Correlation of sperm DNA fragmentation index with semen parameters / 中华男科学杂志

Objective@#To explore the relationship of sperm DNA fragmenation index (DFI) with semen parameters and assess its application value in the evaluation of semen quality.@*METHODS@#A total of 9 694 semen samples were collected and examined for sperm DFI and high DNA stainability (HDS) by flow cytometry-assisted sperm chromatin structure analysis (SCSA). According to the WHO Laboratory Manual for the Examination and Processing of Human Semen (5th Ed), the samples were divided into a normal group and abnormal groups A (sperm concentration ［SC］: ［11.3－14.0］ ×10⁶/ml, total sperm motility ［TSM］: 30%－39%, progressively motile sperm ［PMS］: 24%－31%), B (SC: ［7.5－11.2］ ×10⁶/ml, TSM: 20%－29%, PMS: 16%－23%), C (SC: ［3.8－7.4］ ×10⁶/ml, TSM: 10%－,19% PMS: 8%－15%) and D (SC: ［0－3.7］×10⁶/ml, TSM: 0－9%, PMS: 0－7%), and also into three sperm DFI groups (DFI 30%). The correlation between sperm DFI and seminal parameters was analyzed by Pearson correlation and multiple linear regression analyses.@*RESULTS@#DFI was dramatically lower in the normal than in the abnormal groups (P < 0.01), and increased in proportion to the decrease of semen parameters in the abnormal groups A, B, C and D (P < 0.01). Pearson correlation analysis showed that DFI was correlated positively with age (r = 0.15, P < 0.01), abstinence time (r = 0.10, P < 0.01), semen volume (r = 0.05, P < 0.01) and HDS (r = 0.15, P < 0.01), but negatively with semen pH (r = －0.06, P < 0.01), SC (r = －0.27, P < 0.01), TSM (r = －0.53, P < 0.01), PMS (r = －0.52, P < 0.01) and morphologically normal sperm (r = －0.16, P < 0.01). Multiple linear regression analysis revealed that TSM, SC, age, abstinence time and semen pH were five important variables associated with DFI, with standardized regression coefficients of －0.47, －0.19, 0.12, 0.07, and －0.04, respectively (all P < 0.01).@*CONCLUSIONS@#There is a moderate correlation between sperm DFI and semen parameters, which can be used synergistically for the assessment of semen quality.

Follow-up of children born after intracytoplasmic sperm injection with epididymal and testicular spermatozoa / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>To evaluate the safety of intracytoplasmic sperm injection (ICSI) with epididymal or testicular sperm, this study compared children born after ICSI treatment with epididymal or testicular sperm with children conceived after ICSI with ejaculated sperm.</p><p><b>METHODS</b>This retrospective study included 317 children born after ICSI with percutaneous epididymal sperm aspiration (PESA), 103 children born after ICSI with testicular sperm aspiration (TESA), and a control group of 1008 children born after ICSI with ejaculated sperm. All of the patients received their assisted reproductive treatment in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2004 to December 2011. Data, such as the rate of stillbirths, perinatal mortality, gestational age, birth weight, and the rate of congenital malformations of the three groups, were compared.</p><p><b>RESULTS</b>PESA and TESA children were not different from ICSI children in the rate of stillbirths, perinatal mortality, infant mortality rate, gestational age, the rate of prematurity, and the rate of malformations (P > 0.05). A slight increase in birth defects was reported in the TESA group compared with those in the control group, but there was no significant difference between the groups (P > 0.05).</p><p><b>CONCLUSION</b>ICSI with epididymal or testicular sperm does not lead to more stillbirths or congenital malformations compared with ICSI using ejaculated sperm.</p>

Pregnancy outcomes of day-2 versus day-3 embryo transfer in poor responders / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate whether the day of embryo transfer (day 2 or day 3) affects clinical pregnancy outcomes in poor responder patients.</p><p><b>METHODS</b>We retrospectively analyzed the pregnancy rates of 265 initial fresh cycles of in vitro fertilization-embryo transfer (IVF-ET), all transferred on day 2 (n = 169) or day 3 (n = 96) irrespective of quality because of an extremely low number of available embryos.</p><p><b>RESULTS</b>Among the poor responders aged < 35 years, a higher rate of clinical pregnancy was achieved in the day-3 than in the day-2 group (50% vs 32.43% ; RR = 0.65, 95% CI: 0.43 - 0.99), and among those aged years, the two groups showed similar pregnancy outcomes.</p><p><b>CONCLUSION</b>Shortening the time of embryo culture has no obvious benefit for the pregnancy outcome. For the poor responders under 35 years of age, day-3 embryo transfer may afford an even higher rate of clinical pregnancy.</p>

Clinical application of oocyte vitrification in failed testicular sperm extraction cycles: report of 8 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To evaluate the clinical application value of oocyte vitrification in failed testicular sperm extraction cycles in non-obstructive azoospermia (NOA) patients.</p><p><b>METHODS</b>We retrospectively analyzed the clinical data of 8 women undergoing oocyte frozen-thawing cycles by vitrification because of failed testicular sperm extraction from their NOA husbands and no banked donor sperm on the day of oocyte retrieval. The oocytes were cryopreserved by vitrification with cryotop and thawed 2 months later. The surviving metaphase II (MII) oocytes were injected with the banked donor sperm of the same blood type as the husbands by intracytoplasmic sperm injection (ICSI) for fertilization. The rates of oocyte survival, fertilization, cleavage, good embryos and pregnancy were evaluated.</p><p><b>RESULTS</b>Sixty oocytes were vitrified and 47 (78.3%) survived after thawing, of which 41 MII oocytes underwent ICSI and 33 (80.5%) of them were fertilized. The rates of cleavage and good embryos were 81.8% (27/33) and 59.3% (16/27) respectively. Fifteen of the embryos were transferred to the 8 patients, with 1.9 +/- 0.8 per cycle, of which 5 (33.3%) were confirmed by ultrasound to have been implanted and 5 resulted in clinical pregnancy (62.5%), all singleton without miscarriage. Three normal boys and 1 normal girl were already born, with the pregnancy time of (39 + 4 +/- 0.4) wk and newborn body weight of (3787.5 +/- 513.7) g, respectively.</p><p><b>CONCLUSION</b>Vitrification of oocytes in failed testicular sperm extraction cycles is a promising technique for preserving female fertility, which, with ICSI of banked donor sperm, may result in satisfactory clinical outcomes.</p>

Outcomes of ICSI with microamount frozen-thawed sperm obtained by PESA or TESA in the treatment of azoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effects and clinical pregnancy outcomes of intracytoplasmic sperm insemination (ICSI) with microamount frozen-thawed sperm obtained by percutaneous epididymal sperm aspiration (PESA) or testicular sperm aspiration (TESA) in azoospermia patients.</p><p><b>METHODS</b>We divided 365 azoospermia patients treated by ICSI into an experimental group (n = 123) and a control group (n = 242) , the former with microamount frozen-thawed sperm, and the latter fresh sperm obtained by PESA or TESA. The rates of fertilization, good embryos, clinical pregnancy, miscarriage, ectopic pregnancy and multiple pregnancy were analyzed and compared between the two groups.</p><p><b>RESULTS</b>With PESA, the experimental group showed no statistically significant differences from the control group in the rates of fertilization (75.67% vs 76.49%), good embryos (64.96% vs 66.09%), clinical pregnancy (55.21% vs 57.22%), clinical miscarriage (13.21% vs 12.61%), ectopic pregnancy (3. 77% vs 5.41%) and multiple pregnancy (37.74% vs 37.84%) (P > 0.05); nor with TESA (74.41% vs 76.43%, 64.63% vs 66.35%, 46.81% vs 53.39%, 18.18% vs 14.55%, 4.55% vs 1.82%, 37.74% vs 37.84%, P > 0.05). The revival rate of the frozen-thawed sperm from PESA was 70.07%, not significantly different from that of TESA (62.67%) (P > 0.05).</p><p><b>CONCLUSION</b>ICSI with frozen-thawed micro-amount sperm obtained by PESA or TESA is a safe, economic and effective method for the treatment of azoospermia. The techniques for reviving frozen sperm from PESA or TESA remain to be optimized, and whether these techniques may result in long-term genetic risks in the offspring deserves further investigation.</p>