Current status of sperm banking for young cancer patients in Japanese nationwide survey / 亚洲男科学杂志(英文版)

This study aimed to ascertain the current status of Japanese sperm banking for young cancer patients. During 2015, we mailed the directors of 695 institutes where sperm cryopreservation might be performed with questionnaires requesting information on the number of patients, age, precryopreservation chemotherapy, semen analyses results and diagnoses, cryopreservation success rate, and causes of unsuccessful cryopreservation. Of these 695 institutes, 92 had cryopreserved sperm before chemotherapy within the study period. In all, 820 cancer patients (237 testicular, 383 hematological, 46 bone and soft tissue, 20 brain, and 134 other malignancy) consulted the responding institutes for sperm cryopreservation. Except for testicular tumor, the number of patients whose sperm was preserved before cancer treatment was low compared to that of young cancer patients. Approximately 20% of patients with malignancies other than testicular tumor underwent chemotherapy before cryopreservation. The success rate of cryopreservation in hematological malignancy was 82.5%, significantly lower than that of both the testicular cancer (93.6%) and other malignancy groups (95.6%) (P < 0.05). The primary reasons for preservation failure were azoospermia and poor semen quality. Patients with hematological malignancies had a higher rate of unsuccessful cryopreservation compared to those in other groups, possibly due to the large number of patients requesting sperm cryopreservation after chemotherapy induction. In Japan, information regarding sperm banking prior to cancer treatment appears to be lacking. Information regarding sperm preservation before chemotherapy should be provided to all Japanese oncologists.

Legal issues and recommendations for public sperm bank

Approximately 15% of couples hoping to conceive are infertile. Male factor infertility is the only cause in 40% of those couples. Approximately 20% of men with infertility have azoospermia. Of these patients, roughly 40% are experience obstruction or absence of sperm passage. However, the other 60% of patients must seek out adoption or conceive using a sperm bank. Currently, recommendations regarding legal issues are needed for sperm banks to be operated safely and effectively, and this paper provides a set of such recommendations.

Reasons of shortage for donated sperm and plan to resolve deficiencies in the sperm donor system

Sperm banking from recruited donors is an important way to help infertile couples who want to achieve pregnancy by therapeutic artificial insemination, even in the era of in vitro fertilization. Korea has the lowest population density of newborns among all Organization for Economic Co-operation and Development countries, with a total fertility rate of 1.17 and an annual birth rate of 300,000 or less as of 2017. This situation emerged due to various causes, including late marriage, fecundity problems, and air pollution. Nevertheless, we have imposed strict limits on basic research and clinical activities, including the operation of sperm banks, in the field of human reproduction under the 2005 Bioethics and Safety Act. Therefore, cryopreserved sperm for artificial insemination is almost absent in the sperm banks of major human reproduction centers. To resolve this difficult situation, as well as to increase the operation of sperm banks in Korea to the global standard level, the author evaluates the underlying reasons for donor sperm use by azoospermic patients from medical, ethical, legal, religious, and cultural perspectives, and then proposes a plan to resolve this situation including highly regulated standard operating procedures to ensure comprehensive safety practices for voluntary sperm donors and infertile couples, as well as to build an ideal sperm donation program.

Sperm Bank: From Laboratory to Patient

No abstract available.

Práticas reprodutivas lésbicas: reflexões sobre genética e saúde / Lesbian reproductive practices: reflections on genetics and health

Resumo A relação entre ciência, tecnologia e capital, intrínseca às Tecnologias Reprodutivas (TR), torna estas uma possibilidade de escolha reprodutiva e uma alternativa para lésbicas que querem ter filhos. O artigo se propõe a refletir sobre os projetos formulados a partir dos depoimentos de casais de lésbicas que utilizaram ou que tinham planos de utilizar as TR. Foram entrevistados oito casais de mulheres com idade entre 26 e 45 anos, todas autodeclaradas brancas e com nível superior completo, residentes na Grande São Paulo/SP, entre 2010-2011. Os resultados revelam a preferência das entrevistadas pelo doador proveniente de banco de esperma e também a valorização da informação sobre o histórico familiar de saúde do doador. Destaca-se o interesse pela importação de sêmen de banco americano, em razão de uma alegada pouca disponibilidade de amostras no Brasil e por ele conter mais informações sobre os doadores. Assim, ao mesmo tempo que as TR possibilitam uma parentalidade não biológica, a genética é valorizada concorrendo para uma medicalização do parentesco.

Abstract The relationship between science, technology and capital, which are intrinsic to Reproductive Technologies (RT), makes them a possibility of reproductive choice and an alternative for lesbians who wish to have children. The article seeks to reflect on the projects formulated based on the statements of lesbian couples who had used or had plans to use RT. Interviews were conducted with eight couples of women with ages between 26 and 45, all self-declared Caucasians, who had completed higher education and were living in the Greater São Paulo region between 2010 and 2011. The results reveal the preference of the respondents for donor sperm originating from a sperm bank and also the importance placed on information on the family history of health of the donor. A noteworthy finding is the interest in importing from an American sperm bank, because of an alleged limited availability of samples in Brazil and the fact that they provide more information about the donors. Thus, while RT enable non-biological parenting, genetics is considered important thereby contributing to the medicalization of parenthood.

Inquiry Survey of Infertile Couples for Sperm Donation and Artificial Insemination by Donor

BACKGROUND: Artificial insemination by donor (AID) is important to chance the pregnancy in male infertile couples by requiring appropriate medical, legal and ethical reviews. The purpose of this study was to investigate the perception changes of AID to collect the basic information for establishing the sperm donation, cryopreservation and artificial insemination management system. METHODS: We evaluated the people's thought of sperm donation, cryopreservation, and artificial insemination by donor by means of national inquiry survey from 247 infertile couples for 4 weeks from October 2016. The questionnaires were composed of 4 areas, and each questionnaire consisted of 15 items. Changes in the perception of AID by year were investigated after review of domestic journals. RESULTS: 67.6% of respondents knew the growth of couples with difficulty getting pregnant due to male infertility. 82.2% of respondents replied the necessary of sperm bank as a treatment option for infertility and 40.5% knew the donation and receipt system of sperm. In the survey of change perception of AID according to year, 37.5% and 39.5% of respondents were got information about AID from doctor in 2003 and 2004, but 49.6% from broadcasting in 2016. As a child grows up, 4.0% (2003), 9.0% (2014), and 42.8% (2016) of respondents answered to tell the child about AID. CONCLUSIONS: Infertile couple's thought of AID about the extension of opportunities for male infertility treatment is changed. In conclusion, it is necessary to establish institutional system of sperm donation, cryopreservation and artificial insemination prior to public sperm bank operation.

Optimizing the transport of porcine semen: a proposal for Brazil / Otimizar o transporte do sêmen suíno: uma proposta para o Brasil

Semen from the first 15mL of the ejaculate (P1) obtained from two boars (30mL) was diluted in glycine-egg yolk extender, cooled at 5°C in a special container and rediluted in standard doses of 3x109 mobile spermatozoa after 12h of storage. Semen was also stored up to 24h after redilution. The physical characteristics of the semen were evaluated at different storage periods (fresh, 0h, 12h, rediluted, 24h, and 36h). The reproductive performance of the boars and their fertility regarding the insemination of primiparous sows were also determined. Two treatments were used: T1-15B sows inseminated with semen originated from hyperconcentrated heterospermic doses (15x109 mobile spermatozoa per dose), rediluted after 12h of storage at 5°C for standard doses of 3x109 mobile spermatozoa per dose and stored at 5°C up to 24h after redilution (n=10); T2-3B sows inseminated with standard heterospermic doses (3x109 mobile spermatozoa per dose), stored at 5°C up to 36h after semen collection (n=10). There was no effect (P>0.05) of treatments on the spermatic motility, even though a pronounced decrease (P>0.05) of their values at 12h of storage was recorded. However, they remained higher than 70% until 36h. There was effect of treatments on spermatic vigour at 0h (P<0.05), when T1-15B vigour was higher. There was also effect of the storage period for both treatments with a progressive decrease throughout 36h of storage, although the differences were not always significant. Pregnancy rates (90%) and the number of total farrowed piglets (15, 11-T1-15B; 13, 44- T2-3B) did not differ (P>0.05) between the treatments. It was concluded that the semen hyperconcentration of 15 billion of mobile spermatozoa per dose, stored at 5°C for 12h, did not result in drawbacks considering the physical characteristics of the semen, maintaining the pregnancy rates and prolificacy of the inseminated sows.

Os primeiros 15mL do ejaculado (P1) de dois varrões foram coletados (30mL) e diluídos em diluidor glicina-gema de ovo, resfriados a 5°C em contêiner especial e rediluídos para doses padrão de 3x109 espermatozoides (sptz) móveis, após 12 horas de armazenamento. Além disso, foram armazenados por até 24 horas após a rediluição, sendo as características físicas avaliadas em diferentes períodos de estocagem (fresco, zero hora, 12h, Red12h, 24h e 36h) e a fertilidade avaliada por meio de fêmeas primíparas inseminadas. Foram realizados dois tratamentos: T1-15B: porcas inseminadas com sêmen de doses heterospérmicas hiperconcentradas (15x109 sptz móveis/dose), rediluídas após 12 horas de armazenamento a 5°C para doses padrão de 3x109 sptz móveis/dose, e armazenadas a 5°C por até 24 horas após a rediluição (n=10); T2-3B: porcas inseminadas com doses heterospérmicas padrão (3x109 sptz móveis/dose), armazenadas a 5°C por até 36 horas após coleta. Não houve efeito (P>0.05) dos tratamentos sobre a motilidade espermática e, embora tenha ocorrido queda (P<0.05) às 12 horas, a motilidade foi superior a 70% durante as 36 horas de armazenamento. Houve efeito (P<0.05) dos tratamentos no tempo zero hora quanto ao vigor espermático, sendo E1T1-15B superior. Além disso, houve efeito do período de estocagem para os dois tratamentos, com queda progressiva do vigor ao longo das 36 horas, embora nem sempre as diferenças tenham sido significativas. As taxas de gestação (90%) e o número total de leitões nascidos (15, 11 - T1-15B; 13, 44 - T2-3B) não diferiram (P>0.05) entre os tratamentos. Concluiu-se que a hiperconcentração do sêmen para 15x109 sptz móveis/dose, armazenado a 5°C por 12 horas não resultou em prejuízos quanto à manutenção das características físicas do sêmen e ao desempenho reprodutivo dos varrões, sendo capaz de manter a taxa de gestação e a prolificidade das fêmeas inseminadas.

The current status of public sperm bank in Korea

Sperm banking is an important option to maintain the male fertilization capacity or induce pregnancy even though under the era of in vitro fertilization. The medical indications for sperm banking are generally consisted of 3 categories. There are cases on planning the permanent contraception like vasectomy or cancer patients to be scheduled the chemotherapy or radiotherapy as first category, male infertile patients with severe oligozoospermia or artificially harvested sperm ie, from microscopic epididymal sperm aspiration or testicular sperm extraction et cetera for the artificial insemination with husband sperm as second category, and the therapeutic donor insemination as third category. Of these three categories, the sperm donation program accompanies various complicated practical, ethical and legal issues. Therefore, highly regulated statements are mandatory in order to secure safety and the complete practices for voluntary sperm donors and infertile couples both. In aspect of administrative structure of sperm bank, there are 3 types that are national based to be established in the most of European countries and China, public based in Japan, and commercially available in the USA. Additionally, each country has different standard guidelines, regulation statements, act and law to control the sperm donation program as well as different cultural or religious background. Nevertheless, we need a consensus document to operate the sperm bank with the standard guidelines to be well revised according to each country's ethical perspectives as well as contemporary scientific evolution. This article will provide what is the Korean model for ideal sperm bank with the history of sperm cryopreservation and banking, background and prerequisite for the public sperm bank operation, and also expected effects.

Semen Analysis in Cancer Patients Referred for Sperm Cryopreservation before Chemotherapy over a 15-Year Period in Korea

PURPOSE: This study evaluated the demographics and semen parameters of males with cancer who banked their sperm prior to chemotherapy. MATERIALS AND METHODS: This is a retrospective study of 66 cases referred for sperm banking prior to initiation of chemotherapy over a 15-year period (1999~2014). Patients who had previously received cancer treatment including chemotherapy or radiotherapy were not included in this study. RESULTS: We studied a total of 66 cancer patients referred for cryopreservation of sperm prior to chemotherapy. The mean age of the patients at the time of banking was 32.0+/-7.9 years (range, 19~58 years). The types of cancer were testicular cancer (31 cases, 47.0%), non-Hodgkin's disease (10 cases, 15.1%), Hodgkin's disease (5 cases, 7.6%), leukemia (8 cases, 12.1%), gastrointestinal malignancy (5 cases, 7.6%), and musculoskeletal malignancy (5 cases, 7.6%). There were significant differences in sperm concentration and viability among the various types of cancer, but no significant difference in semen volume or sperm motility and morphology. CONCLUSIONS: In this study we found that sperm quality could decrease even before chemotherapy. Because chemotherapy can also negatively affect spermatogenesis, sperm cryopreservation prior to treatment should be strongly recommended for cancer patients of reproductive age.

"Fazendo a escolha certa": tecnologias reprodutivas, práticas lésbicas e uso de bancos de sêmen / "Making the right choice": reproductive technologies, lesbian practices and use of semen banks

A obtenção de sêmen para reprodução é uma questão central no projeto de filiação entre lésbicas e envolve considerações em torno de ideais culturais, parentesco e princípios normativos/legais. O estudo de natureza qualitativa foi realizado com lésbicas buscando a maternidade por meio de tecnologias reprodutivas e aquisição de sêmen em bancos no Brasil e no exterior. Foram realizadas entrevistas semiestruturadas com profissionais de saúde atuantes no campo de tecnologias reprodutivas (10) e lésbicas (10 casais) em São Paulo/SP entre 2010/2012. Há um desejo por maximizar conexões estabelecendo um link da filiação com as características fenotípicas presentes na família e no casal, num arranjo que proporcione uma percepção de "natural" conexão, com a biologia como um importante símbolo do compartilhamento do vínculo criado. Em razão de uma alegada pouca disponibilidade de sêmen compatível com as demandas formuladas pelos casais, tem havido importação de sêmen para os procedimentos, acarretando uma série de novas questões...

Obtaining semen for reproduction is a key issue in the project design of lesbian motherhood. The process of choosing the genetic material involves considerations of cultural ideals, kinship and normative principles regarding fertility services. The manuscript is based on study of lesbians seeking parenthood through the use of reproductive technologies (RT) and acquisition of semen in banks in Brazil and abroad. The qualitative study made use of semi-structured interviews with health professionals working in RT (10) and lesbians (10 couples) undergoing treatment with RT in São Paulo/SP, Brazil, in 2010/2012. There is a desire to maximize connections by establishing a link with the phenotypic characteristics of membership in the family and the couple, in an arrangement that provides a perception of "natural" connection with the use of biology as an important symbol of sharing the bond created. Due to an alleged lack of available semen samples compatible with the demands made by lesbian couples there has been an increase in the importation of semen from the United States for the procedures leading to a number of new issues in terms of parenthood, choice and design of a family...

The Attitudes of Infertile Male Patients Toward the Use of Artificial Insemination by Donor: A Korean Regional Survey

PURPOSE: Infertile couples interested in nonspouse artificial insemination by donor (AID) not only require a thorough understanding of the medical procedure but also must scrutinize the effects it will have on family relationships, including those on the infant to be born. We conducted a series of surveys in couples with male infertility to collect information necessary for AID counseling. MATERIALS AND METHODS: A total of 384 cases with noncurable male infertility were enrolled in this inquiry survey. The questionnaire consisted of 18 items that assessed demographic characteristics, background information concerning the choice to use AID, subjective experiences, long-term effects, and an overall evaluation. RESULTS: A total of 126 surveys were returned (32.8%). AID was first suggested by the husband in about half of the cases. The major reason for considering the procedure was to form a complete family. Two-thirds of the couples were anxious about the procedure, most often about possible congenital or acquired deformities in the infant. After the birth of the child, most couples were positive about their decision to have used AID. About half of the couples felt that the child was their own and expected not to tell the child about AID. Overall, about 50% of the couples were satisfied with the procedure. CONCLUSIONS: Those who underwent AID experienced various psychological effects, including anxiety about the child to be born. To overcome these problems, sufficient medical information and consultation about the process of selecting the donor and about AID procedures should be provided before the procedure is used.

Screening results and causes of uncompleted donation process in 1 145 sperm donors / 中华男科学杂志

<p><b>OBJECTIVE</b>To improve the reception and recruitment of sperm donors in sperm banks in China, and solve the problem of insufficiency in sperm donation.</p><p><b>METHODS</b>We reviewed the recruitment of 1 145 men for sperm donation in the Human Sperm Bank of Hubei Province from September 2011 to April 2012, analyzed the reasons for those not included, and interviewed those included but unwilling to donate sperm.</p><p><b>RESULTS</b>Among the 1 145 recruits, 551 (48.12%) were students and 594 (51.88%) were other individuals. After the first semen screening, 503 (43.93%) quitted, including 202 students (36.66% of the students recruited) and 301 others (50.67% of the other individuals recruited). After the second semen screening, 432 (37.73%) were excluded, and another 45 (3.93%) excluded after laboratory examination, including 16 cases of mycoplasma positive. Totally, 165 recruits (14.41%) passed the semen screening and laboratory examination, but only 144 of them (87.27%) completed, while the other 21 (12.73%) failed to complete the whole donation process.</p><p><b>CONCLUSION</b>Low rates of screening qualification and donation process completion are common problems in human sperm banks. The rate of qualified sperm donors can be increased and the operational cost of the human sperm bank can be reduced by enabling the recruits to accomplish the whole donation process. Explanation at the reception, later interview with the recruits, and donors' trust in the sperm bank play important roles in raising the completion rate of sperm donation process.</p>

Post-thaw sperm functions of high- and low-fertility sperm donors: a comparative study of 40 cases / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate sperm function indexes that can be used to effectively evaluate the sperm donors' fertility so as to select healthy post-thaw semen samples and improve the success rate of assisted reproductive technology.</p><p><b>METHODS</b>According to the pregnancy outcomes, we divided 40 donor semen samples into a high-fertility group (n = 20) and a low-fertility group (n = 20). We measured and compared the concentration, progressive motility, morphology, acrosome intactness, DNA integrity and mitochondrial membrane potential (MMP) of the post-thaw sperm between the two groups.</p><p><b>RESULTS</b>There were statistically significant differences between the high- and low-fertility groups in the percentages of morphologically normal sperm ([18.50 +/- 6.10]% vs [14.42 +/- 6.44]%, P < 0.01), acrosome intactness ([86.17 +/- 4.49]% vs [80.04 +/- 7.52]%, P < 0.05) and DNA fragmentation index ([9.21 +/- 3.22]% vs [15.72 +/- 8.20]%, P < 0.05), but not in MMP ([56.75 +/- 18.80]% vs [52.23 +/- 18.86]%, P > 0.05). A significantly positive correlation was found between MMP and sperm motility (r = 0.760, P < 0.05), but not between other sperm functions and sperm concentration and motility.</p><p><b>CONCLUSION</b>Sperm concentration, motility, morphology, acrosome intactness rate and DNA integrity contribute effectively to the evaluation of the fertilization capacity of post-thaw donor semen samples.</p>

Pre-freezing equilibration improves post-thaw human semen parameters / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the effect of pre-freezing equilibration on the cryo-survival of human sperm and to optimize the protocol of direct fumigation for the freeze-thawing of human sperm.</p><p><b>METHODS</b>We collected 50 semen samples from healthy donors, each subjected to cryopreservation with 3 different methods: non-equilibration freezing (Group A), 10-min equilibration at room temperature before freezing (Group B), and 10-min equilibration at 4 degrees C before freezing (Group C). We examined all the post-thaw semen samples by computer-assisted semen analysis for the sperm motility parameters, and detected the sperm vitality and deformity index (SDI).</p><p><b>RESULTS</b>The recovery rate of progressive sperm motility was (61.88 +/- 16.94)% in Group C, remarkably higher than in A ([48.61 +/- 16.44]%) and B ([49.41 +/- 13.77]%) (P < 0.05), but with no significant difference between the latter two. And there were no significant differences in sperm vitality and SDI among the three groups.</p><p><b>CONCLUSION</b>Ten-minute equilibration at 4 degrees C before freezing can evidently improve the progressive motility of sperm in addition to its advantages of easy operation and controllable experimental condition.</p>

Analysis of the pregnancy outcomes of 13 723 tubes of sperm specimens from the sperm bank / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the safety of assisted reproductive technology (ART) with donated sperm from the sperm bank and the differences in the pregnancy outcomes of different means of promoting pregnancy.</p><p><b>METHODS</b>We analyzed and compared the feedback data on promoting pregnancy with donated sperm from the sperm bank by artificial insemination by donor (AID), in vitro fertilization (IVF), and intracytoplasm sperm injection (ICSI).</p><p><b>RESULTS</b>Totally, 13 723 tubes of sperm specimens were used for ART. The number of specimens used differed in different clinical reproductive centers, some using 1 tube and others using 2 tubes per cycle. The 13 723 tubes were used for a total of 7 743 cycles. Among the 7 123 cycles of AID, there were 1 415 clinical pregnancies (19.87%), 1 221 normal births (86.29%), 169 abortions (11.94%), 6 cases of birth defects (0.43%), 19 ectopic pregnancies (1.34%), and 0 sexually transmitted infection. Among the 571 cycles of IVF, there were 367 clinical pregnancies (64.27%), 330 normal births (89.92%), 35 abortions (9.54%), 0 birth defect, 2 ectopic pregnancies (0.54%), and 0 sexually transmitted infection. Among the 49 cycles of ICSI, there were 28 clinical pregnancies (57.14%), 25 normal births (89.29%), 3 abortions (10.71%), 0 birth defect, 0 ectopic pregnancy, and 0 sexually transmitted infection. There were statistically significant differences in the rate of clinical pregnancy among AID, IVF and ICSI (P < 0.05), but not between IVF and ICSI (P > 0.05), nor were there any significant differences in the rates of abortion, birth defects and ectopic pregnancy among AID, IVF and ICSI (P > 0.05).</p><p><b>CONCLUSION</b>None of the recipients of the donated sperm from the sperm bank was infected with sexually transmitted diseases. AID, IVF and ICSI showed no significant differences from natural conception in the rates of abortion, birth defects and ectopic pregnancy. ART with donated sperm from the sperm bank is safe. IVF and ICSI are associated with a higher rate of pregnancy than AID, though the latter costs less than the former two.</p>

Congelación ultra rápida de espermatozoides humanos: efecto sobre la función espermática y producción de especies reactiva de oxígeno / Ultra rapid freezing in human spermatozoa: effect on sperm function and reactive oxygen species production

El incremento del número de pacientes que desean mantener su fertilidad, ya sea por motivos oncológicos o de fertilidad, como son los pacientes con enfermedades infecciosas virales trasmitidas por vía sexual, o que se someten en forma voluntaria a la esterilización quirúrgica, requieren de métodos de congelación que preserven en forma adecuada la función de los espermatozoides. En el área de la criobiología, la utilización de técnicas de congelación ultrarrápida ha permitido preservar en forma exitosa ovocitos, embriones y tejido ovárico. Este método se ha incorporado recientemente para preservar el gameto masculino. El presente estudio evalúa el efecto de la congelación ultrarrápida (vitrificación) sobre la función espermática de 10 donantes normozoospérmicos. Los espermatozoides se seleccionaron por Swim-up y la solución espermática se dividió en dos subfracciones. Una fracción se vitrificó sumergiéndola directamente en nitrógeno líquido mientras que la segunda se utilizó como control. En ambas fracciones se determinaron viabilidad, movilidad, potencial de membrana mitocondrial (YMMit), integridad del ADN, reacción de acrosoma espontánea e inducida, y superóxido intracelular (O2.-). Se observó que la vitrificación preserva una adecuada función celular en un alto número de espermatozoides, siendo además un método simple, rápido y de menor costo, ya que no necesita equipo de congelación. No obstante, existe una significativa activación de la producción de especies reactivas de oxígeno, que conlleva a una prematura capacitación espermática, evento que es necesario de modular, especialmente si se utilizan estas células en técnicas de inseminación intrauterina. Futuros estudios con adición de antioxidantes a los medios de congelación parecen necesarios para optimizar esta técnica.

The number of patients who wish to maintain their fertility is ever increasing. This group of patients includes cancer patients, those with fertility problems or viral infectious diseases acquired through sexual contact and others submitting to voluntary surgical sterilization; all of the above requiring freezing methods to adequately preserve sperm function. In the field of cryobiology the use of ultra-rapid freezing techniques has successfully preserved oocytes, embryos and ovarian tissue. This method has recently been incorporated in preserving male gametes. This study evaluates the effect of ultra-rapid freezing (vitrification) on sperm function of 10 normozoospermic donors. The sperm were selected by swim-up technique and the solution divided into two fractions. One fraction is vitrified by dipping directly into liquid nitrogen and the second fraction is used as control. In both fractions, viability, motility, mitochondrial membrane potential (YMMit) DNA integrity, spontaneous and induced acrosome reaction and intracellular superoxide (O2.-) were determined. It was noted that vitrification preserves cell function in a great number of spermatozoon, and is also simple, rapid and cost effective as this method does not require freezing equipment. There is however, significant activation of the production of reactive oxygen species, which leads to premature sperm capacitation, an event necessary to modulate particularly when using these cells in intrauterine insemination techniques. Future studies with addition of antioxidants to freezing media are necessary to further improve this technique.

Karyotype analysis of qualified sperm donors on preliminary screening / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the significance of karyotype analysis in screening sperm donors.</p><p><b>METHODS</b>From January 1, 2004 to December 31, 2008, a total of 2537 potential sperm donors passed our preliminary screening, and all were routinely karyo-typed via peripheral blood. Follow-ups were conducted on the pregnancy outcome and congenital malformation after artificial insemination with the sperm from the qualified donors.</p><p><b>RESULTS</b>Among the 2537 qualified sperm donors, 2362 were of the normal karyotype 46, XY and 135 showed polymorphism. Abnormal karyotype was found in 6 cases, and controversial abnormal karyotype in 34.</p><p><b>CONCLUSION</b>Karyotype analysis can reduce the risk of chromosomal disease in neonates from artificial insemination, and genetic counseling for abnormal karyotype sperm donors may help them solve their future reproductive problems.</p>

Safety evaluation of the offspring conceived by assisted reproductive technology with donor's semen / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate and compare the incidences of birth defects in the offspring conceived by assisted reproductive technology (ART), including artificial insemination with the donor's semen (AID), in vitro fertilization with donor's semen (IVF-D) and intracytoplasmic sperm injection with the donor's semen (ICSI-D), and in those conceived through ART with the husband's semen, including AIH, IVF and ICSI, in order to further evaluate the safety of ART with the donor's semen.</p><p><b>METHODS</b>From January 2005 to October 2009, Shanghai Human Sperm Bank provided sperm copies to 11 medical institutions, which resulted in a total of 904 offspring born by ART. We followed up all these cases and investigated the status of the offspring. The control group included 4195 offspring of infertile couples from 4 Reproductive Medical Centers approved by health management administrations, which were conceived by ART in the same period. After investigating the number of offspring and cases of birth defects caused by various methods of assisted reproductive technology, we compared the incidence of birth defects resulting from the donor's semen and that from the husband's.</p><p><b>RESULTS</b>There were 7 cases of birth defects (0.77%) in the offspring born by ART with the donor's semen, and 42 cases (1.00%) in those born by ART with the husband's semen, with no significant differences between the two groups (P > 0.05).</p><p><b>CONCLUSION</b>There were no significant differences in the category of birth defects between ART with the donor's semen and that with the husband's, while the incidence of birth defects resulting from ART with the donor's semen was significantly lower than that from ICSI in infertile couples. The present findings indicate a higher safety of ART with the donor's semen.</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>