genética , Chaperonas Moleculares/metabolismo , Mutação , Espermatozoides/metabolismo , Teratozoospermia/genética , Teratozoospermia/metabolismo
5.
Reprod Biomed Online ; 44(5): 769-775, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35153142

RESUMO

The value of assessing subfertile males with oligozoospermia is controversial due to prevailing notions that therapies are limited and ICSI may provide the couple with a baby without the need to explain the nature or cause of underlying male infertility. This article highlights that indiscriminately offering ICSI to oligozoospermic men is not free of potential adverse effects and does not grant subfertile men the best fertility pathway. Recent data support associations between oligozoospermia and poor male reproductive health, DNA and epigenetic damage in spermatozoa, and possible adverse health consequences to offspring. Many conditions affecting the testicles are capable of causing oligozoospermia (varicocele, genital infections, congenital and genetic defects testicular torsion/trauma, chronic diseases, inadequate lifestyle, occupational/environmental exposure to toxicants, drugs, cancer and related treatments, acute febrile illness, endocrine disorders, and iatrogenic damage to the genitourinary system). If oligozoospermia is detected, therapeutic interventions can improve sperm quantity/quality and the overall male health, ultimately resulting in better pregnancy outcomes even when ICSI is used. Fertility clinics are urged to engage male infertility specialists in diagnosing and treating oligozoospermia as a matter of best clinical practice. A well-conducted male infertility evaluation represents a unique opportunity to identify relevant medical and infertility conditions, many of which may be treated or alleviated. The andrological assessment may also help guide the optimal application of ICSI. The final goals are to positively impact the overall patient health, the couple's pregnancy prospects, and the offspring's well-being.


Assuntos
Infertilidade Masculina , Oligospermia , Feminino , Fertilidade , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Masculino , Oligospermia/genética , Oligospermia/terapia , Gravidez , Injeções de Esperma Intracitoplásmicas , Espermatozoides
6.
Endocrinol Metab Clin North Am ; 51(1): 133-148, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35216712

RESUMO

Hypogonadism can be present in up to 40% in men who present with couple infertility. Testosterone is the major androgen regulating-spermatogenesis in men; as a result, men with either primary or secondary hypogonadism may be subfertile because of impaired spermatogenesis. The clinical impact of hypogonadism on fertility potential depends on the timing of its onset (fetal, prepubertal, or postpubertal) and effect on semen parameters. Treatment pathways and success rates differ according to the cause of hypogonadism and the time of its onset. When medical therapy fails to induce sufficient sperm, assisted reproductive technologies are considered.


Assuntos
Hipogonadismo , Infertilidade Masculina , Fertilidade , Humanos , Hipogonadismo/complicações , Hipogonadismo/tratamento farmacológico , Infertilidade Masculina/complicações , Infertilidade Masculina/terapia , Masculino , Espermatogênese , Testosterona/uso terapêutico
7.
Int J Mol Sci ; 23(4)2022 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-35216156

RESUMO

Male pediatric survivors of cancers and bone marrow transplantation often require adjuvant chemoradiation therapy that may be gonadotoxic. The optimal methods to preserve fertility in these prepubertal males are still under investigation. This manuscript presents an in vivo experiment which involved transplantation of immature testicular tissues (ITT) from transgenic donor, to wild-type recipient mice. Donors and recipients were age-mismatched (from 20-week-old donors to 3-week-old recipients, and vice versa) and the transplantation sites involved the abdomen, skin of the head, back muscle, and scrotum. The application of poly-l-lactic acid (PLLA) scaffold was also evaluated in age-matched donors and recipients (both 3-weeks-old). To quantitively evaluate the process of spermatogenesis after ITT transplantation and scaffold application, bioluminescence imaging (BLI) was employed. Our result showed that ITT from 3-week-old mice had the best potential for spermatogenesis, and the optimal transplantation site was in the scrotum. Spermatogenesis was observed in recipient mice up to 51 days after transplantation, and up to the 85th day if scaffold was used. The peak of spermatogenesis occurred between the 42nd and 55th days in the scaffold group. This animal model may serve as a framework for further studies in prepubertal male fertility preservation.


Assuntos
Preservação da Fertilidade/métodos , Infertilidade Masculina/terapia , Espermatogênese , Testículo/citologia , Engenharia Tecidual/métodos , Animais , Infertilidade Masculina/etiologia , Masculino , Camundongos , Poliésteres/química , Lesões Experimentais por Radiação/complicações , Testículo/crescimento & desenvolvimento , Testículo/fisiologia , Tecidos Suporte/química
8.
BMC Urol ; 22(1): 16, 2022 Feb 02.
Artigo em Inglês | MEDLINE | ID: mdl-35109852

RESUMO

BACKGROUND: The incidence of 47, XYY syndrome in live-born male infants is 1/1000. Due to its variable clinical symptoms, the diagnosis is easy to miss. The incidence of congenital bilateral absence of the vas deferens (CBAVD) in infertile men is 1-2%. The main cause is the mutation of CFTR and ADGAG2 genes. CASE PRESENTATION: The patient was a 33-year-old man who visited a doctor 5 years ago due to infertility. The investigation revealed that the patient's secondary sexual characteristics, testicular, and penis development were normal, and there was no gynecomastia, but the bilateral vas deferens and epididymis were not palpable. Transrectal ultrasound showed that the left seminal vesicle was missing, and the right seminal vesicle was atrophied. No abnormality was observed in Y chromosome microdeletion. Karyotype analysis indicated that the patient was 46, XY/47, XYY mosaic. Genetic testing found heterozygous mutations at two sites of CFTR (c263T > G and c2249C > T). CONCLUSIONS: Herein, we report the rare case of a male patient with clinical manifestations of infertility, chromosome 46, XY/47, XXY mosaic type, simultaneously manifested as the absence of bilateral vas deferens. Two pathogenic heterozygous CFTR gene mutations were found. Given the low genetic risk of the disease, we recommend that patients undergo intracytoplasmic sperm injection (ICSI) for fertility assessment.


Assuntos
Transtornos dos Cromossomos Sexuais/diagnóstico , Ducto Deferente/anormalidades , Cariótipo XYY/diagnóstico , Adulto , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Heterozigoto , Humanos , Infertilidade Masculina/genética , Infertilidade Masculina/terapia , Cariotipagem , Masculino , Mutação , Transtornos dos Cromossomos Sexuais/diagnóstico por imagem , Injeções de Esperma Intracitoplásmicas , Ultrassonografia , Cariótipo XYY/diagnóstico por imagem
9.
PLoS One ; 17(2): e0263886, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35171948

RESUMO

Many childhood cancer survivors desire biological children but are at risk for infertility after treatment. One option for mitigating risk is the use of fertility preservation prior to gonadotoxic therapy. Adolescents and emerging adults may rely on their parents to help them decide whether to use fertility preservation. While this is often a collaborative process, it is currently unknown how parents can optimally support adolescents and emerging adults through this decision. To address this gap, we developed a family-centered, psychoeducational intervention to prompt adolescents and emerging adults to reflect on their future parenthood goals and attitudes towards fertility preservation, as well as to prompt their parents (or other caregivers) to reflect on their own and their child's perspectives on the topic. In this randomized controlled trial, families will be randomized to either the standard of care control group (fertility consult) or the intervention group. After their fertility consult, adolescents and emerging adults and parents in the intervention group will complete a fertility preservation values clarification tool and then participate in a guided conversation about their responses and the fertility preservation decision. The primary expected outcome of this study is that participation in the intervention will increase the use of fertility preservation. The secondary expected outcome is an improvement in decision quality. Chi-square analyses and t-tests will evaluate primary and secondary outcomes. The goal of this intervention is to optimize family-centered fertility preservation decision-making in the context of a new cancer diagnosis to help male adolescents and emerging adults achieve their future parenthood goals.


Assuntos
Sobreviventes de Câncer/psicologia , Comunicação , Tomada de Decisões , Preservação da Fertilidade/psicologia , Infertilidade Masculina/terapia , Neoplasias/complicações , Adolescente , Adulto , Criança , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/psicologia , Masculino , Neoplasias/diagnóstico , Pais , Projetos Piloto , Sistemas de Apoio Psicossocial , Ensaios Clínicos Controlados Aleatórios como Assunto , Encaminhamento e Consulta , Inquéritos e Questionários , Adulto Jovem
10.
Fertil Steril ; 117(2): 258-267, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35125173

RESUMO

Over the past 40 years, since the publication of the original WHO Laboratory Manual for the Examination and Processing of Human Semen, the laboratory methods used to evaluate semen markedly changed and benefited from improved precision and accuracy, as well as the development of new tests and improved, standardized methodologies. Herein, we present the impact of the changes put forth in the sixth edition together with our views of evolving technologies that may change the methods used for the routine semen analysis, up-and-coming areas for the development of new procedures, and diagnostic approaches that will help to extend the often-descriptive interpretations of several commonly performed semen tests that promise to provide etiologies for the abnormal semen parameters observed. As we look toward the publication of the seventh edition of the manual in approximately 10 years, we describe potential advances that could markedly impact the field of andrology in the future.


Assuntos
Andrologia/tendências , Infertilidade Masculina , Saúde do Homem/tendências , Saúde Reprodutiva/tendências , Análise do Sêmen/tendências , Saúde Sexual/tendências , Difusão de Inovações , Fertilidade , Previsões , Testes Genéticos/tendências , Genômica/tendências , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/genética , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/terapia , Masculino , Reprodução , Comportamento Sexual
11.
Reprod Biol Endocrinol ; 20(1): 5, 2022 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-34980136

RESUMO

BACKGROUND: Potassium channels are important for the structure and function of the spermatozoa. As a potassium transporter, the mSlo3 is essential for male fertility as Slo3 knockout male mice were infertile with the series of functional defects in sperm cells. However, no pathogenic variant has been detected in human SLO3 to date. Here we reported a human case with homozygous SLO3 mutation. The function of SLO3 in human sperm and the corresponding assisted reproductive strategy are also investigated. METHODS: We performed whole-exome sequencing analysis from a large cohort of 105 patients with asthenoteratozoospermia. The effects of the variant were investigated by quantitative RT-PCR, western blotting, and immunofluorescence assays using the patient spermatozoa. Sperm morphological and ultrastructural studies were conducted using haematoxylin and eosin staining, scanning and transmission electron microscopy. RESULTS: We identified a homozygous missense variant (c.1237A > T: p.Ile413Phe) in the sperm-specific SLO3 in one Chinese patient with male infertility. This SLO3 variant was rare in human control populations and predicted to be deleterious by multiple bioinformatic tools. Sperm from the individual harbouring the homozygous SLO3 variant exhibited severe morphological abnormalities, such as acrosome hypoplasia, disruption of the mitochondrial sheath, coiled tails, and motility defects. The levels of SLO3 mRNA and protein in spermatozoa from the affected individual were reduced. Furthermore, the acrosome reaction, mitochondrial membrane potential, and membrane potential during capacitation were also afflicted. The levels of acrosome marker glycoproteins and PLCζ1 as well as the mitochondrial sheath protein HSP60 and SLO3 auxiliary subunit LRRC52, were significantly reduced in the spermatozoa from the affected individual. The affected man was sterile due to acrosome and mitochondrial dysfunction; however, intra-cytoplasmic sperm injection successfully rescued this infertile condition. CONCLUSIONS: SLO3 deficiency seriously impact acrosome formation, mitochondrial sheath assembly, and the function of K+ channels. Our findings provided clinical implications for the genetic and reproductive counselling of affected families.


Assuntos
Acrossomo/patologia , Astenozoospermia/genética , Infertilidade Masculina/genética , Reação Acrossômica/genética , Adulto , Astenozoospermia/patologia , China , Estudos de Coortes , Consanguinidade , Características da Família , Feminino , Homozigoto , Humanos , Infertilidade Masculina/patologia , Infertilidade Masculina/terapia , Canais de Potássio Ativados por Cálcio de Condutância Alta , Masculino , Potencial da Membrana Mitocondrial/genética , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Membranas Mitocondriais/patologia , Mutação de Sentido Incorreto , Linhagem , Gravidez , Injeções de Esperma Intracitoplásmicas , Espermatozoides/anormalidades , Espermatozoides/patologia
12.
J Endocrinol Invest ; 45(5): 1085-1113, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35075609

RESUMO

PURPOSE: Infertility affects 15-20% of couples and male factors are present in about half of the cases. For many aspects related to the diagnostic and therapeutic approach of male factor infertility, there is no general consensus, and the clinical approach is not uniform. METHODS: In the present document by the Italian Society of Andrology and Sexual Medicine (SIAMS), endorsed by the Italian Society of Embryology, Reproduction, and Research (SIERR), we propose evidence-based recommendations for the diagnosis, treatment, and management of male factor infertility to improve patient and couple care. RESULTS: Components of the initial evaluation should include at minimum medical history, physical examination, and semen analysis. Semen microbiological examination, endocrine assessment, and imaging are suggested in most men and recommended when specific risk factors for infertility exist or first-step analyses showed abnormalities. Full examination including genetic tests, testicular cytology/histology, or additional tests on sperm is clinically oriented and based on the results of previous investigations. For treatment purposes, the identification of the specific cause and the pathogenetic mechanism is advisable. At least, distinguishing pre-testicular, testicular, and post-testicular forms is essential. Treatment should be couple-oriented, including lifestyle modifications, etiologic therapies, empirical treatments, and ART on the basis of best evidence and with a gradual approach. CONCLUSION: These Guidelines are based on two principal aspects: they are couple-oriented and place high value in assessing, preventing, and treating risk factors for infertility. These Guidelines also highlighted that male infertility and in particular testicular function might be a mirror of general health of a man.


Assuntos
Andrologia , Infertilidade Masculina , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Masculino , Reprodução , Análise do Sêmen , Espermatozoides
13.
Reprod Sci ; 29(3): 944-954, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34642916

RESUMO

Today, infertility affects 15% of couples and half of this rate is due to reproductive problems in men. Radiation-induced damage to the testicles causes sterility depending on the dose. Radiation causes endoplasmic reticulum (ER) stress and ER stress induces apoptosis. In this study, the effect of human amniotic membrane-derived mesenchymal stem cells (hAMSCs) and conditioned medium (hAMSCs-CM) on testicular damage induced by ionizing radiation is aimed to be elucidated through ER stress and apoptosis mechanisms. Six gray scrotal irradiation was used to create a testicular injury model. hAMSCs isolated and characterized with immunofluorescence and flow cytometry, while 2.5 × 105 hAMSCs were transplanted into testis and hAMSCs-CM was applied. Fertility assessment was performed. Expressions of ER stress markers GRP78, Ire1, Chop and Caspase-12, and Caspase-3 were determined. TUNEL was performed. Serum FSH, LH, and testosterone were measured. After hAMSC transplantation and administration of hAMSCs-CM, offsprings were obtained. Seminiferous tubule diameter and seminiferous epithelial height increased. The expression of GRP78, IRE1α, CHOP, Caspase-12, and Caspase-3 decreased. Percentages of tunel positive cells decreased. While FSH and LH levels decreased, testosterone increased. After irradiation, both hAMSCs transplantation and paracrine activity of hAMSCs may have a role in reducing ER stress by suppressing the UPR response. Decrease in FSH and LH and increase in testosterone level after MSCs transplantation may have contributed to the improvement of spermatogenesis. Thus, it can be said that MSCs derived from human amniotic membrane can improve ionized radiation-induced testicular damage by reducing ER stress and apoptosis.


Assuntos
Âmnio/citologia , Apoptose/efeitos da radiação , Estresse do Retículo Endoplasmático/efeitos da radiação , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Transplante de Células-Tronco Mesenquimais , Testículo/efeitos da radiação , Animais , Meios de Cultivo Condicionados , Feminino , Humanos , Masculino , Ratos
14.
Andrology ; 10(2): 310-321, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34723422

RESUMO

BACKGROUND: An explosive increase in couples attending assisted reproductive technology has been recently observed, despite an overall success rate of about 20%-30%. Considering the assisted reproductive technology-related economic and psycho-social costs, the improvement of these percentages is extremely relevant. However, in the identification of predictive markers of assisted reproductive technology success, male parameters are largely underestimated so far. STUDY DESIGN: Retrospective, observational study. OBJECTIVES: To evaluate whether conventional semen parameters could predict assisted reproductive technology success. MATERIALS AND METHODS: All couples attending a single third-level fertility center from 1992 to 2020 were retrospectively enrolled, collecting all semen and assisted reproductive technology parameters of fresh cycles. Fertilization rate was the primary end-point, representing a parameter immediately dependent on male contribution. Pregnancy and live birth rates were considered in relation to semen variables. Statistical analyses were performed using the parameters obtained according to the World Health Organization manual editions used for semen analysis. RESULTS: Note that, 22,013 in vitro fertilization and intracytoplasmic sperm injection cycles were considered. Overall, fertilization rate was significantly lower in patients with abnormal semen parameters compared to normozoospermic men, irrespective of the World Health Organization manual edition. In the in vitro fertilization setting, both progressive motility (p = 0.012) and motility after capacitation (p = 0.002) significantly predicted the fertilization rate (statistical accuracy = 71.1%). Sperm motilities also predicted pregnancy (p < 0.001) and live birth (p = 0.001) rates. In intracytoplasmic sperm injection cycles, sperm morphology predicted fertilization rate (p = 0.001, statistical accuracy = 90.3%). Sperm morphology significantly predicted both pregnancy (p < 0.001) and live birth (p < 0.001) rates and a cut-off of 5.5% was identified as a threshold to predict clinical pregnancy (area under the curve = 0.811, p < 0.001). DISCUSSION: Interestingly, sperm motility plays a role in predicting in vitro fertilization success, while sperm morphology is the relevant parameter in intracytoplasmic sperm injection cycles. These parameters may be considered reliable tools to measure the male role on ART outcomes, potentially impacting the clinical management of infertile couples.


Assuntos
Fertilização In Vitro/estatística & dados numéricos , Infertilidade Masculina/patologia , Técnicas de Reprodução Assistida/estatística & dados numéricos , Análise do Sêmen/estatística & dados numéricos , Injeções de Esperma Intracitoplásmicas/estatística & dados numéricos , Adulto , Coeficiente de Natalidade , Feminino , Humanos , Infertilidade Masculina/terapia , Nascido Vivo , Masculino , Valor Preditivo dos Testes , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Motilidade Espermática , Espermatozoides/patologia , Resultado do Tratamento
15.
J Matern Fetal Neonatal Med ; 35(4): 685-691, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32295443

RESUMO

OBJECTIVE: The aim of this study was to evaluate the impact of male infertility or intracytoplasmic sperm injection (ICSI) technique on perinatal outcomes. MATERIALS AND METHODS: A retrospective cohort study included patients with singleton live births after fresh-cycle embryo transfer that occurred between 1st January 2016 and 31st May 2018. The patients were divided into four groups: (1) IVF treatment without male infertility; (2) ICSI treatment without male infertility; (3) ICSI treatment with male infertility; and (4) IVF treatment with male infertility. RESULT: In total, 2118 patients were analyzed. When comparing perinatal outcomes between the four groups, there were significant differences with regard to gender proportions of offspring and GDM. No statistically significant differences were reported in the incidence of preterm birth, gestational hypertension, placenta previa, fetal malformation, macrosomia, or low birthweight. A separate multiple logistic regression model was performed for each abnormal perinatal outcome to eliminate confounding factors, with the exception of GDM, the above abnormal perinatal outcomes still did not differ significantly when comparing the four groups. However, the incidence of GDM was higher in the third group than it was in the first group. The proportion of male births was significantly decreased in the third and fourth groups. CONCLUSION: The results showed that ICSI may be associated with the risk of GDM in abnormal perinatal outcomes, but the risk is not due to male infertility. However, male infertility may reduce the proportion of male births.


Assuntos
Infertilidade Masculina , Nascimento Prematuro , Feminino , Fertilização In Vitro , Humanos , Recém-Nascido , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Masculino , Gravidez , Resultado da Gravidez/epidemiologia , Estudos Retrospectivos , Injeções de Esperma Intracitoplásmicas
16.
Clin Pharmacol Ther ; 111(2): 382-390, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33826770

RESUMO

We reviewed the available animal and human reproductive function studies of recently approved noncytotoxic oncology drugs. We reviewed the oncofertility information in the prescribing information for the US Food and Drug Administration (FDA)-approved products and/or the product information and consumer medicine information for Therapeutic Goods Administration (TGA)-approved drugs of 32 novel oncology drugs approved between 2014 and 2018 in the United States and/or Australia supplemented by a literature review for additional reproductive effects. No human studies were available on the reproductive effects of all 32 drugs. A systematic literature review of animal reproductive toxicity studies provided only very limited data with nine drugs displaying impaired male fertility, three impaired female fertility, and nine producing impaired fertility in both male and female animals. Two drugs in the study are reported to have no demonstrable impact on fertility in animal reproductive toxicity studies and nine are reported to have unknown effects on fertility. Of the 32 newly listed drugs, only 4 had recommendations regarding potential human fertility risks and accordingly advised clinicians about fertility preservation procedures for patients. The lack of human data and limited animal reproductive toxicity data raises concerns about the potential impact of these novel oncology drugs on human fertility and reproductive function. Consequently, adequate oncofertility recommendations, including for fertility preservation procedures, counselling for psychological or cost implications, and future prognosis for fertility are hindered by this paucity of relevant data. More data on human reproductive effects of novel oncology drugs is urgently required to facilitate effective use of the growing array of oncofertility care options available.


Assuntos
Antineoplásicos/efeitos adversos , Preservação da Fertilidade , Fertilidade/efeitos dos fármacos , Infertilidade Feminina/induzido quimicamente , Infertilidade Masculina/induzido quimicamente , Animais , Feminino , Humanos , Infertilidade Feminina/fisiopatologia , Infertilidade Feminina/terapia , Infertilidade Masculina/fisiopatologia , Infertilidade Masculina/terapia , Masculino , Medição de Risco , Fatores de Risco
17.
Andrologia ; 54(1): e14244, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34492132

RESUMO

At present, there is still a lack of attention to male infertility and fertility impairment. Indeed, the pathologies affecting the reproductive area in man are derived from anatomical or functional alterations of neuroendocrine system; thus, the study of these dysfunctions is necessary for a correct aetiopathogenetic and therapeutic framing of infertile patients. In this article, we underline the importance of the study of the molecular mechanisms regulated by the most common therapy used to treat infertile men, with the aim to highlight the necessity to avoid the administration of the wrong posology or, even more important, the wrong therapy to the patient. Accordingly, we present some pioneer data obtained on primary testicular cells cultured in vitro and treated with human chorionic gonadotropin (hCG). These data pave the way on the possibility to preliminarily test the effectiveness of the therapy in vitro, in order to identify the responsiveness of patient-derived cells to the treatment and its effectiveness in each subject, in order to identify the correct dosage in a personalised way.


Assuntos
Fertilidade , Infertilidade Masculina , Gonadotropina Coriônica/farmacologia , Humanos , Infertilidade Masculina/terapia , Masculino , Medicina de Precisão , Testículo
18.
Zygote ; 30(2): 234-238, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34313208

RESUMO

Congenital domestic absence of vas deferens (CBAVD) is a common factor in male infertility, and percutaneous epididymal sperm aspiration (PESA) combined with intracytoplasmic sperm injection (ICSI) is a primary clinical treatment, but the effect of the sperm obtained on pregnancy outcome remains to be explored. This study aimed to investigate the relationship between sperm motility with clinical outcome of PESA-ICSI in infertile males with CBAVD. A cohort of 110 couples was enrolled. In total, 76 infertile males were included in the high motility group, while the remaining 34 males were placed in the low motility group. Clinical pregnancy, embryo implantation rate and live birth rate were included as the primary outcome. After all follow-ups, we found that the high motility group achieved higher normal fertilization rates, cleavage rates, transplantable embryo rates and high-quality embryo rates than those in low motility group (normal fertilization rate, 78.2 ± 11.7% vs. 70.5 ± 10.2%, P = 0.003; cleavage rate, 97.1 ± 2.9% vs. 92.3 ± 3.0%, P = 0.000; transplantable embryo rate, 66.8 ± 14.9% vs. 58.6 ± 12.6%, P = 0.009 and high-quality embryo rate, 49.9 ± 10.5% vs. 40.5 ± 11.2%, P = 0.000). Additionally, compared with the low motility group, the clinical pregnancy rates, embryo implantation rates, and live birth rates in the high motility group were significantly increased (pregnancy rate, 61.8% vs. 26.5%, P = 0.009; embryo implantation rate, 36.5% vs. 18.0%, P = 0.044; live birth rate, 55.3% vs. 17.6%, P = 0.000). We concluded that the motility of sperm obtained by PESA affected the clinical outcome of ICSI in infertile males with CBAVD.


Assuntos
Infertilidade Masculina , Injeções de Esperma Intracitoplásmicas , Epididimo , Feminino , Humanos , Infertilidade Masculina/terapia , Masculino , Doenças Urogenitais Masculinas , Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Motilidade Espermática , Recuperação Espermática , Espermatozoides , Ducto Deferente/anormalidades
19.
Asian J Androl ; 24(2): 125-134, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34259196

RESUMO

Infertility affects 10%-15% of couples worldwide. Of all infertility cases, 20%-70% are due to male factors. In the past, men with severe male factor (SMF) were considered sterile. Nevertheless, the development of intracytoplasmic sperm injection (ICSI) drastically modified this scenario. The advances in assisted reproductive technology (ART), specifically regarding surgical sperm retrieval procedures, allowed the efficacious treatment of these conditions. Yet, before undergoing ICSI, male factor infertility requires careful evaluation of clinical and lifestyle behavior together with medical treatment. Epidemiologically speaking, women whose male partner is azoospermic tend to be younger and with a better ovarian reserve. These couples, in fact, are proposed ART earlier in their life, and for this reason, their ovarian response after stimulation is generally good. Furthermore, in younger couples, azoospermia can be partially compensated by the efficient ovarian response, resulting in an acceptable fertility rate following in vitro fertilization (IVF) techniques. Conversely, when azoospermia is associated with a reduced ovarian reserve and/or advanced maternal age, the treatment becomes more challenging, with a consequent reduction in IVF outcomes. Nonetheless, azoospermia seems to impair neither the euploidy rate at the blastocyst stage nor the implantation of euploid blastocysts. Based on the current knowledge, the assessment of male infertility factors should involve: (1) evaluation - to diagnose and quantify seminologic alterations; (2) potentiality - to determine the real possibilities to improve sperm parameters and/or retrieve spermatozoa; (3) time - to consider the available "treatment window", based on maternal age and ovarian reserve. This review represents an update of the definition, prevalence, causes, and treatment of SMF in a modern ART clinic.


Assuntos
Azoospermia , Infertilidade Masculina , Feminino , Fertilização In Vitro/métodos , Humanos , Infertilidade Masculina/epidemiologia , Infertilidade Masculina/terapia , Masculino , Prevalência , Técnicas de Reprodução Assistida , Injeções de Esperma Intracitoplásmicas/métodos , Espermatozoides
20.
Andrologia ; 54(3): e14351, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34935173

RESUMO

Multiple morphological abnormalities of the sperm flagella (MMAF) is a characteristic form of severe asthenozoospermia and closely related to male infertility. However, it is not sure whether intracytoplasmic sperm injection (ICSI) allows MMAF patients reproductive success. The present study reported the first case of successful intracytoplasmic sperm injection-embryo transfer (ICSI-ET) in Chinese brothers with a novel compound heterozygous mutation of FSIP2 (fibrous sheath interacting protein 2), a newly identified MMAF-related genes. The proband and his brother were referred for MMAF because of their abnormal sperm flagellum. Through whole-exome sequencing in the genetic analyses of the proband, his brother and parents showed that the proband and his brother carry a novel compound heterozygous FSIP2 mutation (c.1750T>A and c.13600A>G), which will lead to abnormal expression of FSIP2 and loss of its function. Considering that these brothers had the MMAF phenotype, we recommended ICSI treatment. The successful outcome of ICSI indicated that a lose-function mutation of FSIP2 might not have any effect on ICSI, although the latest report showed a failed outcome of ICSI in a patient with FSIP2 mutation. This study provides new knowledge to understand the effect of MMAF caused by FSIP2 mutation on ICSI outcome.


Assuntos
Infertilidade Masculina , Injeções de Esperma Intracitoplásmicas , China , Transferência Embrionária , Humanos , Infertilidade Masculina/genética , Infertilidade Masculina/terapia , Masculino , Mutação , Irmãos , Cauda do Espermatozoide , Espermatozoides
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