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Introduction: Assisted reproductive technology has been developed significantly throughout the past few years, particularly diagnosing and treating male infertility. Many studies have been performed showing that Intracytoplasmic Sperm Injection (ICSI) is a successful method to attain clinical pregnancy and live birth through impaired spermatozoa characteristics or low sperm count, such as severe oligospermia. Severe oligospermia indicates low sperm count, which in some cases leads to azoospermia. Severe oligospermia can be caused by several factors such as genetics or medication. In search of efficient treatment for couples with Severe oligospermia, numerous retrospective and prospective researches have reported high pregnancy and live birth rates through testicular sperm for men with severe oligospermia and cryptozoospermia with or without high sperm DNA damage. The research showed that the use of testicular sperm in combination with ICSI yielded a high pregnancy rate and live births over another source of sperm, such as ejaculated sperms. Moreover, the use of ICSI in severe oligospermia has shown successful fertilization and pregnancy. Methods: In search for effective treatment for couples with severe male factor, a number of small retrospective and prospective studies have reported high pregnancy and live birth rates using testicular sperm for men with necrozoospermia, cryptozoospermia and oligozoospermia with or without elevated sperm DNA damage. Although the data suggest that there may be some benefit in performing testicular sperm retrieval (TSR)-ICSI in select groups of non-azoospermic infertile men, there are potential risks involved with TSR. Clinicians should balance these risks prior to the recommendation of TSR-ICSI on the result of a semen analysis or sperm DNA test alone. Careful evaluation and management of male factor infertility is important. The use of TSR-ICSI in the absence of specific sperm DNA defects is still experimental. Discussion: In 1992 and subsequently, several reports indicated that ICSI was a successful technique to achieve clinical pregnancy and live birth using spermatozoa with severely impaired characteristics. The initial optimism over the ability of ICSI to overcome significant sperm abnormalities was later tempered by the findings of more recent publications suggesting that some sperm deficits may not be as effectively treated with ICSI. Conclusion: Severe oligospermia indicates low sperm count, which can lead to male infertility; severe oligospermia which can be overcome through ICSI. Genetic factors like microdeletions of the Y chromosome (Yq) can cause severe oligospermia or chemotherapy molecules, affecting the sperm count directly.
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The extent of spermatogenic impairment on intracytoplasmic sperm injection (ICSI) outcomes and the risk of major birth defects have been little assessed. In this study, we evaluated the relationship between various spermatogenic conditions, sperm origin on ICSI outcomes, and major birth defects. A total of 934 infertile men attending the Center for Reproductive Medicine of Ren Ji Hospital (Shanghai, China) were classified into six groups: nonobstructive azoospermia (NOA; n = 84), extremely severe oligozoospermia (esOZ; n = 163), severe oligozoospermia (sOZ, n = 174), mild oligozoospermia (mOZ; n = 148), obstructive azoospermia (OAZ; n = 155), and normozoospermia (NZ; n = 210). Rates of fertilization, embryo cleavage, high-quality embryos, implantation, biochemical and clinical pregnancies, abortion, delivery, newborns, as well as major birth malformations, and other newborn outcomes were analyzed and compared among groups. The NOA group showed a statistically lower fertilization rate (68.2% vs esOZ 77.3%, sOZ 78.0%, mOZ 73.8%, OAZ 76.6%, and NZ 79.3%, all P < 0.05), but a significantly higher implantation rate (37.8%) than the groups esOZ (30.1%), sOZ (30.4%), mOZ (32.6%), and OAZ (31.0%) (all P < 0.05), which was similar to that of Group NZ (38.4%). However, there were no statistically significant differences in rates of embryo cleavage, high-quality embryos, biochemical and clinical pregnancies, abortions, deliveries, major birth malformations, and other newborn outcomes in the six groups. The results showed that NOA only negatively affects some embryological outcomes such as fertilization rate. There was no evidence of differences in other embryological and clinical outcomes with respect to sperm source or spermatogenic status. Spermatogenic failure and sperm origins do not impinge on the clinical outcomes in ICSI treatment.
Subject(s)
Female , Humans , Infant, Newborn , Male , Pregnancy , Azoospermia/therapy , China , Oligospermia/therapy , Pregnancy Rate , Retrospective Studies , Sperm Injections, Intracytoplasmic/methods , Sperm Retrieval , Spermatogenesis , SpermatozoaABSTRACT
A large proportion of patients with idiopathic spermatogenic failure (SPGF; oligozoospermia or nonobstructive azoospermia [NOA]) do not receive a diagnosis despite an extensive diagnostic workup. Recent evidence has shown that the etiology remains undefined in up to 75% of these patients. A number of genes involved in germ-cell proliferation, spermatocyte meiotic divisions, and spermatid development have been called into play in the pathogenesis of idiopathic oligozoospermia or NOA. However, this evidence mainly comes from case reports. Therefore, this study was undertaken to identify the molecular causes of SPGF. To accomplish this, 15 genes (USP9Y, NR5A1, KLHL10, ZMYND15, PLK4, TEX15, TEX11, MEIOB, SOHLH1, HSF2, SYCP3, TAF4B, NANOS1, SYCE1, and RHOXF2) involved in idiopathic SPGF were simultaneously analyzed in a cohort of 25 patients with idiopathic oligozoospermia or NOA, accurately selected after a thorough diagnostic workup. After next-generation sequencing (NGS) analysis, we identified the presence of rare variants in the NR5A1 and TEX11 genes with a pathogenic role in 3/25 (12.0%) patients. Seventeen other different variants were identified, and among them, 13 have never been reported before. Eleven out of 17 variants were likely pathogenic and deserve functional or segregation studies. The genes most frequently mutated were MEIOB, followed by USP9Y, KLHL10, NR5A1, and SOHLH1. No alterations were found in the SYCP3, TAF4B, NANOS1, SYCE1, or RHOXF2 genes. In conclusion, NGS technology, by screening a specific custom-made panel of genes, could help increase the diagnostic rate in patients with idiopathic oligozoospermia or NOA.
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Oligozoospermia is a common infertility disease, and the incidence rate is increasing year by year. Cuscuta chinensis is a commonly used medicine for the treatment of oligozoospermia in Chinese medicine. Flavonoids are its main component. GM-CSF is a multifunctional cytokine that plays an important role in the inflammatory response. In this paper, we performed HE staining and immunohistochemical staining on the testis of rats with oligozoospermia. We intend to study the expression changes of GM-CSF in rats with oligospermia and the effect of flavonoids on the expression of GM-CSF in testis of rats with oligozoospermia.
La oligozoospermia es una enfermedad común de infertilidad, con una tasa de incidencia que aumenta año tras año. Cuscuta chinensis es un medicamento de uso común para el tratamiento de la oligozoospermia en la medicina china. Los flavonoides son su componente principal. GM-CSF es una citocina multifuncional que tiene un rol importante en la respuesta inflamatoria. En este trabajo, realizamos tinción con hematoxilina y eosina y tinción inmunohistoquímica en testículos de ratas con oligozoospermia. TNuestro objetivo fue estudiar los cambios de expresión de GM-CSF en ratas con oligozoospermia y el efecto de los flavonoides en la expresión de GM-CSF en testículos de ratas con oligozoospermia.
Subject(s)
Animals , Male , Rats , Oligospermia/metabolism , Oligospermia/drug therapy , Flavonoids/administration & dosage , Granulocyte-Macrophage Colony-Stimulating Factor/metabolism , Cuscuta , Testis/drug effects , Testis/metabolism , Immunohistochemistry , Rats, Sprague-DawleyABSTRACT
Follicle-stimulating hormone (FSH) represents a therapeutic option in normogonadotropic patients with idiopathic oligozoospermia. The aim of this review was to evaluate the possible dose- and drug-dependent efficacy of FSH treatment on conventional sperm parameters. We performed a comprehensive systematic review via a meta-analysis of all available randomized controlled trials, in which FSH administration was compared with placebo or no treatment when administered to normogonadotropic patients with idiopathic oligozoospermia. Of the 971 articles that were retrieved, 5 were finally included, including a total of 372 patients and 294 controls. Overall, FSH treatment was effective in ameliorating the sperm concentration, total count, progressive motility, but not normal forms. On the basis of the weekly dosage, the studies were classified into those using low (175-262.5 IU per week), intermediate (350-525 IU per week), and high (700-1050 IU per week) doses. At low doses, FSH improved only sperm motility. At intermediate doses, FSH ameliorated sperm concentration and morphology. Total sperm count and progressive motility showed a trend toward the increase. At high doses, FSH increased sperm concentration, total sperm count, and progressive motility. Sperm morphology showed a trend toward the increase. Finally, both highly purified FSH (hpFSH) and recombinant human FSH (rhFSH) improved sperm concentration, total sperm count, progressive motility, but not morphology. No different efficacy was observed between these two preparations. This meta-analysis provides evidence in favor of high FSH doses. The FSH efficacy was not related to the preparation type (recombinant vs highly purified). Further studies are needed to evaluate the effectiveness of long-standing treatment regimes.
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Chromosomal abnormalities and Y chromosome microdeletions are considered to be the two more common genetic causes of spermatogenic failure. However, the relationship between chromosomal aberrations and Y chromosome microdeletions is still unclear. This study was to investigate the incidence and characteristics of chromosomal aberrations and Y chromosome microdeletions in infertile men, and to explore whether there was a correlation between the two genetic defects of spermatogenic failure. A 7-year retrospective study was conducted on 5465 infertile men with nonobstructive azoospermia or oligozoospermia. Karyotype analysis of peripheral blood lymphocytes was performed by standard G-banding techniques. Y chromosome microdeletions were screened by multiplex PCR amplification with six specific sequence-tagged site (STS) markers. Among the 5465 infertile men analyzed, 371 (6.8%) had Y chromosome microdeletions and the prevalence of microdeletions in azoospermia was 10.5% (259/2474) and in severe oligozoospermia was 6.3% (107/1705). A total of 4003 (73.2%) infertile men underwent karyotyping; 370 (9.2%) had chromosomal abnormalities and 222 (5.5%) had chromosomal polymorphisms. Karyotype analysis was performed on 272 (73.3%) patients with Y chromosome microdeletions and 77 (28.3%) had chromosomal aberrations, all of which involved sex chromosomes but not autosomes. There was a significant difference in the frequency of chromosomal abnormalities between men with and without Y chromosome microdeletions (P< 0.05).
ABSTRACT
The mosaic 45,X/46,XY karyotype is a common sex chromosomal abnormality in infertile men. Males with this mosaic karyotype can benefit from assisted reproductive therapies, but the transmitted abnormalities contain 45,X aneuploidy as well as Y chromosome microdeletions. The aim of this study was to investigate the clinical and genetic characteristics of infertile men diagnosed with 45,X/46,XY mosaicism in China. Of the 734 infertile men found to carry chromosomal abnormalities, 14 patients were carriers of 45,X/46,XY mosaicism or its variants, giving a prevalence of 0.27% (14/5269) and accounting for 1.91% (14/734) of patients with a chromosomal abnormality. There were ten cases (71.43%, 10/14) of 45,X mosaicism exhibiting AZF microdeletions. Case 1 and Case 4 had AZFc deletions, and the other eight cases had AZFb+c deletions. A high frequency of Y chromosome microdeletions were detected in male patients with 45,X/46,XY mosaicism. Preimplantation genetic diagnosis should be offered to men having intracytoplasmic sperm injection for hypospermatogenesis caused by 45,X/46,XY mosaicism, to avoid the risk of transfering AZF microdeletions in addition to X monosomy in male offspring.
Subject(s)
Humans , Male , Adult , Middle Aged , Sex Chromosome Disorders of Sex Development/genetics , Infertility, Male/genetics , Mosaicism , Sex Chromosome Aberrations , China , Polymerase Chain Reaction , Chromosome Deletion , Chromosomes, Human, Y/genetics , KaryotypingABSTRACT
Objective:To study the effect of Wuzi Yanzong Wan on the expressions of voltage-dependent anion channel 1 （VDAC1）， adenine nucleotide transposase （ANT）， cyclophilin D （CypD） and other proteins， and analyze its mechanism in intervening with sperm mitochondrial permeability transition pore （mPTP） opening. Method:Forty rats were randomly divided into 4 groups， namely normal group， model group， positive group （Shengjing capsule， 1.6 g·kg-1·d-1）， and Wuzi Yanzong Wan group （4.0 g·kg-1·d-1）， with 10 rats in each group. Except for the normal group， tripterygium wilfordii glycosides （GTW， 30 mg·kg-1） was intragastrically administered for 8 weeks to establish the oligozoospermia model. After the 4th week， each group was given drugs through intragastric administration for 4 weeks， and fasted for 12 h after the last administration. These rats were anesthetized with 3% chloral hydrate， and their testis and epididymis tissues were collected. Western blot was used to determine the protein expressions of VDAC1，ANT，CypD，B-cell lymphoma/leukemia2 （Bcl-2）， Bcl-2 associated X protein （Bax）， Caspase-3， Caspase-9 in rat testis， Testicular tissue and its ultrastructure were observed under electron microscopy. The apoptosis in spermatogenic cells was detected by terminal-deoxynucleoitidyl transferase mediated nick end labeling （TUNEL）. Result:Western blot results showed that compared with the normal group， the expressions of VDAC1， CypD， Caspase-3， Caspase-9 and Bax/Bcl-2 in the model group were increased （P<0.01）. The expressions of VDAC1， CypD， Caspase-3， Caspase-9 and Bax/Bcl-2 were significantly decreased in the positive group and the Wuzi Yanzong Wan group compared with the model group （P<0.01）. There was no significant change in the expressions of ANT and Bcl-2 protein between the groups. Testicular ultrastructural evaluation showed different sizes and disordered arrangement of sperm mitochondria and a large number of swelling and vacuoles in the model group， while complete structure and neat arrangement of sperm mitochondria and much less swelling and vacuole in positive group and Wuzi Yanzong Wan group. TUNEL results showed that the apoptosis rate of spermatogenic cells in the model group was significantly higher than that of the normal group （P<0.01）， while the apoptosis rate in the positive drug and Wuzi Yanzong Wan group was significantly lower than that of the model group （P<0.01）. Conclusion:Wuzi Yanzong Wan may resist germ cell apoptosis by inhibiting the expressions of VDAC1， CypD and Bax， reducing the permeability of mPTP， and preventing the cascade activation reaction of the Caspase family of apoptosis proteins.
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OBJECTIVE: To evaluate the clinical effect of acupuncture combined with Chinese medicine in the treatment of oligozoospermia/asthenozoospermia. METHODS: Randomized controlled trials (RCTs) of acupuncture combined with traditional Chinese medicine (TCM) in the treatment of oligozoospermia/asthenozoospermia published up to February 15, 2019 were searched from databases of CNKI, CBM, Wanfang Data, VIP, PubMed, Embase, and The Cochrane Library. Two reviewers independently performed quality assessment and data extraction of the studies, and RevMan5.3 was used to perform the meta-analysis. RESULTS: A total of 13 articles with 12 RCTs were included, with a total of 1 183 patients. The meta-analysis showed that acupuncture combined with TCM achieved a significantly higher pregnancy rate than TCM alone in the treatment of oligozoospermia/asthenozoospermia(risk ratio [RR] ＝1.46, 95% confidence interval [CI]: 1.13－1.90，P＝0.004). The patients treated with acupuncture combined with TCM had a significantly higher effective rate than those treated with TCM alone (RR＝1.17, 95% CI：1.10－1.24, P<0.000 01). Compared with TCM alone, acupuncture combined with TCM achieved significantly better improvements in sperm survival rate (mean difference [MD]＝8.28, 95% CI: 6.48－10.08, P<0.000 01), sperm motility (MD＝17.01, 95%CI：11.06－22.96, P<0.000 01), sperm concentration (MD＝8.71, 95%CI：5.92－11.50, P<0.000 01), and number of grade A sperms (MD＝6.39, 95%CI：5.27－7.50, P<0.000 01). CONCLUSION: Acupuncture combined with TCM has a better clinical effect than TCM alone in the treatment of oligozoospermia/asthenozoospermia. Due to the low methodological quality of the studies included in this analysis, acupuncture combined with TCM in the treatment of oligozoospermia/asthenozoospermia should be used based on patients' conditions in clinical practice.
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The use of extracellular or circulating nucleic acids (Cfs), as a diagnostic or prognostic tool in oncology, has been broadly documented. However, their use in gynecology-obstetrics as non-invasive biomarkers in the management of infertility has become a recurring fact. The circulating nucleic acids are constituted by: free DNA which can be long or short DNA strands resulting from the apoptotic or necrotic processes, the free RNA containing: micro-RNAs (miRNAs) which are short single-stranded ribonucleic acids (RNA) that are able to deter the production of protein from a gene, Piwi-interacting RNAs (PiRNAs) that are small RNAs expressed in germ cells or even early embryos and small interfering RNAs (siRNAs) that are small RNAs that can bind specifically to a messenger RNA sequence and prevent gene expression by cleaving that RNA. The presence of circulating nucleic acids in many biological fluids such as: urine, seminal plasma and serum, the fact that they are easy to detect, the variation of their level according to the physiopathological conditions of the body and their implication in many biological processes such as folliculogenesis, steroidogenesis and spermatogenesis make nucleic acids circulating important biomarkers of interest in the management of male infertility. They compose a real complementary help for practitioners of medically assisted procreation. As a result, circulating nucleic acids are a promising avenue in the prevention of implantation failures. In this article, we will seek to affirm further, their importance in the management of male infertility, by highlighting their different uses.
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OBJECTIVE@#To assess the effect of electroacupuncture (EA) on expression of cytoskeletal proteins from Sertoli cells (SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen (Kidney) essence syndrome (OIKES).@*METHODS@#Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control, tripterygium glycosides (TG) treatment, sham and EA groups (n=5 in each group). A rat model of OIKES was established by oral gavage with TG. The EA group was treated with TG and received EA at Shenshu (BL 23) and Zusanli (ST 36) acupoints for 20 min, once daily for 30 days, while the sham group received EA at identical acupoints with skin penetration without stimulation. After 30 days, the final body weight and coefficients for the testis and epididymis were calculated and sperm parameters were measured. Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen (PCNA) immunoreactivity in germ cells. Apoptosis in germ cells was quantified by the transferase biotin-dUTP nick end labeling assay.@*RESULTS@#Compared with the control group, the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different, but the sperm count and motility were lower (P<0.05). Expressions of vimentin and α-tubulin were also significantly weaker (P<0.01). The PCNA immunoreactivity of germ cells was decreased (P=0.059), whereas the apoptotic index of germ cells was increased significantly (P<0.01). In contrast, EA at BL 23 and ST 36 acupoints significantly improved the final body weight as well as the sperm count, concentration and motility (P<0.01 or P<0.05). EA increased expression of vimentin and α-tubulin in SCs markedly, and significantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells (P<0.01 or P<0.05).@*CONCLUSIONS@#EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES. This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.
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Objective@#To investigate the familial cytomolecular genetics of an infertile male.@*METHODS@#We analyzed the clinical phenotypes and karyotypes of three males from the family of an infertile man, detected the sequence-tagged sites (STS) in the AZF deletions of the Y chromosome by multiplex polymerase chain reaction (PCR), and identified the target genes by multiplex ligation-dependent probe amplification (MLPA).@*RESULTS@#The karyotypes of the proband and his brother were 46, XY, inv (19) (p13.3q13.1) and that of his father was 46, XY. The three males were all carriers of AZFc deletion of the Y chromosome, and all found with the same reduction of the gene copy number in the AZFb and AZFc regions.@*CONCLUSIONS@#Combined use of karyotype analysis, Y chromosome STS PCR, and MLPA revealed the genetic causes of the male infertile family.
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In the present study, we evaluated the impact of sperm origins and concentration on the clinical outcomes of intracytoplasmic sperm injection (ICSI) cycles. A total of 1201 ICSI cycles were retrospectively analyzed for male azoospermia or oligozoospermia between January 2015 and December 2015 in the Peking University Third Hospital. Patients were divided into three groups (Group 1 vs Group 2/3; surgically extracted sperm vs ejaculated sperms): Group 1 included 343 ICSI cycles and Group 2 analyzed 388 cycles on semen with sperm concentration <5 × 106 ml-1 (severe oligozoospermia group). Group 3 included 470 cycles with sperm concentration between 5 × 106 ml-1 and 15 × 106 ml-1 (mild oligozoospermia group). Fertilization rates, clinical pregnancy rates, and live birth rates were analyzed and compared among groups of different semen origins and concentrations on the oocyte retrieval day. Group 2 showed a lower fertilization rate than Group 3 (62.9% ± 21.6% vs 66.8% ± 22.1%,P< 0.05). There were no statistically significant differences in clinical pregnancy rate per transfer (51.3%, 46.7%, and 50.0%, respectively), live birth rate per transfer (44.4%, 40.9%, and 41.4%, respectively), accumulative live birth rate (58.3%, 51.0%, and 52.1%, respectively), twin birth rate (18.4%, 10.6%, and 12.6%, respectively), and birth defects rate (0, 0.3%, and 0.2%, respectively) among three groups. The results of this study indicated that sperm origins and concentration do not impact the clinical outcomes in ICSI cycles.
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@#BACKGROUND. In the world, infertility occurs in 10-15% of the total couples and male infertility accounts for 40-50% of the infertile cases. Infertility frequency in Mongolia is 8.7% in 2003 and 11.6% in 2013. According to the Child and Maternity hospital study, 25.6% of infertility is due to men. Microdeletions of the Y chromosome long arm are the most common molecular genetic causes of severe infertility in men. They affect three regions including azoospermia factors (AZFa, AZFb and AZFc), which contain various genes involved in spermatogenesis. OBJECTIVES. The aim of the present study is to investigate the relationship between sexual hormones and AZF microdeletion on Y chromosome in Mongolian infertile men with azoospermia and severe oligozoospermia. MATERIAL AND METHODS. Through a cross sectional study, 50 infertile men were examined for Y chromosome microdeletions from January 2018 to August 2018. We determined hormone level, testis biopsy and microdeletions of the Y chromosome using six loci of 3 regions of the AZF gene were investigated by multiplex polymerase chain reaction. Semen analysis was performed on samples obtained by self-masturbation at the hospital after 2-7 days of sexual abstinence. Reproductive hormone level in serum including total testosterone, follicular stimulating hormone (FSH), and LH is measured at time 8 am to 11 am. If sperm is not recovered, testicular biopsy was performed on the patient. All collected datas were evaluated with Statistical Package for Social Sciences (SPSS, version 22.0). RESULTS. The rate of microdeletion was 4.0% (2 out of 50 patients). The deletion was on AZFa in the first patient, AZFc in the second patient. The patients with Y chromosome microdeletion had azoospermia. AZFa deleted patient has sertoli cell only syndrome in testis biopsy with FSH 58.0 mIU/ml, LH 12.0 mIU/ml, total testosterone 5.0 ng/ml. AZFc deleted patient had FSH 23.85 mIU/ml, LH 13.01 mIU/ml, total testosterone 4.06 ng/ml. Serum FSH and LH levels were significantly higher in Y chromosome deleted group and FSH level was significantly lower in sperm-retrieved group on TESE. СONCLUSION. We determined 2 cases of Y chromosome microdeletion (4.0%) in infertile men. Serum FSH and LH levels were significantly higher in Y chromosome deleted group.
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The aim of the present work was to present the outcomes of the patients with Y-chromosome microdeletions treated by intracytoplasmic sperm injection (ICSI), either using fresh (TESE) or frozen-thawed (TESE-C) testicular sperm and ejaculated sperm (EJAC). The originality of this work resides in the comparisons between the different types of Y-microdeletions (AZFa, AZFb, and AZFc) and treatments, with detailed demographic, stimulation, embryological, clinical, and newborn (NB) outcomes. Of 125 patients with Y-microdeletions, 33 patients presented severe oligozoospermia (18 performed ICSI with ejaculated sperm) and 92 secretory azoospermia (65 went for TESE with 40 having successful sperm retrieval and performed ICSI). There were 51 TESE treatment cycles and 43 TESE-C treatment cycles, with a birth of 19 NB (2 in AZFa/TESE-C, 12 in AZFc/TESE, and 5 in AZFc/TESE-C). Of the 29 EJAC cycles, there was a birth of 8 NB (in AZFc). In TESE and EJAC cycles, there were no significant differences in embryological and clinical parameters. In TESE-C cycles, there was a significant lower oocyte maturity rate, embryo cleavage rate and mean number of embryos transferred in AZFb, and a higher mean number of oocytes and lower fertilization rate in AZFc. In conclusion, although patients with AZFc microdeletions presented a high testicular sperm recovery rate and acceptable clinical outcomes, cases with AZFa and AZFb microdeletions presented a poor prognosis. Due to the reported heredity of microdeletions, patients should be informed about the infertile consequences on NB and the possibility of using preimplantation genetic diagnosis for female sex selection.
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Patients with extremely severe oligozoospermia (ESO) and cryptozoospermia (CO) are suitable using intracytoplasmic sperm injection (ICSI) as an infertility treatment. However, some andrologists are confused to distinguish ESO and CO in clinic diagnose. This study was designed for the first time to evaluate and compare patients with ESO and CO to determine whether these are useful clinical distinctions. A total of 270 infertile men in our center were classified into four groups as Group nonobstruction azoospermia (NOA, n = 44), Group ESO (n = 78), Group CO (n = 40), and Group obstruction azoospermia (OA, n = 108). Comparisons of the volume of bilateral testes, the level of follicle stimulating hormone (FSH) and inhibin B were obtained in four groups. Then comparisons of fertilization rates, cleavage rate, and excellent embryos rate were obtained when couples performed ICSI. All indexes (volume of bilateral testis, level of FSH and inhibin B) in Groups ESO and CO were no difference, while Groups OA versus NOA, OA versus ESO, and OA versus CO were significant differences (P < 0.05). The rates of fertilization were no differences in Groups ESO and CO while Groups OA versus ESO, OA versus CO were significant differences (P < 0.05). Therefore, the spermatogenic functions in patients with CO and ESO were similar, better than NOA but worse than OA. However, it would be helpful to evaluate their spermatogenesis using testicular biopsies, especially accompanied azoospermia in clinical practice.
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Background: Human semen contains high concentrations of zinc (Zn) and copper (Cu). The presence of abnormal levels of these trace elements may affect sperm production, maturation, motility and fertilizing ability. Objective: To evaluate the levels of Zn and Cu in seminal plasma of Sudanese infertile male and their effect on reproductive capacity. Methods: The concentrations of Zn and Cu were measured in 150 semen samples from normozoospermic, oligozoospermic, and azoospermic men using the atomic absorption spectrometry and data was analyzed using the statistical software package SPSS version 17. Results: Results showed that the mean values of seminal plasma Zn concentrations were significantly decreased in the two groups of infertile male subjects, azoospermic (p=0.02), and oligozoospermic (p=0.03) compared with fertile males, while there was insignificant decrease in seminal plasma Cu concentration of azoospermic patients compared to control (p=0.21), and insignificant increase in oligozoospermic patients compared to control (p=0.06). Conclusion: On the basis of the observations of the present study, seminal zinc may contribute to fertility through its effects on semen parameters.
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Objetivo: estudio realizado durante los años 2009 y 2010 en las ciudades de Barranquilla y Sincelejo, tuvo como fin determinar las microdeleciones de regiones AZF, del cromosoma Y, en hombres infértiles, Materiales y Métodos: estudio realizado con una muestra de 33 hombres, seleccionados de las consultas especializadas; previa confirmación de infertilidad mediante estudios de espermogramas. Se analizaron 17 STSs, de las diferentes regiones de azoospermia, además del gen SRY el DS271 y Kaly. Para el análisis se efectúo extracción de ADN de sangre periférica, mediante el protocolo de Bio-.mol, PCR multiplex máster mix de promega y corrido electroforético en gel de agarosa al 4%, se visualizaron las imágenes a través de foto documentador. Resultados: los hallazgos arrojaron un 3,03% de microdeleciones del cromosoma Y en los STSs: SY242, (DAZ) SY208 (DAZ), SY254 (DAZ), SY255 (DAZ) y SY157 (DYS240), comprometiendo toda la región AZFc para los STSs estudiados. Conclusiones: Se determinó microdeleción de la región AZFc, del cromosoma Y en una proporción de 3.03%, con evidente ausencia de los genes de controles internos, se presentan las bandas estudiadas para los juegos de iniciadores máster D y E confirmando la reproducibilidad del producto obtenido por PCR. Paciente con presencia de locus SRY, antecedentes de azoospermia secretora, varicocele izquierdo, órganos sexuales normales, biopsia testicular con 80% de ausencia de células germinales y 20% sin maduración. La proporción de casos se ubica en el intervalo encontrada en diversos estudios a nivel mundial.
Objective: Study carried out between the years 2009 and 2010 in the cities of Barranquilla and Sincelejo that has as main objective to determine the microdeletions in the DAZ region of the Y chromosome in infertile men. Materials and Methods: study was developed with a sample of 33 men, selected in specialized consultation, previous confirmation of infertility through spermograms studies. Seventeen STSs were analyzed from different azoospermia regions in addition to the SRY, the DS271 and the Kaly gene. DNA extraction from peripheral blood through Bio-mol protocol, PCR multiplex master mix of Promega and electrophoresis in agarose gel 4% was performed for data analysis and the images were visualized through photo-documenter. Results: Findings showed 3.03% microdeletions in Y chromosome in STSs: SY242 (DAZ) SY208 (DAZ), SY254 (DAZ), SY255 (DAZ) and SY157 (DYS240), compromising the whole AZFc region in the STSs studied. Conclusions: was determined microdeletion of AZFc region of Y chromosome in a proportion of 3.03%, with evident absence in the genes of the internal control, the bands studied for the set of the master indicators D and E are presented, confirming reproducibility of the product obtained through PCR. Patients with presence of locus SRY, secretory azoospermia, left varicocele, normal sexual organs, testicular biopsy with absence 80% of germ cells and 20% without maturation. The proportion of cases located in the range found in various studies globally.
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Azoospermia is a descriptive term referring to ejaculates that lack spermatozoa without implying a specific underlying cause. The traditional definition of azoospermia is ambiguous, which has ramifications on the diagnostic criteria. This issue is further compounded by the apparent overlap between the definitions of oligospermia and azoospermia. The reliable diagnosis of the absence of spermatozoa in a semen sample is an important criterion not only for diagnosing male infertility but also for ascertaining the success of a vasectomy and for determining the efficacy of hormonal contraception. There appears to be different levels of rigor in diagnosing azoospermia in different clinical situations, which highlights the conflict between scientific research and clinical practice in defining azoospermia.
Subject(s)
Humans , Male , Azoospermia/diagnosis , Oligospermia/diagnosis , Semen Analysis , CentrifugationABSTRACT
PURPOSE: To determine the frequency of genetic alterations in a population of Brazilian infertile men with severe oligozoospermia or non-obstructive azoospermia. MATERIALS AND METHODS: Retrospective study of a group of 143 infertile men with severe oligozoospermia or non-obstructive azoospermia from the Andrology Outpatient Clinic of the Human Reproduction Service at the ABC School of Medicine. Of these patients, 100 had severe oligozoospermia, and 43 non-obstructive azoospermia. All patients underwent a genetic study which included karyotype analysis and Y-microdeletion investigation. RESULTS: Genetic abnormalities were found in 18.8 percent of the studied patients. Chromosomal abnormalities were found in 6.2 percent of the patients, being more prevalent in the azoospermia group (11.6 percent) than in the oligozoospermia group (4 percent). Chromosomal variants were found in 8.3 percent, and Y-chromosome microdeletions in 4.2 percent of patients. CONCLUSION: The high frequency of genetic alterations (18.8 percent) in our series justified performing a genetic investigation in a population with idiopathic infertility, as results may help determine the prognosis, as well as the choice of an assisted reproduction technique. Moreover, a genetic investigation could minimize the risk of transmitting genetic abnormalities to future generations such as genetic male infertility, mental retardation, genital ambiguity and/or birth defects.